On admission, neurological examination revealed disorientation to date, significantly impaired short-term recall, visuospatial memory impairment, and limited attention span. Speech was fluent with frequent paraphasic errors and anomia. She had mild gait ataxia.
A rapidly progressive dementia was suspected. Studies ruled out autoimmune diseases and thyroid disfunction. Brain MRI with contrast and sleep-deprived EEG showed no abnormalities. Cerebrospinal fluid analysis was normal. Genetic studies for prion protein and Huntington's chorea were normal. Copper in urine and blood was normal. As part of a paraneoplastic study, breast MRI revealed signs of intracapsular rupture of both silicone breast implants (Figure 1).
The implants were surgically removed with surgical cleaning of the silicone capsules. The patient's symptoms completely remitted within 7 days.
Based on these findings and the neurological and systemic symptoms, a diagnosis of ASIA syndrome was considered.