Louisiana Via Research Day Book 2026

Case Studies: Section 1

Case Studies: Section 1

Sophie Qui, OMS-III 1 ; Sabeen Wazir, OMS-III 1 ; David Chachkhiani, MD 2 1 VCOM-Louisiana; 2 Opelousas General Health System Neurology Clinic, Opelousas, Louisiana 39 STIFF-PERSON SYNDROME IN THE SETTING OF TYPE 1 DIABETES MELLITUS: DIAGNOSTIC AND THERAPEUTIC CHALLENGES

Russel T. Wagner, OMS-I 1,2 ; Rachel E. Bush, OMS-I 2 ; Madelyn I. Duncan, OMS-I 2 ; Jacopo Berardinelli, MD 1 ; Amin Kassam, MD 1 ; Julian Bailes, MD 1 ; Melanie Fukui, MD 1 ; George Bobustuc, MD 1 ; Sammy Khalili, MD 1 ; Neil Mundi, MD 1 1 Intent Medical Group, Northwest Community Hospital, Arlington Heights, Illinois; 2 VCOM-Louisiana 40 RECURRENT GLIOBLASTOMA RESECTION WITH MICROVASCULAR FREE FLAP RECONSTRUCTION AND ASSOCIATED GAMMATILE® IMPLANTATION: A PERSONALIZED APPROACH WITH ONCOLOGIC AND RECONSTRUCTIVE INTEGRATION

Context: Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder characterized by muscle rigidity, painful muscle spasms, and gait impairment. It is commonly associated with other autoimmune conditions, most notably type 1 diabetes mellitus (T1DM). Case: A 66-year-old woman with T1DM, coronary artery disease, and osteoarthritis presented with recurrent falls, painful muscle spasms, and dysphagia. Her symptoms were initially attributed to musculoskeletal and esophageal etiologies. However, persistently elevated anti–GAD65 antibodies, brisk reflexes, and marked clinical improvement with Baclofen supported a diagnosis of SPS. Despite an initial positive response, she later developed fluctuating nocturnal spasms and progressive weakness while on oral Baclofen. Neuroimaging showed no structural myelopathy, and electromyography was nondiagnostic, complicating diagnostic confirmation and management. Referral to a neuromuscular specialty center was planned for consideration of immunotherapy.

Conclusions: This case highlights the importance of considering SPS in patients with T1DM who present with unexplained falls, dysphagia, or spasms. Early recognition and treatment are critical for improving quality of life and preventing morbidity.

Background: Glioblastoma multiforme (GBM), despite aggressive multimodal treatment comprising surgery followed by chemoradiation, is almost uniformly associated with inevitable recurrence and poor outcomes. In this clinical context, local radiation therapy—an emerging approach—has gained considerable attention over time for its potential to address the limitations of traditional treatment options for GBM. Multiple surgeries and adjuvant chemoradiation therapy can negatively impact the integrity of the scalp soft tissues and can compromise the ability to achieve primary closure over the surgical site. In these circumstances, complex reconstruction with free tissue transfer may be necessary. Method: We report the case of a 37-year old female patient with recurrent GBM and associated wound healing complications who underwent single-stage GammaTile® surgically targeted radiation therapy combined with microvascular free flap scalp reconstruction. Results: Immediate free flap reconstruction over the site of GammaTile implantation did not result in any wound healing complications

and did not compromise the viability of the transplanted tissue. This approach also provided immediate and localized radiation, possibly enhancing patient progression free survival while reducing the likelihood of radiation-induced adverse effects. Conclusions: We report the first case of GammaTile implantation with immediate reconstruction of the overlaying soft tissue defect with a free flap. Despite the immediate local radiation produced by the tiles abutting the deep surface of the free flap, there were no complications noted in the vascularity of the transplanted tissue. This finding provides preliminary evidence supporting the safety of using free tissue transfer alongside GammaTile implantation for complex reconstruction.

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2026 Research Recognition Day