An unusual case of basilar artery aneurysm presenting with spastic quadriparesis.

Unruptured aneurysm usually presents with headache and neuro-ophthalmic features; when it ruptures, it presents with subarachnoid haemorrhage. Basilar artery aneurysm represents only 3-5% of cerebral aneurysms. Non-haemorrhagic symptoms and the signs of unruptured aneurysms are manifested as mass effect, thromboembolic phenomenon or epileptical attacks.

Multiple endocrine neoplasia type 1 presenting with refractory seizures.

We report a case of 29-year-old woman referred to us for management of refractory epilepsy. Under observation, she was detected to have recurrent hypoglycaemia during the episodes of seizures. On investigation, she was found to have hyperinsulinemic hypoglycaemia.

Chewing-induced facial dystonia: a rare presentation of task-specific dystonia.

This case is an addition to scarce literature available for a rare condition, chewing-induced task-specific dystonia. The patient was a 63-year-old woman who presented with a 4-year history of progressive difficulty in eating food only during chewing associated with abnormal facial grimaces without any difficulty in drinking, swallowing, speaking or singing. Examination revealed dystonia of facial muscles every time she chewed but absent during drinking and speaking.

Osmotic demyelination syndrome in type 1 diabetes in the absence of dyselectrolytaemia: an overlooked complication?

Central pontine myelinolysis (CPM) is a demyelinating disorder of central nervous system which involves central portion of the pons and sometimes extrapontine areas also. It is commonly reported in settings of hyponatraemia or its rapid correction, but in the last few years it has also been reported in patients with diabetes in the absence of electrolyte disturbances or correction of serum osmolality. Here we report a case of a 20-year-old female patient, with a known history of type 1 diabetes mellitus, who presented with acute onset spastic quadriparesis with dysarthria and mild ataxia which evolved over 2 weeks.

Juvenile myoclonic epilepsy with multiple sclerosis: is there a dual role for valproate?

A 27-year-old woman was diagnosed with juvenile myoclonic epilepsy since the age of 13 and was on valproate therapy. She had a single episode of demyelinating illness while on valproate therapy. Two years earlier, her medication was changed to lamotrigine to avoid the teratogenic effects of valproate, after which the frequency of her demyelinating events increased to four episodes in 1.

Erb's paraplegia with primary optic atrophy: Unusual presentation of neurosyphilis: Case report and review of literature.

SYMPTOMATIC NEUROSYPHILIS (NS) CAN HAVE VARIED SYNDROMIC PRESENTATIONS: Meningitis, meningovascular and parenchymatous involvement. Non-tabetic syphilis affecting the spinal cord is rare and only sporadic case reports have been published. The variant of meningomyelitis known as Erb's paraplegia refers to patients of spinal syphilis with very slow progression over many years and predominantly motor signs.

'Dancing eyes, dancing feet syndrome' in small cell lung carcinoma.

A 60-year-old man presented with a 25-day history of acute onset instability of gait, tremulousness of limbs and involuntary eye movements. Examination revealed presence of opsoclonus, myoclonus and ataxia, without any loss of motor power in the limbs. Prompt investigations were directed towards identifying an underlying malignancy which is often associated with this type of clinical scenario.

'Trapped temporal horn' of lateral ventricle in tuberculous meningitis.

A young girl presented with a 1-month history of constitutional symptoms, headache and vomiting and 7-day history of left hemiparesis. Neuroimaging showed the 'trapped temporal horn' sign, suggestive of focal obstructive hydrocephalus at the foramen of Monro. Analysis of the cerebrospinal fluid and other investigations revealed a tubercular aetiology.