Loss and Return of Ticklishness in Functional Neurological Disorder.

Background: People with functional neurological disorder (FND) have abnormalities in sensory processing. Loss of ticklishness has been rarely reported.

Objectives: To describe associated clinical features in people with FND and loss of ticklishness and explore correlations with sensory changes.

Maculopathy Masquerading as Migraine.

We describe a case of a 23-year-old Caucasian woman with a background history of migraines who presented with bilateral paracentral scotomata. The ophthalmoscopy and MRI head were originally thought to be normal, and the scotomata were attributed to be of migrainous origin: a persistent negative aura. However, persistence of her symptoms prompted further specialist review 10 months later, at which time subtle bilateral perifoveal changes were noted, which had been apparent but overlooked at the initial assessment.

A brain origin for factitious disorder (Munchausen's) with malingering? A single case with an old frontal lobe lesion.

We describe a patient who presented with gender identity dysphoria and stroke-like symptoms who we diagnosed with Munchausen's syndrome (factitious disorder). We discuss whether a brain lesion in the left frontal cortex is a possible risk factor, and support this hypothesis through neuropsychological investigation, EEG abnormalities, and a personality assessment. This case report supports previous suggestions that underlying brain disease/lesions might be risk factors for Munchausen's syndrome (factitious disorder).

Management of functional neurological disorder.

Functional neurological disorder (FND) is a common cause of persistent and disabling neurological symptoms. These symptoms are varied and include abnormal control of movement, episodes of altered awareness resembling epileptic seizures and abnormal sensation and are often comorbid with chronic pain, fatigue and cognitive symptoms. There is increasing evidence for the role of neurologists in both the assessment and management of FND.

Musical hallucinations: review of treatment effects.

Background: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare.

Objective: To review the effects of published treatment methods for musical hallucinations.

Musical hallucinations treated with acetylcholinesterase inhibitors.

Musical hallucinations are relatively rare auditory percepts which, due to their intrusive nature and the accompanying fear of impending mental decline, tend to cause significant distress and impairment. Although their etiology and pathophysiology appear to be heterogeneous and no evidence-based treatment methods are available, case reports indicate that acetylcholinesterase inhibitors may yield positive results in patients with comorbid hearing loss. We present two female patients (aged 76 and 78 years) both of whom suffered from hearing impairment and practically incessant musical hallucinations.

Antibodies to GABAA receptor α1 and γ2 subunits: clinical and serologic characterization.

Objective: To search for antibodies against neuronal cell surface proteins.

Methods: Using immunoprecipitation from neuronal cultures and tandem mass spectrometry, we identified antibodies against the α1 subunit of the γ-aminobutyric acid A receptor (GABAAR) in a patient whose immunoglobulin G (IgG) antibodies bound to hippocampal neurons. We searched 2,548 sera for antibodies binding to GABAAR α, β, and γ subunits on live HEK293 cells and identified the class, subclass, and GABAAR subunit specificities of the positive samples.

Severe unilateral headache caused by skull bone infarction with epidural haematoma in a patient with sickle cell disease.

Background: The clinical manifestations of sickle cell disease (SCD) vary, but may be attributed to vaso-occlusion, chronic hemolytic anemia, and infections as a result of functional asplenia. We report a case of a man who presented with severe headache caused by an uncommon complication of SCD.

Case: A 19-year-old Surinamer man presented to the emergency department with severe headache.

[Neck pain due to tendonitis of the longus colli muscle].

Two patients presented to Accidents and Emergency with severe neck pain: a 70-year-old woman with acute, severe neck pain, which had developed a few days after outpatient resection of her left lingual tonsil. The patient was suspected to have spondylodiscitis. The other patient, a 54-year-old woman, was referred with severe neck pain and suspected meningitis.