Neuromyelitis Optica in a Healthy Female After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA-1273 Vaccine.

Neuromyelitis optica spectrum disorder is an autoimmune demyelinating disease with high relative prevalence in the East Asian population. Clinical manifestations include optic neuritis, longitudinally extensive transverse myelitis, area postrema syndrome, brainstem syndromes, and diencephalic syndromes. In this case report, we present a case of neuromyelitis optica spectrum disorder that developed 10 days after the first dose of the severe acute respiratory syndrome coronavirus 2 mRNA-1273 vaccine.

Hyperglycemia Followed by an Abrupt Decrease of Blood Glucose Is a Rare Cause of Posterior Reversible Encephalopathy Syndrome (PRES).

Introduction: Posterior Reversible Encephalopathic Syndrome (PRES) is a clinical syndrome of headache, confusion or decreased level of consciousness, visual changes, seizures and focal neurologic signs associated with characteristic neuroimaging findings of posterior cerebral white matter edema. In most cases, PRES is precipitated by sudden increase in blood pressure; however, in the case presented here, the etiology was different as it was secondary to extreme changes in glucose levels.

Case Presentation: A 49-year-old female with a past medical history of hypertension and diabetes mellitus, type 2 was brought to the emergency room with a chief complaint of visual changes for 1 hour in duration.

Facial diplegia, pharyngeal paralysis, and ophthalmoplegia after a timber rattlesnake envenomation.

The timber rattlesnake, also known as Crotalus horridus, is well known to cause significant injury from toxins stored within its venom. During envenomation, toxic systemic effects immediately begin to cause damage to many organ systems including cardiovascular, hematologic, musculoskeletal, respiratory, and neurologic. One defining characteristic of the timber rattlesnake is a specific neurotoxin called crotoxin, or the "canebrake toxin," which is a potent β-neurotoxin affecting presynaptic nerves that can cause paralysis by inhibiting appropriate neuromuscular transmission.