Asymptomatic elevation of liver enzymes due to levetiracetam: a case report.

Levetiracetam is a commonly used broad-spectrum anticonvulsant efficacious in both partial and generalized seizures. It has an extremely favorable side effect profile with few drug-drug interactions, low potential for hematological and hepatic toxicity, and thus has rapidly become the preferred drug in patients with traumatic brain injuries who need seizure prophylaxis. We report, here, a patient who was started on levetiracetam for seizure prophylaxis after developing large bifrontal-parietal traumatic subdural hematomas (SDH) following a fall from a horse necessitating bifrontal craniotomies for evacuation.

Central nervous system fungal infections: observations from a large tertiary hospital in northern India.

Objective: To report our observations regarding fungal infections of the brain over two years from a large tertiary hospital in northern India. To identify fungal infections in immunocompetent and immunocompromised patients and to compare the two groups with respect to their age of occurrence, demographic data, clinical profile, radiological findings, response to treatment and outcome.

Methods: All consecutive cases of central nervous system (CNS) fungal infections admitted to the hospital over two years were included in this study.

Central nervous system tuberculosis masquerading as primary dementia: a case report.

Primary dementias are the most common cause of memory impairment in patients above the age of 60. Hypothyroidism, depression, vitamin B12 deficiency and infectious diseases such as syphilis at times may present with memory impairment mimicking primary dementias in their clinical presentation. We present here a 64-year-old female who presented with complaints of forgetfulness, confusion, memory loss and impaired concentration for the past 3 months.

Vocal cord palsy: An uncommon presenting feature of myasthenia gravis.

Vocal cord palsy can have myriad causes. Unilateral vocal cord palsy is common and frequently asymptomatic. Trauma, head, neck and mediastinal tumors as well as cerebrovascular accidents have been implicated in causing unilateral vocal cord palsy.

Delayed left anterior and middle cerebral artery hemorrhagic infarctions after attempted strangulation: a case report.

The 2 common carotid arteries bifurcate in the neck into the internal and external carotid arteries. The internal carotid artery enters the skull and further divides into the anterior and middle cerebral artery. During its short course in the neck, the carotid artery travels encased in the carotid sheath along with the vagus nerve and the internal jugular vein.

Nonconvulsive status epilepticus presenting with throat clearing as part of clinical seizure semiology.

Oro-alimentary automatisms such as chewing movements, lip-smacking, repeated snuffling, swallowing and retching have been reported with seizures usually of temporal lobe origin. Throat clearing, usually along with other vegetative signs, has been reported in patients with temporal and rarely extra-temporal lobe epilepsy. We report a case of a 93-year-old woman admitted with acute right temporo-occipital stroke.

Supine catch sign--a simple clinical test to differentiate between true and false (pseudo) radial nerve palsy.

Patients at times present with neurological symptoms and signs for which at times extensive investigation fails to identify any structural or organic pathology within the nervous system. These pseudo neurological syndromes can mimic almost any organic disease of the central and peripheral nervous system. Some such as pseudo seizures also referred to as psychogenic non-epileptic seizures (PNES) are more commonly encountered than others.

Head-supporting sign during reclining: an indication of craniovertebral junction involvement.

The craniovertebral (CV) junction can be involved in many diseases, e.g. rheumatoid arthritis, as well as destructive bone pathologies such as tumour and tuberculosis (craniovertebral Pott's disease).