A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS).

Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS.

Valproate Induced Delirium due to Hyperammonemia in a Case of Acute Mania: A Diagnostic Dilemma.

Divalproex sodium is commonly used drug to treat variety of psychiatric and neurological disorders. Hyperammonemia is infrequent adverse affect of treatment with divalproex sodium. It needs high degree of clinical suspicion or else can lead to delirium of non hepatic origin in some group of patients and to medication errors or even death.