Valproate Induced Hyperammonemic Encephalopathy.

Valproate is a commonly prescribed anticonvulsant drug. It has a potential to cause hyperammonemia even in the presence of normal liver function tests. This hyperammonemic state can lead to encephalopathy referred as Valproate induced hyperammonemic encephalopathy (VHE).

Massive haemorrhage: an unusual presentation of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) usually affects young females and its presentation with haemorrhage is unusual. Intracerebral bleed (ICB) has been described in a few case reports, but massive haematuria has not been reported in the literature so far. Here, we present a case of a 56 year-old-lady who presented with expanding lobar bleed and massive haematuria as the first presentation of SLE secondary to vasculitis.

Case Report: Isolated Lingual Dystonia.

Oromandibular dystonia is defined as a focal dystonia that manifests as forceful contractions of the face, jaw, and/or tongue. Lingual dystonia is a rare subtype of oromandibular dystonia that specifically affects the tongue. Multiple etiologies are thought to attribute to oromandibular dystonia, including brain damage, the use of neuroleptic medications, neurodegenerative disorders, metabolic disorders, neurodevelopmental disorders, and viral infections.