POST-ENCEPHALITIC DYSTONIA


Dystonia refers to sustained, involuntary contractions of muscle groups, resulting into abnormal postures, and is often associated with pain and disability. There are several underlying causes of dystonia, in which case, they are referred to as secondary dystonia. When no obvious cause is identified, it is referred to as primary dystonia. In this video, weContinue reading “POST-ENCEPHALITIC DYSTONIA”

Left Lateral Rectus (Abducens nerve) Palsy


This video shows a person with left lateral rectus palsy. On asking him to look to the left side, he can not move the left eyeball completely, and it stops in the middle. However, on asking him to look to the right side, both eyeballs move normally. Lateral rectus muscle is supplied by the abducensContinue reading “Left Lateral Rectus (Abducens nerve) Palsy”

New Guidelines for Migraine Prevention in Children and Adolescents


Migraine is common in children and adolescents and is a significant cause of disability. Migraine adversely affects their studies, games and other recreational activities. Over the years, newer evidences have been generated and the current guidelines have incorporated them. The key recommendations for prevention of headaches are: Topiramate is more effective than placebo in reducingContinue reading “New Guidelines for Migraine Prevention in Children and Adolescents”

FOOT DROP


This video shows a patient with right sided foot drop. Foot drop occurs due to weakness of dorsiflexors of ankle and toes. The muscles involved are tibialis anterior, extensor hallucis longus and extensor digitorum longus. These muscles are supplied by deep peroneal nerve, a branch of common peroneal nerve. While walking, the patient has exaggeratedContinue reading “FOOT DROP”

Focal Cortical Gliosis and ULEGYRIA Causing Focal Epilepsy


Focal epilepsy affects only one side of body and in most cases, consciousness is preserved during seizures. However, in some cases, seizures can spread to the opposite side (known as secondary generalisation), which can lead to loss of consciousness. In several cases of focal epilepsy, structural changes on MRI can be seen. This case isContinue reading “Focal Cortical Gliosis and ULEGYRIA Causing Focal Epilepsy”

Natural Progression of Neurocysticercosis Without Treatment


Single lesion of neurocysticercosis (tape worm infection of brain) is a common cause of seizures. In most of these cases, only anti-epileptic drugs (AEDs) are advised. Anti-helminthic treatment with albendazole is usually not recommended, as most of these lesions spontaneously resolve over time. This is in contrast to patients with multiple brain lesions in NCC,Continue reading “Natural Progression of Neurocysticercosis Without Treatment”

Use of Susceptibility-Weighted MRI for detecting calcified Neurocysticercosis


Neurocysticercosis (NCC) is the the commonest cause of symptomatic epilepsy in India and many other countries. NCC infection is caused by Taenia solium (tapeworm). Active NCC infection is suggested by presence of scolex, contrast-enhancement, perilesional edema and cystic appearance on brain scan (CT or MRI, however, MRI is preferred). Active infection increases the risk ofContinue reading “Use of Susceptibility-Weighted MRI for detecting calcified Neurocysticercosis”

CALCIFIED ACTIVE NEUROCYSTICERCOSIS


Neurocysticercosis (NCC) is one of the commonest causes of symptomatic epilepsy in India and many other countries. It is caused by Taenia solium (tapeworm infection). On CT scan, signs of active (alive) worm include: 1. Perilesional edema (seen as hypodensity in plain and contrast images, 2. Enhancement of lesion (disc-like or ring like) on contrastContinue reading “CALCIFIED ACTIVE NEUROCYSTICERCOSIS”

Sacral Dimple and Tuft of Hair may Indicate Spinal Abnormality


25-year old presented with low back pain of twelve years duration. He also had radicular pain involving left lower limb. Bladder and bowel symptoms were absent. Local examination showed sacral dimple and tuft of hair. MRI spine showed features of spina bifida and tethered cord syndrome. He was referred to Neurosurgeon for further management. GeneralContinue reading “Sacral Dimple and Tuft of Hair may Indicate Spinal Abnormality”

Wernicke’s Encephalopathy Following Bariatric Surgery


The prevalence of obesity is increasing worldwide, and therefore, bariatric surgery is being routinely performed. Bariatric surgery may be associated with complications in the post-operative period. Here I present one such complication. A 25-year old man presented with visual disturbances (diplopia, blurred vision), memory disturbances and imbalance while walking of 3 days duration. He underwentContinue reading “Wernicke’s Encephalopathy Following Bariatric Surgery”