POLYMINIMYOCLONUS


Polyminimyoclonus refers to involuntary, jerky, small amplitude, tremor-like movements, most commonly seen in hands. The commonest cause is degenerative anterior horn cell disease, commonly known as motor neuron disease or amyotrophic lateral sclerosis. These tremor-like movements (polyminimyoclonus) correspond to fasciculations in forearm muscles.

Jaw Tremors and Asymmetric hand Tremors in a Case of Essential Tremors


A 65-year old lady presented with six years history of tremors affecting both upper limbs, left more than right. I had periodically seen her during these 6 years. Tremors were of postural type and affected left upper limb more than the right upper limb. She developed jaw tremors for the past 3-6 months, which wereContinue reading “Jaw Tremors and Asymmetric hand Tremors in a Case of Essential Tremors”

Mechanical Thrombectomy in Wake-Up Stroke


Mechanical thrombectomy is very effective in the first few hours after onset of symptoms, in patients with acute ischemic stroke. It is approved within the first six hours of symptom onset, if there is occlusion of internal carotid artery or proximal middle cerebral artery, provided the NIHSS score is 6 or more. However, problem arisesContinue reading “Mechanical Thrombectomy in Wake-Up Stroke”

HERPES ZOSTER OPHTHALMICUS


58-year old lady presented with right sided facial pain of three days duration. She had noted skin eruptions over the right side of forehead and right upper eyelid. Drooping of right upper eyelid was also noted. She was a diabetic. On examination, vesicular eruptions were noted in the distribution of right V1- ophthalmic division ofContinue reading “HERPES ZOSTER OPHTHALMICUS”

Excellent Response to Medical Treatment in a Case of Brain Tuberculoma


Tuberculous infection of the brain is quite common. TB can affect brain and spine in a number of ways- tuberculous meningitis, tuberculoma, brain abscess, Pott’s spine, etc. Brain tuberculoma are commonly seen in India. The patients with tuberculoma of brain present with seizures and focal neurological deficits. Here, I am presenting a 35-year old manContinue reading “Excellent Response to Medical Treatment in a Case of Brain Tuberculoma”

SWI (GRE) Sequences are the BEST to Detect Bleed on MRI Brain


It is extremely vital that we differentiate brain hemorrhage (bleeding) from brain infarcts, when patients present with clinical features of stroke. This is because patients with infarcts are eligible to receive thrombolytic treatment, to lyse the blood clots. On the other hand, thrombolytic treatment is contraindicated in patients with brain hemorrhage (bleed). Drugs used forContinue reading “SWI (GRE) Sequences are the BEST to Detect Bleed on MRI Brain”

RESTLESS LEGS SYNDROME-Description of Symptoms by a Patient


Restless legs syndrome (RLS) is characterized by unpleasant or uncomfortable symptoms in the legs and an irresistible urge to move them. The sensation is most often described as pain or ache. Symptoms usually affect both legs and are worse at nights. Symptoms are exacerbated with inactivity and reduced with activity such as moving the legs.Continue reading “RESTLESS LEGS SYNDROME-Description of Symptoms by a Patient”

Predictors of Poor Outcome in Thalamic Hematoma


Thalamic hematomas form the second largest group of spontaneous intracerebral hemorrhage (ICH), which are related to hypertension. Outcome depends on several factors including age, size of hematoma, GCS score and CT scan findings. Factors predicting poor outcome in a patient with thalamic hematoma are: Male sex Low GCS (<8) Older age Uncontrolled high BP especiallyContinue reading “Predictors of Poor Outcome in Thalamic Hematoma”

Management of Multiple Sclerosis (MS) in Pregnancy


How common is this situation- pregnancy in women with MS? MS is most often diagnosed between the ages of 20 to 40 years. This is the age when most women plan their pregnancies. Therefore, it is very common to find women with MS, who are pregnant or those who are planning pregnancy. Which is aContinue reading “Management of Multiple Sclerosis (MS) in Pregnancy”

MRI Brain in a Patient Recovering from Central Pontine Myelinolysis (CPM)


Central pontine myelinolysis (CPM) is a condition characterized by demyelinating lesions in pons, usually secondary to rapid correction of hyponatremia. In some cases, extrapontine areas such as basal ganglia, midbrain, thalamus and cerebellum may also be involved. Patients with CPM present with quadriplegia, encephalopathy, seizures, dysphagia, dysarthria, etc. Our patient was a 30-year old ladyContinue reading “MRI Brain in a Patient Recovering from Central Pontine Myelinolysis (CPM)”