FOCAL DYSTONIA-WRITER’S CRAMP


Writer’s cramp is among the most common focal dystonias. Patients with writer’s cramp have a task-specific dystonia, which occurs while writing. Patients with writer’s cramp face severe handicap and disability in their jobs or education, as they are unable to write properly. A diagnosis of writer’s cramp can be made on the basis of historyContinue reading “FOCAL DYSTONIA-WRITER’S CRAMP”

Incidental Pineal Cyst on MRI Brain


Pineal cysts may be incidentally noted on MRI brain. A pineal cyst is called “incidental” if it does not produce any symptoms or signs. In a large series of >42,000 MRI brains, incidental pineal cysts were noted in 281 (0.67%) patients. About two-thirds of them were females. The mean size of incidental pineal cyst wasContinue reading “Incidental Pineal Cyst on MRI Brain”

Incidental Saccular Aneurysm in Brain


Aneurysms are incidentally detected when brain imaging is done for indications other than subarachnoid hemorrhage. The most common indication for brain MRI/MR Angiogram is stroke. It is also done in people who have a high risk of getting brain stroke in future (on account of risk factors and family history). In our case, a 45-yearContinue reading “Incidental Saccular Aneurysm in Brain”

“Dawson’s Fingers” on MRI Brain in Small Vessel Ischemia


Dawson’s fingers refer to the periventricular white matter lesions, which extend perpendicular to the lateral ventricles and/or callosal junction. These represent perivenular inflammation, and are hallmarks of multiple sclerosis (MS), a demyelinating disorder of brain, optic nerves and spinal cord. Dawson’s fingers, however, can be seen in conditions other than MS too. The commonest conditionContinue reading ““Dawson’s Fingers” on MRI Brain in Small Vessel Ischemia”

External Brain Herniation 4 Months after Decompressive Hemicraniectomy


Decompressive hemicraniectomy (DH) is a life-saving surgery, performed in cases of severe mass effect due to stroke (ischemic or hemorrhagic) or head trauma. The skull bone overlying the affected cerebral hemisphere is removed (and stored in a “bone bank”). Decompressive hemicraniectomy is generally safe, however, it could be associated with complications in a few cases.Continue reading “External Brain Herniation 4 Months after Decompressive Hemicraniectomy”

Resting Tremors of Right Hand in Parkinson’s Disease


Resting tremors are a hallmark of Parkinson’s disease (PD). Tremors start on one side of the body affecting upper limb more severely than the lower limb. After 3 years or in some cases even longer, tremors become symmetric involving the other side. In this case, the patient continued to have only right-sided tremors even 7Continue reading “Resting Tremors of Right Hand in Parkinson’s Disease”

Occurrence of New-onset Oro-facial Dyskinesia after starting LEVOSULPIRIDE


This gentleman was being treated for Parkinson’s disease for several years and was doing well on medications. However, he presented with recent worsening of Parkinsonian symptoms. In addition, he had developed new onset orofacial dyskinesias, which he did not have before. These new symptoms developed after he was started on levosulpiride for his stomach-related ailment.Continue reading “Occurrence of New-onset Oro-facial Dyskinesia after starting LEVOSULPIRIDE”

MRI BRAIN Abnormalities in a Case of Spinocerebellar Ataxia (SCA)


Spinocerebellar ataxia (SCA) comprises of a group of neurodegenerative disorders characterized by progressive cerebellar ataxia (either alone or in combination with other neurological system involvement). They are currently classified into various subtypes based on the underlying genetic defect. Currently, there are about 40 subtypes of SCA, referred to as SCA 1, SCA2, ….SCA 40. MRIContinue reading “MRI BRAIN Abnormalities in a Case of Spinocerebellar Ataxia (SCA)”

Noncontrast CT Brain in Cerebral Venous Sinus Thrombosis


Cerebral venous sinus thrombosis (CVST) commonly presents with headache, raised ICP, seizures and focal neurological deficits. Diagnosis can be made on the basis of CT and MRI brain. The usual initial investigation done is CT brain-plain (non-contrast). It is important to pick up the findings on plain CT so that an early diagnosis can beContinue reading “Noncontrast CT Brain in Cerebral Venous Sinus Thrombosis”

TRIGEMINAL NEURALGIA- Description of Symptoms


Trigeminal neuralgia (TN) is among the commonest causes for episodic facial pain. It commonly affects one side of face, however, in some patients, both sides of face may get affected. Here, we have a patient suffering from left sided trigeminal neuralgia, describing her symptoms. Pain is episodic, shock-like, lasting for a few seconds. Pain isContinue reading “TRIGEMINAL NEURALGIA- Description of Symptoms”