Syrinx refers to a fluid (cerebrospinal fluid) filled cavity in the spinal cord. A small syrinx either may not cause any symptoms or cause only minor symptoms, and therefore, they remain undiagnosed for long. They get detected when MRI spine is done for evaluation of neck pain, or other symptoms. In the MRI of cervicalContinue reading “INCIDENTAL CERVICAL SYRINX”


This is the CT scan of a 24-year old person man who met with a road-traffic accident. He was riding a two-wheeler, without wearing helmet. CT scan shows right frontal contusion, with mass effect. There is fracture of overlying frontal bone. Treatment is conservative in the initial stage with anti-cerebral edema measures and anti-epileptic drugs.Continue reading “POST-TRAUMATIC RIGHT FRONTAL CONTUSION”

Carpopedal Spasm due to Hypocalcemic Tetany

22-year old lady was noted to have painful cramps and spasms affecting both hands. Her calcium level was found to be 7.2 mg/dl (normal: 9-10.5 mg/dl). Pictures of her hands are shown above. A diagnosis of hypocalcemic tetany was made. In carpopedal spasm, both hands and feet are affected. In hands, there is flexion atContinue reading “Carpopedal Spasm due to Hypocalcemic Tetany”

Eschar: A clue to the Diagnosis of Scrub Typhus

Scrub typhus is among the common causes of febrile illnesses, noted globally. It should be included in the differential diagnosis of febrile illness along with more common conditions such as malaria, typhoid, leptospirosis, etc. In addition to fever, patients with scrub typhus may have headache, skin rash, joint pains, lymphadenopathy and an eschar. Eschar isContinue reading “Eschar: A clue to the Diagnosis of Scrub Typhus”

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”

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”

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”

Essential Tremors

Essential tremors are the commonest causes of tremors in the world. These are also known as familial tremors or benign tremors. Tremors are often bilateral and commonly involve hands. In some cases, asymmetry may be seen, as in the case shown here, where the tremors are present only in left hand. Tremors can also involveContinue reading “Essential Tremors”


Blepharospasm refers to involuntary contraction of eyelids. Eyelid closure are intermittent and of short duration. Spasms of eyelids may get triggered by light, wind, pollution, stress, etc. Here, you can also facial grimacing. These symptoms can occur as a part of Meige syndrome, which is more common in women, and commonly affects people between theContinue reading “Blepharospasm”