Facial diplegia with hyperreflexia-a mild Guillain-Barre Syndrome variant, to treat or not to treat?

Guillain Barre Syndrome (GBS) is readily diagnosed when the presentation is that of ascending weakness and areflexia. Atypical presentations with preserved, and at times, brisk reflexes, can be a diagnostic dilemma. We describe a patient with GBS who presented with facial diplegia and hyperreflexia on examination and discuss management options

Gruźlica ośrodkowego układu nerwowego naśladująca pierwotne otępienie: opis przypadku

Primary dementias are the most common cause of memory impairment in patients above the age of 60. Hypothyroidism, depression, vitamin B12 deficiency and infectious diseases such as syphilis at times may present with memory impairment mimicking primary dementias in their clinical presentation. We present here a 64-year-old female who presented with complaints of forgetfulness, confusion, memory loss and impaired concentration for the past 3 months. Neuroimaging and computed tomography of the chest were suggestive of active tuberculosis. Anti-tubercular therapy led to resolution of enhancing lesions in the brain and abatement of memo ry deficits.Otępienia pierwotne są najczęstszą przyczyną zaburzeń pamięci u pacjentów powyżej 60. roku życia. Niedoczynność tarczycy, depresja, niedobór witaminy i choroby zakaźne, np. kiła, mogą niekiedy manifestować się zaburzeniami pamięci, które naśladują obraz kliniczny otępienia pierwotnego. W pracy przedstawiono przypadek 64-letniej kobiety, która zgłosiła się z powodu utrzymujących się od 3 miesięcy zapominania, zmącenia, utraty pamięci i upośledzonego skupienia uwagi. Badania obrazowe układu nerwowego i tomografia komputerowa klatki piersiowej wskazywały na aktywną gruźlicę. Leczenie przeciwprątkowe doprowadziło do wycofania wzmacniających się zmian w mózgu i ustąpienia zaburzeń pamięci

Vocal cord palsy: An uncommon presenting feature of myasthenia gravis

Vocal cord palsy can have myriad causes. Unilateral vocal cord palsy is common and frequently asymptomatic. Trauma, head, neck and mediastinal tumors as well as cerebrovascular accidents have been implicated in causing unilateral vocal cord palsy. Viral neuronitis accounts for most idiopathic cases. Bilateral vocal cord palsy, on the other hand, is much less common and is a potentially life-threatening condition. Myasthenia gravis, an autoimmune disorder caused by antibodies targeting the post-synaptic acetylcholine receptor, has been infrequently implicated in its causation. We report here a case of bilateral vocal cord palsy developing in a 68-year-old man with no prior history of myasthenia gravis 2 months after he was operated on for diverticulitis of the large intestine. Delay in considering the diagnosis led to endotracheal intubation and prolonged mechanical ventilation with attendant complications. Our case adds to the existing literature implicating myasthenia gravis as an infrequent cause of bilateral vocal cord palsy. Our case is unusual as, in our patient, acute-onset respiratory distress and stridor due to bilateral vocal cord palsy was the first manifestation of a myasthenic syndrome

Cysticercosis of temporalis muscle: an unusual cause of temporal headaches. A case report

Abstract Cysticercosis is a com-mon parasitic infection caused by encysted larvae of the helminth Taenia solium (pork tapeworm). The central nervous system (CNS) is the most important primary site of infection and the disease can present with solitary or multiple space occupying lesions. Less common presentations in the CNS include the racemose variety with macroscopic groups of cysticerci in the subarachnoid space giving the appearance of a cluster of grapes and basal or ventricular cysticercosis causing obstructive hydrocephalus. Involvement of other organs: skeletal muscle, eyes, myocardium and the lungs has also been reported. Cases of cysticercosis presenting as isolated muscle mass (pseudotumours) without involvement of the CNS have also been recently described in the literature. We present a case of a 43-year-old woman who com-plained of subacute onset of left temporal pain and headache. Magnetic resonance imaging (MRI) showed characteristic imag-ing findings suggestive of cysticer-cosis of the temporalis muscle