Pruritus as Unusual Manifestation of Lupus Myelopathy.

Lupus myelopathy is a relatively uncommon manifestation of SLE. Atypical presentation of this rare entity with neuropathic itch has never been reported. We report a young girl who presented with predominant symptom of refractory pruritus which after clinical localization and imaging was detected to have long segment patchy myelitis. Detailed evaluation led to a diagnosis of lupus myelopathy and the patient responded to immunosuppressive therapy with significant clinical and radiological improvement. Maintaining a high level of suspicion for neurological cause in a patient with refractory localized itching resistant to regular antiallergic treatment is important in the right clinical setting.

Overreligious beliefs with neuropsychiatric manifestations in a young lady-Rule out Marchiafava-Bignami disease.

Marchiafava- Bignami disease is a rare condition characterized by demyelination of corpus callosum due to alcohol or malnutrition. Here we report a young lady who, due to her religious beliefs had stopped taking food and presented with neuropsychiatric manifestations. Neuroimaging was suggestive of Marchiafava Bignami disease and with adequate nutritional and thiamine therapy she had dramatic improvement clinically and had near complete resolution of lesions in neuroimaging.

Hemorrhagic Stroke in Chronic Kidney Disease.

Hemorrhagic stroke is leading cause of death in Chronic Kidney Disease (CKD) population. Uremic patients are susceptible to hemorrhagic complications due to multiple reasons i.e platelet dysfunction, low platelet number, use of heparin during hemodialysis, use of anticoagulants for thromboembolic risk etc. Prevention and treatment of hemorrhagic stroke is complicated in CKD setting and if not managed properly can lead to several fold increased mortality and morbidity rate. In this brief review we will discuss about the magnitude of hemorrhagic stroke, important risk factors and outcomes in predialysis and dialysis setting and its important preventive and treatment strategy.

Cerebral venous sinus thrombosis as a warning signal for double positive crescentic glomerulonephritis in a young male with complete renal recovery.

Double positive crescentic glomerulonephritis is relatively rare in young population and has variable outcomes. Although increased incidence of deep venous thrombosis in antineutrophil cytoplasmic antibody-associated vasculitis has been reported, cerebral venous sinus thrombosis (CVT) is very rare. We present a young male who presented with CVT followed by rapidly progressive crescentic glomerulonephritis and with appropriate therapeutic modalities he had complete renal and partial neurological recovery.

Optical Coherence Tomography and Subclinical Optical Neuritis in Longitudinally Extensive Transverse Myelitis.

OBJECTIVE: The aim is to compare the retinal nerve fiber layer (RNFL) thickness of longitudinally extensive transverse myelitis (LETM) eyes without previous optic neuritis with that of healthy control subjects. METHODS: Over 20 LETM eyes and 20 normal control eyes were included in the study and subjected to optical coherence tomography to evaluate and compare the RNFL thickness. RESULT: Significant RNFL thinning was observed at 8 o'clock position in LETM eyes as compared to the control eyes (P = 0.038). No significant differences were seen in other RNFL measurements. CONCLUSION: Even in the absence of previous optic neuritis LETM can lead to subclinical axonal damage leading to focal RNFL thinning.