Ovarian mass Presenting as Paraneoplastic cerebellar degeneration with peripheral neuropathy and anti-Yo antibody.

Paraneoplastic neurological syndromes (PNS) are a group of disorders with diverse neurological manifestations that are observed in patients with various types of cancer. Any portion of the nervous system can be affected by these syndromes, which are brought on by processes other than metastasis, direct tumour spread or chemotherapy side effects. An immune-mediated attack on the cerebellar Purkinje cells and consequent cerebellar symptoms define paraneoplastic cerebellar degeneration(PCD), a subtype of the PNS. Axonal or demyelinating paraneoplastic peripheral neuropathies are both possible. Here, we describe the case of a middle-aged woman who presented with subacute-onset cerebellar symptoms and peripheral neuropathy, was discovered to have a positive anti-Yo antibody, and was later detected to have an ovarian mass. This case illustrates the significance of considering a paraneoplastic aetiology in patients with otherwise unexplained neurological manifestations and initiating an appropriate workup and early treatment for the primary malignancy.

Giant Cell Arteritis Masquerading As Migraine: A Case Report.

Giant cell arteritis, or temporal arteritis, is a chronic granulomatous vasculitis that affects large- and medium-sized arteries. An elderly male of 61 years presenting with chronic headaches for the past one year had been misdiagnosed as having migraine because of the similarity in symptoms. General examination revealed the presence of bilateral large, tortuous temporal arteries without any scalp tenderness, diminished arterial pulsations, or skin changes over the dilated arteries. A temporal artery biopsy revealed giant cell arteritis and was treated with steroids. This case report highlights the importance of considering secondary headaches, especially giant cell arteritis, in the differential diagnosis of new-onset headaches or worsening headaches in the elderly.

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated longitudinally extensive transverse myelitis (LETM) and primary Sjogren syndrome: a rare association.

Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a recent addition to the field of central nervous system inflammatory disorders. It can have a wide range of presentations, including optic neuritis, transverse myelitis, acute disseminated encephalomyelitis or any combination of these. The aquaporin-4-positive neuromyelitis optica (NMO) is a close differential owing to the similar clinical presentation. There is a proven association between NMO and autoimmunity, whereas such an association is yet to be established in the case of MOGAD. Here we describe the case of a woman in her 30s presenting with sudden-onset quadriparesis with sensory and autonomic involvement who was diagnosed with MOGAD (cervicothoracic longitudinally extensive transverse myelitis) and found to have primary Sjogren syndrome on further workup. This association between MOGAD and autoimmunity should be kept in mind, as diagnosis of the former should alert the physician to the possibility of the latter's existence and the need to initiate an appropriate workup.

Migraine and audiovestibular dysfunction: is there a correlation?

PURPOSE: To study the audiovestibular functions in cases of migraine with or without vertigo. MATERIALS AND METHODS: This was a prospective study involving 50 cases of migraine who were divided into 2 groups: patients with vertigo and those without. All patients underwent a detailed otological and neurootological examination followed by full audiological and vestibular investigation including pure tone audiometry, speech reception threshold, speech discrimination score, tone decay, short increment sensitivity index, auditory brainstem-evoked responses, and electronystagmography (ENG). RESULTS: Thirty-eight (76%) of 50 patients had vertigo on presentation, of which rotatory nonpositional vertigo (22/38) was the most common. Phonophobia was the most common auditory symptom (35/50, 70%) followed by tinnitus (25/50, 50%). Only 17 patients (34%) reported hearing loss, of whom only 7 had documented hearing loss on pure tone audiometry. However, the auditory brainstem-evoked responses of all these patients showed some abnormalities in the form of prolonged absolute latency or prolonged interwave peak latencies or both. Electronystagmography revealed canal paresis in 13 patients (26%), although there was no statistical difference between patients with or without vertigo on various electronystagmographic parameters. CONCLUSION: Auditory brainstem-evoked response abnormalities may be the earliest indicator of impending auditory involvement in migraine.