Post-Coronavirus Disease Autoimmunity-associated Morvan's Syndrome.

A lot of autoimmune conditions have been found to be associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are multiple cases of autoimmune and autoinflammatory diseases reported after the coronavirus disease 2019 (COVID-19) pandemic. Autoimmune neurological presentations have also been reported but are very rare. Morvan's syndrome is a life-threatening autoimmune disease and is very rare. Morvan's syndrome is classically characterized by neuromyotonia, dysautonomia, insomnia, and neuropsychiatric symptoms. Leucine-rich glioma-inactivated protein 1 (LGI1) and contactin-associated protein 2 (CASPR2) autoimmunity has also been associated with Morvan's syndrome. We hereby report an interesting case of a male patient in his 40s, who had a history of COVID-19 infection, following which he had bilateral lower-limb weakness and pain, with profuse sweating, and was later diagnosed as a case of SARS-CoV-2-associated Morvan's syndrome.

Linezolid-Associated Posterior Reversible Leuco-encephalopathy Syndrome in a Patient with Disseminated Tuberculosis.

Neurological side-effects of linezolid manifesting as a posterior reversible leuco-encephalopathy syndrome (PRES) is rare. Early identification of this offending drug might reverse this catastrophic event. We report a 45-year-old female, who was diagnosed as a case of disseminated tuberculosis and was treated with antitubercular drugs (ATT), but later developed ATT-induced hepatitis. She was then put on modified ATT (moxifloxacin, terizidone, and linezolid). In the next two days she developed an altered sensorium. Brain imaging was suggestive of PRES. Linezolid was withdrawn, following which she showed an excellent clinical and radiological recovery.

An Unusual Case of Muscle Twitching: Its LGI1.

A 50-year-old male, presented with a two-months history of ascending paresthesias, with continuous twitchings over the body, associated with insomnia. His electromyography (EMG) revealed neuromyotonia and was diagnosed as a case of peripheral nerve hyperexcitability (PNH) syndrome due to Leucin-rich glioma-inactivated 1 (LGI1) antibody. He showed significant improvement with intravenous immunoglobulin and carbamazepine.

Expanding the canvas of PRKN mutations in familial and early-onset Parkinson disease.

BACKGROUND: Mutations in PRKN (PARK2) are commonly encountered in early-onset Parkinson disease (PD). OBJECTIVES: To screen for PRKN mutations in a clinically well-characterized cohort of early-onset PD patients with a family history (FEOPD; ≤50 years at onset) or sporadic (SEOPD; ≤50 years at onset) and late-onset familial patients (FLOPD; >50 years at onset). METHODS: A total of 97 patients including 52 SEOPD and 45 familial PD (FEOPD: 23; FLOPD: 22) were screened for variants in PRKN by PCR- Sanger sequencing. PRKN dosage and variants in known PD genes were screened by qPCR and whole-exome sequencing in a subset of samples. RESULTS: A total of 25 (25.77%) patients (SEOPD: 12, FEOPD: 6, and FLOPD: 7) were positive for PRKN variants. Of these, two patients manifested homozygous variants; while one patient was carrying three PRKN variants and two patients were carrying two PRKN variants. But, we could not examine their parents or relatives and their genotypes remain unknown. The remaining 20 (80%) patients were carrying heterozygous variants only. 32% of these variants were in exon 2, including a novel truncating homozygous variant (c.97C > T:p.Arg33Ter) in a SEOPD patient. CONCLUSION: In our cohort, a novel homozygous variant (c.97C > T:p.Arg33Ter) in a patient with hyperhidrosis expands the spectrum of PRKN associated mutations. Furthermore, ~80% of the PRKN variants being heterozygous in this study cohort, implies the utility of the cohort for identification of additional novel/known causative PD gene(s).

Carpal Tunnel Syndrome in Sarcoidosis: A Case Report of a Rare Neurologic Manifestation.

INTRODUCTION: Sarcoidosis is a multisystemic inflammatory disease with myriad clinical manifestations. Neurologic involvement in sarcoidosis is uncommon. Peripheral neuropathic presentations include mononeuropathy, mononeuritis multiplex, and generalized sensory, motor, autonomic, and sensorimotor polyneuropathies. CASE PRESENTATION: We report a case of carpal tunnel syndrome caused by sarcoidosis in a 30-year-old woman. Other causes of carpal tunnel syndrome were ruled out. The patient responded well to the standard line of corticosteroid treatment and wrist splinting. DISCUSSION: Carpal tunnel syndrome caused by sarcoidosis is a rare presentation. The mechanism of neurologic involvement in sarcoidosis is not clear.

Temporomandibular joint ankylosis in ankylosing spondylitis: A case report and review of literature.

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder. It primarily affects the axial skeleton through involvement of the peripheral joint scan occurs. Temporomandibular joint (TMJ) involvement in AS varies from 4% to 35%. Here, we present a case of a 35-year-old male, follow-up of AS from last 8 years on nonsteroidal anti-inflammatory drugs, presented with fresh complaints of painfully restricted movements of jaw during swallowing. Computer tomography of patient demonstrates articular cartilage changes with disc and joint abnormalities.

Complicated malaria: a rare presentation of Plasmodium ovale.

Malaria has emerged as a major public health problem worldwide. Complications are commonly seen in Plasmodium falciparum (P. falciparum) and Plasmodium vivax (P. vivax) infection, but due to Plasmodium ovale (P. ovale) infection is rarely described in literature. Here we report a case of severe disease due to P. ovale infection complicated with jaundice, thrombocytopenia, hypotension and acute renal failure.

An Unusual Presentation of Dengue Fever: Association with Longitudinal Extensive Transverse Myelitis.

Association of dengue fever with transverse myelitis in the form of extensive spinal cord involvement is a rare entity described in the literature. We describe a middle-aged man who presented with dengue fever and in whom weakness of the bilateral lower limbs and urinary incontinence developed on the third day of fever. Magnetic resonance imaging confirmed the diagnosis of longitudinally extensive transverse myelitis. Over a four-week course of corticosteroids with supportive management, the patient recovered without any residual neurologic deficit.

Splenic abscess: Plasmodium vivax with secondary Escherichia coli infection.

Splenic abscess is a rare clinical entity as described in literature. The incidence is in the range of 0.14-0.7% and it has a high mortality rate. Hence, it is important to know its clinical presentation and complications, so that it can be treated early. We report a 40-year-old diabetic man who presented with fever with chills and rigor for the last 9 days and heaviness in the left hypochondrium for the last 6 days. He was initially diagnosed as having splenomegaly due to Plasmodium vivax (P. vivax), but was later found to have a splenic abscess due to Escherichia coli (E. coli). This was successfully managed by catheter drainage (CD) and antibiotic treatment.

Acute viral hepatitis E presenting with haemolytic anaemia and acute renal failure in a patient with glucose-6-phosphate dehydrogenase deficiency.

The association of acute hepatitis E viral (HEV) infection with glucose-6-phosphate dehydrogenase (G6PD) deficiency leading to extensive intravascular haemolysis is a very rare clinical entity. Here we discuss such a patient, who presented with acute HEV illness, developed severe intravascular haemolysis and unusually high levels of bilirubin, complicated by acute renal failure (ARF), and was later on found to have a deficiency of G6PD. The patient recovered completely with haemodialysis and supportive management.