A case of neck pain in emergency department

Neck pain is a common presentation to the emergency department (ED) and a prominent source of disability in the adult population, accounting for about 10�% of the population. Neck pain can be challenging for ED clinicians to accurately diagnose and manage. The vital role of ED remains in diagnosing the musculoskeletal red flag conditions such as cervical spine fractures or dislocations, radiculopathies, and disk disruptions. However, most non-traumatic causes of neck pain do not have a specific pathoanatomical etiology that can be identified on imaging to identify the cause of pain in the absence of red flags signs. In this article, we would like to discuss one such case, wherein our patient, a 49-year-old gentleman presented to our ED with neck pain which rapidly progressed to quadri paresis within a short duration of ED stay and the diagnostic hurdles faced and the outcome of the patient.

Early to recognize and Early to recover: A case series on Thyrotoxic periodic paralysis

Thyrotoxic periodic paralysis (TPP) is a rare disease of muscle, presenting with sudden onset weakness of muscles with or without features of hyperthyroidism. The disease most commonly occurs in the Asian population representing about 1.9% of thyrotoxic patients. It involves a predominantly male population with no family history, with or without hypokalemia. Pathophysiology is still not clearly understood. We are describing, a case series of two different patients of TPP presented to our emergency department (ED). One patient presented with classical episodic weakness of both lower limbs specifically during the night times with spontaneous reversal of weakness early in the morning. Another patient presented with complete weakness of both lower limbs for the past 1 day. Both of them had a history of weight loss and intermittent palpitations. They were promptly diagnosed in the ED and successfully treated. We recommend evaluating thyroid function status in the emergency room with the aforementioned clinical features, as early recognition and correction of thyrotoxic state are the definitive treatment helping in a complete reversal of weakness. Potassium supplements, beta-blockers, and antithyroid medications are used in treating acute attacks and preventing recurrence