Hypersomnia and Bilateral Horner's as a Initial Presentation in Multiple Sclerosis.

Multiple Sclerosis is characterized by recurrent neurological deficiet attributable to white matter tracts, at least initially. Deep grey matter nuclei can be rarely involved in early disease as seen in MRI studies. Clinical manifestations attributable to involvement of these grey matter nuclei are extremely rare especially in early disease and is usually considered as a red flag for the diagnosis of multiple sclerosis. We report a case of a young girl presenting as a clinically isolated syndrome with bilateral Horner's and hypersomnia with MRI evidence of hypothalamic involvement.

Intravenous - Thrombolysis in a 90 year Old.

Intravenous thrombolysis in acute ischemic stroke has been conventionally avoided in the elderly (>80years of age) with fear of higher incidence of complications like symptomatic intracranial hemorrhage (SICH) and possible loss of efficacy of thrombolysis in view of lack of evidence with most previous trials excluding this group of patients. There has been recent evidence suggesting benefit of IV thrombolysis in the elderly (>80 years) especially when treated within 3 hours of stroke onset. We report a successful thrombolysis in a 90 years old lady which to our knowledge is the first successful thrombolysis reported from India.