ABSTRACT
Rhabdomyolysis is defined as breakdown of skeletal muscle fibers with subsequent release of its cellular components into the circulation. It is associated with variety of causes and status epilepticus is one of it. The excessive muscular activity associated with seizure is possible explanation for it. It is clinically evident by the new onset severe generalized bodyache, weakness and myalgia associated with dark coloured urine. Acute kidney injury is one of the most serious complications associted with rhabdomyolysis. Single episode of generalized seizure is not a frequent cause for rhabdomyolysis. Acute kidney injury due to rhabdomyolysis, following a single episode of seizure is a rare entity. Here we report a case of rhabdomyolysis with acute kidney injury following a single episode of generalized seizure. High index of suspicion is required to timely diagnose and treat such patients. Timely intervention with hemodialysis along with other supportive care can completely revert this potentially serious complication to normal.
ABSTRACT
Mills hemiplegic variant of Amyotrophic lateral sclerosis (ALS) is a gradually progressive, spastic ascending or descending hemiparesis or hemiplegia without any sensory involvement. Authors presented a 47 years old female with history of gradually progressive left sided wasting of muscles including the tongue, left hemiparesis along with dysarthria and fasciculation’s of tongue and left sided muscles with left sided cortico-spinal tract signs of 2 years duration. There were no sensory as well as bowel bladder involvement. Her cognition was intact. Relevant blood and CSF examinations were within normal limit. MRI Brain and whole spine were unremarkable. Nerve conduction study was essentially normal. Electromyography(EMG) showed chronic denervation potentials which is in accordance to Revised El Escorial criteria, 2015 for the diagnosis of this extremely uncommon entity- Mills hemiplegic variant of ALS. The major challenge in diagnosis of this disease entity is to exclude other diseases/disorders that may mimic its symptomatology.