Morvan’s syndrome after intra-scrotal injection of lignocaine and denatured spirit for hydrocoele

Morvan’s syndrome is a rare form of neuromyotonia having prominent central symptoms. We present a series of 9 patients who developed Morvan’s syndrome after scrotal tap and local instillation of lignocaine and denatured spirit into scrotal sac to treat hydrocoele. The course of the disease was self-limiting. All patients improved within 3 months of onset of symptoms.

Reversible parkinsonism in central pontine and extrapontine myelinolysis: A report of five cases from India and review of the literature

Parkinsonism with or without dystonia has been rarely described following central pontine myelinolysis and extrapontine myelinolysis. We report 5 cases of reversible parkinsonism and dystonia with imaging evidences of central pontine myelinolysis and extrapontine myelinolysis associated with hyponatremia from a center in Eastern India. Their presentations varied from mild masked facies to extra pyramidal syndromes characterized by progressive supranuclear palsy like feature and marked dystonia. Two cases presented with flaccid quadriplegia later evolved into spasticity and dystonia. The cause of hyponatremia was due to vomiting in two, diuretic-induced, nutritional and psychogenic polydipsia one each. The onset was acute in 4, and gradual in one from psychogenic polydipsia. They responded well to gradual correction of electrolyte imbalance, dopaminergic and antidystonic agents including botulinum toxin. The movement disorders of central pontine myelinolysis with extrapontine myelinolysis represent a treatable manifestationof the osmotic demyelination syndrome and rewarding result can be achieved.