Extra Pontine Myelinolysis without Striatal involvement Presenting as Pathological Crying, Reversible Parkinsonism and Dystonia.

A case of Central Pontine Myelinolysis and Extrapontine Myelinolysis presented with dystonia, Parkinsonism, and pathological crying that developed few days after gradual correction of hyponatremia. EEG slowing was evident before onset of symptoms, and disappeared with clinical improvement. Thalamic lesions alone produced these features. It dramatically responded to the Trihexyphenidyl therapy. Thus, basal ganglia involvement is not mandatory to produce this clinical picture; early onset of symptoms, resolution of EEG slowing and prompt response to anticholinergics may indicate better prognosis.

Magnetic resonace appearance of gall bladder ascariasis.

Ascariasis is a common disease in many developing countries and is a common cause of biliary and pancreatic diseases in endemic areas. Numerous studies have been published on biliary tract ascariasis. All these have documented ultrasonography as the primary imaging modality for biliary tract ascariasis. Magnetic Resonance Cholangiopancreatography (MRCP) has been the latest entrant for the study of bilary tract. MRCP findings of biliary tract ascariasis have been scarcely documented. MRCP is a unique non-invasive investigation for demonstrating ascariasis in gall bladder and bilary tract clearly. We present MR appearances of gall bladder and biliary tract in a proven case of biliary ascariasis.