Opercular syndrome: Case reports and review of literature

Five cases of “bilateral opercular syndrome” of vascular etiology are reported. Cortical pseudobulbar palsy (i.e. spastic anarthria and inability to swallow) with dissociation of automatic voluntary movements in the affected muscles are the essential features of this syndrome. Additional motor and sensory symptoms differentiate its subtypes. All 5 patients had bilateral opercular syndrome. The unusual features was its occurrence as the presenting feature of preeclampsia in a young lady, and the development of the transient syndrome following a right focal seizure with generalization at high altitude in a young female trekker who had an old unilateral infarct in left opercular region. Whereas the limb motor weakness recovered well, the recovery was unsatisfactory for speech and for swallowing.

Diagnostic delay in a multi-organ tuberculosis immunocompetent patient: a case report.

A 67-year-old immunocompetent male presented with intermittent fever for 3 months associated with urinary incontinence, altered bowel habits and history of loss of appetite and weight. He was treated as having enteric fever at various clinics in the city by different physicians. On evaluation the patient was found to have disseminated tuberculosis with involvement of the lungs, eyes, testes, brain, bone, kidneys, liver, spleen and possibly the gastrointestinal tract. This paper reports a case of disseminated tuberculosis to many organs with significant diagnostic delay more than twelve decades after the discovery of the tuberculosis bacillus by Robert Koch.