Phenytoin-Induced Exanthematous Drug Eruption: A Rare Complication to Watch Out for!

Phenytoin is a first-generation anticonvulsant medicine that efficiently cures a wide range of seizures, including status epilepticus, complex partial seizures, and generalized tonic-clonic seizures (GCTS). The major advantage of phenytoin is that its neurological functions are preserved. Phenytoin works by inhibiting voltage-dependent membrane Na channels, which are essential to generate action potential. This function inhibits the positive feedback, leading to high-frequency repeated firing, reducing seizure spread in the focal region. A purple color rash on the chest, abdomen, and trunk developed in a 21-year-old female patient after being treated with phenytoin is being reported. The presentation, pathophysiology, and management are also reviewed.

Adaptive Neuroplasticity in Brain Injury Recovery: Strategies and Insights.

This review addresses the relationship between neuroplasticity and recovery from brain damage. Neuroplasticity's ability to adapt becomes crucial since brain injuries frequently result in severe impairments. We begin by describing the fundamentals of neuroplasticity and how it relates to rehabilitation. Examining different forms of brain injuries and their neurological effects highlights the complex difficulties in rehabilitation. By revealing cellular processes, we shed light on synaptic adaptability following damage. Our study of synaptic plasticity digs into axonal sprouting, dendritic remodeling, and the balance of long-term potentiation. These processes depict neural resilience amid change. Then, after damage, we investigate immediate and slow neuroplastic alterations, separating reorganizations that are adaptive from those that are maladaptive. As we go on to rehabilitation, we evaluate techniques that use neuroplasticity's potential. These methods take advantage of the brain's plasticity for healing, from virtual reality and brain-computer interfaces to constraint-induced movement therapy. Ethics and individualized neurorehabilitation are explored. We scrutinize the promise of combination therapy and the difficulties in putting new knowledge into clinical practice. In conclusion, this analysis highlights neuroplasticity's critical role in brain injury recovery, providing sophisticated approaches to improve life after damage.

Acute Ischemic Stroke Post Honeybee Sting: A Rare Case Report.

Stings by bees or wasps are frequent worldwide. From minor urticaria to severe anaphylaxis, allergic symptoms are typically present. Various reports of unexpected reactions to bee stings affecting the neurological, renal, cardiac, pulmonary, and ocular systems have been published. Here, we present a rare instance of subacute bee sting syndrome that resulted in an ischemic stroke over a 24-hour period.

Dyke-Davidoff-Masson Syndrome as a Predecessor of Recurrent Seizures in an Adult Male: A Report of a Rare Case.

Dyke-Davidoff-Masson syndrome (DDMS) is a rare condition that usually presents in early life with recurrent seizures. It can be congenital or can be acquired by perinatal hypoxia, infections, and intracranial hemorrhage. Its frequency remains unknown. It is usually diagnosed by neuroimaging. The classical neuroimaging features are unilateral cerebral hemiatrophy, volume loss, and hyperpneumatization of the sinus. We present the case of a 22-year-old male who presented with complex partial status epilepticus and had a history of recurrent seizures since he was six years old. The diagnosis of DDMS was made on neuroimaging.

Vanishing lung syndrome masquerading as pneumothorax in a smoker: Now you see me, now you do not.

A rare clinical syndrome, giant bullous emphysema, also known by the name of vanishing lung syndrome (VLS), is characterized by an X-ray of the chest showing disappearance of the lung. VLS is a chronic disease that progresses gradually and is usually seen in young male smokers, with other risk factors being alpha-1 antitrypsin deficiency and marijuana abuse. Giant emphysematous bullae are a pathognomonic presentation with a preference towards the upper lobe of the lungs. These emphysematous bullae may remain dormant for a long duration before presenting as worsening dyspnoea. Computed tomography is an essential tool to diagnose VLS. The treatment modalities include surgical and thoracoscopic resection of the bullae. We have reported a rare case of VLS in a 58-year-old chronic smoker managed conservatively.

A Case of Suprasellar, Intrasellar, and Infrasellar Meningioma Presenting as a Visual Field Defect in an Obese Female.

Bitemporal hemianopia is the most common visual field defect encountered in suprasellar meningiomas compressing the optic chiasma and its vascular supply. It is hard to distinguish between meningioma and tumors that arise from suprasellar, intrasellar, and infrasellar extensions. Clinical findings, hormonal levels, and radiological findings could help in labeling it as meningioma. A 53-year-old obese woman with a history of blurred vision more in the right eye, loss of smell, and a headache was diagnosed with meningioma having suprasellar, intrasellar, and infrasellar extension on neuroimaging. She developed bitemporal hemianopia, which gradually worsened over the course of six months with concomitant headaches and dizziness that was treated with analgesics leading to a delayed diagnosis. As she was symptomatic, it was decided to resect her tumor. The patient underwent an endoscopic transsphenoidal approach for tumor resection. Successful excision of the tumor was accomplished. Postoperatively on further evaluation, the patient's anosmia and the visual deficit were resolved. This instance shows that meningioma located in the sella can cause symptoms like anosmia and visual field loss, which should not be neglected. It also underlines the significance of visual field evaluation on a regular basis as this might predict radiological and symptomatic progression.

Artery of Percheron Stroke: A Case Report With a Diagnostic Challenge.

Artery of Percheron (AOP) is a unique anatomical variant of blood supply to the paramedian thalamus and also to the rostral part of the midbrain. It arises from the P1 part of the posterior cerebral artery. Obstruction of this artery accounts for the infarction of the bilateral thalamus with or without the involvement of the midbrain. Symptoms of artery of Percheron infarction may differ with respect to the portion of the brain it supplies and its different anatomical variations. The various symptoms include memory loss, altered consciousness, vertical gaze palsy, and others. Diagnosis is difficult due to a variety of clinical presentations and differential diagnoses like viral infections or tumors. Artery of Percheron infarction rarely occurs, and early diagnosis is a challenge as it is often missed on a conventional CT scan and even on an MRI scan of the brain. Delay in diagnosis and initiation of treatment must be avoided in such cases. We report a case of this 57-year-old male who had vertical gaze palsy and irrelevant talks, which was evaluated further and found to be the artery of Percheron infarct on MRI brain and treated with antiplatelets after which the symptoms of the patient ameliorated, and he was discharged after five days of admission.

Seronegative Autoimmune Basal Ganglia Encephalitis Presenting as Acute Parkinsonism and Refractory Faciobrachial Seizures: A Case Report.

Autoimmune basal ganglia encephalitis (BGE) typically presents with acute onset parkinsonism and on imaging is associated with lesions in the basal ganglia. It is associated with chorea and other movement disorders. Seizures are still rare. Various autoantibodies are associated with the development of basal ganglia encephalitis. These autoantibodies are against dopamine D2 receptor (D2R) and N-methyl-D-aspartate receptor (NMDAR). Another paraneoplastic antibody known as anti-recoverin antibodies (Abs) is also associated with basal ganglia encephalitis. We report a case of a 45-year-old male who presented in this hospital with a history of cognitive dysfunction and slowness of activities for eight days and faciobrachial seizures. Magnetic resonance imaging (MRI) of the brain revealed lesions in the putamen and caudate nucleus. Infection and antibody screening were negative. The seizures were refractory to conventional antiepileptics. The patient responded to intravenous immunoglobulin (IVIG) therapy.

Splenic Artery Embolization in Subcapsular Splenic Hematoma Secondary to Dengue Hemorrhagic Fever.

Dengue hemorrhagic fever (DHF) is a common syndrome of dengue viral infection but complications such as sub-capsular splenic hematoma leading to capsular rupture in dengue are rare. We report a case of a young male who presented with fever, breathlessness, and acute abdomen. His CT of the abdomen revealed subcapsular splenic hematoma measuring 16.7 cm × 13.0 cm × 11 cm. His laboratory parameters were suggestive of anemia, thrombocytopenia, acute kidney injury, coagulopathy, and hepatopathy because of which instead of splenectomy, splenic artery embolization with ultrasound-guided splenic hemorrhage drainage was performed for his management as his clinical condition deteriorated. This case report sensitizes newer modalities of treatment of subcapsular splenic hematoma with splenic arterial embolization.

Caring for Cancer Patients during Corona Pandemic-(COVID-19)-A Narrative Review.

Background Coronavirus disease 2019, the third pandemic of 21st century which has brought the whole world under panic, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a zoonotic beta coronavirus sharing phylogenetic, genomic similarities with SARS virus and Middle East Respiratory Syndrome virus. Specific Concerns Cancer patients are at double the risk than normal patients since these patients are at immunocompromised state. WHO guidelines advice the patients to plan only emergency hospital visits only till the pandemic persists. Should meet patient/visitors in a well-ventilated room or outdoors and maintain at least 2 m distance between the visitor/patients. It also encourages the patient to refill the prescribed medications in well advance and to stay physically active, if possible. Discussion The World Health Organizations' isolate, trace, test, treat policy needs to be followed to protect these high-risk patients from this global pandemic.].