Brown-Séquard Syndrome as a First Presentation of Multiple Sclerosis.

A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.

A Rare Presentation of Tubercular Meningitis as Persistent Neutrophilic Meningitis.

Persistent neutrophilic meningitis is an atypical form of chronic meningitis defined as clinical meningitis with a cerebrospinal fluid (CSF) analysis suggestive of neutrophilic pleocytosis that persists for more than one week despite giving empirical antimicrobial therapy. The predominant presentation of tubercular meningitis is with CSF lymphocytic pleocytosis and even if early phase of the disease presents with neutrophilic pleocytosis, no persistence is usually observed for more than one week. We hereby report the case of an immunocompetent man aged 25 years with tubercular meningitis manifesting as persistent neutrophilic meningitis which is very rare as an entity in tubercular meningitis (TBM). Patient was started on anti-tubercular therapy based on the granulomas in magnetic resonance imaging (MRI) of the brain after which there was a reduction in total cell count in CSF but persisting neutrophilic predominance. Patient improved clinically and was given a full course of anti-tubercular treatment (ATT) thereafter.

Isolated Myocysticercosis.

Cysticercosis, a parasitic disease caused by larval form of Taenia solium, is a major health concern in the developing world. The encysted larval stage can affect any part of the body, but are most frequently detected in brain, eye, skeletal muscle and subcutaneous tissue. Most muscular cysticercosis are almost always associated with central nervous system involvement or with multiple intramuscular cysts or both. Here we report an unusual case of cysticercosis in right rectus muscle which was an isolated muscle involvement without any other systemic manifestation.