Anabolic-androgenic steroid (AAS) abuse increased in recent years, and it is associated with numerous adverse effects. Few reports on ischemic stroke related to anabolic steroid abuse have been published. We report a case of a 26-year-old male amateur athlete who suffered a posterior territory ischemic stroke. No abnormalities were found in angiography and echocardiography studies, neither in hemostatic profile. His only significant risk factor was nonmedical use of stanozolol, an anabolic steroid. Anabolic steroids are capable of increasing vascular tone, arterial tension, and platelet aggregation; therefore, they are prone to produce atherothrombotic phenomena. Because of young people's widespread use of anabolic steroids, physicians should be aware of this kind of complication.

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PurposeNeurosurgery appears to be a reasonable alternative in carefully selected patients with refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE). We discuss the optimal timing of the surgery and the use of previous stereoelectroencephalography (SEEG) invasive evaluation.MethodsWe identified 3 patients (two pediatric and one adult) who underwent epilepsy surgery because of RSE or SRSE from our epilepsy surgery database, one of them with previous SEEG.ResultsStatus epilepticus resolved acutely in all of them with no mortality and no substantial morbidity. At follow-up (median: 2 years), 1 patient was seizure-free, and 2 had significant improvement.ConclusionSurgery should be considered in all cases of RSE and SRSE early in the course of the evolution of the disease.

A 13-year-old girl presented with left-sided periorbital headache and homolateral ptosis with normal ocular motility and pupillary response (video segment 1 on the Neurology ® Web site at www.neurology.org). She had a similar episode 1 year before. Brain MRI showed enhancement of the left oculomotor nerve (figure). She recovered completely within 7 days (video segment 2). Two months later, MRI was normal.Ophthalmoplegic migraine is very rare. One similar report was identified in the literature. 1Differential diagnoses include neoplasm, aneurysm, carotid dissection, temporal arteritis, sarcoidosis, Tolosa-Hunt syndrome, and infectious etiologies.Response to steroids and the reversible MRI contrast enhancement of the affected cranial nerve both point to an inflammatory mechanism rather than a migrainous condition, and introduce the possibility of reclassifying ophthalmoplegic migraine as a recurrent neuritis.