Foix-Chavany-Marie opercular syndrome is a severe form of pseudobulbar palsy caused by bilateral anterior opercular lesions (1,2). It is characterized by a loss of voluntary control of facial, lingual, pharyngeal and masticatory muscles in the presence of preserved reflexive and automatic functions of the same muscles (3,4). A 35-year-old male with diabetes had history of right leg deep vein thrombosis (DVT), which was treated since the age of 2 years. His sisters also had a history of DVT, and one of his sisters had had two abortions. The condition started one month ago as an inability to swallow, along with drooling of the saliva, which started suddenly when the patient developed the inability to speak with right side heaviness, mainly in the upper limb. An improvement in the weakness occurred five days later but he still could not speak; the patient then suddenly developed drooling and even an inability to open his mouth and move his tongue. The patient denied having history of hypertension. An examination of the central nervous system revealed a conscious patient with bilateral facial palsy, bulbar palsy, and normal power.
Multiple Sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Up to 10 % of MS patients have onset in paediatric age group. Although the clinical profile of MS appears similar to that seen in adults, several features may differ and specific issues arise in children. Here, we reported a 12-year old girl who presented with 3-year history of episodes of seizures and facial nerve palsy and finally fatigue and cognitive impairment were noted and interfered with her academic performance. Because of the presumed atypical clinical presentations, the diagnosis was missed then dismissed despite neuroimaging features and CSF immunological findings that were highly suggestive of MS. Later, evolution of the disease by neuroimaging helped confirming the diagnosis and directed toward the delayed therapy.
We describe a large functioning non metastasizing ACC in 8 years old boy who presented with a history of precocious puberty noticed by his parents since 3 months .Ultrasound of the abdomen showed a large well defined right suprarenal mass with calcification and necrosis . MRI showed the mass to be hypojntense to liver on T1 and hyperintense to liver on T2, and dynamic CT scan revealed a large hetrogenous enhancing right suprarenal mass with calcification and necrosis , clear chest .Histopathology done after surgical removal reveal adrenocortical carcinoma,so we recommend to do an abdominal ultrasound to any child with precocious puberty because it is easy,cheap and non invasive , if any suprarenal mass found it should be further characterized by MRI and dynamic conontrast enhanced CT to determine its respectability
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