Use of a nerve stimulator did not aid in anatomical dissection of the RLN and was useful in identifying only one EBSLN. Discontinuous nerve monitoring by stimulation during total thyroidectomy confers no obvious benefit for the experienced surgeon in nerve identification, functional testing or injury prevention.

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Background:Trigeminal neuralgia (TN) may rarely be the presenting or only symptom of Chiari 1 malformation (CM). Isolated case reports have described resolution of TN following craniocervical decompression where TN is present in association with CM.Case Report:This report discusses an unusual case of pure TN associated with CM that was successfully treated with craniocervical decompression and duroplasty and reviews the limited literature on the subject.Conclusion:TN may be the sole presenting symptom of CM and can be successfully managed with craniocervical decompression. Clinicians should be aware of the association of TN with CM and consider surgical management.

Calcium pyrophosphate deposition disease of the spine mimicking septic arthritis A 68-year-old woman presented with a 5-day history of progressive lower back pain, bilateral anterior thigh pain and subjective fevers. Her history included hypertension, osteoarthritis and neurogenic claudication, without previous inflammatory arthritis or trauma. Examination revealed low-grade fever (37.8 C) and L2-4 midline tenderness, with unremarkable neurological and systemic examination. Peripheral leucocyte count was 12.2 (normal: 4.0-11.0) and C-reactive protein was 105 mg/L