No abstract

Background: Chorea and ballism are well-recognized acute potentially reversible movement disorders as the presenting manifestation of non-ketotic hyperglycemic states among older type-2 diabetics. Myoclonus as the form of presentation of diabetic keto-acidosis (DKA) in previously undiagnosed type-1 diabetic has never been reported before. Case report: We herein report the case of a 36-year-old previously healthy patient who presented with acute onset incessant faciobrachial myoclonus for 10 days. The patient was found to be suffering from DKA and eventually diagnosed as type-1 diabetes mellitus. Myoclonus disappeared with achieving euglycemia and did not recur. Discussion: Apart from expanding the spectrum of acute movement disorder among diabetics, this case reiterates the importance of rapid bedside measurement of capillary blood glucose in all patients presenting with acute onset abnormal movements irrespective of their past glycemic status. This simple yet life-saving approach can clinch the diagnosis at the earliest and thus will avoid costly investigations and mismanagement.

Seizures and involuntary movements are relatively rare, but well-known neurological complications of non-ketotic hyperglycemia. While hemichorea-hemiballism secondary to diabetic striatopathy is increasingly being reported, unilateral caudate atrophy resulting from chronic vascular insufficiency/insult in a backdrop of poorly controlled diabetes mellitus is sparsely described in literature. We herein report a 75-year-old woman with poorly controlled diabetes mellitus who presented with concurrent epilepsia partialis continua involving left side of her face and hemichorea on the right side in the context of non-ketotic hyperglycemia. Neuroimaging revealed a space-occupying lesion suggestive of low-grade glioma in the right superior frontal cortex and left-sided caudate atrophy as well. Possibly, space-occupying lesion in motor cortex acted as an inciting factor for seizures and non-ketotic hyperglycemia further lowered the seizures threshold. On the other hand, atrophied left caudate had led to persistent choreiform movements secondary to chronic uncontrolled hyperglycemia. The simultaneous presence of acute and chronic neurological complications of diabetes mellitus makes this case unique. It also highlights the need for strict control of blood glucose and utility of appropriate neuroimaging to rapidly diagnose and prevent further complications.

No abstract

Background: Poisoning is the most common method, employed for the act of deliberate self-harm. The wide availability, lack of rules and regulations for the sale of pesticides resulted in wide spread use of Organophosphate as one of the most common poison used for deliberate self-harm.Methods: In this study, authors aim to find out clinical profile with respect to different O.P. compounds, prognosis and outcome of each patient in relation to the delay in getting medical attention. Present study objective is to find out if there is any specific clinical finding which can predict bad outcome.Results: Out of 344 cases, 189 cases had type 1 respiratory failure, while in 34 cases type II respiratory failure present. 61 cases expired and out of these 61 cases 47 cases died within 24 hours and 11 cases died in next 48 hours.Conclusions: Maximum number of cases were in the age group of 21 - 30years. The maximum number of deaths were in the first 72 hours. Number of cases were more in males as compared to females. Chances of survival was better in persons who reached early to the hospital.