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Came in with complaints of feeling of weakness of left index tip. Flummoxed me a bit till the full exam

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There is a peculiar pleasure in diagnosing a condition out of your specialty: something that you studied a long time ago in your undergrad. Kind of makes up for all the unnecessary and useless stuff that you had to study back then: a partial vindication Don’t you think?

Xray ↘️; non weight bearing as I forgot about it , even then there is some e/o arch collapse Final Dx- Mononeuropathy with unilateral Charcot joints

Ncv shows absent SNAPs in the right foot ( med and lat plantar) Exam shows a unilateral rocker bottom foot

Unsteady gait and some tripping Lady with long standing rheumatoid arthritis and prior mono neuritis multiplex On examination- mild sensory deficits in the soles

Satralizumab Phase 3 METEOROID Trial is the First-Ever Positive Trial in MOGAD (AAN 2026 / Life Science Daily News / NeurologyLive 2026) Impact: STZ ↘️68% relapse risk reduction, 79% reduction in active MRI lesions, 73% reduction in rescue therapy need. MOGAD previously had NO approved therapies and this is good news as pts relapse on existing therapies

🚨 Burning Vertex Syndrome: A novel headache 🔥 A common problem in the Neurological OPD, well described by our colleague Pravin Thomas et al 🧠 Curr Opin Neurol 2025 ➡️ Episodic, burning pain localized to the vertex (10–20 cm zone) ➡️ Mostly affects women (~65%), avg. age ~41 ➡️ Duration: 1 min to 24 hrs, often <4 hrs ➡️ Frequency: daily to 1–3x/week ⚠️ Associated features in 76%: •Nausea, vomiting •Photophobia/phonophobia •Autonomic signs •Localized warmth (rare) 🧬Hypothesized mechanism? Small fiber scalp neuropathy 💉 Interesting finding: GON block helped in 2 patients #NeuroTwitter #Headache

@Shreyansh081546 👋👋

@bobvarkey DISH neet pg mcq

A 36 year old obese man on Rx for schizophrenia, diabetes and metabolic syndrome, comes to you with a six month hx of neck pain. On examination there are no focal neurological deficits. Neck movement is slightly restricted This is his Xray

@DrLKrishnamurt1 Spot on , sir

@bobvarkey DISH

They’re not even conducting Exams fairly & They want us to believe that they’re conducting Elections fairly.

He has no hx of low back pain or morning stiffness . Esr and CRP are normal What are your thoughts?

@Mo_element26 I don’t think it’s sensitive at all . Just an interesting clinical correlative sign. EEG is the gold standard

@bobvarkey How reliable is it in comparison to EEG ? Especially in NCSE Definitely useful to know if the patient is already sedated with benzos & there is no EEG available

Clinical pearl- Epileptic hippus- pupillary diameter oscillation during a status epilepticus

If you see a team walking around the hospital, kindly refer to them by the appropriate name: ⚕️A ganglia of neurologists ⚕️An inflammation of rheumatologists ⚕️A caffeine of nurses ⚕️A murmur of cardiologists ⚕️A croup of pediatricians ⚕️ Infectious disease docs in clusters

@HowToAI_ Asking for a friend: Does it matter if you’re building the app on Claude code anyway

Someone built a tool that lets Claude Code autonomously test your entire IOS app It navigate your entire app, opens every screen, tests every flow, reads the debug logs, and hands you a structured bug report. one prompt and that's it

Just went through a neuropsychological assesment of a child who was referred for difficulty with studies and behavioural phone addiction . The psychologist spent 10 minutes talking with him and sent me a report that he seemed like a bright child and did not seem to have ADHD. Contrast this with an assesment performed for his sibling in the US who underwent a detailed assesment and was finally diagnosed with mild ADHD. After starting medications, the child improved significantly. These were the tests the second child underwent 1. a clinical Interview 2.Behavioral Observations 3. Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) 4.The Beery-Buktenica Developmental Test of Visual-Motor Integration - Sixth Edition 5.Delis-Kaplan Executive Function System (D-KEFS) 6.Conners' Continuous Auditory Test of Attention 7.Conners' Continuous Performance Test - Third Edition 8.Behavior Assessment System for Children - Third Edition, Parent, Teacher and Self report forms 9.Behavior Rating Inventory of Executive Function - Second Edition, Parent and Self report forms The difference in quality of the tests was astounding and eye-opening. I was unable to even face the parent with such a shoddy test report. We need to do better than just make diagnoses based on a hunch. It's a big problem in India, where we often take shortcuts; maybe due to lack of time or large OPDs....but we compromise tremendously on quality and hardly ever make any edge contributions

@esenu_shem Thank you

A metastasis seems highly likely in this presentation. In skull base osteomyelitis, taking malignant otitis externa as the primary. There's usually DM in the patient. There's also excruciating otalgia, often times granulation tissue in the ear canal at the fissures of Santorini. It may as well present with lower cranial nerve palsies. Though that being said, a diagnosis can be made on a Technetium 99 scan.

A 75 year old 🧔with gradually increasing left sided headache of 1 month duration No fever/ ear discharge No hx of Diabetes O/e: temporal skull tenderness Clinical dd/‘s : Skull base osteomyelitis/ metastasis MRI/CT ; show an ill defined soft tissue in the region of the left occipital console and left lateral aspect of the Atlantic occipital joint What are your thoughts on?

Occipital condyle lesions are overwhelmingly metastatic in origin (>90%) from prostate, lung , breast : the rest are due to primary skull base tumors or rarely due to infections such as Tb Waiting for a PET-CT😃