The clinical land neuroimaging features of 49 patients with non-gestational cerebral venous thrombosis encountered over a period of two years are described here. The age at presentation ranged from nine to forty-eight years (mean 21.4 years). Sex ratio (M: F) was 1:1.04. The commonest symptoms were headache (100%), vomiting (61.2%) and convulsions (34.7%). the duration of symptoms varied from three to fifteen days in 59.2% of patients. Headache was diffuse in 51%, occipital in 18.4% and bifrontal in 14.3%. Fourteen (82.4%) out of the 17 patients with seizures had generalized seizures. The commonest focal deficit was hemiparesis. Seven patients had history of oral contraceptive intake. CT scan was normal in 12 patients (24.5%). Infarcts were noted in 24.5% of patients. MRI was done in all patients with normal CT (12 patients) and in some with abnormal CT (17 patients). MRI was also normal in three patients, where the diagnosis was by MR venogram. The superior sagittal sinus was the most commonly involved sinus. Non-gestational CVT needs a high index of clinical suspicion for diagnosis. It can present with protean clinical manifestations. As CT scan can be normal in upto 25% of patients, the investigation of choice is MRI, with MR venography for analyzing the extent of the disease.

Familial Autoimmune myasthenia gravis is rare, occurring in only about 1.3% cases of myasthenia gravis (MG). Here in we report a family with three family members affected by MG. Proband presented with generalised myasthenia where as the other two affected family members had only ocular myasthenia. Anti-acetylcholinereceptor antibody was strongly positive in the proband and he responded to steroids. His brother in addition had vitiligo over his face substantiating the autoimmune nature of myasthenia gravis. Familial cases of myasthenia gravis should be investigated with acetyl choline receptor antibody estimation and an attempt should be made to search for other autoimmune diseases in the patient and relatives.

A random population of 618 people with epilepsy hailing from different parts of Kashmir valley was screened for photosensitivity both clinically and on a standard protocol of intermittent photic stimulation (IPS) provoked EEG recordings. Six (0.9%) patients with a mean age of 15+6.57 years were found to be photosensitive; five had generalized and one had absence seizures. The baseline EEG in all patients showed generalized epileptiform discharges. On IPS, similar EEG findings were obtained with a narrow range of stimulus frequency i.e. 7-12 cycles/sec. There appears to be a low prevalence of photo-sensitivity in our epileptic population, possibly related to genetic factors.

Cortical deafness occurs following lesions of the Heshcl's gyri or the subcortical auditory pathways. Stroke is the commonest etiology. The clinical, audiological, electrophysiological and radiological observations of a patient with cortical deafness secondary to ischemic stroke involving bilateral Heschl's gyri, with long term follow up is being reported. He had profound degree of hearing loss, poor auditory verbal comprehension, poor auditory repetition, inability to take dictation and poor response to other non-linguistic sounds despite having adequate hearing assessed by objective audiological tests. He was advised to adopt speech reading techniques and resort to gestural and written modalities to augment his communication skills. He has shown only a marginal improvement over the last six years.

Non epileptic seizures were diagnosed in 20 (F:15, M:5) school children and adolescents by a positive provocative test consisting of induction and termination of the attack with suggestions and saline injection and normal ictal EEG. Patients were followed up for a period of two years. The major provocating factors were (a) family problems, mainly conflict between the parents in 25%, (b) problems in schooling in 20%, (c) combination of both in 30%, (d) sexual and physical abuse in 10% and (e) undetectable in 15%. The frequency of the attacks were > 1/day in 55%, 1 - 6 / week in 25%, 1 - 3 / month in 15% and occasional in 5%. During follow up, 55% were free from attacks, 10% had recurrence occasionally for one year and free from it during the second year, 10% continued to get attacks and 25% were lost to follow up. In those free from attacks, multiple somatic complaints were reported by 30% of patients.