Neurological manifestations are rare in dengue fever. Two cases with encephalopathy and systemic features of dengue fever with abnormal CSF and MR imaging are reported. Striking MRI finding was bilateral symmetrical thalamic lesions similar to those reported in Japanese encephalitis. This report highlights that MRI findings can be similar in dengue and Japanese encephalitis.

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Material and Method: Study was conducted in 132 cases of JME. They were selected after screening 1210 patients presenting with syndrome of generalized seizures in age group 10-36 years. Diagnosis was established clinically by standard criterias and confirmed by EEG. Duration of study was 9 years. Results : We observed JME is under diagnosed since majority (27%) were referred as uncontrolled seizures. Other patients were referred as Lenox Gestaut syndrome (19%), progressive myoclonic epilepsy (7.5%) or subacute sclerosing pan-encephalitis (3.7%). There were 25 (15.5%) fresh cases of JME who reported directly. We observed few atypical features in our study. They were in the form of (a) wide range in age of onset (b) gross delay in diagnosis (90%)-lack of clinical suspicion and non-use of activation procedures in EEG appear to be important reasons for this delay (c) negative family history (90%) (d) mild cognitive impairment (14%) and (e) good clinical response to other drugs viz; clobazam, phenytoin (PHT) and carbamazepine (CBZ) besides sodium valproate (VPA) or clonazepam (CLO). However phenobarbitone (PB) was ineffective. Sequential EEG became normal in 63% patients controlled on VPA while it was persistently abnormal in all patients who were well controlled on other drugs. Conclusion : Clinical spectrum of JME appears to be different in India. We suggest that it should be strongly suspected in juvenile patients of generalized epilepsy not responding to treatment.

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Somnambulism (sleep walking) is a disorder of arousal that falls under the parasomnia group. It is more common in children than in adults. (1). The onset of sleep walking in adult life is most unusual and suggests the presence of secondary causes rather than a primary sleep disorder (1). We report a 30-year-old male who presented with repeated episodes of sleep waling possibly due to nocturnal temporal lobe epilepsy.

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Chronic Daily Headache (CDH) generally refers to frequent headache occuring more than 15 days/month for over three months. Such headaches may be primary or secondary - the latter referring to headaches related to identifiable intra and extracranial vascular or other pathologies or systemic illnesses. The primary type may be subclassified as short and long lasting ones, depending upon whether the headache spells are more or less than four hours in duration. The present review would deal with the four major types of long lasting primary CDH which include Chronic migraine (CM), Chronic tension type headache (CTTH), New daily persistent headache (NDPH) and Hemicrania continua (HC). The first part of the article would focus on the clinical pattern recognising features of these types. The relationship of medication overuse to CM would be critically evaluated. In the second part, the status of CDH in the recently proposed classification of headache disorders by the International Headache Society would be briefly evaluated. In the next section the clinical Profile or CDH in Indian patients would be highlighted based on available published data. Lastly, the pathophysiology of this vexing condition would be discussed specially in relation to CM and postulating on how it may evolve from episodic migraine.

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Full text not available  [PDF]

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Full text not available  [PDF]