Cryptococcal-postinfectious inflammatory response syndrome (c-PIIRS) in an immunocompetent host is a rare entity. Unlike cryptococcal-immune reconstitution inflammatory syndrome, in c-PIIRS, macrophage clearance defect can be persistent, and the patient requires prolonged immunosuppressants to control inflammation. Early identification and treatment can reduce the mortality and morbidity in cryptococcal meningitis (CM). Here, we describe c-PIIRS in an apparently healthy individual who developed CM and treated with effective antifungal regimen. After initial improvement, the patient showed clinical and radiological worsening, which could be likely due to PIIRS. The patient was responded to prolonged steroids.

Hereditary neuropathy with liability to pressure palsy is an autosomal dominant demyelinating disorder. In individuals with numerous compressive neuropathies, hereditary neuropathy with liability to pressure palsies (HNPP) should be taken into consideration.Here We present a case of 49-year-old man who exhibited right upper and lower extremity weakness with tingling and numbness of right upper limb and lower limb. Electrophysiological studies showed widespread, multifocal, motor > sensory, chronic peripheral neuropathy affecting the upper and lower limbs.Type: demyelinating >> axonal.Genetic studies showed Heterozygous deletion of PMP22 gene (upstream, exons 1-5) along with anking regions encompassing TEKT3 and COX10 genes were detected.Treatment for this usually self-limiting illness is debatable, in this instance, patient was managed conservatively following which there is an improvement in patient condition

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Neuromyelitis Optica spectrum disorder or Devic's disease is an autoimmune disease characterized by by acute inammation of the optic nerve and spinal cord. A relapsing disease course is common, especially in untreated patients. In more than 80% cases it is caused by immunoglobulin G autoantibodies to aquaporin 4 the most abundant water channel protein in the central nervous system. Episodes of optic neuritis and myelitis can be simultaneous or successive.

Scorpion envenomation is a life-threatening emergency. It is prevalent in certain tropical and subtropical regions of the world, such as Africa, India, and Latin America. There are several species of scorpions, some with potentially lethal venom to humans. This case presented here is one among the rarest in this tertiary care hospital where scorpion sting presented as PRES. A 25 year old male was brought to the Emergency Depar Case History: tment with alleged history of scorpion sting on the left foot followed by sweating, drooling of saliva and agitation. He presented to ER with altered sensorium and had an episode of generalized tonic clonic seizures that lasted for 2 minutes, associated with up rolling of eyeballs and frothing from mouth. CT brain plain after 24 hrs was suggestive of right frontal lobe hypo density likely infarct or focal encephalitis. MRI Brain contrast with angio showed multifocal areas of sub cortical and deep white matter T2 FLAIR hyper intensities in bilateral parietal, frontal and occipital lobes. Differential diagnosis of encephalitis, PRES and ADEM was made. Patient was given 3 vials of anti-scorpion venom and showed signicant clinical improvement over a period of 2-3 days. He was discharged after 7 days of hospital stay. Although scorpion venom is able to cause neuromuscular ac Conclusion: tivation syndromes and stroke, the neurological complications induced by scorpion envenomation are uncommon. Antiscorpion venom is very effective for treatment of the neurological complications.