A 9-year-old girl with akinetic-rigid parkinsonism with tremor is described. She was hospitalized with neuroleptic malignant syndrome that started 3 days after anticonvulsant drug treatment owing to epileptic seizures. Cranial magnetic resonance imaging (MRI) was normal, and during the follow-up, magnetic resonance spectroscopy revealed a decrement on N-acetylaspartate in the basal ganglia, suggesting neuronal dysfunction. The basal ganglia and dopamine are involved in the pathophysiology of parkinsonism and neuroleptic malignant syndrome and have been recognized in seizure propagation and seizure threshold. Parkinsonism in children is considered an acquired, secondary, and reversible disorder with a dramatic improvement to treatment. However, our patient still has parkinsonism 2 years after diagnosis. This case represents the unusual presentation of epilepsy, parkinsonism, and neuroleptic malignant syndrome, which might have a common pathophysiologic pathway (dopaminergic dysfunction) involving the basal ganglia and the hypothalamus.

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We describe a case report of ovarian torsion in a Korean-speaking woman with a 24-week twin pregnancy who attended a Spanish- and English-speaking institution. Ovarian torsion represents a diagnostic challenge for clinicians and radiologists because of its lack of pathognomonic symptoms and imaging findings. Ultrasonography may show unilateral ovarian enlargement without color Doppler flow and free fluid; however, clinical data should be mandatory for management decisions.

Evaluación del cartílago articular de la rodilla utilizando la secuencia de mapeo en T2 por resonancia magnética Evaluation of articular cartilage of the knee using T2 mapping sequence in magnetic resonance

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