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Artery of Percheron is a rare anatomical variant of thalamic vascular supply. Stroke involving this vasculature is an uncommon event. Occlusion of this vessel produces a peculiar pattern in the form of bilateral thalamic infarcts with or without midbrain infarction. This results in variable clinical features ranging from somnolence or altered sensorium to coma in affected individuals, accompanied by characteristic neurological manifestations. Diagnosis of artery of Percheron infarction at the initial presentation may be difficult as it is infrequent and early neuroimaging studies may be negative. Here we report a patient, a case of AOP infarct whose MRI brain and clinical picture demonstrated the characteristic features.

Though the report of late onset myasthenia gravis is seen frequently in literature, isolated bulbar myasthenia in elderly age group is rarely found. Moreover, dysphonia as an initial manifestation of bulbar myasthenia has not been emphasized in late-onset MG. Here we report an elderly man who presented with bulbar symptoms in whom diagnosis was made with clinical clues as well as serological test like anti acetylcholine receptor (AChR) antibody. A high index of suspicion is required to exclude other common causes of acute bulbar weakness like stroke, demyelinating neurological diseases, toxicity, infection and other causes. This case illustrates one of the uncommon presentations of late-onset MG.

Elephantiasis neuromatosa (EN) is a rare and unique complication of plexiform neurofibroma, a type of neurofibromatosis type 1, and manifests as hypertrophy of an extremity (either lower limb or upper limb). EN can be seen in individuals of any age group including children and young adults where males and females are affected equally. Diagnosis is done primarily by magnetic resonance imaging of the affected region along with a history and clinical examination. EN may lead to severe functional impairment of the involved limb with cosmetic disfigurement. Treatment is mainly surgical with less satisfactory results. Here, we present a 6-year-old child with EN.

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