Guillain-Barre syndrome (GBS) rarely complicates pregnancy, but can be associated with high maternal and perinatal morbidity if not properly identified and treated. A high index of suspicion, supportive measures, access to intensive care unit and intravenous immunoglobulin (IVIG) therapy are cornerstones of management in GBS complicating pregnancy. Neurologists and Obstetricians should be aware of the risks of relapsing GBS in the immediate postpartum period. Surgery and anesthesia may be triggers for relapse in association with an overall increase in pro-inflammatory cytokines in the postpartum period. We report a unique case of GBS complicating pregnancy in the third trimester followed by a relapse in the postpartum period. She made a good recovery with supportive measures and a repeat course of IVIG during the relapse.

A 14‐year‐old boy presented with a prodromal respiratory infection followed by super refractory status epilepticus. A diagnosis of Febrile Infection‐Related Epilepsy Syndrome (FIRES) was made. Initial MRI study and CSF analysis were normal. He required multiple anticonvulsants owing to the refractory nature of the seizures. The course of the illness was rather stormy, laced with various medical problems viz. hepatic dysfunction, sepsis, hemodynamic, and hematological abnormalities which posed several challenges in the management. Hemophagocytic lymphocytic histiocytosis (HLH) was identified as the etiology of the illness and was treated but without success. The case report highlights the several immunomodulatory strategies that were employed to treat the disease, despite which the outcome was unfavorable.

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A 55‐year‐old diabetic woman presenting with right sixth nerve palsy was diagnosed initially as having diabetic cranial neuropathy. Worsening headache and reported blurring of the right optic disc margin warranted further evaluation. CT scan of the brain was normal and a diagnosis of idiopathic intracranial hypertension was made. Her headache worsened and a partial pupil involving third nerve palsy evolved, at which point she was referred to our institution. Cranial MRI revealed features suggestive of Tolosa‐Hunt syndrome and she responded dramatically to steroid therapy. While third nerve palsy is the most common cranial neuropathy in diabetic patients, sixth nerve palsy merits a wide array of differential diagnoses. A gadolinium‐enhanced MRI of the brain is the preferred imaging modality for evaluating such patients, before branding them as having diabetic cranial neuropathy. Copyright © 2013 John Wiley & Sons.