Indian Journal of Emergency Medicine

Multiple sclerosis is a chronic autoimmune inflammatory disease characterized by axonal degeneration and  demyelination of the central nervous system Isolated facial nerve palsy is commonly seen with Bell's palsy. However, it can be associated with a central lesion  at the level of the ipsilateral facial nucleus or the facial nerve at the pons. Isolated cranial neuropathies are rarely  seen with multiple sclerosis. Isolated facial nerve palsy due to multiple sclerosis is a rare scenario and can often get  misdiagnosed and treated as Bell's palsy. The patient being reported is a 30-year-old female who developed isolated facial nerve palsy, which was initially  treated as Bell's palsy. However, she was found to be knowncase of multiple sclerosis.

Heatstroke is a medical emergency warranting critical, time sensitive interventions. Due to its infrequent  occurrence inside medical facilities, and symptoms overlapping with other commonly seen conditions in an  emergency setting, the recognition of heatstroke is often undermined. With the ongoing SARS CoV-2 pandemic, Several makeshift field hospitals have been set up in Mumbai, India.  Heatstroke is not a common occurrence in patients infected by the SARS CoV-2 virus. More so, it is almost never  anticipated in hospitalized individuals.  Our case report aims to highlight the unusual presentation of a heat illness occurring inside a field hospital  dedicated to managing Coronavirus disease (COVID-19). We hope to sensitize the clinician to this rare event, and  subsequently aim towards preparedness and mitigation for the future strategizing of such field hospitals.

Hypokalemic (Induced) Periodic Paralysis is a rare group of disorders that can cause sudden onset of flaccid  paralysis. Here we present a case of 41 year old female who presented to the ED complaining of severe flaccid  paralysis in both lower & upper limbs since morning. Initially, she was treated as a stroke alert patient and had head  scans which showed no acute pathologic changes. Laboratory evaluation revealed a markedly low potassium level.  The patient's paralysis resolved after potassium correction and she was discharged with no neurologic deficits.  Although rare, Periodic Paralysis must be differentiated from other causes of weakness and paralysis so that the  proper treatment can be initiated quickly.