Indian Journal of Emergency Medicine

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.

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.

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.