International Journal of Neurology and Neurosurgery

Giant interhemispheric arachnoid cysts are rare lesions. These are generally associated with midline neurodevelopmental anomalies as seen in aforementioned case (2, 3). Treatment of these lesions is controversial. None of the surgical techniques described has proven superiority over others. Conservative management can be considered irrespective of the size in cysts with no change in size or raised ICP. We are reporting a case of giant intracranial interhemispheric arachnoid cyst in a 2year old male child.

Key words: Giant interhemispheric; Arachnoid cysts; Neurodevelopmental anomalies. 

Eagle’s syndrome or stylalgia is a disorder related to the abnormally elongated styloid process (>30 mm). Itis characterized by pharyngeal pain localized in the tonsillar fossa, radiating to the oesophagus,  to the hyoid bone, painful head rotation and lingual movements. The pain is exacerbated by swallowing and chewing. Other symptoms include foreign body sensation (globus hystericus) and voice change lasting for only a few minutes. A variety of additional symptoms have been reported such as clicking jaw, unilateral pain, pain radiating to the neck, to the tongue, chest or temporo-mandibular joint (TMJ) and facial paraesthesia, hypersalivation, sometimes visual problems, dysphagia and pharyngeal spasm. However no psychiatric co-morbidity has been reported till date. We hereby discuss a case of a middle aged male presenting to psychiatry OPD with symptoms suggestive of Eagle’s Syndrome and unspecified anxiety disorder.  

Keywords: Eagle’s syndrome; Anxiety disorder. 

peripheral diabeticneuropathy (pdn) is one of the major complications arising in patients with diabetes. pain relief is a major clinical burden in patients with pdpn due to its associated psychosocial issues like depression, anxiety and suicidal tendencies which arise due to reduced sleep, very severe intensity and its chronic disabling nature. acupuncture had been shown to be an effective therapeutic adjunct to relieve pain in patients with other etiologies of pain. thus there is a dearth need to evaluate the current evidence on effectiveness of acupuncture in diabetic peripheral neuropathy (dpn). the objective of this review is to provide and evidence-informed update on the effects, efficacy and effectiveness of acupuncture treatments in patients with painful diabetic peripheral neuropathy (pdpn). medline was searched for articles and five studies were obtained and a descriptive review found that acupuncture provided short-term symptom relief. there is insufficient evidence to provide any recommendations for acupuncture to be a viable and affordable treatment option for patients with pdpn.  

Keywords: Diabetic peripheral neuropathy; Complementary and alternative medicine; Acupuncture. 

various techniques of drain fixation have been described in the past, but we have encountered technical difficulties like slipping of drain which has defeated its purpose. We present a simple method of fixing the suction drain which ensures safe and secure way of fixation until the drain is removed at a desired time. this is easy to learn, secure and remove.  

keywords: Suction drain; Fixation; Rubber tubing; Plastic guard; Hematoma; Seroma. 

Nose is a central projection in the face with fragile skeleton. A trivial trauma can result in a significant deformity. Although majority suffer a bony injury, overlying swelling masks the deformity. If such deformity is not identified and intervened, it can lead to soft tissue changes as well as bony deformity, which may require septoplasty or rhinoplasty later. Hence in nasal bone fracture intervention in the timely manner is a must to reduce the long term morbidity and the cost of treatment.  

Keywords: Nasal bone fracture; Nasal bone: Trauma; Timely intervention. 

Musculoskeletal pain (MSKP) was proposed to arise from various mechanisms out of which nociceptive mechanism was common. Role of Sympathetic nervous system (SNS) in MSKP was not recognized until stress was found to have effect on MSKP. Thus this review focuses on the role of SNS in MSKP and itsevaluation and treatment.Recent studies have suggested that SNS contributes to chronic pain. It forms the secondary component of pain dysfunction. This type of pain was termed as ‘Sympathetically Maintained Pain’ (SMP). It can occur due to a pathophysiological or pathomechanical cause. Various mechanisms have been proposed for SMP based on animal and human studies. It has been proposed that sympathetic- sensory coupling is responsible for SMP. Sympathetic- sensory coupling can occur directly in dorsal root ganglia, chemical coupling in the skin, or development of alpha adrenoceptor mediated supersensitivity. The mediator for the coupling is nor-adrenalin and the adrenergic receptors involved are the alpha 2 adrenoceptors.Diagnosis of SMP is based on signs and symptoms, routine physical examination, specific neurodynamic tests like Sympathetic Slump test, and sympathetic blockade. SMP is managed using pharmalogical treatment and physical therapy. Thus, SMP presents as a true clinical challenge and key to successful management is early diagnosis and treatment.

Keywords: Sympathetically maintained pain; Chronic pain; Sympathetic nervous system; Musculoskeletal pain; Sympathetic slump.