Vernet

Marcus Gunn jaw winking phenomenon has been thought to result from a congenitally abnormal innervation of the levator palpaebrae muscle by a branch of the trigeminal nerve. A 22-year old man presented with bilateral eyelid elevation on the chewing or eating since infancy. Neurological examination showed bilateral Marcus Gunn Jaw wingking phenomenon in this patient. We referred this patient to the department of ophthalmology and plastic surgery for levator resection or orbicularis oculi muscle flap. We report bilateral Marcus Gunn jaw winking phenomenon, although unilateral disorder is the most common form of trigemino-oculomotor synkinesis. Neurologists should be aware of this phenomenon for decision of proper management and take detailed neurologic examination for elucidating the association of other cranial nerves.

It has been reported that antisynthetase syndrome belongs to the idiopathic myositis group which includes pulmonary interstitial disease, arthritis, Raynaud

We report a case of chiasmal optic neuritis in a patient who had been diagnosed as multiple sclerosis, and was presented with bitemporal hemianopsia. The brain MRI revealed a high signal lesion with focal enhancement in optic chiasm, and the visual evoked potential functionally supported it. This is the first case of chiasmal optic neuritis in multiple sclerosis with temporally and spatially disseminated lesions.

Background
It has been proposed that proprioceptive input can modulate neural excitability in both primary motor cortices (M1) simultaneously, although direct evidence for this is still lacking. Previous studies showed that proprioceptive accuracy of one hand is reduced after the application of one-Hz repetitive transcranial magnetic stimulation (rTMS) for 15 minutes over the contralateral somatosensory cortex. The aim of this study was to investigate the effect of rTMSinduced central proprioceptive deafferentation to excitability of both M1 as reflected in ipsilateral and contralateral motor evoked potentials (MEP).
Methods: MEPs of both abductor pollicis bravis (APB) muscles were recorded using single-pulse TMS over right M1 in seven healthy subjects. Immediately after one-Hz rTMS was applied for 15 minutes over the right somatosensory cortex, the MEP measurement was repeated. The proprioceptive function of the left thumb was assessed, before and after rTMS, using a position-matching task.
Results: There was an increase in ipsilateral MEP after the rTMS: whereas no MEPs were recorded on the ipsilateral hand before the rTMS, MEPs were recorded in both ipsilateral and contralateral hand in three of seven subjects. At the same time, the mean log amplitude was reduced and the mean latency was prolonged in the contralateral MEP.
Conclusions: rTMS-induced central proprioceptive deafferentation reduces the MEP generation in the contralateral hand, and fascilitates that in the ipsilateral hand. A further study with a larger sample seems warranted to confirm this finding and to elucidate the neurophysiology underlying it.

We present a case with stepwise weakness and sensory involvement of both hands for more than 2 months. His nerve conduction study findings revealed prolonged terminal latencies, decreased motor and sensory conduction velocities and conduction blocks of both ulnar nerves, more severely on left side. And there were other abnormalities manifested with mononeuropathy multiplex. Increased cerebrospinal fluid protein was found. We diagnosed him as Lewis-Sumner syndrome and tried high dose oral steroid therapy for 2 months. He showed improvement of motor functioning with persistent conduction block.

Neuroleptic malignant syndrome is a serious complication of levodopa withdrawal in patients with Parkinson

Patients of chronic alcoholism may show many kinds of complications such as myopathy, nutritional problems,peripheral neuropathy, withdrawal seizure and encephalopathies. We report an unusual case of alcoholic myopathy diagnosed with typical laboratory and pathological findings initially manifested as acute reversible encephalopathy showing transient abnormalities on brain MRI.

Myoclonus may originate from the cerebral cortex, subcortical structures, brainstem, spinal cord or peripheral nerve.But unilateral upper limb myoclonus related to cortical infarct is an unusual clinical picture. We report a 67-year-oldman presented with myoclonus, associated with primary motor cortex infarction.

The Guillain-Barre syndrome (GBS) is an acute polyradiculoneuropathy marked by flaccid areflexic paralysis.Although the pathogenesis of GBS remains incompletely defined, considered as an autoimmune disease most frequentlytriggered by an previous infection. Antecedent infections with Campylobacter jejuni, cytomegalovirus, Ebstein-Barrvirus, Mycoplasma pneumoniae, Haemophilus influenzae, human immunodeficiency virus, enterovirus, rotavirus arecommon. But, it is rare that GBS following typhoid fever. We present a case of typical GBS after antecedentSalmonella typhi infection.