Adult-onset progressive spastic paraparesis occurs commonly due to spinal cord pathology. Here, we report a middle-aged man who presented with adult-onset progressive spastic paraparesis of 10 year duration and MRI showed ‘snake-eye’ appearance in cervical cord posterior horn region. The probable cause for spastic paraparesis was sporadic Hereditary Spastic Paraparesis (HSP)

Acute Disseminated Encephalomyelitis (ADEM) is an acute widespread autoimmune demyelinating disease affecting central nervous system. It is characterized by multifocal white matter lesions on neuroimaging. Grey matter can also be affected, particularly basal ganglia, thalami, and brainstem. Variant Creutzfeldt - Jakob disease (vCJD) is a rare and fatal human neurodegenerative condition affecting younger patients. Pulvinar sign on Magnetic Resonance Imaging (MRI) is considered to be a strong indicator of variant CJD. We report a young patient who presented with febrile illness and altered mental state. Brain imaging revealed hyperintensity in bilateral medial and posterior thalamus. These imaging abnormalities are similar to those seen in variant CJD.

Herpes Zoster Ophthalmicus (HZO) is associated with variety of ocular manifestations like episcleritis, keratitis, glaucoma, and cataracts. Extraocular muscle palsies are rare complications occurring in 7-31% of HZO. Complete unilateral ophthalmoplegia in HZO is rare. We report an elderly patient with left HZO who developed progressive left complete ophthalmoplegia with complete ptosis within 10 days of onset of a zosteriform rash. Magnetic resonance imaging brain showed contrast enhancement in cavernous sinus which has not been reported so far

Acute alcohol withdrawal syndrome leads to fluctuating changes in mental status. It also may cause cardiovascular collapse and death occasionally. We report a patient who dies due to cardiovascular complications of delirium tremens. Early clinical interventions such as hydration, sedation, preventing seizures by using benzodiazepines [1], infusion of dextrose and thiamine can be lifesaver. Hospitalization to Intensive Care Unit (ICU) must be provided immediately. Death is sometimes inevitable even if physicians perform an entire multidisciplinary clinical intervention. In this case, the situation of the patient, who suffers from alcohol withdrawal, worsens rapidly and he dies in two days during the follow-up in ICU.