Cranial Myokymia Paroxysmal episodes of left facial (Orbicularis oculi) and left abducens spasms after remote radiation to a brainstem medulloblastoma - Remote radiation induced cranial myokymia? Dr. Boby Varkey Maramattom @bobvarkey #Cranial #Myokymia #clinical #video #neurology #physicalexam #CNVI #CN6 #Abducens

One & a half syndrome with upbeat nystagmus due to a left pontine + bimedullary infarction Dr. Boby Varkey Maramattom @bobvarkey #OneAndAHalf #One #Half #Syndrome #PhysicalExam #clinical #video #ophthalmology #neurology

The Bing Sign on Neurological Examination Pricking the dorsum of the great toe with a pin in a casted patient and eliciting an extensor plantar. It’s the equivalent of a Babinski response. Dr. Boby Varkey Maramattom @bobvarkey #Bings #Reflex #Sign #PhysicalExam #clinical #neurology #Pyramidal #video

Tandem Gait Ataxia in Atypical Parkinsonism Tandem ataxia is more common in atypical Parkinsonism than PD and maybe an early discriminator. This lady has PSP. Dr. Boby Varkey Maramattom @bobvarkey #Tandem #Gait #Ataxia #Atypical #Parkinsonism #clinical #video #physicalexam #neurology #PSP

Catalepsy on Neurological Examination Catalepsy (patient adopts positions that they are put in by the examiner): Waxy flexibility (light resistance to repositioning) Mutism. In this patient, seen with Organic catatonia Dr. Boby Varkey Maramattom @bobvarkey #Catalepsy #Catatonia #clinical #video #physicalexam #neurology #psychiatry

Propofol Frenzy on Neurological Examination Propofol frenzy; Presented with a cluster of seizures, now on Propofol, being treated as ongoing status epilepticus, but cEEG is normal (shows only myogenic artefacts). Diagnosed as Propofol Frenzy & advised to stop Propofol [idiosyncratic SE due to NMDA receptor activation] Dr. Boby Varkey Maramattom @bobvarkey #Propofol #Frenzy #clinical #video #neurology #physicalexam

Ocular Flutter on Examination Encephalitis and Ocular Flutter Due to an Undifferentiated Connective Tissue Disorder Dr. Boby Varkey Maramattom @bobvarkey #Ocular #Flutter #clinical #video #physicalexam #neurology #ophthalmology

Locked-in Syndrome (LiS) in ALS What happens when ALS patients opt for mechanical ventilation? They can become hypothermic and locked in at the final stages. Dr. Boby Varkey Maramattom @bobvarkey #LockedIin #Syndrome #LiS #ALS #clinical #video #physicalexam #ocular #neurology

Miller Fisher Syndrome (MFS) on Neurological Examination Miller Fisher Syndrome (MFS)- a variant of Guillain Barre syndrome is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia. Our patient had partial external ophthalmoplegia, ataxia and areflexia. Was treated with IVIG with improvement. Dr. Boby Varkey Maramattom @bobvarkey #MFS #Miller #Fisher #Syndrome #clinical #video #physicalexam #neurology

Portosystemic collaterals in Cirrhosis Milking abdominal veins demonstrates centrifugal blood flow in caput medusae. Dr. Boby Varkey Maramattom @bobvarkey #collaterals #Milking #abdominal #veins #caput #medusae #clinical #video #physicalexam #cirrhosis #hepatology