Clinical Neurology

Source of support: Nil Conflict of interest: None declared. How to cite this article: E.A. Ashok Kumar, M. Ravi Teja Raidu. A rare case of invasive pituitary macroadenoma with hemorrhage in MEN 1 syndrome-A case report. IAIM, 2021; 8(4): 106-117. Abstract Multiple Endocrine Neoplasia (MEN) disorders are very rare. These are hereditary diseases which develop into a number of endocrine glands and result in tumor formation. The MENs are run in families because they are the exact consequence of genetic mutations and their symptoms are completely dissimilar dependent on the involving glands. Multiple endocrine neoplasia (MEN) is characterized by the occurrence of tumors involving two or more endocrine glands in a single patient. Four major forms of MEN, which are autosomal dominant disorders, are recognized and referred to as: MEN type 1 (MEN1), due to menin mutations; MEN2 (previously MEN2A) due to mutations of a tyrosine kinase receptor encoded by the rearranged during transfection (RET) protoncogene; MEN3 (previously MEN2B) due to RET mutations; and MEN4 due to cyclin-dependent kinase inhibitor (CDNK1B) mutations. Each MEN type is associated with the occurrence of specific tumors. MEN1 is characterized by the occurrence of parathyroid, pancreatic islet and anterior pituitary tumors. In this case report we present a patient who developed an Invasive Pituitary Macroadenoma with Hemorrhage in MEN 1 Syndrome.

The femoral neuralgia is a rather frequent and invalidating clinical disorder. It takes on many clinical forms because of the anatomical variations of the cutaneous branches of saphenous and femoral nerves. The neuroplasticity of the somato-sensory system has now been determined which allows for a better understanding of the techniques of somatosensory rehabilitation. The authors precisely explain the various stages necessary in the care of patients suffering from femoral neuralgia. The various strategies of somatosensory rehabilitation are mentioned. The authors also present a brief review of the pharmacological treatments of peripheral neuropathic pain. Lastly, the result of the somatosensory rehabilitation of femoral neuralgia (NNT = 1.8) is documented on the basis of a prospective study done on 59 patients.

Damage to the dorsomedial thalamus usually leads to impaired episodic memory, attention, and executive function, but the role of the dorsomedial thalamus in memory processing is still not fully understood. Clinical evidence is inconclusive about whether dorsomedial thalamic damage impairs recall or whether it impairs recognition. I report a unique patient who suffered a cardioembolic stroke in the paramedian artery territory, caused by a patent foramen ovale. He was left with a chronic ischemic lesion centered in the parvocellular and, to a lesser extent, the magnocellular portions of the left dorsomedial thalamic nucleus, and marginally involving the midline and intralaminar nuclei. A year after the stroke, the patient's neuropsychological assessment showed a selective verbal memory deficit with greater loss of recall than recognition. His memory was normal when he was given semantically encoded material. His test results showed that damage to the left dorsomedial thalamic nucl...