Neurology
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To describe the clinical phenotype of paroxysmal extreme pain disorder (previously called familial rectal pain syndrome), an autosomal dominant condition recently shown to be a sodium channelopathy involving SCN9A. ⋯ Paroxysmal extreme pain disorder is a highly distinctive sodium channelopathy with incompletely carbamazepine-sensitive bouts of pain and sympathetic nervous system dysfunction. It is most likely to be misdiagnosed as epilepsy and, particularly in infancy, as hyperekplexia and reflex anoxic seizures.
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Infratentorial empyema is an uncommon complication of bacterial meningitis. Very little is known about its recognition and appropriate management. ⋯ Infratentorial empyema is a life-threatening rare complication of bacterial meningitis. MRI, including diffusion-weighted imaging, is the preferred imaging technique in patients with suspected or proven bacterial meningitis and associated ear-nose-throat infection with deterioration in consciousness and neurologic signs that suggest a posterior fossa lesion. Neurosurgery should be regarded as first choice therapy.