Have you heard of PALATAL MYOCLONUS (tremor), a very rare condition affecting muscles of the soft palate. It presents with a persistent CLICKING NOISE. Where is the lesion? #neuroscience #neurotwitter #Medical
Precise #localization: It occurs due to infarction, bleed or tumor within the Guillain-Mollaret Triangle in the brainstem. The triangle includes the midbrain red nucleus, medulla inferior olivary nucleus, and contralateral cerebellum dentate nucleus.
Often patients report tinnitus and merely asking patients to open their mouth demonstrates the characteristic clicking noise. The patients sense the sound in their ears.

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More from @OGdukeneurosurg

Sep 26
50 yo female with progressive eye redness and loss of visual acuity. She has a h/o hypertension. Thoughts? #MedEd
#MedTwitter #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #neuroscience #neurotwitter
#sciencetwitter #brain #medstudenttwitter #medical Image
Neuro intact other than vision.
What is reason for redness, specifically?
Read 4 tweets
Sep 24
What in the world is going on here on this awake #patient ?
Hint: it is not a c1-2 puncture, which is used when lumbar puncture is not an option. Image
Occipital puncture into 4th ventricle in awake patient. Image
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Sep 24
This… is why I became a #neurosurgeon and what rehabilitative specialties love to do.
Source: ESPN. The key of spine surgery and rehabilitative efforts is collaborating with our patients to achieve functional independence in the presence and in the absence of any neurological recovery.
I look forward to further advances and applications of brain computer interface, spinal cord stimulation, neural prosthesis, exoskeletons, nerve transfers, and things we don’t know of yet… for assisting patients with spinal cord injuries.
Read 4 tweets
Sep 19
Intentionally causing ASYSTOLE with ADENOSINE to assist with Clipping of Cerebral Aneurysms
Source: AA Abla. Adenosine is useful in intraop ruptures as well.
Other Measures to soften cerebral aneurysms include rapid ventricular pacing and deep hypothermic arrest with bypass. Image
Read 4 tweets
Sep 18
48 y.o. underwent an urgent abdominal surgery. Postop, his family said he did not have a red left side face before surgery, what'd you to him? Work Up? Etiologies? Treatment?
It’s not harlequin, but good idea.
DM Me on any / all cases and I’ll give you answers and the treatment on your timeline.
Read 5 tweets

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