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Homocystinuria follows an autosomal recessive pattern and transpires due to Cystathionine beta-synthase enzyme deficiency. This condition is associated with thrombotic and thromboembolic complications due to an increase in homocysteine and methionine levels in the plasma and urine. We present a case of an Indian adolescent boy who presented to us with generalized tonic clinic seizure and Broca's aphasia he was diagnosed as having homocystinuria type 1, and he responded well to treatment.Background: Stroke and seizure disorders in young adults have increased substantially and are a relatively common disorder that presents in the emergency department in all age groups. Secondary seizures are more common and manifest as a result of another underlying pathology. This case demonstrates the importance of considering rarer causes of thrombosis such as arterial thrombosis, even in younger patients, with no obvious risk factors or comorbidities. A detailed medical history and thorough investigations need to be taken to identify a potentially treatable underlying cause.Objective: To increase awareness about this rare etiology and help clinicians to have a higher level of suspicion to diagnose this condition and prevent future life-threatening complications in younger patients with thrombotic and thromboembolic events.  Â

Thyrotoxic periodic paralysis is a unique disorder that causes episodic proximal lower extremity muscle weakness in a patient who already has a hyperthyroid state and is not treated for the underlying disease state. The affected population mostly includes Asian in origin specifically the male gender (vs most thyroid disorder affects the women gender). Precipitating factors include in addition to a hyperthyroid state are strenuous exertion, a high-carbohydrate meal, and drugs like diuretics, insulin, high dose of steroids, antiretrovirals, and interferon therapy. Other genetic causes include the decreased activity of Kir2.6 mutation increased activity of Na+/K+ ATPase causing an intracellular shift of potassium that leads to hypokalaemia. The other challenging part for the physician is to differentiate it from Familial periodic paralysis an autosomal disorder seen in Caucasians and Western countries because both the disorders present similarly and differentiate between them by the presence of hyperthyroid state with hypokalaemia in Thyrotoxic periodic paralysis. The mortality is associated with respiratory paralysis hence the acute intervention includes giving nonselective beta-blockers followed by anti-thyroid medications. We present a case of an Indian adolescent who presented to us with lower muscle weakness with an underlying thyrotoxicosis state. This help physician with early diagnosis and appropriate treatment.  Â