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Low back pain accounts for a large amount of loss of productivity in the workforce. When the low back pain extends into the lower limb along the distribution of a dermatome then radiculopathy is said to be present. Although most people experience back pain during their lifetime, only a fraction experience lumbosacral radiculopathy as a consequence of nerve root compression or irritation. Almost 5% males and 2.5% females experience lumbosacral radiculopathy at some time in their lifetime. Magnetic resonance imaging (MRI) is the preferred investigation for the diagnosis of lumbosacral radiculopathy. So, in the evaluation of a patient of lumbosacral radiculopathy is essential to correlate clinical symptoms and signs with the finding detected in the MRI to arrive at a correct diagnosis and arrange an appropriate management. So this study was done to see the correlation between clinical and MRI finding of radiculopathy at different nerve root level in patients with lumbosacral radiculopathy. It was a cross sectional descriptive study. All 40 patients of lumbosacral radiculopathy who were presented to Rajshahi Medical College Hospital during the study period from 01/11/2011 to 30/10/2012 were included in the study. There were 30 males and 10 females having an M: F ratio of 3:1. Mean age of total patients 43 + 14.74 years. 67.5% patients were between 20 to 50 years and 60% patients were performing heavy work. 67.5% patients had unilateral involvement while 32.6% patients had bilateral involvement. 72.5% patients had muscle weakness and 27.5% had no muscle weakness. 67.5% patients had sensory impairment and 32.5% had no sensory involvement. Knee jerk changes were present in 60% patients and ankle jerk changes in 66.66% patients. As expected 52.18% had L5 and 32.61% had S1 radiculopathy. The difference in clinical and MRI detection of root involvement was statistically significant (p value < 0.05) in both sides at L4, L5 and S1 root levels but there was no significant difference at the L3 root level (p value 1.00) Intervertebral disc herniation was the commonest cause of lumbosacral radiculopathy (72.32%) and second common cause was spinal canal stenosis (19.44%). Others are intervertebral disc budging (61.52%), disc protrusion (23.08%) and disc extrusion (15.38%). Correlation between clinical severity and MRI grading of lumbosacral radiculopathy which was statistically significant. So, it is concluded that clinical findings correlate well with MRI finding, but all MRI abnormalities need not have a clinical significanceTAJ 2015; 28(1): 32-39

Introduction: Diseases of the spinal cord are called myelopathy. They are frequently devastating. They produce quadriplegia or paraplegia with sensory deficits far beyond the site of damage. Many spinal cord diseases are reversible if recognized and treated at an early stage.Objectives: The aim of this study was to evaluate clinical presentation and aetiology of myelopathy among the patients attending Rajshahi Medical College Hospital with the help of history, clinical examination and investigations.Methodology: This was a cross-sectional type of descriptive study. A total 44 myelopathic patients were evaluated between January 2009 to December 2009.Result: Out of 44 patients, 33 (75%) were male and 11 (25%) were female (ratio 3:1), mean aged 35 ± 13.9 years (range 13-65 years). Among them 24 (54.5%) patients had paraparesis and 20 (45.5%) patients had quadriparesis. It was observed that majority 33 (75%) of them had compressive type and 11 (25%) patients had non-compressive type of involvement. Out of 33 compressive myelopathy, the commonest cause was cervical spondylotic myelopathy 14 (42.4%) in number. 2nd cause was Pott’s disease 8 (24.2%) in number. Syringomyelia was detected in 5 (11.4%) patients, disc herniation was in 2 (6.1%) patients, schwannoma was in 2 (6.1%) patients, lipoma was in 1 (3%) patient and 1 (3%) patient was metastasis to the vertebra. Out of 11 non-compressive myelopathy, acute transverse myelitis was detected in 9 (81.8%) patients and familial spastic paraplegia in 2 (18.2%) patients.Conclusion: All patients with myelopathy should be investigated for potentially treatable causes.TAJ 2013; 26: 48-52

Idiopathic Intracranial Hypertension is a disease of unknown aetiology common in obese females and presents with headache, papilledema, raised CSF opening pressure, no abnormalities in CSF examination and no abnormality on CT scan or MRI of the Brain. Sinovenous abnormalities are commonly detected in patients of IIH by different neuroimaging techniques. But the exact role of these sinovenous abnormalities in the causation of the disease or whether they are an effect of the disease is not yet known. Nor has a ‘gold standard’ investigation been established yet for detection of the sinovenous abnormalities. This study was done to detect the presence of sinovenous abnormalities in IIH patients by performing a Magnetic Resonance Venography of the brain. All 33 patients of IIH who presented to Rajshahi Medical College Hospital during the study period from June 2009 to May 2010 were included in the study. There were 30 females and 3 males having a F:M ratio of 10:1. 91% of the patients were between 20 and 35 years of age and most of them were married housewives. 63.64% patients had history of use of oral contraceptives. Unusually 51.52% of the patients had a BMI less than 25 indicating that they were not even overweight (BMI 25 to 30). Only 6% of the patients had BMI > 30 indicating that they were obese. Headache and papilloedema were present in all patients but visual difficulties were present only in 54.54% of the patients. Abnormalities in MRV of the brain were detected in 27.27% (9/33) of the patients and transverse sinus hypoplasia was the commonest finding (88.89% - 8/9 patients). There was no statistically significant difference in the findings of MRV abnormalities between the males and females or among the patients having BMI less or more than 25TAJ 2013; 26: 53-56

Introduction: Fever with seizure is a common childhood emergency. This may be due to febrile seizure or CNS infection like meningitis. Febrile seizure makes up the most common convulsive event in children 6 months to 5 years of age. Despite the commonness of this clinical problem, the need for routine lumbar puncture following a first simple febrile seizure below 18 months of age to exclude meningitis continues to be debated.Objectives: To evaluate the role of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age and to determine the causes of fever of the patient presented with fever with simple seizure in this age group.Methodology: This cross-sectional type of descriptive study was conducted at Paediatric department of Rajshahi Medical College from January 2013 to December 2014.A total of 73 children ages 6 months to 18 months with first simple febrile seizure were enrolled by purposive sampling technique. Lumbar puncture was performed in all patients to evaluate occult meningitis.Results: A total of 73 children ages 6 months to 18 months with first simple febrile seizure were included in the study. 37% (n = 27) were < 12 months of age and 63% (n = 46) were ≥12 months of age with a mean age 13±3.575 months. 43.8% of our study population had family history of febrile seizure. CSF findings of all children > 12 months of age group 63% (n = 46) were normal but in case of age group

‘Nothnagel Syndrome' is a brainstem syndrome which is often underdiagnosed by the physicians due to rarity of the disease and complex clinical presentation. We present a case of brainstem midbrain syndrome caused by ischemic stroke. The male hypertensive diabetic patient presented with sudden onset of diplopia, ptosis and gait imbalance. Right-sidedgaze palsy with nystagmus and ataxic gait were the clinical findings. Brain imaging (MRI and DWI) showed high signal intensity at upper midbrain. The patient was finally diagnosed as ischemic stroke in the brainstem called Nothnagel syndrome. Up to now, there was no case reported as Nothnagel Syndrome due to ischemic stroke. J MEDICINE JAN 2020; 21 (1) : 62-64

Posterior reversible encephalopathy syndrome (PRES) is a reversible phenomenon diagnosed with both clinical and radiological criteria. We present anatypical case of PRES with unusual delayed reversal. A 29-year-old female presented withseizure and altered consciousness during post-partum periods. The initial computed tomographyscan of brain was normal. But subsequent magnetic resonance imaging of brain showed hyperintense lesion in rightparieto-occipital region. After 7 weeks of multidisciplinary team effort, the patient recovered both clinically and radiologically. High index of suspicion with long term follow up is crucial for this curable and reversible syndrome. Because of rarity in delayed recovery, this case of PRES is reported. Birdem Med J 2019; 9(3): 248-250