a 38 year old Male patient came to psychiatry opd with wife and brother ( informants - reliable and adequate) with complaints of giddiness, headache, tingling sensation and numbness in bilateral limbs with coarse tremors, disturbances in gait ( wide base gait with stamping of the feets) , visual disturbances ( both short and distant vision with blurring) wife reports low mood, decreased interaction and irritability. forementioned complaints present for past 5-6 months. The patient is a also a known alcoholic with consumption from last 5-6 years. Has h/o consumption of both English and country liquor ( desi, hath bhatti) ranging from two and half to three quarters with h/o binge drinking for 6 month. There have short intervals of abstinence with patient having tremors and headache. however the patient has been abstinent for past 4-5 months owing to above mentioned complaints that were gradually progressive. The patient has H/o head trauma 6 months backs falling roadside with H/o severe bleeding, patient was intoxicated then no Loss of consciousness, ENT bleed, seizures. the patient's major complaint is visual and gait disturbances with coarse tremors. with mood disturbances and irritability. provisional diagnosis with Differentials investigations treatment.

80 yrs male patient brought by relatives with history of sudden onset of giddiness and slurred speech since 10 -12 hrs kco DM On OHA since 10 yrs at present conscious oriented , no neuro deficits BP 180/100mmHg PR 90bpm cxr Copd lungs

Recurrent Ataxia with slurring of speech under Ix.. Can it be MS Or any other cerebellar cause??.. Why there is slurring of speech while cranial Nv examination is normal.. *Chief Complaints* A 50 yr old male has come with unable to walk properly and slurring of speech since 4-5 months. Pt had similar history back a couple of times, for which he was taking treatment from outside. He was diagnosed as SACD and was taking Hydroxycobalamine without any improvement. I did complete neurological examination. Mental function, cranium, spine, Meninges, motor system, sensory function and cranial nv are normal. Pt had ataxia, with dysdidochokinesia and difficulty with past pointing, incordination, ataxia etc. No nystgmus, titubation or INO. No H/O HTN, T2DM, Thyroid disorder, substance abuse, Trauma, high risk behaviour etc. His previous report shows both cerebellar and cerebral atrophy, normal Sr Vit B12 level, normal Thyroid profile. Now we are planning MRI Brain, MRI spine, Spinal fluid for oligoclonal band etc. Ur opinion plz.. What else need to be done.. I have attached the link of neurological examination. Kindly take a look. *Investigations* https://youtu.be/PA-KRbrjFsE

Premature 34 weeks 6 months age Evolutive encephalopathy Nystagmus Spasms Convulsive crisis

7 yr old with seizures , nystagmus , poor responsiveness and irritability