Cerebral malaria is a serious complication of Plasmodium falciparum infection with a high mortality rate, usually present with diffuse cerebral involvement and rarely with focal neurologic defi cit. Here we report a case of a young adult without any risk factors for stroke who presented with quadriparesis and was diagnosed to have bilateral midbrain stroke-like syndrome due to Plasmodium falciparum malaria. This is an unusual presentation of Plasmodium falciparum malaria. In tropical countries like India, all patients who present with fever and neurologic defi cit should be tested for malaria.

Gitelman's syndrome (GS), also referred to as familial hypokalaemia-hypomagnesaemia syndrome, is an autosomal recessive renal tubular disorder characterised by hypokalaemic metabolic alkalosis, hypomagnesaemia and hypocalciuria. It is caused by a defect of the thiazide-sensitive sodium chloride co-transporter at the distal tubule. This condition was previously confused with Bartter syndrome. Documentation of hypocalciuria helps to differentiate GS from Bartter syndrome. We report a 44-year-old woman who presented with a history of seizure disorder and periodic paralysis. On investigation, she was found to have hypokalaemic metabolic alkalosis, hypomagnesaemia, hypocalciuria, hypoparathyroidism, hypocalcaemia and basal ganglia calcification, consistent with GS. The atypical features in our case, namely basal ganglia calcification and hypocalcaemia, prompted the writing of this case report.
Adult ; Basal Ganglia Diseases ; diagnosis ; pathology ; Brain ; pathology ; Calcinosis ; diagnosis ; pathology ; Diagnosis, Differential ; Female ; Gitelman Syndrome ; diagnosis ; pathology ; Humans ; Hypocalcemia ; diagnosis ; pathology ; Hypokalemic Periodic Paralysis ; diagnosis ; pathology ; Neuroimaging ; Tomography, X-Ray Computed