28/03/2026
Epstein Barr Virus Overview
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28/03/2026
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13/01/2026
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A 26-year-old woman presents to her GP with a facial rash which she feels is affecting her confidence and self-esteem. This has appeared, and been gradually getting worse, over the past couple of weeks. She has no other symptoms and feels well. On examination, she has a monomorphic papular rash across most of the face; there are no comedones or cysts visible.
Her only past medical history is a number of allergies, for which she was referred to an allergy consultant. Two months ago she was commenced on 15mg prednisolone daily. She takes no other medications and has no significant family history.
What is the definitive management for the likely condition?
A.Oral antibiotic and topical retinoid
B.Oral retinoid
C.Stop prednisolone
D.Taper prednisolone gradually
E.Topical antibiotic and topical retinoid
02/01/2026
Millard-Gubler syndrome was first described by two French physicians in 1858, Auguste Louis Jules Millard and Adolphe-Marie Gubler.
♦️The most common structures involved in Millard-Gubler syndrome include:
✔ Abducens nerve fibers (cranial nerve VI)
✔ Facial nerve fibers (cranial nerve VII)
✔ Pyramidal tract fibers
♦️ There are three vascular territories in the pons:
✪ (1) Anteromedial: supplied by pontine perforating arteries from the basilar artery
✪ (2) Anterolateral: supplied by the anterior inferior cerebellar artery
✪ (3) Lateral: supplied by lateral pontine perforators from the basilar artery, anterior inferior cerebellar artery, or superior cerebellar artery
Miller-Gruber syndrome therefore arises from ischemic related to the basilar artery distribution.
♦️Clinical Manifestations:
◑ Ipsilateral sixth nerve palsy and weakness on abduction of the eye.
◑ Ipsilateral facial palsy, leading to flaccid paralysis of the facial muscles.
◑ Contralateral hemiplegia or hemiparesis of the upper and/or lower extremities.
◑ Cerebellar ataxia may be present if damage extends to the middle cerebellar peduncles due to their proximity to cranial nerve VII.
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