Acute painful peripheral neuropathy due to metronidazole.

372 CMYK limbs versus the lower extremities (cruciate palsy, brachial diplegia) is seen in the traumatic central cord syndrome or cervical spondylotic myelopathy of elderly patients. Brachial diplegia due to pyramidal tract involvement was first described by Mohr, while the term man-in-the-barrel syndrome (MIBS) was coined by Sage and Van Clitert to describe the clinical aspect of the patient with disproportionate weakness of both arms, while maintaining mobility of face and lower limbs (as though the trunk of the patient is stuck on a barrel). The term cruciate palsy is best used for lesion of corticospinal tracts in the medulla, while exclusive use of the term MIBS for bilateral frontal lobar lesions as in the original description would provide more clarity to the terminology. MIBS is seen commonly after cardiac tamponade, aortic surgery, systemic hypoperfusion and hypovolaemic shock, head injury, anoxic damage to the cortex in the area of somatotopic representation of the arms. There is only one report of tumors being responsible for MIBS – that due to cerebral metastases from undifferentiated carcinoma lung. Multicentric glioma presenting as MIBS has not been reported earlier.