Immune thrombocytopenic purpura (ITP) is caused by alterations in the immune system resulting in platelet destruction. It often manifests clinically with bleeding or on routine lab work revealing thrombocytopenia in asymptomatic individuals. Neurologic manifestations of this condition are sparsely documented in the literature. Among the symptoms reported were case reports of ischemic strokes, transient ischemic attacks, mononeuropathy multiplex, and polyneuropathy as neurological complications from immune thrombocytopenic purpura. Isolated cranial nerve palsies are uncommon. The following case describes a patient with immune thrombocytopenic purpura who presented with an isolated cranial nerve III palsy. A 55-year-old presented with pain in the right eye that was found in a downward and lateral gaze paralysis. There was no evidence of central or peripheral neurovascular etiology on imaging. However, workup revealed isolated thrombocytopenia with platelets <2000/ml(3). Other possible etiologies, such as human immunodeficiency virus (HIV) and infectious etiologies, were evaluated and excluded. Thrombotic thrombocytopenia purpura was excluded with the results from ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity. The patient was appropriately transfused with platelets and was treated with methylprednisolone, which improved his platelets. At the time of discharge, the patient continued to have cranial nerve III palsy and was referred to follow up with hematology on an outpatient basis. In prior case reports where ITP presented as neurological deficits, there was evidence of intraneural microhemorrhage. Our case is unique in that the primary neurologic presentation without central nervous system pathology eventually led to the diagnosis of ITP. The symptoms were attributed to microhemorrhages that were not detected in imaging studies. Further studies are warranted to explore any correlation or causative association between ITP and neurological symptoms. This case report highlights the need to consider uncommon but possible manifestations of conditions that may initially appear seemingly irrelevant to the patient's chief complaint.

South Asian Americans experience multifaceted sociocultural and acculturative stressors that influence mental well-being, yet few studies have applied contemporary behavioral theories to understand relaxation behaviors in this population. This cross-sectional study examined predictors of initiating and sustaining relaxation behaviors using the Multi-Theory Model (MTM) of health behavior change. A web-based survey of 271 South Asian adults incorporated the Perceived Stress Scale (PSS-10), MTM constructs, and sociodemographic characteristics. Reliability was high across MTM subscales (Cronbach’s α = 0.81–0.93). Structural equation modeling demonstrated acceptable fit (CFI > 0.90, TLI > 0.90, RMSEA < 0.08, SRMR < 0.08). Hierarchical regressions revealed that among participants practicing relaxation (n = 202), behavioral confidence significantly predicted initiation (β = 0.481, p < 0.001), followed by participatory dialogue (β = 0.194, p < 0.05) and changes in the physical environment (β = 0.242, p < 0.01). Emotional transformation strongly predicted sustenance (β = 0.395, p < 0.001), along with practice for change (β = 0.307, p < 0.05) and changes in the social environment (β = 0.210, p < 0.05). MTM constructs explained 69.8% of initiation variance and 70.4% of sustenance variance. Among non-practitioners, participatory dialogue predicted initiation (β ≈ 0.18–0.34, p < 0.05), and emotional transformation predicted sustenance (β = 0.570, p < 0.001). These findings underscore MTM’s strong predictive utility and support culturally tailored interventions enhancing confidence, emotional regulation, and social/environmental supports to promote relaxation behaviors in South Asian communities in the United States.