Nepal Journal of Neuroscience最新文献

{"title":"Post-Stroke Mania- A Case Series","authors":"Yogi Rana, Abhishek Pathak, Manish Singh, Vishesh Yadav, Rahul Singh","doi":"10.3126/njn.v21i1.61170","DOIUrl":"https://doi.org/10.3126/njn.v21i1.61170","url":null,"abstract":"Background: Post-stroke mania is a complex neuropsychiatric phenomenon that poses challenges in both diagnosis and management. This paper presents a detailed analysis of three distinct cases, comprising two females and one male, each exhibiting post-stroke mania following cerebrovascular events. Our study aims to provide insights into the varied clinical presentations, contributing factors, and therapeutic interventions in this unique subset of stroke survivors.\u0000Case 1: A 71-year-old female experienced a left hemispheric stroke, subsequently displaying manic symptoms characterized by elevated mood, impulsivity, and increased energy. Neuroimaging revealed damage to the parieto-occipital lobe, prompting further exploration into the neural correlates of post-stroke mania.\u0000Case 2: A 51-year-old female presented with right hemiparesis. Shortly after the stroke, he manifested manic features, including decreased need for sleep and heightened irritability. Psychosocial factors and pharmacological interventions were investigated to better understand the interplay of biological and environmental influences.\u0000Case 3: A 55-year-old male suffered a left hemispheric stroke. Poststroke, she exhibited manic symptoms such as distractibility and excessive goal-directed activity. The impact of lesion location on the manifestation of post-stroke mania was explored in this case.\u0000Conclusion: Through a comprehensive analysis of these cases, we aim to contribute to the growing body of literature on post-stroke mania, shedding light on its clinical heterogeneity and paving the way for tailored treatment approaches. Recognizing the nuanced nature of post-stroke mania is crucial for healthcare providers to optimize care strategies and improve the quality of life for stroke survivors grappling with this challenging neuropsychiatric condition","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" 65","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral venous thrombosis and the eye: the neuro-ophthalmology of cerebral venous blood clot","authors":"A. Mishra, Ruchi Shukla, Archana Verma, Rameswar Nath Chaurasia","doi":"10.3126/njn.v21i1.59342","DOIUrl":"https://doi.org/10.3126/njn.v21i1.59342","url":null,"abstract":"Introduction: Cerebral venous thrombosis (CVT) is a form of venous thromboembolism which has varied clinical presentation. Ocular clinical features are quite common in CVT and may be the sole presenting feature and often tend to get misdiagnosed. This study was conducted to analyse clinical features especially neuro ophthalmological manifestations in CVT patients.\u0000Materials and Methods: In this prospective study 60 patients were enrolled in a study period of 3 years at tertiary care hospital. Follow up visits were performed at 1 month, 3 months, 6 months and 12 months after the initial diagnosis. We analysed the clinical features as well as aetiology of CVT, special focus was on the ocular symptoms and signs.\u0000Results: Headache was the most common clinical symptom with 93.33% patients. Among ocular symptoms 43.33 % patients presented with complaint of blurring of vision. Among ophthalmological signs papilledema was reported in 40.0 % patients, cranial nerve involvement in 10.0 % patients, diplopia was seen in 6.66 % patients. In patients with papilledema the intensity reduced as time progressed. Vision loss was seen in 2 patients who had secondary optic atrophy.\u0000Conclusion: To avoid misdiagnosis and for the prevention of vision deterioration the ophthalmologist must pay attention to CVT symptoms and signs when patients present with ocular symptoms as the initial manifestation.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" March","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare presentations of Acute Acquired Demyelinating Syndromes (ADS) among children","authors":"Jeffy Joy, Rose Xavier, Ebin Jose, Binod Varghese","doi":"10.3126/njn.v21i1.62423","DOIUrl":"https://doi.org/10.3126/njn.v21i1.62423","url":null,"abstract":"Acute demyelinating syndromes (ADS) in children presents with neurological symptoms with a pathology involving either single central nervous system (CNS) location (mono focal ADS) or multiple sites (poly focal ADS), with or without encephalopathy. It is a diagnostic dilemma requiring a high index of suspicion. A thorough clinical examination with neuroimaging and cerebrospinal fluid (CSF) analysis is needed for making a diagnosis. Clear cut guidelines regarding long term management and prognosis is lacking. Myelin oligodendrocyte glycoprotein (MOG) antibody must be done in all suspected cases as it helps in prognosticating and counselling parents. Recurrence is rare, recovery is usually complete and most children respond to pulse high dose methylprednisolone injection. In this case series we map out different unique presentations of acute ADS with and without Myelin oligodendrocyte glycoprotein (MOG) antibody positivity among children from a tertiary care hospital in central Kerala, India.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"117 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Subdural Hematoma associated with Meningioma : Two case reports","authors":"Samir Acharya, Ramesh Prajapati, Bishal Shrestha, Samriddha Malla, P. Gurung, Basant Pant","doi":"10.3126/njn.v21i1.62408","DOIUrl":"https://doi.org/10.3126/njn.v21i1.62408","url":null,"abstract":"Introduction: Spontaneous subdural hematoma rarely presents with a hyper vascular or malignant tumor but even less frequently in a benign tumor like meningioma. We encountered two cases with spontaneous subdural hematoma associated with benign meningioma.\u0000Case Description: A 47-year-old Asian woman presented with severe headache and forgetfulness, initiated 3 months  before, with no other complaints, denying any previous head trauma. Head computed tomography revealed a chronic left hemisphere subdural hematoma  for this issue she underwent  burr hole and evacuation of hematoma 1 month  before. However her symptoms was not  relieved and her magnetic resonance imaging of brain showed  left frontal lesion , suggestive of meningioma. Surgical treatment was performed. The tumor was histologically confirmed as a transitional meningioma grade I. After surgery, no neurological deficits were registered, and headache subsided.\u0000Similarly, second case, a 56-year-old woman presented  with  complaints  of severe headache for 6 hours. There is no history of seizure like activities, any previous history of head trauma. On examination, no neurological deficits noted. Computed Tomography (CT) of head showed a hyper dense extradural lesion with acute subdural lesion on left hemisphere. MRI brain revealed well defined extra axial round to oval lesion measuring 3.1 X 3.5 X 2.5 cm with areas of heterogeneous enhancement of the left parietal parasagittal area .She underwent left parietal craniotomy and en-bloc tumor resection done. Post operatively there was no neurological deficits and she was discharged on 5th post-operative day.\u0000Conclusions: As we could not identify any other cause for the subacute subdural hematoma, hemorrhage from the meningioma was the most probable cause. Although meningiomas are commonly benign according to their histological traits, they can lead to spontaneous bleeding and cause neurologically unstable condition. Therefore, meningiomas need to be considered as a cause of spontaneous subdural hematoma if radiologically suspicious, which should be reflected by proper management for a positive outcome.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" 525","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Spinal PNET: A Rare Case with Aggressive Progression.","authors":"Vijaya Kumar Gupta, A. S. Carvalho, Nagendra Shekhawat, Yelda Vyas, Ekata Gupta","doi":"10.3126/njn.v21i1.60016","DOIUrl":"https://doi.org/10.3126/njn.v21i1.60016","url":null,"abstract":"PNET of spine are extremely rare, it represent less than 1% of spinal tumors. They are highly invasive and malignant, rapidly growing with grave prognosis. In this case report a 34 yrs lady presented clinically as back ache, urinary symptomps and progressive weakness & spasticty of both lower limbs.\u0000After workup patient underwent laminectomy & microscopic gross total excision of tumor, following surgery she improved symptomatically. After confirmation of HPE and IHC she underwent radiotherapy, but she not tolerated chemotherapy and later on tumor recurred and patient succumbed to the disease.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Antipsychotics and Lithium Induced Neuroleptic Malignant Syndrome associated with Acute Kidney Injury: A Case Report","authors":"Riya S. Shah, Sachin K. Akhani, Sapna D. Gupta, Supriya D. Malhotra","doi":"10.3126/njn.v21i1.60125","DOIUrl":"https://doi.org/10.3126/njn.v21i1.60125","url":null,"abstract":"Neuroleptic Malignant Syndrome (NMS) is a rare but serious adverse reaction to antipsychotic medications. This case report presents a 56-year-old male with bipolar disorder on a regimen of Olanzapine, Clozapine and Lithium carbonate, who developed typical NMS. He had muscle rigidity, hyperthermia, rhabdomyolysis which led to acute kidney injury. Prompt withdrawal of psychotropic medications and administration of supportive therapies was done, yet the patient's condition deteriorated, leading to Multiple Organ Dysfunction Syndrome (MODS) and eventually mortality. This case shows the complexity of managing NMS in the context of polypharmacy emphasizing the need for vigilance when prescribing antipsychotic combinations and the challenges faced in treating NMS, especially when there are associated complications.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" 72","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twig-like MCA: A Rare Vascular Anomaly","authors":"Niharika Pant, Saujanya Rajbhandari, S. Rajbhandari, Saddam Ansari, Nipun Raghubanshi, P. Rajbhandari, Basant Pant","doi":"10.3126/njn.v21i1.64692","DOIUrl":"https://doi.org/10.3126/njn.v21i1.64692","url":null,"abstract":"Twig-like middle cerebral artery (T-MCA) or rete mirabile anomaly is a rare vascular anomaly with clinical relevance characterized by the replacement of the M1 segment by a plexiform network of small vessels. With an incidence ranging from 0.11% to 1.17%, it is more prevalent in Asia. The twig arises from the distal ICA and ends at the distal horizontal portion of MCA while lenticulostriate arteries (LSAs) arise from the plexiform network of the involved M1 segment. It is crucial to distinguish this embryological anomaly from Moyamoya Disease (MMD), moyamoya-like syndrome, atherosclerotic steno-occlusive disease, and vasculitis to prevent misdiagnosis and unnecessary treatment. We present the case of a 30-year-old male who complained of left eyelid ptosis and diplopia. Incidentally, he was diagnosed with both a twig-like middle cerebral artery (MCA) anomaly and an associated anterior communicating artery (ACoM) aneurysm.\u0000The twig-like middle cerebral artery (T-MCA) anomaly, also known as rete mirabile anomaly, is a rare vascular variation characterized by the replacement of the M1 segment with a plexiform network of small vessels. Here, we present a case of a 30-year-old male with left eyelid ptosis and diplopia, who was incidentally diagnosed with T-MCA anomaly along with an associated anterior communicating artery (ACoM) aneurysm.  ","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"118 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostering Student Success: A Prevailing Provision for Dyscalculia and Dyslexia in the School Curriculum and Strategies for Support","authors":"Rajendra Kunwar","doi":"10.3126/njn.v21i1.63381","DOIUrl":"https://doi.org/10.3126/njn.v21i1.63381","url":null,"abstract":"This article examines the impact of dyscalculia and dyslexia on students' mathematics learning and proposes strategies for supporting learners with these learning disabilities. It provides a concise overview of dyscalculia and dyslexia, emphasizing their distinct characteristics and prevalence rates within the Nepalese context. The study explores the challenges faced by students with dyscalculia and dyslexia in mathematics education and discusses the importance of inclusive education. It also provides an overview of the school-level curriculum in Nepal, highlighting the effects of dyscalculia and dyslexia on mathematics learning and the specific challenges experienced by students with these disabilities. The article uncovers areas within the school-level curriculum in Nepal that require attention and offers practical ways to support learners with dyscalculia and dyslexia. Overall, this article provides valuable insights into the challenges faced by students with dyscalculia and dyslexia in learning mathematics and offers practical recommendations for developing an inclusive curriculum that caters to the specific needs of the dyscalculic and dyslexic learners.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141366041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LGI 1 Antibody Encephaltis:Clinical characteristics and short term outcome along with review of literature.","authors":"P. Panicker, D. Ramachandran, Raj Satheesh Chandran, Thomas Iype","doi":"10.3126/njn.v21i1.55654","DOIUrl":"https://doi.org/10.3126/njn.v21i1.55654","url":null,"abstract":"LGI1 (Leucine-rich glioma inactivated protein-1) antibody disease is one of the major causes of limbic encephalitis encountered in clinical practice manifesting with clinical seizures, behavioural disturbances and movement disorders. Here we discuss the varied presentations of this disease through three cases encountered at our center emphasizing the cardinal clinical, imaging and laboratory diagnostic features. Recognition of these characteristics would lead to early diagnosis and prompt management of this eminently treatable condition.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"104 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141362129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fahr Disease: Review and case Report","authors":"Prabhat Jha","doi":"10.3126/njn.v21i1.60794","DOIUrl":"https://doi.org/10.3126/njn.v21i1.60794","url":null,"abstract":"Introduction: Fahr disease is a rare neurodegenerative condition characterized by diffuse calcifications within brain. It is common in the fourth to sixth decade and few cases have been described in pediatric population\u0000Case presentation: This case report describes a twelve year old boy with suspected Fahr disease. The clinical presentation was seizure, ataxia, tremor. The patient was managed conservatively with anti seizure medication.\u0000Conclusion: Fahr disease is a rare neurodegenerative disease and can present in pediatric population as well.\u0000 \u0000Key words\u0000Fahr disease, Pediatric","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"104 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}