Nepal Journal of Neuroscience最新文献

{"title":"Decompressive craniotomy for severe traumatic brain injury: Our experience and review of literature","authors":"Krishna Sharma","doi":"10.3126/njn.v21i1.63309","DOIUrl":"https://doi.org/10.3126/njn.v21i1.63309","url":null,"abstract":"Introduction: Severe traumatic brain injury (TBI) is the most devastating injury affecting physical, mental, social and financial health of an individual and a society. The research, understanding and management of TBI is mainly focussed towards the secondary effects of the traumatic brain injury. Maintaining intracranial pressure within reasonable bounds is essential for successful TBI therapy, as an uncontrolled intracranial pressure (ICP) plays a major role in determining the course and prognosis of the injury. In general, ICP can be managed medically and/or surgically. In this article, we discuss our experience, the most recent understanding, and a method for managing ICP in traumatic brain injury.\u0000Material and Methods: This study comprised 350 patients with moderate to severe traumatic brain injury (TBI) who were treated by a single neurosurgeon at several institutions between 2005 and 2020. 76.6% (268) of the patients were men, and 64% (224) of the patients were under 60 years old. The most common mode of injury was road traffic accident followed by fall from height. The study excluded those patients with brain stem injuries, bilateral non-reacting pupils, and concomitant significant injuries in other body parts. All were first treated medically with appropriate resuscitation, hyper-osmolar therapy (mannitol, 3% saline), hyperventilation, and barbiturate coma as per the response and requirement. Surgical intervention was used for patients who did not respond to medical management. In addition, decompressive craniectomy (DC) was primarily performed on those whose GCS was less than 5 and who had reacting pupils, upon presentation.\u0000Results: Out of the 350 patients, 53.2% (186) had moderate TBI and 46.8% (164) had severe TBI. Due to failure of medical management, 30.5% (54) of moderate and 69.5% (123) of severe TBI underwent decompressive craniectomy in the form of bifrontal craniectomy in 18% (32), unilateral fronto-temporo-parietal craniectomy (hemicraniectomy) in 64% (113) , bilateral hemicraniectomy in 6% (11) and 12% (21) underwent limited fronto-temporo-parietal craniectomy. Decompressive craniectomy was not performed for posterior fossa. The data on outcome is very poor, inadequate and unreliable due to bad follow up. 5 years Follow up could be obtained only of 127 out of 350 (36%) patients and majority of these 69% (88) were moderately or severely disabled. Of those operated ones, only 27% (48) agreed for cranioplasty. 17% (30) had to undergo VP shunt for hydrocephalus. The group with severe traumatic brain injury (TBI) accounted for the majority of deaths (17%), with respiratory tract infections being the primary cause.\u0000Conclusion: Decompressive craniectomy is the sole option in medically refractory cases of traumatic intracranial hypertension, who continue to deteriorate clinically. Nevertheless, the benefit falls short of expectations, particularly with regard to functional recovery. However prompt and appropriate decompression in ap","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" August","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364408","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":"Neurogenomics contribution to neurodegenerative Diseases","authors":"O. Adeleye, Darasimi Racheal Olorunlowu, Joshua Ayodele Yusuf, Elizabeth Kehinde Opoola, Stephen Tunmise Akanbi, S. Akindokun","doi":"10.3126/njn.v21i1.58673","DOIUrl":"https://doi.org/10.3126/njn.v21i1.58673","url":null,"abstract":"Introduction: Neurodegenerative diseases are a group of complex disorders that progressively impair the structure and function of the nervous system, resulting in debilitating symptoms and reduced quality of life for affected individuals. Over the past few decades, advances in the field of genomics have revolutionized our understanding of the underlying molecular mechanisms driving these disorders. Neurogenomics, the intersection of neuroscience and genomics, has emerged as a crucial discipline in unraveling the genetic and molecular underpinnings of neurodegenerative diseases. Neurogenomics focuses on deciphering the genetic variations that contribute to the susceptibility and progression of neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis (ALS), and Huntington's disease. Advances in DNA sequencing technologies have enabled researchers to identify specific genetic mutations and variations that are associated with increased disease risk. By studying the genetic mutations involved in neurodegenerative diseases, neurogenomics has provided valuable insights into the underlying disease mechanisms. These insights have led to a deeper understanding of protein aggregation, mitochondrial dysfunction, inflammation, and other cellular processes implicated in disease progression. By harnessing the power of neurogenomics through further studies, researchers and clinicians are moving closer to the goal of effectively preventing, diagnosing, and treating neurodegenerative diseases, thus offering hope to millions of individuals affected by these challenging conditions.\u0000Conclusion: Neurogenomics has emerged as a pivotal field in unraveling the complex interplay between genetics and neurobiology in neurodegenerative diseases. By dissecting the genetic architecture, elucidating molecular mechanisms, and paving the way for targeted therapies, neurogenomics offers new avenues for understanding, diagnosing, and ultimately treating these disorders.","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":"141363378","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":"Factors affecting facial nerve outcome in vestibular Schwannoma surgery","authors":"R. Jha, Rajendra Shrestha, Binod Rajbhandari, S. Bhattarai, Sameer Aryal, Sindhu Gautam, B. Jha, Anuj Jung Karki","doi":"10.3126/njn.v21i1.61342","DOIUrl":"https://doi.org/10.3126/njn.v21i1.61342","url":null,"abstract":"Background: Preservation of facial nerve injury is a key important factor in vestibular schwannoma surgery as facial paralysis has devastating functional and psychological consequences for patients.\u0000Objective: To correlate different factors resulting in facial nerve preservation in vestibular schwannoma surgery by retro mastoid retro sigmoid approach.\u0000Method: This is a retrospective analysis of facial nerve status of 212 cases of vestibular schwannoma microsurgery through Retrosigmoid Retromastoid (RSRM) approach. This study was carried out in National Neurosurgical Referral Center(NNRC), National Academy Of Medical Sciences (NAMS), Bir hospital between January 2016 to December 2022.Preoperative and post operative details of facial nerve function status compared according to House and Brackmann (H and B) grading system, and factors influencing outcome in facial nerve preservation were analyzed. Recurrent and residual tumors were excluded.\u0000Results: A total of 212 cases of vestibular schwannoma were operated during the study period. The average age of presentation was 47 years. Most common affected age group was 51-60 years. Female to male ratio was 3:2.5. The most common clinical symptoms for vestibular schwannoma were sensorineural hearing loss followed by headache and difficulty in limb coordination. Tumor size and consistency was most important indicator of facial nerve function outcome.\u0000Conclusion: The incidence of post operative facial palsy is found to be correlated to tumor size and consistency. Improvement of the facial nerve outcome is detected in patients undergone simultaneous intraoperative monitoring (IONM).","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":" January","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364330","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":"Climate Change and the Nervous System","authors":"Mohan Raj Sharma, M. Pyakurel","doi":"10.3126/njn.v21i1.62730","DOIUrl":"https://doi.org/10.3126/njn.v21i1.62730","url":null,"abstract":"Climate change has received significant media attention. The recent COP 28 summit in November and December 2023 in Dubai has once again brought together the leaders of all countries and has made everyone aware of its effect on global health. Despite this attention, scholarly works on the subject, particularly from developing economies are relatively scarce.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"119 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141362628","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":"Clinico-epidemological profile of migraine and its correlation with depression, anxiety and stress in a teritiary care hospital in South India","authors":"Baishyak Renuji, Rammohan Krishna Pillai","doi":"10.3126/njn.v20i3.54400","DOIUrl":"https://doi.org/10.3126/njn.v20i3.54400","url":null,"abstract":"Introduction: We studied the clinico-epidemiological profile of patients with migraine and to study the correlation of migraine severity with depression, anxiety and stress. Materials and Methods: 98 subjects who were meeting inclusion and exclusion criteria were studied after obtaining informed written consent. Data was collected using prestructured performa and then analysed using SPSS software. Result: 64.3% patients had unilateral headache and 76.5% had frontal area pain. Migraine with aura was present in 40.8% with commonest aura being visual (85%). Most common visual aura was scotoma (47.5%) and the most common associated symptom was photophobia (83.7%) followed by nausea (78.6%). The most common trigger was sun exposure (70.4%) followed by sleep deprivation (69.4%). Severe disability was present in 26.5% of subjects. Severity of migraine showed significant positive association with those who were taking alternative medicine. Migraine severity showed positive correlation with depression, anxiety and stress with correlation coefficient of 0.506, 0.509, and 0.604 respectively. Maximum correlation was with stress which may be considered as an independent risk factor for severe migraine. Conclusion: Anxiety, depression and stress were strongly associated with severe migraine. They can act as factors that trigger and perpetuate migraine, of which stress may be considered as an independent risk factor for severe migraine. Early screening and management of depression, anxiety and stress might provide better control of migraine, thus improving the quality of life of migraineurs.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"102 16","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137858","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":"Anti- NMDAR Encephalitis in a 28 years old female: Revisited","authors":"Rajiv Jha, Pankaj Jalan, Rajiv Shah, Adarsh Chaturvedi","doi":"10.3126/njn.v20i3.56715","DOIUrl":"https://doi.org/10.3126/njn.v20i3.56715","url":null,"abstract":"Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the prevailing subtype of autoimmune encephalitis, commonly misdiagnosed initially as infectious encephalitis due to its symptomatology resembling that of viral encephalitis and meningitis. The condition exhibits a higher incidence in females, with a gender ratio of 4:1 compared to males. While electroencephalogram (EEG) and magnetic resonance imaging (MRI) aid in the diagnostic process, the presence of antibodies in the cerebrospinal fluid (CSF) serves as the definitive confirmation. Autoimmune encephalitis typically presents with a spectrum of neuropsychiatric symptoms","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"103 37","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135138155","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":"Detection of interictal epileptiform discharge in focal seizures","authors":"Shikha Saxena, Kamal Kant Gupta","doi":"10.3126/njn.v20i3.58795","DOIUrl":"https://doi.org/10.3126/njn.v20i3.58795","url":null,"abstract":"Introduction: Many factors underlying basic epileptic conditions determine the characteristics of epileptic seizures and the therapeutic outcome. Visual obvious abnormalities in resting baseline EEG are cardinal but incompletely understood like feature of seizure onset zone in focal epilepsy and interictal epileptiform discharge. Present study is an attempt to diagnose that evidence of epileptic discharge in temporal lobe epilepsy (TLE), would persist during interictal period in absence of abnormalities in baseline EEG, which could increase the impact of automatic analysis of EEG waves for clinical relevance.
 Material and Methods: By using 10-20 system, functional connectivity was estimated in the 20 channels of delta, theta, alpha, beta and gamma frequency bands of EEG, from 16 diagnosed focal epileptic seizure patients and 16 age and sex matched controls. To observe the dynamics of the healthy brain, differ from the brain of dynamically focal epileptic patients during interictal period treated with anti-epileptic drugs in the context of resting state during eye close session of EEG. Such differences can be observed by using absolute spectral power from BESS ((Brain Electro Scan Software) of the Axxonet System and statistically measure by applied unpaired student t -test.
 Result: The high significance results in slow frequency EEG waves (delta and theta) in power spectral analysis were observed that demonstrates the potential epileptic discharge occurring during interictal period without visible pathological activity for helping in the diagnosis and lateralization of TLE.
 Conclusion: The detailed spectral analysis of EEG waves offers novel insight into focal epileptic patients when visually EEG findings were normal. This linear analysis helpful in extracting information from EEG signals in diagnosing specific neuronal correlates for TLE. Present findings concluded that epileptic discharges occur at different topographical regions of brain during interictal period and power spectral analysis plays a new insight in diagnosis of focal discharge.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"117 41","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136712","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":"A Study to Detect Risk Factors of Chronic Subdural Hematoma Recurrence","authors":"Sajag Kumar Gupta","doi":"10.3126/njn.v20i3.56488","DOIUrl":"https://doi.org/10.3126/njn.v20i3.56488","url":null,"abstract":"Introduction: Chronic subdural hematoma (CSDH) is a common type of intracranial hemorrhage in elderly patients. The risk factors for recurrence of chronic subdural hematoma (CSDH) after surgical evacuation has not been completely understood until now, but several risk factors for recurrence have been reported. Meanwhile, the definitive risk factors have not been defined until now. The aim of this study was to study the potential risk factors, including preoperative, operative and post-operative ones for CSDH recurrence. Materials and Methods: The study population comprised of all > 18 year age group patients who were operated for chronic subdural hematoma in Neurosurgery Department of tertiary care center. It was prospective cohort study. Patients who met inclusion criteria, postoperative outcomes were assessed at discharge, then at one month and three months afterwards in the neurosurgery OPD. Both the treatment options i.e. BHC Burr hole craniotomy and minicraniotomy as required as per CT scan or MRI findings. Results: 7 patients (10.7%) had recurrence, of CSDH. All the reoccurrences occurred in burr hole operated patients. There was no recurrence in mini craniotomy operated group. Conclusions: Many risk factors for recurrence of CSDH have been found, including old age, cerebral atrophy, large hematoma, bilateral hematomas, hematoma density, inflammation markers, alcohol ingestion, bleeding tendency, and some technical aspects of surgery such as irrigation with small amount of fluid, not excising thick membrane preventing brain expansion.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"122 15","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136563","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":"A Treatable Cause of Cervical Myelopathy in a Young Female","authors":"Krishnan Balagopal, Jeyaseelan Nadarajah, Sreyas Santhosh, Munavira K Shams, Riya Ann Koshy, Pretty Ponnachan","doi":"10.3126/njn.v20i3.56919","DOIUrl":"https://doi.org/10.3126/njn.v20i3.56919","url":null,"abstract":"Neuromyelitis Optica (NMO) or Devics Disease is an inflammatory demyelinating disorder of the central nervous system involving the neurons of the optic nerve and the spinal cord. It is seen more commonly in females and follows a relapsing clinical course in more than eighty percent of cases. The incidence of the same is rising in the Indian subcontinent. We present here a case of a young female patient presenting with features of a subacute cervical myelopathy with longitudinally extensive transverse myelitis on imaging of the spine. Investigations revealed features of Neuromyelitis Optica. She was diagnosed and treated early which led to good long term outcome","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"103 32","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135138159","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":"Isolated spinal Intramedullary Neurocysticercosis: A rare case report and review of literature","authors":"Subigya Man Lama, Kumar Paudel, Narendra Shalikhe, Pradhumna Kumar Yadav, Somraj Lamichhane","doi":"10.3126/njn.v20i3.56915","DOIUrl":"https://doi.org/10.3126/njn.v20i3.56915","url":null,"abstract":"Neurocysticercosis is Taenia solium infection of the central nervous system and meninges. Although highly uncommon, spinal cysticercosis frequently occurs in conjunction with intracranial cysticercosis. The least frequent are often those involving the intramedullary. We report a 50-year-old male patient who presented with complaints of lower back pain with a burning sensation over bilateral thighs. A magnetic resonance imaging (MRI) scan of his dorsal spine revealed a relatively well-defined lobulated lesion at T11 vertebral level. Intramedullary cysticercosis is a challenge to diagnose, and neurocysticercosis should also be considered in cases of intramedullary space-occupying lesion.","PeriodicalId":33296,"journal":{"name":"Nepal Journal of Neuroscience","volume":"119 13","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135138491","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}