Annals of Indian Academy of Neurology最新文献

{"title":"Malnutrition in Females and Anxiety in Males Predicts Mild Neurocognitive Disorder: Insights from LASI-DAD.","authors":"Poorvikha Satish, G Sandhya, Thomas Gregor Issac","doi":"10.4103/aian.aian_313_26","DOIUrl":"https://doi.org/10.4103/aian.aian_313_26","url":null,"abstract":"<p><strong>Background and objectives: </strong>Dementia is a debilitating neurological disorder and a major public health priority. Age is the strongest known non-modifiable risk factor for dementia, followed by sex. The objective of this study was to examine sex-specific prevalence and the effects of risk factors associated with cognitive impairment.</p><p><strong>Methods: </strong>Data from Wave 1 of the nationally representative Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (2017-2019; n = 4,096) were used for this analysis. Neurocognitive disorder (NCD) was classified according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Editioncriteria, with participants categorized as cognitively normal, mild NCD, or major NCD. In the multinomial logistic regression analysis, two separate models were implemented: an age-adjusted model and a fully adjusted model that incorporated all variables found to be statistically significant in the first model, in addition to age.</p><p><strong>Results: </strong>Of the 4,096 participants, 46.1% were male and 53.9% were female. The distribution of mild or major NCD diagnoses did not differ significantly by sex ( P = 0.077). In the multiple risk factor model, among men, only anxiety remained significantly associated with mild NCD [odds ratio (OR), 3.30; 95% confidence interval (CI), 1.25-8.74; P = 0.016], whereas among women, being underweight was independently associated with mild NCD (OR, 2.93; 95% CI, 1.13-7.58; P = 0.027).</p><p><strong>Conclusions: </strong>These findings suggest that the determinants of late-life cognitive impairment are sex-dependent and multifactorial, with psychological factors appearing more salient in men, whereas nutritional vulnerability may be more relevant in women. Interventions aimed at reducing cognitive decline may therefore need to be sex-specific.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrophysiological Profile and Comparative Analysis in Brachial Plexus Injuries.","authors":"V H Ganaraja, Deepak Menon, Suresha Kodapala","doi":"10.4103/aian.aian_222_26","DOIUrl":"https://doi.org/10.4103/aian.aian_222_26","url":null,"abstract":"<p><strong>Background and objectives: </strong>Brachial plexopathies (BPs) are disabling peripheral nerve disorders resulting in significant motor and sensory deficits. Traumatic BP is the most common etiology, typically following high-energy injuries, while non-traumatic causes include inflammatory and other etiologies. Although imaging provides anatomical detail, electrodiagnostic studies-nerve conduction study (NCS) and needle electromyography (EMG)-remain central to functional assessment.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of patients evaluated for BP at a tertiary electrophysiology laboratory between 2017 and 2022. Patients with symptom duration ≥1 month and complete NCS and EMG datasets were included. These datasets were analyzed to determine lesion localization, including trunks, cords, anterior primary rami (APR), and preganglionic involvement. Electrophysiological patterns were compared between traumatic and non-traumatic etiologies.</p><p><strong>Results: </strong>Seventy-eight patients were included (69 males; mean age 31.7 years); 70 (89.7%) had traumatic and 8 (10.3%) had non-traumatic BPs. Pan-plexopathy was the most frequent localization (73.1%), followed by upper trunk involvement. EMG was abnormal in all patients and provided incremental diagnostic yield beyond NCS alone, identifying plexus involvement in 2.6% of patients with normal NCS and detecting APR or preganglionic involvement in an additional 6-9%. Preganglionic and root avulsion patterns were observed exclusively in traumatic cases (8.9%). Apart from proximal lesions in the form of APR and root involvement exclusivity in traumatic BP, electrophysiological patterns overlapped substantially between etiologies.</p><p><strong>Conclusions: </strong>Pan-plexopathy and upper trunk involvement predominate in BPs. EMG provides critical information beyond NCS alone, particularly for identifying proximal and preganglionic lesions, and remains indispensable for accurate localization.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undetected Cognitive Impairment in Saudi Arabia: A National Analysis of Screening Coverage, Diagnostic Yield, and Equity Gaps in Primary Healthcare.","authors":"Ahmed A Almohammadi","doi":"10.4103/aian.aian_618_26","DOIUrl":"https://doi.org/10.4103/aian.aian_618_26","url":null,"abstract":"<p><strong>Background and objectives: </strong>Dementia and mild cognitive impairment represent a growing neurological burden in Saudi Arabia, driven by population aging and a high concentration of modifiable risk factors. Most affected individuals remain undiagnosed, yet no national analysis of cognitive screening coverage, diagnostic yield, or equity gaps has been conducted within the primary healthcare system. To quantify cognitive impairment screening coverage among adults aged ≥60 years, characterize diagnostic yield and tool utilization patterns, identify equity gaps, and assess alignment with the World Health Organization (WHO) Global Action Plan on Dementia 2017-2025 targets.</p><p><strong>Methods: </strong>This descriptive study used a serial (repeated) cross-sectional design with trend analysis, analyzing annual secondary surveillance and survey data from 2016 to 2023 drawn from the WHO Global Dementia Observatory, Saudi Ministry of Health Annual Statistical Yearbooks, the Saudi Health Interview Survey 2018, and a regional dementia prevalence study. Descriptive statistics characterized screening and diagnostic patterns over time; regional and urban-rural comparisons were assessed cross-sectionally at single time points (2023 and 2018).</p><p><strong>Results: </strong>National cognitive screening coverage increased from 8.3% in 2016 to 21.7% in 2023. The Mini-Mental State Examination was the most utilized instrument (62.4% of screening encounters), followed by the Montreal Cognitive Assessment (28.1%). Among screened individuals, 34.2% received a new clinically confirmed diagnosis of mild cognitive impairment or dementia, and 71.3% of these new diagnoses had no prior documented cognitive concern. Screening coverage ranged from 31.4% (Central region) to 9.2% (border regions) and was roughly twice as high in urban areas (26.8%) as in rural areas (13.1%). The dementia diagnosis documentation rate-the indicator most directly aligned with the WHO Global Action Plan's Target 4 for dementia diagnosis-improved from 18.4% in 2016 to 41.6-64.6% of estimated prevalent cases in 2023.</p><p><strong>Conclusions: </strong>Cognitive impairment screening coverage in Saudi Arabia's primary healthcare system remains critically low, and this shortfall in case-finding capacity is the most likely driver of continued underdiagnosis. Whether the WHO Global Action Plan's dementia diagnosis target has been met remains uncertain given the wide prevalence-estimate range, underscoring the need for better prevalence data alongside systematic screening integration, standardized tool adoption, and equity-focused outreach.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deficiency of Adenosine Deaminase 2 Presenting as Recurrent Stroke and Steroid-Responsive Hearing Loss in a Young Adult.","authors":"Tanushree Chawla, Ruchika Goel, Chanchal Goyal, Vinay Goyal","doi":"10.4103/aian.aian_128_26","DOIUrl":"https://doi.org/10.4103/aian.aian_128_26","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech-Induced Myoclonus-Dystonia Mimicking Stuttering and Responding to Zonisamide.","authors":"Gouri R Passi, Puja Kapoor","doi":"10.4103/aian.aian_208_26","DOIUrl":"https://doi.org/10.4103/aian.aian_208_26","url":null,"abstract":"<p><strong>Abstract: </strong>We present the case of a child with myoclonus-dystonia (MD) who was mistaken for having stuttering and responded to oral zonisamide therapy. An 11-year-old boy presented with a 3-month history of speech-induced myoclonus, dystonia, and speech disfluency, with a positive family history in his father. A final diagnosis of MD was made, and the child responded to zonisamide. MD is a treatable form of neurogenic stuttering. It may mimic stuttering, and detailed analysis of the phenomenology and the evaluation of family history may help establish the diagnosis. A trial of zonisamide may be considered in the treatment of this disabling condition.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Compound Heterozygous NAGS Gene Variants in a Neonate with Hyperammonemic Encephalopathy: Importance of Early Metabolic Suspicion and Neuroimaging Clues.","authors":"Vykuntaraju K Gowda, Archana K Verghese, Varunvenkat M Srinivasan, Amena Nayyer","doi":"10.4103/aian.aian_403_26","DOIUrl":"https://doi.org/10.4103/aian.aian_403_26","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Drooping Finger: An Atypical Manifestation of Myasthenia Gravis.","authors":"Akshata Huddar, Vishal Chandra Sharma, Vaibhav Bhat","doi":"10.4103/aian.aian_350_26","DOIUrl":"https://doi.org/10.4103/aian.aian_350_26","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective, Single-Arm, Observational Study in Patients with Multiple Sclerosis in India Receiving Ocrelizumab Therapy for 1 Year.","authors":"Mv Padma Srivastava, Joy Dev Mukherji, Anshu Rohatgi, Sameer Arora","doi":"10.4103/aian.aian_165_26","DOIUrl":"https://doi.org/10.4103/aian.aian_165_26","url":null,"abstract":"<p><strong>Background and objectives: </strong>Ocrelizumab is an established therapy for multiple sclerosis (MS). However, real-world data from Indian clinical settings remain limited. Hence, the present study was conducted to evaluate the clinical effectiveness, radiological response, and safety profile of ocrelizumab over 12 months of therapy among patients with MS in India.</p><p><strong>Methods: </strong>This retrospective observational study included data from adults diagnosed with multiple sclerosis (MS) who received ocrelizumab for at least 12 months. Clinical, radiological, and safety data were recorded. Primary outcomes were changes in the Expanded Disability Status Scale (EDSS) score and relapse rate. Secondary outcomes included magnetic resonance imaging (MRI) lesion counts and safety events. Statistical comparisons were performed.</p><p><strong>Results: </strong>Fifty-five patients were included with a mean age of 38.2 (8.75) years. 61.8% were female. EDSS scores improved significantly from 3.77 (1.71) at baseline to 3.28 (2.05) at 12 months (P < 0.001). The annualized relapse rate decreased from 0.60 to 0.15, and MRI analysis showed significant reductions in both T2 lesions (17.06 [12.94] to 1.09 [2.38]; P < 0.001) and gadolinium-enhancing T1 lesions (1.26 [1.17] to 0.06 [0.23]; P < 0.001). Clinically indicated MS-related hospitalizations (excluding all treatment-administration admissions) decreased from 32.7% before treatment to none during the 12-month follow-up. No serious adverse events were reported, and 96.4% of patients experienced no adverse events. Regression analysis identified baseline EDSS as the only independent predictor of disability at 12 months.</p><p><strong>Conclusions: </strong>Twelve months of ocrelizumab therapy was associated with significant reductions in relapse activity and MRI lesion burden, as well as improvement/stabilization of disability, with a favorable safety profile.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bupivacaine-Induced Chemical Meningitis: An Uncommon Cause of Meningitis Following Spinal Anesthesia - Two Cases.","authors":"Jibu K Jo, Kondanath Saifudheen","doi":"10.4103/aian.aian_118_26","DOIUrl":"https://doi.org/10.4103/aian.aian_118_26","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relapsing Cavernous Sinus Pachymeningitis as a Paradoxical Reaction to Central Nervous System Tuberculosis Successfully Treated with Infliximab.","authors":"M Srinath, Vivek Jacob Phillip, Sandhya Pulukool, Gopal Krishna Dash, Kuldeep Shetty","doi":"10.4103/aian.aian_337_26","DOIUrl":"https://doi.org/10.4103/aian.aian_337_26","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}