Annals of Indian Academy of Neurology最新文献

{"title":"Utility of Dorsal Sural Nerve for Clinical Correlation and Detection of Early Diabetic Neuropathy.","authors":"Partisha Gupta, Ajoy Kumar Sodani, Rahul Jain, Ashish Gaur","doi":"10.4103/aian.aian_1121_24","DOIUrl":"https://doi.org/10.4103/aian.aian_1121_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Monofilament and tuning fork are commonly applied in clinical testing for distal sensory peripheral neuropathy (DSP). However, a dependable diagnosis of DSP requires nerve conduction studies (NCS). In the present study, we emphasize on the utility of dorsal sural sensory nerve action potential (dsSNAP) abnormality over sural sensory nerve action potential (SNAP) abnormality in detecting early DSP. Furthermore, we study the correlation between the clinical findings and sural SNAP and dsSNAP abnormalities.</p><p><strong>Methods: </strong>The study included 101 persons with type 2 diabetes mellitus (T2DM) (PWD; 202 lower extremities [LEs]) aged 18-70 years, with the duration of T2DM being ≥6 months. Normative data was generated from controls (200 LEs). Clinical and electrophysiological findings of the study group were analyzed and discussed in comparison with the normative data. Furthermore, receiver operating characteristic (ROC) curve analysis determined the optimal cut-off for different sensory modalities, and Spearman's correlation tests were applied to analyze the correlation between NCS and clinical parameters.</p><p><strong>Results: </strong>dsSNAP was abnormal in 39.1%, while sural SNAP was abnormal in 9.8% of asymptomatic PWD. Early neuropathy was detectable with subjective losses of 10% in temperature and pain sensations, 20% in touch sensation, and vibration duration <12 sec. Conventionally, the lower limit of normal of SNAP is considered as the cut-off for abnormality in the Electrophysiology (EP) lab. On ROC analysis, we found different optimal cut-offs for different sensory modalities.</p><p><strong>Conclusions: </strong>Incorporating dorsal sural nerve into routine NCS enhances the detection of early DSP. Clinical sensory abnormalities, especially temperature and vibration sensation, showed the highest sensitivity and specificity, respectively, in relation to NCS abnormalities. Relying solely on standard institute-based reference SNAP amplitudes may potentially overlook early DSP.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574721","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":"Cerebral Chromoblastomycosis: A Unique Presentation of Dematiaceous Fungal Infection in an Immunocompromised Patient.","authors":"Norton Stephen, Soundarya Ravi, Srinivas Bheemanathi Hanuman, Vir Singh Negi, Madhavan Sasidharan Gopalakrishnan","doi":"10.4103/aian.aian_747_24","DOIUrl":"10.4103/aian.aian_747_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574709","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":"Mastoid Signal Change and Acute Cerebral Venous Sinus Thrombosis: Unlocking the Puzzle.","authors":"Ayush Agarwal, Venugopalan Y Vishnu, Meena Chandu, Divyani Garg, Manjari Agarwal, Ranjot Kaur, Maneesh Shakywar, Rohit Bhatia, Achal K Srivastava, Ashish Upadhyay, Ajay Garg, Mv Padma Srivastava","doi":"10.4103/aian.aian_99_25","DOIUrl":"10.4103/aian.aian_99_25","url":null,"abstract":"<p><strong>Abstract: </strong>Mastoid signal changes on magnetic resonance imaging in cerebral venous sinus thrombosis (CVT) patients are often misinterpreted as septic CVT. Studies have revealed mastoid signal changes in CVT patients. We conducted this study to investigate this relationship. Single-center, retrospective, observational study. Patients aged ≥18 years with venography-proven CVT were enrolled, excluding those with sepsis-induced CVT. Mastoid changes and clot burden score (CBS) were calculated. We screened and enrolled 128 and 124 CVT patients, respectively. Seventy per cent of patients had mastoid signal changes. The median mastoid score and CBS were 1 and 3, respectively. CBS was higher in CVT patients with mastoid changes. A higher CBS was associated with a higher mastoid score ( P = 0.003). Logistic regression analysis revealed an odds ratio of 0.67 (95% confidence interval: 0.52-0.87) for this association. The presence of radiological mastoid involvement is not sine qua non of associated middle ear infections and should raise the possibility of CVT.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574710","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":"Patatin-Like Phospholipase Domain-Containing Protein 8 Mutation Associated with Gonadal Dysgenesis, Cerebellar Ataxia, and Peripheral Neuropathy in an Indian Family.","authors":"Alvee Saluja, Shahbaz Anees, Lekharaj H Ghotekar, Vikas Yadav, Anul Haque, Mehar C Sharma","doi":"10.4103/aian.aian_15_25","DOIUrl":"https://doi.org/10.4103/aian.aian_15_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526212","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":"Shaky Beginnings: A Novel CoQ8A Mutation in Adolescent-Onset Cerebellar Ataxia with Head Tremors.","authors":"Vishnu K Subramanian, Saranya B Gomathy, Shamir Sella Sugan, Ramkumar Sugumaran, Sunil K Narayan","doi":"10.4103/aian.aian_247_25","DOIUrl":"https://doi.org/10.4103/aian.aian_247_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526213","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":"Uremic Peripheral Neuropathy in Nondiabetic Chronic Hemodialysis Patients.","authors":"Taoufiq Aatif, Narjiss Labioui, Hajjar Laasli, Yassir Zajjari, Driss El Kabbaj","doi":"10.4103/aian.aian_74_25","DOIUrl":"https://doi.org/10.4103/aian.aian_74_25","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic kidney disease is a global public health problem. Emphasis has been placed on uremic peripheral neuropathy (PN) in nondiabetic chronic hemodialysis (HD) patients. This complication could affect the quality of life. We aimed to determine the prevalence and risk factors of PN. This was a cross-sectional study. Evaluation of PN was made by clinical examination and electroneuromyogram. The prevalence of PN was 30.3%. The most common symptoms were paresthesia and burning. Neuropathic pain was symmetrical in the majority of cases and localized to the lower limb (60%). All patients had axonal type PN. In univariate analysis, the risk factors for PN were advanced age (P = 0.012), hypertension (P = 0.007), ischemic heart disease (P = 0.036), high C-reactive protein (microinflammation) (P = 0.002), low urea reduction ratio (P = 0.013), and high ß2 microglobulin (P = 0.002). Since PN is common in nondiabetic chronic HD patients, it becomes necessary to diagnose it and correct its risk factors.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526214","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":"Embolic Stroke of Undetermined Source (ESUS): Prevalence, Risk Factors, and Diagnostic Insights from a Prospective German Cohort.","authors":"Priyanka Boettger, Jamschid Sedighi, Martin Juenemann, Michael Buerke, Omar Alhaj Omar","doi":"10.4103/aian.aian_327_25","DOIUrl":"https://doi.org/10.4103/aian.aian_327_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Embolic stroke of undetermined source (ESUS) was introduced to standardize the classification of cryptogenic strokes with presumed embolic origin. However, ESUS comprises a heterogeneous group with diverse clinical and diagnostic features. This study aimed to characterize ESUS within a prospective stroke cohort and compare it with other defined ischemic stroke subtypes.</p><p><strong>Methods: </strong>In this prospective, single-center study, patients with acute ischemic stroke or transient ischemic attack (TIA) were enrolled over 6 months. Stroke etiology was classified according to established criteria, including ESUS definitions based on the exclusion of major cardioembolic sources, ≥50% large-artery stenosis, and small-vessel disease. All patients underwent neuroimaging, vascular diagnostics, and cardiological workup, including echocardiography and rhythm monitoring.</p><p><strong>Results: </strong>Of 714 patients, 98 (13.7%) met ESUS criteria. ESUS patients were younger (median 67 vs. 74 years), predominantly male (61.2%), and had fewer prior strokes or TIAs (11.2% vs. 27.6%, P < 0.001) than nonESUS patients. Hypertension (72.2%) and obesity (54.2%) were common. Stroke severity at discharge was lower in ESUS (National Institutes of Health Stroke (NIHSS) 1.9 ± 2.3) compared to cardioembolic (4.8 ± 3.7) and atherosclerotic strokes (3.5 ± 3.1) (P < 0.05), and no in-hospital deaths occurred in the ESUS group (P = 0.02). While overall diagnostic imaging rates were similar across groups, transesophageal echocardiography was performed more frequently in ESUS (38.8%).</p><p><strong>Conclusions: </strong>ESUS accounted for 18% of ischemic strokes and represents a distinct, clinically relevant subgroup with unique demographic and outcome profiles. These findings support the refinement of ESUS classification and the need for individualized diagnostic and secondary prevention strategies.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526211","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":"Movement Disorders in CSF1R-Related Leukoencephalopathy: A Case Series.","authors":"Nitish Kamble, R S Harishma, Vikram V Holla, Shweta Prasad, Jitender Saini, Pramod K Pal","doi":"10.4103/aian.aian_51_25","DOIUrl":"https://doi.org/10.4103/aian.aian_51_25","url":null,"abstract":"<p><strong>Abstract: </strong>CSF1R-related leukoencephalopathy is a rare, dominantly inherited leukoencephalopathy caused by mutations in the CSF1R gene that codes for colony-stimulating factor 1 receptor. We describe the clinical and neuroimaging features in three genetically confirmed cases (two women) of CSF1R-related leukoencephalopathy. The age at onset ranged from 41 to 45 years. Cognitive and behavioral disturbances were seen in all patients, and one patient had epilepsy. The movement disorders included parkinsonism, freezing of gait, cerebellar ataxia, tremors, etc., Pyramidal signs were noted in two patients. Magnetic resonance imaging of the brain showed signal changes in the white matter. Whole-exome sequencing revealed mutation in the CSF1R gene, confirming the diagnosis. A combination of rapidly progressive cognitive and behavioral disturbances with involvement of pyramidal, extrapyramidal, and characteristic neuroimaging suggests diagnosis. Currently, the treatment is symptomatic as there is no specific treatment for the disease and a multidisciplinary team is required for managing these patients. Hematopoietic stem cell transplantation has shown to benefit a few patients.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274065","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":"Tetrapolydactyly and Hydrocolpos in an Infant: Neuroimaging Gives Clue to the Diagnosis.","authors":"Singanamalla Bhanudeep, Bramhini B Koneti","doi":"10.4103/aian.aian_217_25","DOIUrl":"https://doi.org/10.4103/aian.aian_217_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265119","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":"Endovascular Approach in Acute Ischemic Stroke Secondary to Bilateral Vertebral Artery Dissection.","authors":"Rajeev Goel, Vivek Gupta, Amit Shankar","doi":"10.4103/aian.aian_20_25","DOIUrl":"https://doi.org/10.4103/aian.aian_20_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265118","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}