Annals of Indian Academy of Neurology最新文献

{"title":"Acute Transient Blepharospasm Following Deep Brain Stimulation.","authors":"Sayooja Sachithanandan, Krishnakumar Kesavapisharady, Asish Vijayaraghavan, Divya Kalikavil Puthenveedu, Syam Krishnan","doi":"10.4103/aian.aian_1268_25","DOIUrl":"10.4103/aian.aian_1268_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"29 4","pages":"663-664"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Opercular Syndrome in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis: An Unusual Presentation.","authors":"Parth Lal, Kiran Anand, Souraja Dutta, Sumit Bhadu, Chirag Ahuja, Arushi G Saini","doi":"10.4103/aian.aian_1315_25","DOIUrl":"10.4103/aian.aian_1315_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"675-677"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seronegative Hypophysitis Presenting as Unilateral Lateral Rectus Palsy.","authors":"Edwin G Pullan, Mathew Abraham, Ramzeen N Hameed","doi":"10.4103/aian.aian_1273_25","DOIUrl":"10.4103/aian.aian_1273_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"29 4","pages":"666-667"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Health in Men and Women with Wilson's Disease: A Cross-Sectional Study.","authors":"Jalumuri Ss Anjusha, Doniparthi V Seshagiri, Lakshminarayanapuram G Viswanathan, Shaik Ahmed, Sinu Ezhumalai, Binu V Sreekumaran Nair, Madhu Nagappa, Sanjib Sinha","doi":"10.4103/aian.aian_109_26","DOIUrl":"10.4103/aian.aian_109_26","url":null,"abstract":"<p><strong>Background and objectives: </strong>Wilson's disease (WD) is a systemic copper toxicity disorder, manifesting as hepatic and neurological symptoms. Sexual health in WD is not well studied. This study aimed to understand sexual health impairment and its related factors in men and women with WD.</p><p><strong>Methods: </strong>Men with WD (MeWD) and women with WD (WoWD) were classified as being in the disease-active phase (DAP) or disease maintenance phase (DMP). Disease-related disability was assessed using the Global Assessment Scale for Wilson's Disease (GAS for WD). Sexual health was assessed with the Arizona Sexual Experience Scale (ASEX). Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales, respectively. Healthy men (MeH) and healthy women (WoH) underwent similar assessments for comparison.</p><p><strong>Results: </strong>The study included 48 MeWD (11 DAP, 37 DMP), 39 WoWD (12 DAP, 27 DMP), 29 MeH, and 34 WoH. In MeWD, ASEX scores (median [Q1-Q3]) were 13 (10-16) in DAP, 13 (11-14) in DMP, and 14 (12-16) in MeH, with no significant differences. However, in WoWD, ASEX scores were more impaired in DAP 19.5 (15.25-24.75) than in DMP 15 (14-17) ( P = 0.029) and WoH 14 (13-18) ( P = 0.025). ASEX scores correlated with GAS for WD in both MeWD ( P = 0.023) and WoWD ( P < 0.001), but not with 24-hour urinary copper excretion at diagnosis.</p><p><strong>Conclusions: </strong>Men and women with WD experience impaired sexual health, which may be related to disease-associated disability. Longitudinal disease registries are required to understand the role of copper metabolism in sexual health impairment in WD.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"579-584"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Versus Delayed Antihypertensive Therapy in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Felicia Jesslyn, Aldy S Rambe, Kevin Ardinata, Yoshe Jesslyn, Kyrie H Panjaitan","doi":"10.4103/aian.aian_1367_25","DOIUrl":"10.4103/aian.aian_1367_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Ischemic stroke remains a major global cause of death and morbidity. Hypertension is often found in this condition and is associated with poorer functional outcomes and higher mortality. This study aimed to evaluate the effectiveness of early antihypertensive therapy in acute ischemic stroke.</p><p><strong>Methods: </strong>This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Literature searches in PubMed, the Cochrane Library, and ClinicalTrials.gov from database inception to October 20, 2025 included randomized controlled trials (RCTs) involving adults with ischemic stroke. The primary outcome was mortality; secondary outcomes included functional outcomes measured by the modified Rankin Scale (mRS), major vascular events, and recurrent stroke. Pooled effects were calculated using a random-effects model as an odds ratio with a 95% confidence interval. Heterogeneity was assessed using the I 2 statistic.</p><p><strong>Results: </strong>Three RCTs were included. Early antihypertensive therapy showed no significant difference compared with delayed treatment in mortality or major disability at 90 days, good functional outcome (mRS: 0-2), or poor functional outcome (mRS: 3-6). No significant subgroup differences were observed. Early treatment also did not reduce the risk of major vascular events or recurrent stroke.</p><p><strong>Conclusions: </strong>Current evidence from a limited number of RCTs suggests that early antihypertensive therapy is not associated with improved mortality or major disability at 90 days, functional outcomes, vascular events, or recurrent stroke in patients with ischemic stroke. However, these findings should be interpreted with caution, given the small number of included studies, and further large-scale RCTs are needed.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"528-535"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden Unexpected Death in Epilepsy (SUDEP) and Cardiovascular Dysfunction - Unraveling the Link: A Narrative Review.","authors":"Meet P Kachhadia, Smit Kotadiya, Nirali Borad, Amina A Muhaimin, Abdul Shafi, Usmaan Topiwala, Francis Demiraj, Sezan Hossain, Juber D Shaikh, Neel Parikh","doi":"10.4103/aian.aian_40_26","DOIUrl":"10.4103/aian.aian_40_26","url":null,"abstract":"<p><p>Sudden unexpected death in epilepsy (SUDEP) represents a major cause of mortality in individuals with epilepsy, accounting for 8-17% of epilepsy-related deaths. Its multifactorial pathogenesis implicates autonomic dysfunction, impaired heart rate variability, seizure-related arrhythmias, genetic channelopathies, and the potential influence of antiepileptic drugs. Epidemiological studies demonstrate increased SUDEP risk in patients with refractory epilepsy, poor seizure control, and polytherapy, with additional contributions from genetic predisposition and sleep-related seizures. Cardiac abnormalities, including ictal tachyarrhythmias, bradyarrhythmias, and altered QT dynamics, may provide the electrophysiological substrate for lethal events. This review synthesizes current understanding of epidemiology, neuro-cardio-respiratory mechanisms, and cardiovascular contributions to SUDEP, highlighting the role of autonomic and genetic factors, as well as peri-ictal cardiac disturbances. The Mortality in Epilepsy Monitoring Unit Study has provided central insights into the cardiorespiratory cascade leading to SUDEP, while emerging risk-stratification tools such as the SUDEP-7 and SUDEP-3 inventories offer promise for clinical risk assessment. Molecular autopsy approaches identifying channelopathies in DEPDC5 , SCN1A , and cardiac ion channel genes may inform family screening and personalized prevention strategies. Preventive strategies remain limited, although closer collaboration between neurology and cardiology, improved seizure control, adherence to antiepileptic regimens, and consideration of cardiac monitoring or device therapy may help reduce risk. Future research should focus on large-scale prospective studies incorporating implantable monitoring and systematic molecular autopsies to clarify mechanisms and guide individualized preventive strategies tailored to resource settings.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"29 4","pages":"536-543"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between Time from Onset to Randomization and Benefit Magnitude in Recent Clinical Trials of Thrombectomy for Patients with Large Ischemic Cores.","authors":"Byron J Gajewski, Katherine R Gajewski, Pooja Khatri, Jeffrey L Saver, Karen C Johnston, Jonathan Beall, Jordan J Elm","doi":"10.4103/aian.aian_72_26","DOIUrl":"10.4103/aian.aian_72_26","url":null,"abstract":"<p><p>Six randomized trials have demonstrated the benefit of endovascular thrombectomy (EVT) for patients with large ischemic core stroke, but the extent to which treatment effect diminishes with increasing onset-to-treatment time remains unclear. We evaluated whether trial-level median time from symptom onset to randomization modifies the absolute EVT effect compared with medical management (MM). Using study-level data from six trials (n=1,881), we modeled differences in 90-day utility-weighted modified Rankin Scale (uw-mRS) outcomes between EVT and MM as a function of median onset-to-randomization time via Bayesian regression, selecting models based on deviance information criteria. Increasing time was strongly associated with declining EVT benefit (posterior probability =0.9925). The absolute treatment effect fell below 0.10 at 10 hours (95% CrI, 7-15) and below 0.03 at 18 hours (95% CrI, 12-33). These findings suggest that treatment delays attenuate EVT benefit and may inform hypothesis generation and future trial design in acute stroke.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"628-630"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Cingulate Island\" Sign in a Patient with Reversible Parkinsonism due to a Portosystemic Shunt.","authors":"Arnab Adhya, Divyani Garg, Ayush Agarwal, Madhavi Tripathi, Ajay Garg, Achal K Srivastava","doi":"10.4103/aian.aian_1208_25","DOIUrl":"10.4103/aian.aian_1208_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"651-653"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging Findings During Encephalopathic Crisis in Glutaric Aciduria Type 1: Expanding the Radiologic Phenotype.","authors":"Shehla H Mohammed, Vinay Hegde, G Girish, A S Jyotsna","doi":"10.4103/aian.aian_141_26","DOIUrl":"10.4103/aian.aian_141_26","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"633-634"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Leptomeningeal Collaterals and Their Impact on Functional Outcomes in Anterior Circulation Acute Ischemic Stroke.","authors":"Sharath Chandra Shetty, Naveen Kumar Paramasivan, Arun Prasad Balasubramanian, Harikrishnan Ramachandran, Chandrasekharan Kesavadas, Sapna E Sreedharan, V T Jissa, P N Sylaja","doi":"10.4103/aian.aian_163_26","DOIUrl":"10.4103/aian.aian_163_26","url":null,"abstract":"<p><strong>Background and objectives: </strong>Leptomeningeal collaterals are essential for maintaining cerebral perfusion during acute large vessel occlusion (LVO) and are predictive of favorable outcomes in stroke patients. However, the factors influencing baseline collateral status are not well understood. We aimed to identify factors predicting poor baseline collateral status and unfavorable 3-month outcomes in acute ischemic stroke (AIS) patients with LVO in the anterior circulation in the Indian subcontinent.</p><p><strong>Methods: </strong>We retrospectively enrolled 239 patients who underwent computed tomography angiography within 24 hours of acute ischemic stroke. Patient demographics, vascular risk factors, baseline stroke severity, etiology, and 3-month functional outcomes were collected.</p><p><strong>Results: </strong>The mean age was 59.5 ± 13.5 years; 152 (64%) patients were males, and the median baseline National Institutes of Health Stroke Scale (NIHSS) score was 15. Bivariate analysis showed that male sex (77% vs. 58%, P = 0.004), absence of valvular disease (92% vs. 82%), lower clot burden score (CBS) (32% vs. 16%, P = 0.003), and renal dysfunction (11% vs. 3%, P = 0.01) were associated with poor collateral status. Logistic regression identified renal dysfunction (odds ratio [OR] 3.9; 95% confidence interval [CI], 1.2-14.68; P = 0.031) and lower CBS (OR, 0.40; 95% CI, 0.23-0.93; P = 0.030) as independently associated with poor collateral status. Poor 3-month outcomes were associated with older age (OR, 1.96; 95% CI, 1.05-3.68; P = 0.034), large vessel atherosclerosis (OR, 2.66; 95% CI, 1.27-5.56; P = 0.009), and poor collateral status (OR, 2.35; 95% CI, 1.18-4.66; P = 0.014).</p><p><strong>Conclusions: </strong>Lower CBS and renal dysfunction were associated with poor collateral status at baseline in AIS patients with LVO. Advanced age, large vessel atherosclerosis, poor collateral status, and greater stroke severity predicted poor functional outcomes at 3 months.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"553-561"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}