{"title":"Correspondence: \"Long-Term Effects of Deep Brain Stimulation on Non-Motor Symptoms in Patients with Parkinson's Disease\".","authors":"Shayan Sharifi, Alisina Mirzaei","doi":"10.4103/aian.aian_947_25","DOIUrl":"10.4103/aian.aian_947_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"132"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028278","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":"Ictal Bruxism - A Sign of Temporal Lobe Ictal Localization: A Case Series.","authors":"Sita Jayalakshmi, Anuja Patil, Dhrumil Shah, Mihir Parekh, Sudhindra Vooturi, Manas Panigrahi","doi":"10.4103/aian.aian_814_25","DOIUrl":"10.4103/aian.aian_814_25","url":null,"abstract":"<p><p>Ictal bruxism (IB) is a rare oro-alimentary automatism in focal seizures. We report a series of six patients with IB in drug-resistant temporal lobe epilepsy (TLE) treated subsequently with temporal lobectomy. All patients had ictal teeth grinding with semiological features, suggestive of temporal lobe origin. Ictal electroencephalogram (EEG) onset showed artifacts corresponding to bruxism; one patient had a \"checkerboard\" pattern of EEG artifacts corresponding with lateral jaw movements. Five patients had a lesion in the mesial temporal lobe, while one patient had a neocortical temporal lobe lesion. Right temporal localization was observed in five, while one patient had left temporal localization. At the latest post-surgery follow-up of 3 to 14 years (mean 8.83 ± 3.53 years), all patients were seizure-free. IB is an under-recognized ictal phenomenon of TLE representing oro-mandibular automatisms involving the limbic networks. It is a sign of ictal localization to the temporal lobe but not a lateralizing sign.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"82-86"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099549","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":"Interpeduncular Angle: A Possible Marker to Differentiate Atypical Parkinsonism from Idiopathic Parkinson's Disease.","authors":"Tejas Shivarthi, Mahima Sriram, Udit Saraf, Rajesh Kannan, Sudheeran Kannoth, Abish Sudhakar, Vivek Nambiar, Siby Gopinath, Gopikrishnan Unnikrishnan, Anandkumar Anandakuttan","doi":"10.4103/aian.aian_357_25","DOIUrl":"10.4103/aian.aian_357_25","url":null,"abstract":"<p><p>Atypical parkinsonian disorders (APD), such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal syndrome (CBS), and Lewy body dementia (LBD) are frequently misdiagnosed, commonly as Parkinson's disease (PD). The study aims to assess the utility of the interpeduncular angle (IPA) in distinguishing APD from PD across age ranges. This retrospective study was conducted with 225 patients (75 with APD, 75 with PD, and 75 healthy controls). Patients were categorized into three age groups: (51-60, 61-70, and 71-80 years). Two independent raters measured the IPA from T1-weighted axial brain magnetic resonance images (MRIs) at a level below the mammillary bodies using standardized measurement techniques. The APD group included 51 (68%) with PSP, 16 (21.33%) with MSA, 5 (6.67%) with LBD, and 3 (4%) with CBS. Bland-Altman analysis for angle measurement suggested good to excellent agreement between raters ( P < 0.001). IPA measurements among the different diagnostic groups showed that PSP was higher than controls ( P < 0.001) and PD ( P < 0.001), and MSA was higher than controls ( P < 0.001) and PD ( P = 0.003). There was no significant association between IPA and age in the APD phenotypes. With increasing age, the significance between APD and IPD groups decreased ( P < 0.001 in 51-60 years to P = 0.686 in 71-80 years). Receiver Operating Characteristic (ROC) analysis revealed increasing IPA thresholds for PSP versus PD (67.66° in 51-60 years to 75.71° in 71-80 years). IPA is not reliable in differentiating APD, particularly PSP and MSA, from PD and controls.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"71-75"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562473","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":"Clinical Presentation and Evolution of Isolated Focal and Segmental Dystonia in Adults - 20 Years' Experience from a Botulinum Toxin Clinic.","authors":"Asish Vijayaraghavan, Syam Krishnan, Khushboo Subash Patel, Sm Krishna Mohan, Vineeth Radhakrishnan, Anju Sanalkumar, S Gangadhara Sarma, Ajith Cherian, Divya Kalikavil Puthanveedu","doi":"10.4103/aian.aian_784_25","DOIUrl":"10.4103/aian.aian_784_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Isolated dystonia generally occurs due to genetic causes, and the pattern and distribution may change over time. Botulinum toxin is the first-line treatment in those with isolated focal and segmental dystonia. We aimed to describe the clinical profile and evolution of adult patients with isolated focal and segmental dystonia presenting for treatment in our botulinum neurotoxin (BoNT) clinic, and the response to treatment, over 20 years.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients with isolated focal and segmental dystonia who had at least two visits in our BoNT clinic. The clinical features at presentation and during follow-up, muscles injected for each type of dystonia, the self-reported benefit with BoNT, and adverse effects were analyzed.</p><p><strong>Results: </strong>Five hundred seventy-eight patients with isolated dystonia were injected and had at least one additional follow-up. Five hundred seventeen (89.4%) had focal dystonia, and 61 (10.6%) had segmental dystonia. Cervical dystonia was the most common type. Spread to other regions was seen in 81 (14%) of patients. Those with blepharospasm as initial presentation tended to have the highest occurrence (27.3%) of spread to other parts. The mean response to BoNT was around 68%. The presence of a sensory trick and the absence of tremor were found to be predictors of good outcomes with BoNT.</p><p><strong>Conclusions: </strong>Isolated focal and segmental dystonia in adults has a good prognosis, with the majority responding well to BoNT and the dystonia remaining confined to the initially affected body part. Our study provides evidence for the response to BoNT therapy in a real-world scenario, outside of a clinical trial setting.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"28-34"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257195","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}
Alamanda V Anupama, Anish Mehta, Mahendra Javali, E Mahesh, Pradeep Rangaiah, Purushottam Acharya
{"title":"Authors' reply- Letter Regarding the Article Entitled \"Prevalence, Risk Factors, and Psychosocial Impact of Restless Legs Syndrome in End-Stage Renal Disease Patients Undergoing Hemodialysis\".","authors":"Alamanda V Anupama, Anish Mehta, Mahendra Javali, E Mahesh, Pradeep Rangaiah, Purushottam Acharya","doi":"10.4103/aian.aian_1075_25","DOIUrl":"10.4103/aian.aian_1075_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"136-137"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218296","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}
Vaibhav Bhandari, Savyasachi Jain, Ayush Agarwal, Divyani Garg, Shailesh B Gaikwad, Achal K Srivastava
{"title":"Fulminant Intracranial Hypertension Secondary to Multiple Cavernomas: A Rare Association.","authors":"Vaibhav Bhandari, Savyasachi Jain, Ayush Agarwal, Divyani Garg, Shailesh B Gaikwad, Achal K Srivastava","doi":"10.4103/aian.aian_845_25","DOIUrl":"10.4103/aian.aian_845_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"126-128"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627388","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}
Iva Fiedorova, Sarka Banikova, Tomas Adamec, Adela Konde, Pavla Hanzlikova, Aravind Ganesh, Michal Bar, Ondrej Volny
{"title":"Robot-Assisted Gait Therapy in the Subacute Phase of Ischemic Stroke: A Randomized Controlled Trial.","authors":"Iva Fiedorova, Sarka Banikova, Tomas Adamec, Adela Konde, Pavla Hanzlikova, Aravind Ganesh, Michal Bar, Ondrej Volny","doi":"10.4103/aian.aian_526_25","DOIUrl":"10.4103/aian.aian_526_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Robot-assisted gait training (RAGT) constitutes a modern neurorehabilitation approach. However, limited data are available regarding the efficacy of RAGT when combined with conventional rehabilitation in the early subacute phase of stroke. This pilot study assessed the additive impact of protocol-defined RAGT on functional ambulation categories (FACs), walking abilities, and balance.</p><p><strong>Methods: </strong>This randomized controlled trial used a 1:1 Prospective Randomized Open Blinded End-point design (NCT04910217), comparing two groups: conventional rehabilitation and the RAGT group. All participants received protocol-defined conventional rehabilitation (15 sessions over 3 weeks). The RAGT group underwent additional sessions using the Lokomat Pro FreeD (15 sessions over 3 weeks). FAC, 10-meter Walk Test (10MWT), Timed Up and Go (TUG), and Berg Balance Scale (BBS) were assessed at 3 weeks and 3 months after randomization. In addition, the modified Rankin Scale was evaluated.</p><p><strong>Results: </strong>Among 184 patients screened between June 1, 2020, and November 30, 2023, 42 were included (19 in the RAGT group and 23 in the conventional group). The median time from stroke to randomization was 13 days (interquartile range [IQR]: 11-16), and the median age was 67 years (IQR: 58-71). Both groups demonstrated improvements in FACs. Significantly, patients in the RAGT group showed better results in the endpoint of FAC improvement by 2 or more points ( P = 0.044). Progress in TUG ( P = 0.034) and BBS ( P = 0.049) during the study period was significantly more favorable in the RAGT group.</p><p><strong>Conclusions: </strong>The addition of RAGT to conventional rehabilitation in the subacute phase of stroke exhibited positive effects on improving gait, walking, and balance.Trial registration number: NCT04910217.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"52-58"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627507","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":"Primary Adult Ventriculitis due to Streptococcus pneumoniae with Obstructive Hydrocephalus: Role of Arachnoid Cyst as a Predisposing Factor.","authors":"Bhavani Madduluri, Phaninder Ln Madiraju, Surya Prabha Turaga","doi":"10.4103/aian.aian_406_25","DOIUrl":"10.4103/aian.aian_406_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"98-101"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123476","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":"Case Report of Andersen-Tawil Syndrome: Rare Presentation of a Rare Disease.","authors":"Himanshu Shakya, Shivangi Bhatnagar, Pratik Babel, Suman Kushwaha, Rajinder K Dhamija","doi":"10.4103/aian.aian_498_25","DOIUrl":"10.4103/aian.aian_498_25","url":null,"abstract":"<p><p>Andersen-Tawil syndrome (ATS) is a rare genetic disorder characterized by a triad of periodic paralysis, cardiac arrhythmias, and dysmorphic features, typically presenting in the first two decades of life. A 45-year-old man presented with acute lower motor neuron-type quadriparesis. He reported similar self-resolving episodes over the past 2 years, triggered by rest after exercise. There were no cardiac symptoms, dysmorphic features, or relevant family history. Biochemical evaluation revealed hypokalemia. Genetic testing confirmed a heterozygous nonsense mutation in the KCNJ2 gene (c.13C>T, p.Arg5Ter). Cardiac and dental evaluations were normal. He was treated with potassium supplementation and later acetazolamide, with no recurrence over 2 years. This case highlights a rare adult-onset presentation of ATS without cardiac or dysmorphic features and a negative family history, contributing to the limited adult ATS literature.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"91-93"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123527","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}
Esen Kiyan, Aylin Pihtili, Hacer Durmus, Yesim Parman
{"title":"Subclinical Respiratory Muscle Weakness and Obstructive Sleep Apnea are Common in Glucosamine-UDP-N-acetyl-2-epimerase / N-acetylmannosamine kinase (GNE) Myopathy.","authors":"Esen Kiyan, Aylin Pihtili, Hacer Durmus, Yesim Parman","doi":"10.4103/aian.aian_725_25","DOIUrl":"10.4103/aian.aian_725_25","url":null,"abstract":"<p><p>Glucosamine-UDP-N-acetyl-2-epimerase / N-acetylmannosamine kinase (GNE) myopathy is a rare, slowly progressive myopathy primarily affecting distal muscles. Limited evidence suggests possible respiratory muscle weakness and obstructive sleep apnea (OSA). We aimed to assess daytime lung functions and OSA in GNE myopathy. Nine patients were evaluated by spirometry, maximal inspiratory pressure (MIP), maximal expiratory pressure, single-breath count (SBC), peak cough flow (PCF), arterial blood gases (ABG), sleep questionnaires, and polysomnography. All patients had normal spirometry and ABGs, but 55.6% had decreased MIP, 44.4% had decreased PCF, and 55.6% had SBC<20. Poor sleep quality was common (77.8%). OSA was present in 66.7% of the patients. In conclusion, subclinical respiratory muscle weakness and OSA were frequent in GNE myopathy patients with normal spirometry. Therefore, MIP, PCF, SBC, and polysomnography should be included in routine evaluation.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"67-70"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111942","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}