Annals of Indian Academy of Neurology最新文献

{"title":"Tyrosine Kinase Inhibitor-Induced Intracranial Artery Stenosis - A Rare Cause of TIA in a Patient of Chronic Myeloid Leukemia.","authors":"Sumedh S Agrawal, Nikith A Shetty, Nisha Shenoy, Arvind N Prabhu, Aparna R Pai","doi":"10.4103/aian.aian_411_24","DOIUrl":"10.4103/aian.aian_411_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"740-742"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387442","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":"Late-Onset Presentation of Spastic Paraplegia 3A ( ATL1 -HSP) and Its Rare Occurrence with Multiple Spinal Neurofibromas.","authors":"Anudeep Ds Davuluri, Sangeeth T Ananthasubramanian, Saraswati Nashi, Faheem Arshad, Hansashree Padmanabha, Seena Vengalil, Rohan Mahale, Pooja Mailankody, P R Srijithesh, Girish B Kulkarni, Mathuranath S Pavagada, Suvarna Alladi, Atchayaram Nalini","doi":"10.4103/aian.aian_308_24","DOIUrl":"10.4103/aian.aian_308_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"727-729"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613600","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":"Developing an Index to Measure the Value of Health Care Provided to Stroke Patients.","authors":"Halil Şengül, Sabahattin Aydın, Emrah Önder, Arzu Bulut","doi":"10.4103/aian.aian_1084_23","DOIUrl":"10.4103/aian.aian_1084_23","url":null,"abstract":"<p><strong>Background and objectives: </strong>It is possible to evaluate health services for stroke patients based on clinical benefits. However, in recent years, questions about responsiveness and outcomes have also emerged. Currently, there is no index that can assess health-care services for stroke patients along these three dimensions. This study introduces the first index designed to measure the value generated by health-care services for stroke patients.</p><p><strong>Methods: </strong>The Case-Mix Variables Data Collection Reference Guide, developed through a review of national and international stroke guidelines, underwent content validation by 10 neurologists and 10 interventional radiologists. Questions with a content validity index exceeding 0.80, along with the World Health Organization responsiveness questionnaire and the Patient-Reported Outcomes Measurement Information System Global-10 short form, were subjected to pairwise comparison by two neurologists, two interventional radiologists, and two public health physicians using the analytic hierarchy process (AHP) method.</p><p><strong>Results: </strong>In the comprehensive ranking of questions formulated using the AHP method and assessed by experts for importance and global weights, new stroke follow-up emerged as the most crucial, garnering an index score of 0.09. Conversely, questioning patients about their alcohol use status was deemed the least significant by experts, registering an index score of 0.00021.</p><p><strong>Conclusions: </strong>Our AHP analyses have furnished an index for gauging the factors that contribute to the value of health-care services rendered to stroke patients.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"695-705"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666941","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":"Trends in Clinico-radiological and Laboratory Characteristics of All-Cause Meningoencephalitis in Western Rajasthan.","authors":"Ravi Krishna Kanth, Samhita Panda, Sarbesh Tiwari, Taruna Yadav, Gopal Krishana Bohra, Ravi Shekar Gadepalli","doi":"10.4103/aian.aian_352_24","DOIUrl":"10.4103/aian.aian_352_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Meningoencephalitis encompasses the coexistence of meningitis and encephalitis in different proportions. This study aimed to delineate the clinical profile, laboratory parameters, radiological features, and outcome predictors of patients with meningoencephalitis.</p><p><strong>Methods: </strong>This prospective, observational, and descriptive study was conducted from July 2021 to March 2023. Patients satisfying the case definition of \"meningitis\" and \"encephalitis\" were enrolled. Mortality and morbidity (by modified Rankin Score [mRS]) were noted at discharge and at 1 and 3 months post-discharge.</p><p><strong>Results: </strong>Of 102 patients recruited, among infectious meningoencephalitis cases, 28 (27.5%) were viral, 11 (10.8%) were pyogenic, 32 (31.4%) were tubercular, four (3.9%) each were rickettsial, atypical bacterial, and fungal, and three (2.9%) were parasitic. Among noninfectious etiologies, 12 (11.8%) were antineuronal antibody mediated, three (2.9%) had systemic inflammatory etiology, and one (1%) had carcinomatous meningitis. Cerebrospinal fluid (CSF) analysis showed the highest protein content (336.82 ± 251.26 mg/dL) and cell count (476.73 ± 999.16/mm 3 ) in pyogenic followed by tubercular (200.29 ± 174.28/mm 3 ) meningoencephalitis. CSF glucose was lowest in tubercular group (38.30 ± 20.29 mg/dL). Imaging showed leptomeningeal enhancement predominantly in tubercular group (89.7%) and limbic involvement in viral etiology (38.5%). Overall mortality was highest in fungal and rickettsial groups (three out of four patients died at 1 month in each group). Pyogenic, atypical bacterial, and systemic inflammatory meningoencephalitis had maximum temporal improvement in mRS at 1 month, while tubercular, viral, and antineuronal antibody-mediated meningoencephalitis had decrease of at least 1 mRS at 3 months. Fever, altered sensorium, speech disturbances, neck stiffness, albumin, total leukocyte count, erythrocyte sedimentation rate, C-reactive protein, kidney and liver function tests showed significant association with mortality.</p><p><strong>Conclusions: </strong>Tubercular, followed by viral meningoencephalitis, was the most common cause in our center in western India. Pyogenic, atypical bacterial, and systemic inflammatory groups had the best recovery at discharge, while fungal and rickettsial meningoencephalitis groups had worst mRS at 3 months.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"638-646"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708876","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":"Recurrent Acute Disseminated Encephalomyelitis (RADEM) Presenting Beyond \"Sixteen-and-a-Half Syndromes\".","authors":"Baiakmenlang Synmon, Shri Ram Sharma, Mahendre Thakre, Ayush Jain, Sri Hari J","doi":"10.4103/aian.aian_468_24","DOIUrl":"10.4103/aian.aian_468_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"745-748"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778940","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 Prospective Single-Arm Cohort Study of Immune-mediated Seizures/Epilepsy Without Encephalopathy (ISEWE) in Children from a Tertiary Care Hospital in South India.","authors":"Basavanagowda Thanuja, Mahesh Kamate","doi":"10.4103/aian.aian_408_24","DOIUrl":"10.4103/aian.aian_408_24","url":null,"abstract":"<p><p>Acute-onset seizures in children pose a diagnostic and therapeutic dilemma. Some epilepsy cases presenting with seizures but without encephalopathy, though treatable with immunotherapy, are often missed due to lack of suspicion of immune mechanism in the context of absent encephalitis. A prospective study was conducted on premorbidly normal children with new-onset seizures occurring in clusters, with normal neuroimaging. Investigations included electroencephalogram (EEG), cerebrospinal fluid examination, and testing for autoantibodies. All cases received methylprednisolone pulse therapy along with antiseizure medications (ASMs), followed by monthly dexamethasone oral pulse therapy. Fifteen cases were enrolled (11 males, four females). Mean age at seizure onset was 4.6 years. Focal seizures were present in 13/15 (86.7%) cases. Magnetic resonance imaging of the brain was normal in all. EEG showed interictal epileptiform discharges in 12 cases (focal in nine) and ictal record in two cases. On monthly oral steroids, number of ASMs could be reduced. Eight cases never had a relapse, while seven did have it. Relapses were more common if more than three ASMs were tried and less if steroids were started within 30 days. Immune-mediated seizures/epilepsy without encephalopathy is a new, important, and treatable entity. Early diagnosis and institution of immunotherapy results in significant improvement in seizure control and also reduces the need for long-term polytherapy. Awareness of this entity is crucial, especially when premorbidly normal children present with new-onset clusters of refractory seizures.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"710-714"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817071","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":"Loss of Ambulation Due to Calcific Myonecrosis: A Rare but Reversible Complication of Wilson's Disease.","authors":"Abhishek Vaingankar, Divyani Garg, Ayush Agarwal, Divya M Radhakrishnan, Awadh Kishor Pandit, Madhavi Tripathi, Achal K Srivastava","doi":"10.4103/aian.aian_419_24","DOIUrl":"10.4103/aian.aian_419_24","url":null,"abstract":"<p><p>We report two cases of established Wilson's disease (WD) presenting with calcific myonecrosis of the pelvic girdle in association with pelvic fractures. Despite initial improvement with chelation, subacute worsening of ambulation in both led to a consideration of neurologic deterioration on chelation therapy. However, evaluation revealed calcific myonecrosis of the hip joint and adjacent muscles as the cause. Both patients improved with intensive rehabilitation. A review of literature indicates that although osseomuscular complications are reported in WD, calcific myonecrosis is a hitherto unknown entity which, if recognized early, may be reversed, preventing disability and unnecessary change in chelation regimens.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"724-726"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153017","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":"SLC39A14 Deficiency: A Rare Cause of Treatable Infantile Neuroregression.","authors":"Singanamalla Bhanudeep, Bramhini B Koneti","doi":"10.4103/aian.aian_571_24","DOIUrl":"10.4103/aian.aian_571_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"752-753"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370817","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":"Tadpole Brainstem Atrophy in Adult-Onset Alexander Disease: A Case Report and Review of Literature.","authors":"Vidyasagar Kota, Lulup Kumar Sahoo, Ajit Prasad Mishra, Adya Kinkar Panda, Hareen Veerapaneni, Devidutta Dash, Monica Karan","doi":"10.4103/aian.aian_402_24","DOIUrl":"10.4103/aian.aian_402_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"738-740"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456578","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":"Contemporary Treatment Practices for Subacute Sclerosing Panencephalitis: A Nationwide Survey Among Adult and Pediatric Neurologists in India.","authors":"Divyani Garg, Archita Makharia, Ayush Agarwal, Ajay Garg, Achal K Srivastava","doi":"10.4103/aian.aian_507_24","DOIUrl":"10.4103/aian.aian_507_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Subacute sclerosing panencephalitis (SSPE) is a progressive disorder caused due to the persistence of mutant measles virus in the brain. Treatment strategies for SSPE remain largely undefined, and there exists no information on how neurologists are currently managing SSPE.</p><p><strong>Methods: </strong>A survey-based study was conducted among Indian neurologists managing pediatric and adult patients with SSPE. A questionnaire-based survey was circulated by email regarding respondent demographics, preference for disease-modifying strategies, and symptomatic therapy.</p><p><strong>Results: </strong>Survey response was obtained from 298 neurologists (responder rate 9.5%) and eventually analyzed from 266 respondents who managed SSPE in routine practice. This included 222 (83.5%) adult and 44 (16.5%) pediatric neurologists from 21 states of India. Ninety-five respondents (35.7%) indicated that they always advised Isoprinosine (inosine pranobex) to their patients. Regarding interferon therapy, 121 (45.5%) reported never advising it, whereas 56 (21.1%) always advised it. For myoclonus, the most frequently used first-line drug was valproate (181, 68%), followed by levetiracetam (58, 21.8%). Most (150, 56.4%) of the respondents favored personalized therapy for the individual patient in terms of the duration of disease-modifying treatment. The patient follow-up was reported to be poor, with most (171, 64.3%) of the patients following up only occasionally and 24 (9%) respondents indicating that patients are lost to follow-up promptly after the initial visit.</p><p><strong>Conclusions: </strong>While SSPE remains a vaccine-preventable illness and the focus should be on prevention through vaccination, there is an unmet urgent need among Indian neurologists for better-defined treatment strategies for patients with SSPE.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"684-689"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783607","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}