Annals of Indian Academy of Neurology最新文献

{"title":"Neurotoxicity of Calcineurin Inhibitors.","authors":"Aleksander Bajon, Jędrzej Sikora, Michal Siwek, Julia Wiecanowska, Miłosz Miedziaszczyk, Ilona Idasiak-Piechocka, Anna Mania","doi":"10.4103/aian.aian_614_24","DOIUrl":"10.4103/aian.aian_614_24","url":null,"abstract":"<p><strong>Abstract: </strong>Cyclosporine and tacrolimus belong to the immunosuppressive drugs of the calcineurin inhibitors group. They are widely used in the treatment of patients after organ transplants. One of their complications is neurotoxicity, the mechanism of which is still not fully understood. The main risk factor for neurotoxicity is hypertension. The most common symptoms include muscle tremors, which are more common in the upper limbs, as well as migraine headaches and peripheral neuropathies. The diagnosis of neurotoxicity is based on imaging tests (magnetic resonance imaging being the most commonly used) and assessment of clinical symptoms. Preventive measures should be initiated as soon as possible to prevent permanent damage to the nerve tissue. The possible preventive methods include reduction of the dose of the administered drug, temporary or complete discontinuation of drugs, or conversion to another immunosuppressive drug. It is also essential to monitor the patient's condition, correct hypertension, electrolyte disturbances, and fight possible infections. So far, effective methods of preventing calcineurin inhibitor-induced neurotoxicity have not been demonstrated.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"505-511"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122028","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":"Prevalence of Restless Legs Syndrome in Patients Who Underwent Percutaneous Coronary Intervention in a Tertiary Care Hospital: A Cross-Sectional Study.","authors":"Anupama Gupta, Sriloy Mohanty, Varun Chhabra, Asmita Shukla, Partha Haldar, Rohit Bhatia, Gautam Sharma","doi":"10.4103/aian.aian_59_25","DOIUrl":"10.4103/aian.aian_59_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Restless legs syndrome (RLS) is a risk for cardiovascular diseases and increases the risk of adverse cardiovascular outcomes following percutaneous coronary intervention (PCI). We aimed to determine the prevalence of RLS and its associated factors among coronary artery disease (CAD) patients undergoing PCI.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted among CAD patients undergoing PCI at a tertiary care institute in India. All study participants underwent a detailed evaluation of RLS symptoms. Clinical and sleep evaluations were done through a prestructured questionnaire, Pittsburgh Sleep Quality Index, Berlin Questionnaire, and Epworth Sleepiness Scale. RLS was diagnosed according to the International Classification of Sleep Disorders-3 rd edition. The symptoms and severity were characterized by using the All India Institute of Medical Sciences (AIIMS) RLS Questionnaire for Indian Patients and the International Restless Legs Syndrome Study Group (IRLSSG) rating scale.</p><p><strong>Results: </strong>Of 116 post-PCI study participants, with a mean age of 51.9 ± 8.5 years and in whom males constituted 92.5%, 25 (21.6%, 95% confidence interval = 14-30) patients had RLS. The prevalence of RLS was significantly higher among those with poor sleep quality (27.5% vs. 8.33%, P = 0.02). Among patients with RLS, the mean (standard deviation [SD]) age of onset of symptoms was 48.5 (10.2) years, and its median (interquartile range) duration was 24 (8-42) months. Mean (SD) IRLSSG score was 17.2 ± 7.3. Four (16%) patients had mild RLS, 14 (56%) had moderate RLS, six (24%) had severe RLS, and one (4%) had very severe RLS.</p><p><strong>Conclusions: </strong>One in five patients with PCI had RLS. Identification and optimal treatment of RLS in these patients could improve their quality of life.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"535-540"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140993","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":"Barriers to Early Hospital Presentation in Acute Stroke: Findings from a Cohort Study.","authors":"Bindu Menon, Jyoti Conjeevaram, Sudarsana Amavarapu","doi":"10.4103/aian.aian_225_25","DOIUrl":"10.4103/aian.aian_225_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>The time taken to transport patients for thrombolytic therapy in stroke cases remains alarmingly high, compromising potential positive outcomes. Addressing these delays can enhance prehospital care and improve patient prognoses.</p><p><strong>Aim: </strong>This study aimed to identify factors causing delays in treating acute stroke patients at a tertiary care hospital in southern India, to inform better practices and expedite care.</p><p><strong>Methods: </strong>Caregivers of ischemic stroke patients were interviewed about delays. Patients were divided into two groups: those who arrived within the critical four-and-a-half-hour window (Group A) and those who arrived later (Group B). Data collected included distance from home to hospital, transportation options, and mode of transport. A comparative analysis was performed between patients from stroke-ready facilities versus others, with data analyzed using SPSS software.</p><p><strong>Results: </strong>The study included 594 patients, with 73.4% arriving outside the recommended window. Women represented one-third of the population overall and 20% in Group A. Younger patients arrived sooner (P < 0.0001). The main reason for delays was a lack of awareness of stroke symptoms (53.2%), followed by initial care sought at non-stroke-ready hospitals (23%). Use of ambulances and vehicle ownership significantly correlated with faster arrivals (P < 0.0001), while distance to the hospital did not significantly affect timeliness. Though most of the variables showed statistical significance between those coming to the hospital within and outside the four-and-a-half hour window with univariate analysis, none of the variables showed a significant association when subjected to logistic regression.</p><p><strong>Conclusions: </strong>Delays in stroke treatment are a major concern, linked to factors like age, gender, and transportation issues. No single factor independently predicted early hospital arrival. To improve outcomes, we need strategies that enhance public education, symptom recognition, and transportation-especially for vulnerable groups like women and the elderly.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"28 4","pages":"554-559"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871084","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":"Long-Term Effects of Deep Brain Stimulation on Non-Motor Symptoms in Patients with Parkinson's Disease.","authors":"Tanaya Mishra, Nitish Kamble, Ravi Yadav, Amitabh Bhattacharya, Vikram V Holla, Dwarakanath Srinivas, Pramod K Pal","doi":"10.4103/aian.aian_229_25","DOIUrl":"10.4103/aian.aian_229_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Deep brain stimulation (DBS) is an approved treatment modality for Parkinson's disease (PD) with significant improvement in motor symptoms. We aimed to study the long-term effects of DBS on non-motor symptoms (NMS) in patients with PD.</p><p><strong>Methods: </strong>In our ambispective study, we included 36 PD patients who had undergone DBS at our institute. The demographic profile, clinical details, levodopa equivalent daily dose, motor severity scales (Unified PD Rating Scale, and Hoehn and Yahr scale), and nine non-motor scales were retrieved from the medical records department. The mean duration from time of DBS surgery to date of assessment was 51.78 ± 34.19 months. Based on this, patients were categorized into group I, whose duration from DBS surgery to date of assessment was ≤51.78 months, and Group II, with >51.78 months duration. Pre-DBS NMS scores were compared with post-DBS scores.</p><p><strong>Results: </strong>There were 20 patients in group I and 16 in Group II. In both groups, motor symptoms improved significantly after DBS that persisted even after 51.8 months. Significant improvement in various NMS was also observed, including daytime sleepiness, sleep quality, quality of life, depression, anxiety, and impulse control disorders (ICDs). In addition, DBS also had a favorable impact on various other non-motor symptoms such as mood, gastrointestinal, and miscellaneous domains of the Non-Motor Symptom Scale (NMSS).</p><p><strong>Conclusions: </strong>DBS, in addition to improving the motor symptoms, has long-term beneficial effects on several NMS. Thereby, it improves the quality of life in PD patients.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"28 4","pages":"519-526"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871086","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":"Signature Clinical Signs in Neurology.","authors":"Bhim Singhal","doi":"10.4103/aian.aian_700_25","DOIUrl":"10.4103/aian.aian_700_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"28 4","pages":"629"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871088","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":"In-Depth Understanding of Hirayama Disease: Dural Detachment Beyond Cervical Spine.","authors":"Seena Vengalil, Vijaykumar Boddu, Karthik Kulanthaivelu, Dipti Baskar, Saraswati Nashi, Nupur Pruthi, Hemant Bhargav, Alok M Uppar, Chandrajit Prasad, Madhulika Kotra, Kiran Polavarapu, Veeramani Preethish-Kumar, Atchayaram Nalini","doi":"10.4103/aian.aian_16_25","DOIUrl":"10.4103/aian.aian_16_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hirayama disease (HD) is a cervical flexion-induced compressive myelopathy. Typically, there is forward displacement and loss of attachment of dural sac to lamina at the cervical level during neck flexion. However, the extent of the dural detachment (DD) has not been studied carefully. We undertook this study to know the extent of DD in HD.</p><p><strong>Methods: </strong>We conducted a retrospective study of HD patients evaluated from 2015 to 2023. Patients with DD extending beyond the cervical spine were selected, and their clinical and radiological features were studied.</p><p><strong>Results: </strong>One hundred and thirty-two (62.8%) patients were identified to have DD beyond the cervical spine in a cohort of 210 HD patients. The mean age at onset and duration were 18.09 ± 2.3 years (13-26) and 38.63 ± 39.9 months, respectively. Proximo-distal involvement was noted in 50% of patients, while 33% and 17% of patients had isolated distal and proximal involvement, respectively. Wasted legs were observed in three patients. Cord atrophy was present in 96.9% of patients, extending from C5 to C7. Epidural detachment and engorgement of posterior epidural venous plexus were evident in all. DD extended from C2 to D10 vertebral level. The cranial extent of DD was from C2 to C4 in 87% of cases, and the caudal extent was D1-D5 in 84% of cases, extending up to D10 in two cases.</p><p><strong>Conclusions: </strong>The HD spectrum continues to evolve phenotypically and radiologically. The pathophysiological mechanisms and DD extend beyond the cervical spine in a large proportion of patients. This makes it important to cover a longer part of the spine during imaging. This may have implications on the management of patients, particularly those with isolated lower limb involvement.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"574-578"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974764","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":"Pediatric Anti-MOG Antibody-Associated Disease (MOGAD) with Coexisting Myasthenia Gravis: A Rare Association.","authors":"Saheli Roy, Nishigandha S Joshi, Basit Ali, Vrajesh Udani","doi":"10.4103/aian.aian_1019_24","DOIUrl":"10.4103/aian.aian_1019_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"611-614"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109521","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":"A Deadly Duo: Viper Bite-Induced Coagulation Disorder and Multiple Territory Ischemic Stroke.","authors":"Sara Sravan Kumar, Sandhya Manorenj","doi":"10.4103/aian.aian_1015_24","DOIUrl":"10.4103/aian.aian_1015_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"622-625"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265116","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":"Transcranial Doppler Screening in Sickle Cell Disease: Insights from a Regional Study in Karnataka, India.","authors":"Suryanarayana Sharma, Pooja Aggarwal, Meenakshi Gowrishankar, Tanya Seshadri, Vijay K Sharma, Kishore Ramachandraiah, Deepa Bhat","doi":"10.4103/aian.aian_65_25","DOIUrl":"10.4103/aian.aian_65_25","url":null,"abstract":"<p><strong>Abstract: </strong>Sickle cell disease (SCD), a hereditary blood disorder in India, disproportionately affects Adivasi communities burdened by socio-economic and systemic inequities. Stroke, a severe complication of SCD, is underexplored in Indian populations, especially among Adivasi groups. This pilot study evaluated the feasibility of transcranial Doppler (TCD) screening in a peripheral healthcare setting in Karnataka, focusing on Adivasi SCD patients. Among 39 participants (27 HbSS, three HbSβ0, nine HbAS) from a hemoglobinopathy registry, none exhibited elevated time-averaged maximum mean (TAMM) velocities, but 73.3% of SCD patients showed unusually low middle cerebral artery (MCA) velocities (<70 cm/s). Significant differences in basilar artery (BA) flow velocities were noted between SCD and sickle cell trait (SCT) patients ( p <0.05), while MCA parameters were comparable. The findings establish baseline TCD velocities and highlight the need for region-specific stroke prevention guidelines tailored to underserved Adivasi populations.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"585-589"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214743","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":"Detection of Medium Vessel Occlusions (MeVOs) using Velocity-Encoded Vessel Maps in Selection and Endovascular Treatment of Double MeVO - A Case Report.","authors":"Santhosh Ks Annayappa, Johanna M Ospel, Mayank Goyal, Nishita Singh, Nima Kashani","doi":"10.4103/aian.aian_1115_24","DOIUrl":"10.4103/aian.aian_1115_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"617-619"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214742","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}