Annals of Indian Academy of Neurology最新文献

{"title":"Subacute Sclerosing Panencephalitis: Recent Advances in Pathogenesis, Diagnosis, and Treatment.","authors":"Ravindra Kumar Garg, Shweta Pandey","doi":"10.4103/aian.aian_1112_24","DOIUrl":"https://doi.org/10.4103/aian.aian_1112_24","url":null,"abstract":"<p><p>Subacute sclerosing panencephalitis (SSPE) is a relentless progressive brain disorder caused by the persistent presence of mutated measles virus in the central nervous system. The disease typically develops years after primary measles infection, with the highest risk observed in children infected before the age of 2 years. The global incidence of SSPE is notably higher in low- and middle-income countries and in regions with low measles vaccination coverage. The pathogenesis of SSPE involves viral persistence through mutations in viral proteins, enabling immune evasion and cell-to-cell propagation within the brain. Neuroinflammation, immune-mediated damage, and neuronal loss further contribute to disease progression. Clinical manifestations range from progressive cognitive decline and behavioral changes, along with myoclonus, seizures, movement disorders, visual impairment, and, finally, a vegetative state. Diagnosis is confirmed through cerebrospinal fluid analysis showing elevated antimeasles antibodies, characteristic periodic electroencephalography discharges, and neuroimaging findings like white matter hyperintensities and cerebral atrophy. Treatment remains challenging, with isoprinosine, interferon-α, ribavirin, and newer agents like favipiravir and aprepitant offering new hope. Symptomatic management and palliative care are needed in all patients. SSPE is invariably fatal. Notably, reports of prolonged survival and disease stabilization have been documented, particularly with early and combined therapy. The coronavirus disease 2019 pandemic's adverse impact on measles vaccination rates highlights the urgent need for robust measles immunization campaigns. Future directions involve exploring antiviral fusion peptide inhibitors and artificial intelligence-driven diagnostic tools to improve early detection, treatment efficacy, and outcome prediction in SSPE.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"28 2","pages":"159-168"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959361","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":"Young-Onset Cerebral Small Vessel Disease Associated with COLGALT1 Mutation.","authors":"Boby V Maramattom","doi":"10.4103/aian.aian_734_24","DOIUrl":"10.4103/aian.aian_734_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"287-289"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943207","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":"Rare Case of Sjögren's Syndrome with Chronic Inflammatory Demyelinating Polyneuropathy and Atrioventricular Block.","authors":"Saurabh Kumar, Shweta Pandey, Akash A Kamble, Kiran P Malhotra, Hardeep S Malhotra, Ravindra K Garg","doi":"10.4103/aian.aian_756_24","DOIUrl":"10.4103/aian.aian_756_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"292-294"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673196","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":"All Tongue Fasciculations are Not Motor Neuron Disease.","authors":"Pushkar Pazhani, Saranya B Gomathy, Jayaram Saibaba, Manoj Manyem, Ramkumar Sugumaran, Sunil K Narayan","doi":"10.4103/aian.aian_690_24","DOIUrl":"10.4103/aian.aian_690_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"280-282"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963651","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":"Symptomatic Bevacizumab-Induced Cerebral Infarction Following Treatment for Radiation Necrosis.","authors":"Boby V Maramattom","doi":"10.4103/aian.aian_645_24","DOIUrl":"10.4103/aian.aian_645_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"278-280"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363304","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":"Comparison of Long-Term Outcomes in Patients with Supratentorial Spontaneous Intracerebral Hemorrhage Treated with and without Surgical Intervention.","authors":"Agrata Sharma, Ayush Agarwal, Ajay Garg, Venugopalan Y Vishnu, N Nilima, Rohit Bhatia, Divyani Garg, Awadh K Pandit, Leve Joseph, Srujana Billa, Manmohan Singh, Ashish Suri, Shashank S Kale, Shailesh B Gaikwad, Mv Padma Srivastava","doi":"10.4103/aian.aian_497_24","DOIUrl":"10.4103/aian.aian_497_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Intracerebral hemorrhage (ICH) is associated with high mortality and morbidity. Uncertainty still exists regarding the benefit of surgery in the management of supratentorial spontaneous ICH (sICH), especially of the basal ganglia and thalamus. Studies have not shown the clinical benefit of early surgical management compared to best medical management plus delayed surgery, when necessary. Our aim was to compare the efficacy of different neurosurgical interventions with best medical management and best medical management alone.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective study at a tertiary care center in India in sICH patients between January 2015 and December 2022. The primary outcome was functional disability evaluated by the modified Rankin Scale (mRS) at 3, 6, and 12 months. Time-to-event outcomes were compared using the Kaplan-Meier curve.</p><p><strong>Results: </strong>Among 2600 stroke patients screened, 661 had sICH. Median age was 55 years, and 250 patients (37.8%) underwent neurosurgical intervention. The most common intervention was craniotomy and hematoma evacuation. The median mRS at discharge and follow-up at 3, 6, and 12 months was lower in the conservatively managed group (4, 3, 3, and 3, respectively) compared to the surgical intervention group (5, 5, 5, 4, respectively). However, the ICH score at admission was lower in the conservatively managed group and after adjustment for ICH score, there was no statistically significant difference between the two. Among the interventions, patients undergoing decompression craniectomy had the best functional outcome.</p><p><strong>Conclusions: </strong>Neurosurgical intervention was not associated with better functional outcome when compared to conservative management.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"220-226"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363220","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":"Novel Presentation of Type 1 Wolfram Syndrome as Intracranial Hemorrhage and Longitudinally Extensive Transverse Myelitis: Neuroimaging and Angiographic Findings.","authors":"Ravi P Singh, S S Jayanth, K T Seetam, Vikram V Holla, H R Arvinda, M Netravathi","doi":"10.4103/aian.aian_613_24","DOIUrl":"10.4103/aian.aian_613_24","url":null,"abstract":"<p><p>Wolfram syndrome (WS), a rare genetic neurodegenerative condition, is primarily characterized by diabetes mellitus, optic atrophy, diabetes insipidus, and sensorineural hearing loss, along with diverse systemic manifestations. Late-stage cases exhibit widespread brain atrophy. While bleeding tendencies are not commonly observed in Type 2 WS (WS2), there is a distinctive bleeding tendency that is exclusive to WS2, with no documented occurrences in Type 1 WS (WS1). Extensive documentation exists regarding various neurologic manifestations of this syndrome; however, as of now, there is no reported mention of intracranial hemorrhage, a rarity within this condition.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"264-267"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778936","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":"Distal Motor Neuropathy with Pyramidal Involvement and Optic Atrophy: Think of C12orf65 Mutation as a Possible Cause.","authors":"Farsana Mustafa, ThobiAshem Sana, Jasmine Parihar, Rajesh Kumar Singh, Deepti Vibha, Manjari Tripathi, Animesh Das","doi":"10.4103/aian.aian_952_24","DOIUrl":"10.4103/aian.aian_952_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"304-306"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708013","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":"Utility of Sleep Questionnaires for Detecting Sleep Apnea in Ischemic Stroke Patients.","authors":"S Mythirayee, Dipti Baskar, G Seethalakshmi, Ravi Yadav, Nitish L Kamble, Girish Baburao Kulkarni, Sanjib Sinha, Pooja Mailankody, P R Srijithesh","doi":"10.4103/aian.aian_730_24","DOIUrl":"https://doi.org/10.4103/aian.aian_730_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Sleep-disordered breathing is highly prevalent in stroke patients. It is associated with recurrence of stroke and poor neurologic outcomes. Polysomnography (PSG), the gold standard for diagnosing sleep apnea, may not be feasible for routine evaluation in stroke patients. There is a need for reliable screening tools to assess the likelihood of sleep apnea in these patients. This study evaluated the efficacy of sleep questionnaires to predict the likelihood of sleep apnea against PSG-determined sleep apnea.</p><p><strong>Methods: </strong>A hospital-based study on ischemic stroke patients used the content-validated Kannada version of Berlin Questionnaire, STOP-BANG questionnaire, and Epworth Sleepiness Scale (ESS). All patients underwent overnight PSG, scored by blinded investigators, to assess the diagnostic properties of the questionnaires for various apnea-hypopnea index cutoffs.</p><p><strong>Results: </strong>The study included 70 Kannada-speaking patients with a mean age of 50.9 years. The study revealed a high prevalence of sleep apnea (80%), with obstructive sleep apnea being the most common type (77.5%). The Berlin Questionnaire showed modest sensitivity (0.51) and specificity (0.60), while the STOP-BANG questionnaire demonstrated moderate sensitivity (0.64) and specificity (0.70). The mean ESS scores were 6.6 (standard deviation [SD] 5.9) for patients with sleep apnea and 4.3 (SD 3.1) for those without sleep apnea.</p><p><strong>Conclusion: </strong>Sleep questionnaires lacked the necessary diagnostic properties to serve as standalone screening tools for sleep apnea in ischemic stroke patients. Future research should aim to develop or improve screening instruments specifically designed for stroke patients.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"28 2","pages":"241-246"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959376","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":"Are Newer Antiseizure Medications Better Off in Maintaining Oral Health in Persons with Epilepsy?","authors":"Jayakumari Nandana, Jithin George, Lakshmi Priya, Thania E Pidiyancheril, K Y Manisha, Ramshekhar N Menon, Ashalatha Radhakrishnan","doi":"10.4103/aian.aian_773_24","DOIUrl":"https://doi.org/10.4103/aian.aian_773_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Persons with epilepsy (PWE) have poor dental hygiene, contributed by the severity of epilepsy, ignoring oral health, and the medications used. A continuing need exists for a better understanding of the effects of antiseizure medications (ASMs) on oral health. Several studies have shown the effects of older ASMs on oral health, but there is a lack of those exploring oral side effects of newer ASMs.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in which 69 PWE on ASMs were compared with 33 controls. A structured questionnaire was used to collect data on demographics, oral hygiene practices, and medication history including use of older and newer ASMs. Dental examination along with plaque, gingival, Decayed, Missing, and Filled Teeth (DMFT), and Decayed, Missing, and Filled teeth Surface (DMFS) indices were assessed. PWE were divided into three groups based on whether they were on older ASMs, newer ASMs, or a combination of both. Data was statistically analyzed.</p><p><strong>Results: </strong>PWE have poor dental health with significantly higher gingival index, plaque index, calculus, DMFS, and DMFT scores compared to controls ( P < 0.001). Concerning ASMs, patients on older ASMs had poor dental health with higher gingival index, gingivitis, and periodontitis compared to those on newer ASMs ( P < 0.005). Patients on polytherapy tended to have worse periodontal parameters. Gingival hyperplasia was common in patients taking phenytoin alone compared to those taking folic acid along with phenytoin ( P < 0.05).</p><p><strong>Conclusion: </strong>Older ASMs, especially phenytoin, can be associated with significant oral side effects. Newer ASMs are relatively safe, but further research is needed to fully understand their long-term effects.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"28 2","pages":"213-219"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958212","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}