{"title":"Isolated Central and Peripheral Nervous System Relapse in Chronic Myeloid Leukemia: A Report of Two Cases with Review of Literature.","authors":"Farsana Mustafa, Divyani Garg, Ajay Garg, Ayush Agarwal, Lavleen Singh, Mounika Pallati, Akash Jha, Achal Kumar Srivastava","doi":"10.4103/aian.aian_841_24","DOIUrl":"10.4103/aian.aian_841_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"297-299"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522346","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":"Characterizing Parkinson's Disease-Associated Pain in Native Patients with Malayalam Version of the King's Parkinson's Disease Pain Scale.","authors":"Prabhu Attur Selvaraj, Asish Vijayaraghavan, Vineeth Radhakrishnan, Divya Kalikavil Puthenveedu, Gangadhara Sarma, Sankara P Sarma, Syam Krishnan","doi":"10.4103/aian.aian_701_24","DOIUrl":"10.4103/aian.aian_701_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pain is an important non-motor symptom in Parkinson's disease (PD) and is often under-recognized. Pain is also a symptom frequently reported by non-PD elderly subjects. The King's Parkinson's Disease Pain Scale (KPPS) is a valid tool to characterize and quantify pain in PD and has been translated into several languages.</p><p><strong>Methods: </strong>We translated KPPS to Malayalam for native patients with PD and examined the pain characteristics in consecutive patients. Correlations with comprehensive disease-specific rating scales, including the Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS), were explored. A group of age- and gender-matched subjects without PD were interviewed using KPPS to examine how the pain reported by the non-PD aging population is different from that in PD.</p><p><strong>Results: </strong>In this study, 82% of patients with PD reported at least one type of pain, compared to 31.3% of age- and gender-matched control subjects ( P < 0.001). KPPS total scores (18.2 ± 14.0 vs. 1.8 ± 3.2; P < 0.001) and all the individual domain scores were significantly higher in patients. Pain scores correlated with age in control subjects (R = 0.46, P < 0.001), but not in patients; females reported more pain in both groups. Patients' pain scores were higher in the postural instability and gait difficulty subtype and showed significant correlations with MDS-UPDRS and NMSS scores.</p><p><strong>Conclusions: </strong>Pain is a prevalent symptom in PD and differs from the pain reported by a non-PD aging population. The Malayalam version of KPPS is a valid tool to characterize pain in native, Malayalam-speaking patients.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"227-233"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998511","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":"When Tuberculosis Lurks: The Silent Risk of Central Nervous System Infection Following In vitro Fertilization.","authors":"Suparna Kumar, Govind Madhaw","doi":"10.4103/aian.aian_1018_24","DOIUrl":"https://doi.org/10.4103/aian.aian_1018_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522349","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}
Aleksander Bajon, Jędrzej Sikora, Michal Siwek, Julia Wiecanowska, Miłosz Miedziaszczyk, Ilona Idasiak-Piechocka, Anna Mania
{"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":"https://doi.org/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":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sapna Erat Sreedharan, Kakarla Saikiran, S C Chandralekha, C A Athira, P N Sylaja, V T Jissa, Narayanan Namboodiri
{"title":"Clinical, Imaging, and Atrial Cardiopathy Markers in Ischemic Stroke Subtypes - Clues to a Cardioembolic Source.","authors":"Sapna Erat Sreedharan, Kakarla Saikiran, S C Chandralekha, C A Athira, P N Sylaja, V T Jissa, Narayanan Namboodiri","doi":"10.4103/aian.aian_772_24","DOIUrl":"https://doi.org/10.4103/aian.aian_772_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cryptogenic strokes account for 20%-25% of all ischemic strokes. Although atrial cardiopathy markers are more prevalent in the cryptogenic embolic stroke of undetermined source (ESUS) subgroup than in the nonembolic stroke subgroup, the utility of individual parameters in predicting cardioembolic sources needs to be studied further. We studied the clinical, imaging, and atrial cardiopathy markers in three ischemic stroke subtypes - large artery atherosclerosis (LAA), cardioembolism (CE), and cryptogenic ESUS - and their role in predicting the source of CE.</p><p><strong>Methods: </strong>This was a prospective observational study of ischemic stroke patients at Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum from April 2021 to December 2022. Clinical and risk factor profiles, imaging details, atrial cardiopathy marker (N-terminal pro-brain natriuretic peptide [NT-pro-BNP]) levels, electrocardiogram (ECG) parameters (P terminal force of V1 [PTFV1], P wave duration, the PR interval), and transthoracic echo parameters (left atrial [LA] diameter and LA volume) were collected. Associations were made between clinical, imaging, and atrial cardiopathy markers and etiological subtypes.</p><p><strong>Results: </strong>We had 255 participants (LAA- 98, CE- 41, and ESUS- 139) with a mean age of 63.53 years. Among the atrial cardiopathy markers, the most prevalent was elevated NT-pro-BNP (43.95%), followed by the ECG markers P wave duration (30.92%) and PTFV1 (28.74%), and LA diameter greater than 37 mm (24.27%) and LA volume greater than 34 ml/m2 (20.31%). Among the atrial cardiopathy markers, NT-pro-BNP and LA enlargement were strongly predictive of CE etiology, when compared to LAA. Chronic non-lacunar infarcts on imaging and elevated NT-pro-BNP showed a strong association with CE, when compared to cryptogenic strokes.</p><p><strong>Conclusions: </strong>The atrial cardiopathy biomarker NT-pro-BNP and chronic non-lacunar infarcts can serve as useful tools for recognizing cardioembolic sources among patients with embolic strokes.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963652","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}
N Manuraj, Asish Vijayaraghavan, Soumya Sundaram, Sajith Sukumaran
{"title":"\"Tracing the Lead\" - Lead Encephalopathy Mimicking Autoimmune Encephalitis.","authors":"N Manuraj, Asish Vijayaraghavan, Soumya Sundaram, Sajith Sukumaran","doi":"10.4103/aian.aian_902_24","DOIUrl":"https://doi.org/10.4103/aian.aian_902_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943177","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}
S S Jayanth, Kshiteeja Jain, Bv Murali Mohan, M Netravathi
{"title":"Rituximab-Induced Hypersensitivity Pneumonitis in Multiple Sclerosis: A Rare Phenomenon.","authors":"S S Jayanth, Kshiteeja Jain, Bv Murali Mohan, M Netravathi","doi":"10.4103/aian.aian_699_24","DOIUrl":"10.4103/aian.aian_699_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"152-154"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765788","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}
Greeshmendu Rajan, Mary Iype, Mini Sreedharan, Shahanaz Ahamed, Sankar V Hariharan, Reshmi Raveendran, Roshni R Lal, Priyanka Sahu, Shama Perween, Neeraja Beena
{"title":"Neimann-Pick Disease Presenting as a Case of Severe Dementia and Seizures.","authors":"Greeshmendu Rajan, Mary Iype, Mini Sreedharan, Shahanaz Ahamed, Sankar V Hariharan, Reshmi Raveendran, Roshni R Lal, Priyanka Sahu, Shama Perween, Neeraja Beena","doi":"10.4103/aian.aian_601_24","DOIUrl":"10.4103/aian.aian_601_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"135-137"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778934","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}
Kollencheri Puthenveettil Vinayan, Arushi Gahlot Saini, Aruna Setumadhava Jyotsna, Gagandeep Singh, Satinder Aneja, Sita Jayalakshmi, Sujata Kanhere, P N Sylaja, Debasis Panigrahi, Anoop Kumar Verma
{"title":"Transition of Care for Pediatric Neurologic Disorders - Are We There Yet?","authors":"Kollencheri Puthenveettil Vinayan, Arushi Gahlot Saini, Aruna Setumadhava Jyotsna, Gagandeep Singh, Satinder Aneja, Sita Jayalakshmi, Sujata Kanhere, P N Sylaja, Debasis Panigrahi, Anoop Kumar Verma","doi":"10.4103/aian.aian_521_24","DOIUrl":"10.4103/aian.aian_521_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"26-31"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998852","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}
Ankur Wadhwa, Ravinder-Jeet Singh, Mohammed Almekhlafi, Bijoy K Menon, Poornima N Nambiar, Arun Kathuveetil, Santhosh Kannath, Manik Chhabra, P N Sylaja, Andrew M Demchuk, Simerpreet Bal
{"title":"Derivation of a CT Angiography-Based Arch Atherosclerosis Grading in Cryptogenic Ischemic Stroke.","authors":"Ankur Wadhwa, Ravinder-Jeet Singh, Mohammed Almekhlafi, Bijoy K Menon, Poornima N Nambiar, Arun Kathuveetil, Santhosh Kannath, Manik Chhabra, P N Sylaja, Andrew M Demchuk, Simerpreet Bal","doi":"10.4103/aian.aian_996_24","DOIUrl":"10.4103/aian.aian_996_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>We aimed to develop a novel computed tomography angiography (CTA)-based grading system to quantify the severity of aortic arch disease and compare the detection of aortic arch atherosclerosis (AAAthero) on routinely acquired arch-to-vertex CTA against transesophageal echocardiogram (TEE) among patients with cryptogenic ischemic stroke.</p><p><strong>Methods: </strong>A systematic literature review was conducted to develop a computed tomography (CT)-based AAAthero grading system. CTA was compared against TEE for detecting AAAthero. The severity of arch atherosclerosis was scored based on a 5-point grading system. Patients with cryptogenic stroke who underwent both CTA and TEE were included in the derivation cohort to assess the sensitivity and specificity of CTA compared to TEE. The CT-based grading system for aortic plaques was then applied to an independent cohort of patients with cryptogenic stroke.</p><p><strong>Results: </strong>Three studies were identified in a systematic review, and 141 patients were included in the derivation cohort. AAAthero was detected in 29 patients (20.6%) and 28 patients (19.9%) on TEE and CTA, respectively. The sensitivity of CTA to detect any atherosclerosis was 76%, which increased to 100% to detect moderate to severe disease. The specificity was 95% for any atherosclerosis and 100% for moderate to severe arch disease. Seven patients with AAAthero on TEE had normal CTA, but mild arch disease. Meanwhile, six patients with CTA and negative TEE had plaques on the arch's transverse segment.</p><p><strong>Conclusions: </strong>Routinely acquired arch-to-vertex CTA provides an accurate, noninvasive alternative to TEE for detecting AAAthero, especially in clinically relevant moderate to severe arch disease.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"43-48"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432391","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}