Epilepsy is the commonest neurological condition affecting people of all ages, race and social class. Patients with epilepsy have two to three times higher risk of mortality compared to general population. The role of epilepsy as a potential risk factor for metabolic syndrome and coronary artery disease is of interest.To study the prevalence of metabolic syndrome among patients with epilepsy.This is a hospital based cross-sectional descriptive study. The subjects were selected from patients attending the epilepsy outpatient clinic of a single tertiary centre (GMCH, Udaipur) during the period of 15 months from January 2021 to March 2022. Fasting blood samples were drawn from them to estimate fasting blood glucose and fasting lipid profile.: Males constituted two thirds of the subjects. Average age was 32.5 years. Mean duration of treatment was 13.6 years (range 3–48 years). 51.9% were on monotherapy. Valproate was used in 33 of the 45 (73.33%) patients. In localization related epilepsy, the commonest drug was carbamazepine used in 57.48%. Eight of the enrolled patients had diabetes mellitus and 35 had impaired fasting glucose. Systemic hypertension was detected in 11.5% patients. No significant association was noted between drug use and cardiovascular risk factors – diabetes mellitus, hypertension or dyslipidemia. Very significant association was noted on lipid profile for carbamzepine, phenytoin and clobazam.Antiepileptic medications, especially valproate and carbamazepine have significant effects on the lipid profile and abdominal obesity in patients on treatment. Metabolic syndrome is more prevalent among adult patients <50 years of age with epilepsy compared to the general population in the same age group. This difference could be related to the effect of the antiepileptic medications, especially valproate. There is a need to monitor patients on antiepileptic medications regularly for development of dyslipidemia and obesity.
{"title":"Cross sectional descriptive study to study the prevalence of metabolic syndrome among patients with epilepsy on antiepileptic drugs in a tertiary care centre","authors":"P. Sharma, A. Jukkarwala, V. Mehta, M. Waghralkar","doi":"10.18231/j.ijn.2022.036","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.036","url":null,"abstract":"Epilepsy is the commonest neurological condition affecting people of all ages, race and social class. Patients with epilepsy have two to three times higher risk of mortality compared to general population. The role of epilepsy as a potential risk factor for metabolic syndrome and coronary artery disease is of interest.To study the prevalence of metabolic syndrome among patients with epilepsy.This is a hospital based cross-sectional descriptive study. The subjects were selected from patients attending the epilepsy outpatient clinic of a single tertiary centre (GMCH, Udaipur) during the period of 15 months from January 2021 to March 2022. Fasting blood samples were drawn from them to estimate fasting blood glucose and fasting lipid profile.: Males constituted two thirds of the subjects. Average age was 32.5 years. Mean duration of treatment was 13.6 years (range 3–48 years). 51.9% were on monotherapy. Valproate was used in 33 of the 45 (73.33%) patients. In localization related epilepsy, the commonest drug was carbamazepine used in 57.48%. Eight of the enrolled patients had diabetes mellitus and 35 had impaired fasting glucose. Systemic hypertension was detected in 11.5% patients. No significant association was noted between drug use and cardiovascular risk factors – diabetes mellitus, hypertension or dyslipidemia. Very significant association was noted on lipid profile for carbamzepine, phenytoin and clobazam.Antiepileptic medications, especially valproate and carbamazepine have significant effects on the lipid profile and abdominal obesity in patients on treatment. Metabolic syndrome is more prevalent among adult patients <50 years of age with epilepsy compared to the general population in the same age group. This difference could be related to the effect of the antiepileptic medications, especially valproate. There is a need to monitor patients on antiepileptic medications regularly for development of dyslipidemia and obesity.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114593370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Solav, S. Savale, Aman S. Solav, Suresh L. Balani
Kleine Levin syndrome (KLS) is a rare neurological disorder characterized by excessive sleep with or without associated symptoms such as hyperphagia, abnormal behavior, cognitive dysfunction. Symptoms are cyclical and usually affect adolescents. Onset of symptoms is usually rapid and may last for days or weeks. The exact cause of KLS is unknown though it shows features of affection of hypothalamus that controls sleep, appetite and body temperature. There have been reports of viral infections preceding KLS raising a possibility of autoimmune response. Presented here is a six years old patient who had features of KLS. The FDG PET CT scan revealed hypometabolism in the thalami quite characteristic of the entity. F-DOPA scan revealed physiologic expression of dopaminergic activity in the neostriatum. However, the over-expression of dopaminergic activity in the right basi-frontal cortex and medial temporal lobe was also noted. The nigrostriatal, mesocortical, mesolimbic, tuberomammillary pathways are known dopamine transmitters. This case report attempts to explain the reason for dopaminergic expression in these regions in KLS.
Kleine Levin综合征(KLS)是一种罕见的神经系统疾病，其特征是过度睡眠，有或无相关症状，如嗜食、异常行为、认知功能障碍。症状是周期性的，通常影响青少年。症状的发作通常很快，可能持续数天或数周。KLS表现出控制睡眠、食欲、体温的下丘脑受影响的特点，但具体原因尚不清楚。有报道称，在KLS之前有病毒感染，这提高了自身免疫反应的可能性。这是一个六岁的病人，他有KLS的特征。FDG PET CT扫描显示丘脑代谢低下，这是该实体的特征。F-DOPA扫描显示新纹状体多巴胺能活性的生理性表达。然而，多巴胺能活性在右侧基底额叶和内侧颞叶也有过表达。黑质纹状体、中皮质、中边缘、结节乳状通路是已知的多巴胺递质。本病例报告试图解释在KLS中这些区域多巴胺能表达的原因。
{"title":"FLUORO-DOPA pattern in Kleine Levin syndrome","authors":"S. Solav, S. Savale, Aman S. Solav, Suresh L. Balani","doi":"10.18231/j.ijn.2022.042","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.042","url":null,"abstract":"Kleine Levin syndrome (KLS) is a rare neurological disorder characterized by excessive sleep with or without associated symptoms such as hyperphagia, abnormal behavior, cognitive dysfunction. Symptoms are cyclical and usually affect adolescents. Onset of symptoms is usually rapid and may last for days or weeks. The exact cause of KLS is unknown though it shows features of affection of hypothalamus that controls sleep, appetite and body temperature. There have been reports of viral infections preceding KLS raising a possibility of autoimmune response. Presented here is a six years old patient who had features of KLS. The FDG PET CT scan revealed hypometabolism in the thalami quite characteristic of the entity. F-DOPA scan revealed physiologic expression of dopaminergic activity in the neostriatum. However, the over-expression of dopaminergic activity in the right basi-frontal cortex and medial temporal lobe was also noted. The nigrostriatal, mesocortical, mesolimbic, tuberomammillary pathways are known dopamine transmitters. This case report attempts to explain the reason for dopaminergic expression in these regions in KLS.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133616005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Typical head-worn brain surface (wired or wireless) EEG electrodes beta (β) band frequencies are amongst 13Hz to 30Hz. However, in the Parkinson`s the high beata frequency is between 20 Hz to 30 Hz. Atypical β-oscillations in BG were linked in the field of Patho physiology of Parkinson disease. 13Hz-30Hz β-oscillations into STN of Parkinson subjects has been verified to distress the spatio-temporal dynamics of high-frequency oscillations (HFOs) typically ranging from 200Hz–500Hz coupled with individual (single) neurons, probably and so hypothetically cooperating the functional litheness (or suppleness) of the motor-circuit. This study experimented the connections through concurrently gathering the field-potentials (i.e.,LFPs) plus single-unit-activity(SUA) from the parallelly connected basal-ganglion circuitry of 15 subjects (PD-patients) in deep-brain-stimulation(DBS) surgical-procedure of bilateral-STN. Stimulus phase-amplitude coupling (PAC) around nuclei was limited to β-phase plus HFO stimulus-amplitude. Coupling was greatest on the abaxial, i.e., dorsal- STN frontier-edge. Findings showed that greater β-HFO-PAC in close proximity (within the vicinity) macro-leads contact which were clinically useful evaluated by continuing un effective-contacts, implying that PAC could prognostic of retort to STN-DBS. Neural-spiking was confined to the shape of 7Hz–30Hz oscillations (/fluctuations in the membranes), then longitudinal-topo-graphy of spike-shape-locking(SSL)/ or spike-phase-locking(SPL) was analogous to PAC. Differences of PAC plus SSL/(SPL) indicated a lack—of spatio-temporal-correlations. β-coupled H.F.O.s and electrical-field protected (locked/fused) neurons have got unique and ideal phase-angles, i.e., signal/waveform-shapes above (+) x-axis and below (-) axis 2D spatio-temporal regions, didn`t transpired in the similar phase of modulating-oscillation. Hence, results yield further help which β-HFO-P.A.C might be key to pathos physiology of Parkinson which advises local electrical field-locked neurons are inadequate alone for the appearance of high frequency β-coupled oscillations.
{"title":"β-oscillations linked by neuronal-spiking in the STN via DBS of parkinson disease","authors":"V. R. Raju","doi":"10.18231/j.ijn.2022.035","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.035","url":null,"abstract":"Typical head-worn brain surface (wired or wireless) EEG electrodes beta (β) band frequencies are amongst 13Hz to 30Hz. However, in the Parkinson`s the high beata frequency is between 20 Hz to 30 Hz. Atypical β-oscillations in BG were linked in the field of Patho physiology of Parkinson disease. 13Hz-30Hz β-oscillations into STN of Parkinson subjects has been verified to distress the spatio-temporal dynamics of high-frequency oscillations (HFOs) typically ranging from 200Hz–500Hz coupled with individual (single) neurons, probably and so hypothetically cooperating the functional litheness (or suppleness) of the motor-circuit. This study experimented the connections through concurrently gathering the field-potentials (i.e.,LFPs) plus single-unit-activity(SUA) from the parallelly connected basal-ganglion circuitry of 15 subjects (PD-patients) in deep-brain-stimulation(DBS) surgical-procedure of bilateral-STN. Stimulus phase-amplitude coupling (PAC) around nuclei was limited to β-phase plus HFO stimulus-amplitude. Coupling was greatest on the abaxial, i.e., dorsal- STN frontier-edge. Findings showed that greater β-HFO-PAC in close proximity (within the vicinity) macro-leads contact which were clinically useful evaluated by continuing un effective-contacts, implying that PAC could prognostic of retort to STN-DBS. Neural-spiking was confined to the shape of 7Hz–30Hz oscillations (/fluctuations in the membranes), then longitudinal-topo-graphy of spike-shape-locking(SSL)/ or spike-phase-locking(SPL) was analogous to PAC. Differences of PAC plus SSL/(SPL) indicated a lack—of spatio-temporal-correlations. β-coupled H.F.O.s and electrical-field protected (locked/fused) neurons have got unique and ideal phase-angles, i.e., signal/waveform-shapes above (+) x-axis and below (-) axis 2D spatio-temporal regions, didn`t transpired in the similar phase of modulating-oscillation. Hence, results yield further help which β-HFO-P.A.C might be key to pathos physiology of Parkinson which advises local electrical field-locked neurons are inadequate alone for the appearance of high frequency β-coupled oscillations.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124765461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moyamoya disease is cerebrovascular disease with stenosis of intracranial arteries and formation of multiple random collateral blood vessels at basal cistern. It can present as hemorrhagic or ischemic complications. Aneurysm in moyamoya disease is very rare, which can rupture leading to subarachnoid hemorrhage and secondary vasospasm leading to ischemia of cerebral lobes. We present a case of young woman with Moyamoya disease presenting with Subarachnoid hemorrhage secondary to rupture of basilar artery aneurysm, later developing cerebral cortical infarct.
{"title":"Moyamoya disease associated with aneurysm –Cerebral ischemia in patient with subarachnoid hemorrhage","authors":"G. Shah, Tushit Mewada, Vivek Baxi","doi":"10.18231/j.ijn.2022.040","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.040","url":null,"abstract":"Moyamoya disease is cerebrovascular disease with stenosis of intracranial arteries and formation of multiple random collateral blood vessels at basal cistern. It can present as hemorrhagic or ischemic complications. Aneurysm in moyamoya disease is very rare, which can rupture leading to subarachnoid hemorrhage and secondary vasospasm leading to ischemia of cerebral lobes. We present a case of young woman with Moyamoya disease presenting with Subarachnoid hemorrhage secondary to rupture of basilar artery aneurysm, later developing cerebral cortical infarct.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128079617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the microelectrode recording and in the macrostimulations through DBS leads, the coupling was highest on the abaxial, i.e., dorsal- sub thalamic nucleus frontier-edge. The results proved that the larger β-high frequency oscillations and phase angle coupling is within the vicinity macro-leads contact which were clinically useful evaluated by continuing un effective-contacts, implying that PAC could prognostic of retort to STN-DBS. Neural-spiking was confined to the shape of 7Hz–30Hz oscillations(/fluctuations in the membranes), then longitudinal topography of spike-shape locking (S.S.L.)/ or spike-phase-locking(SPL) was analogous to PAC. Differences of phase amplitude coupling plus SPL indicated a lack—of spatio-temporal-correlations. β-coupled H.F.O.s and electrical-field protected (locked/fused) neurons have got unique and ideal phase-angles, i.e., signal/waveform-shapes above (+Ve) x-axis coordinates and below (-Ve) axis coordinates 2D spatio-temporal regions, did not occurred in the similar phase of modulating-oscillation. Therefore, our findings help which β – H.F.O—PAC could be key to patho physiology of Parkinson disease which suggests— locally electrical field-locked neurons are inadequate alone for the appearance of high frequency β-coupled oscillations.
{"title":"β-oscillations linked by neuronal-spiking within the STN neurons via deep brain stimulation (DBS) in parkinson disease: Part – II","authors":"V. R. Raju","doi":"10.18231/j.ijn.2022.045","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.045","url":null,"abstract":"In the microelectrode recording and in the macrostimulations through DBS leads, the coupling was highest on the abaxial, i.e., dorsal- sub thalamic nucleus frontier-edge. The results proved that the larger β-high frequency oscillations and phase angle coupling is within the vicinity macro-leads contact which were clinically useful evaluated by continuing un effective-contacts, implying that PAC could prognostic of retort to STN-DBS. Neural-spiking was confined to the shape of 7Hz–30Hz oscillations(/fluctuations in the membranes), then longitudinal topography of spike-shape locking (S.S.L.)/ or spike-phase-locking(SPL) was analogous to PAC. Differences of phase amplitude coupling plus SPL indicated a lack—of spatio-temporal-correlations. β-coupled H.F.O.s and electrical-field protected (locked/fused) neurons have got unique and ideal phase-angles, i.e., signal/waveform-shapes above (+Ve) x-axis coordinates and below (-Ve) axis coordinates 2D spatio-temporal regions, did not occurred in the similar phase of modulating-oscillation. Therefore, our findings help which β – H.F.O—PAC could be key to patho physiology of Parkinson disease which suggests— locally electrical field-locked neurons are inadequate alone for the appearance of high frequency β-coupled oscillations.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"214 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116158470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We are reporting a rare case of neurosarcoidosis that presented with superior orbital fissure syndrome. A 51-year-old Indian woman who suffered from 2 weeks duration, insidious onset gradually progressive left sided headache limited to forehead, left periorbital pain, diplopia on looking toward left, and numbness on the left forehead was referred to our hospital. Ophthalmic findings included left oculomotor nerve, trochlear nerve and abducens nerve palsies, absent corneal reflex, and loss of touch, pain and temperature sensation in V1 distribution. Brain and orbit magnetic resonance imaging (MRI) showed contrast enhancing area at the left orbital apex with normal optic nerve. Normal CSF analysis. High ESR, and chest x-ray showing non-homogenous patchy opacities in bilateral lung fields leaded us for neoplastic screening. Chest computed tomography (CT) revealed multiple ill-defined irregular lung parenchymal nodular opacities of varying sizes involving bilateral lungs with enlarged mediastinal and bilateral axillary lymph nodes. Elevated angiotensin converting enzyme level was found. Biopsy of the axillary lymph node showed non-caseating granulomatous lymphadenitis with giant cells containing schaumann bodies and asteroid bodies in the cytoplasm. These findings indicating an inflammatory response induced by sarcoidosis. After the initiation of steroid treatment, the patient experienced complete remission without any recurrence. When examining a case presenting with superior orbital fissure syndrome with contrast enhancing MRI lesion at the orbital apex, the additional chest CT to exclude neoplastic lesions can detect pulmonary sarcoidosis and extraneural lesions. These may avoid delays in the diagnosis and management of neurosarcoidosis.
{"title":"A rare presentation of neurosarcoidosis as the superior orbital fissure syndrome","authors":"H. Zadafiya, Shaji Cv, Kabeer Ka, Prasanth Sr","doi":"10.18231/j.ijn.2022.041","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.041","url":null,"abstract":"We are reporting a rare case of neurosarcoidosis that presented with superior orbital fissure syndrome. A 51-year-old Indian woman who suffered from 2 weeks duration, insidious onset gradually progressive left sided headache limited to forehead, left periorbital pain, diplopia on looking toward left, and numbness on the left forehead was referred to our hospital. Ophthalmic findings included left oculomotor nerve, trochlear nerve and abducens nerve palsies, absent corneal reflex, and loss of touch, pain and temperature sensation in V1 distribution. Brain and orbit magnetic resonance imaging (MRI) showed contrast enhancing area at the left orbital apex with normal optic nerve. Normal CSF analysis. High ESR, and chest x-ray showing non-homogenous patchy opacities in bilateral lung fields leaded us for neoplastic screening. Chest computed tomography (CT) revealed multiple ill-defined irregular lung parenchymal nodular opacities of varying sizes involving bilateral lungs with enlarged mediastinal and bilateral axillary lymph nodes. Elevated angiotensin converting enzyme level was found. Biopsy of the axillary lymph node showed non-caseating granulomatous lymphadenitis with giant cells containing schaumann bodies and asteroid bodies in the cytoplasm. These findings indicating an inflammatory response induced by sarcoidosis. After the initiation of steroid treatment, the patient experienced complete remission without any recurrence. When examining a case presenting with superior orbital fissure syndrome with contrast enhancing MRI lesion at the orbital apex, the additional chest CT to exclude neoplastic lesions can detect pulmonary sarcoidosis and extraneural lesions. These may avoid delays in the diagnosis and management of neurosarcoidosis.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129668734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prayer is paramount in the spiritual welfare and development of an individual. Prayer is also considered a form of complementary alternative medicine if employed in primary healthcare delivery.This paper examines if God can be measured based on the impact Christian activities have on humanity, and explores the impact of Christian activities such as prayer as a form of complementary medicine.This paper presents a review of the empirical literature. Christian activities such as prayer, as ordered by God, have many health benefits such as better sleep, less stress, mood stabilizing, improvements in cardiovascular symptoms, and improvements from physical illnesses.The impact of prayer as a Christian activity is not only biblical but also scientifically confirmed.
{"title":"Measuring God through science: A review of christian prayer as complementary medicine","authors":"R. Obu, L. Aggrey-Bluwey","doi":"10.18231/j.ijn.2022.032","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.032","url":null,"abstract":"Prayer is paramount in the spiritual welfare and development of an individual. Prayer is also considered a form of complementary alternative medicine if employed in primary healthcare delivery.This paper examines if God can be measured based on the impact Christian activities have on humanity, and explores the impact of Christian activities such as prayer as a form of complementary medicine.This paper presents a review of the empirical literature. Christian activities such as prayer, as ordered by God, have many health benefits such as better sleep, less stress, mood stabilizing, improvements in cardiovascular symptoms, and improvements from physical illnesses.The impact of prayer as a Christian activity is not only biblical but also scientifically confirmed.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133897589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meningiomas are most common primary intracranial neoplasm. They arise from the arachnoid cap cells. They were previously divided into WHO grade I, grade II and grade III depending on their histological features and clinical features. However, in the new WHO 2021 updates it has been assigned a single group. Meningiomas may arise in the brain and spinal cord. An integrated approach based on clinical examination, history, radiology and histopathology aids in diagnosis. Herein we present a case series of a spectrum of clinico-pathological presentations of meningiomas. A 35-year-old female presented with headache. After clinical examination and on CT scan an intracranial lesion was noted. Craniotomy was performed and tissues examination was consistent with meningothelial meningioma. A 55-year-old female presented with pain in the limbs associated with weakness to the orthopaedics clinic. On neurological examination there was loss of power in the limbs. MRI spine revealed a round extramedullary intradural mass at T7 level. Laminectomy was done and histopathological examination showed features of Psammomatous meningioma, based on histomorphology and immunohistochemistry.A 32-year-old female presented to the Surgery clinics with dizziness and headache which was progressive and not responding to medications. MRI revealed an ovoid enhancing mass involving left parieto-occipital region, with a provisional diagnosis of meningioma. A report of Transitional meningioma was given based on histomorphology and immunohistochemistry. A 40-year-old female presented to the ophthalmic clinic with complaints of diplopia and disturbances in gait. Fundus examination revealed disc oedema and retinal vessel narrowing. MRI revealed large ovoid extra axial mass, with a provisional diagnosis of meningioma. A report of Secretory meningioma was signed out on histomorphology and immunohistochemistry.
{"title":"Meningioma – A spectrum of varied case presentations: A case series","authors":"K. Akhtar, D. Sinha, M. Adil, Aprajita","doi":"10.18231/j.ijn.2022.043","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.043","url":null,"abstract":"Meningiomas are most common primary intracranial neoplasm. They arise from the arachnoid cap cells. They were previously divided into WHO grade I, grade II and grade III depending on their histological features and clinical features. However, in the new WHO 2021 updates it has been assigned a single group. Meningiomas may arise in the brain and spinal cord. An integrated approach based on clinical examination, history, radiology and histopathology aids in diagnosis. Herein we present a case series of a spectrum of clinico-pathological presentations of meningiomas. A 35-year-old female presented with headache. After clinical examination and on CT scan an intracranial lesion was noted. Craniotomy was performed and tissues examination was consistent with meningothelial meningioma. A 55-year-old female presented with pain in the limbs associated with weakness to the orthopaedics clinic. On neurological examination there was loss of power in the limbs. MRI spine revealed a round extramedullary intradural mass at T7 level. Laminectomy was done and histopathological examination showed features of Psammomatous meningioma, based on histomorphology and immunohistochemistry.A 32-year-old female presented to the Surgery clinics with dizziness and headache which was progressive and not responding to medications. MRI revealed an ovoid enhancing mass involving left parieto-occipital region, with a provisional diagnosis of meningioma. A report of Transitional meningioma was given based on histomorphology and immunohistochemistry. A 40-year-old female presented to the ophthalmic clinic with complaints of diplopia and disturbances in gait. Fundus examination revealed disc oedema and retinal vessel narrowing. MRI revealed large ovoid extra axial mass, with a provisional diagnosis of meningioma. A report of Secretory meningioma was signed out on histomorphology and immunohistochemistry.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114300832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Smija Aravind, S. C. Velayudhan, Kabeer Abdulkhayarkutty, P. Sudhakaran, Jayaraj Kezhukkut
Tuberculous rhombencephalitis is an uncommon presentation of intracranial tuberculosis. A 57 year old female, presented with central positional vertigo and features of left 5 and 7 cranial nerve palsy, with a sensory dermatomal level to pain and temperature and diminished vibration sense on left side. On evaluation, was found to have multiple discrete and conglomerate ring enhancing lesions in pons with normal MRI of spine. After extensive evaluation with Magnetic Resonance Spectroscopy, Cerebrospinal fluid and blood investigations and Mantoux test, possible tuberculosis rhombencephalitis was considered and was started on antitubercular treatment, to which she responded well. Our patient had an atypical presentation with sensory level in trunk, which has not been reported in literature. Hence we describe this case and review the neuroanatomical substrates involved. A high index of suspicion is always needed, while dealing with atypical presentations.
{"title":"Tuberculous rhombencephalitis presenting with pseudo-spinal pattern of sensory loss","authors":"Smija Aravind, S. C. Velayudhan, Kabeer Abdulkhayarkutty, P. Sudhakaran, Jayaraj Kezhukkut","doi":"10.18231/j.ijn.2022.039","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.039","url":null,"abstract":"Tuberculous rhombencephalitis is an uncommon presentation of intracranial tuberculosis. A 57 year old female, presented with central positional vertigo and features of left 5 and 7 cranial nerve palsy, with a sensory dermatomal level to pain and temperature and diminished vibration sense on left side. On evaluation, was found to have multiple discrete and conglomerate ring enhancing lesions in pons with normal MRI of spine. After extensive evaluation with Magnetic Resonance Spectroscopy, Cerebrospinal fluid and blood investigations and Mantoux test, possible tuberculosis rhombencephalitis was considered and was started on antitubercular treatment, to which she responded well. Our patient had an atypical presentation with sensory level in trunk, which has not been reported in literature. Hence we describe this case and review the neuroanatomical substrates involved. A high index of suspicion is always needed, while dealing with atypical presentations.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123524920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerebral Palsy (CP) is prevalent disability starting in early childhood characterized as a series of difficulties caused by Central Nervous System lesions. Motor and secondary musculoskeletal problems are seen in CP. The trunk plays an important role in the organization of postural control, balance and also provides free movement of upper limb but in subjects with CP may challenge by manual skills such as fine motor activities and may also have difficulty in maintaining trunk control. : Aim of the study was to assess and investigate the correlation between trunk control and upper limb function in subjects with cerebral palsy. Cross sectional study was conducted in which 34 Subjects from SBB College of physiotherapy, SVP hospital and private clinics were taken. Subjects diagnosed with any clinical type of either gender aged 6 to 15 years CP with Gross Motor Functional Classification System level Ⅱ, Ⅲ, Ⅳ, were included and recent trauma or surgery of upper extremity and spine (less ˂ 6 months) were excluded in the study by convenient sampling. After taken consent, Trunk Control Measurement scale (TCMS) were filled up by primary therapist and ABILHAND kids Gujarati version questionnaires were filled up by parents personal interview. : Data analysis for 34 subjects was done by using SPSS version 16 and Microsoft excels 2019. For data screened nonparametric Spearman correlation co˗ efficient test was used with level of significance kept at 5%. Results showed that there is strong positive correlation between trunk control and upper limb function (r ₌ 0.773 p ₌ 0.05) in subjects with cerebral palsy. Study concluded that Trunk Control is highly correlated with upper limb function in subjects with CP. Therefore, it is important in NeuroRehabilitation applications to improve upper limb function along with control of trunk.
脑瘫(CP)是一种始于儿童早期的普遍残疾，其特征是由中枢神经系统病变引起的一系列困难。CP患者可出现运动和继发性肌肉骨骼问题。躯干在姿势控制、平衡和上肢自由活动方面发挥着重要作用，但CP患者可能会受到精细运动活动等手工技能的挑战，也可能在维持躯干控制方面存在困难。目的探讨脑瘫患者躯干控制与上肢功能的关系。横断面研究选取SBB理疗学院、SVP医院和私人诊所的34名被试。研究对象年龄在6 - 15岁之间，被诊断为任何临床类型，性别不限，大运动功能分类系统水平为Ⅱ、Ⅲ、Ⅳ，并通过方便抽样排除上肢和脊柱近期创伤或手术(小于小于6个月)。征得同意后，由主治医师填写主干控制量表(Trunk Control Measurement scale, TCMS)，由家长个人访谈填写ABILHAND儿童古吉拉特语版问卷。: 34名受试者的数据分析采用SPSS version 16和Microsoft excels 2019进行。对于筛选的数据，我们使用非参数Spearman相关性测试，显著性水平保持在5%。结果显示脑瘫患者躯干控制与上肢功能之间存在显著正相关(r 0.773 p 0.05)。研究表明，CP患者的躯干控制与上肢功能高度相关，因此在改善上肢功能的同时改善躯干控制在神经康复应用中具有重要意义。
{"title":"Correlation between trunk control and upper extremity function in subjects with cerebral palsy","authors":"P. Darji, S. Diwan","doi":"10.18231/j.ijn.2022.034","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.034","url":null,"abstract":"Cerebral Palsy (CP) is prevalent disability starting in early childhood characterized as a series of difficulties caused by Central Nervous System lesions. Motor and secondary musculoskeletal problems are seen in CP. The trunk plays an important role in the organization of postural control, balance and also provides free movement of upper limb but in subjects with CP may challenge by manual skills such as fine motor activities and may also have difficulty in maintaining trunk control. : Aim of the study was to assess and investigate the correlation between trunk control and upper limb function in subjects with cerebral palsy. Cross sectional study was conducted in which 34 Subjects from SBB College of physiotherapy, SVP hospital and private clinics were taken. Subjects diagnosed with any clinical type of either gender aged 6 to 15 years CP with Gross Motor Functional Classification System level Ⅱ, Ⅲ, Ⅳ, were included and recent trauma or surgery of upper extremity and spine (less ˂ 6 months) were excluded in the study by convenient sampling. After taken consent, Trunk Control Measurement scale (TCMS) were filled up by primary therapist and ABILHAND kids Gujarati version questionnaires were filled up by parents personal interview. : Data analysis for 34 subjects was done by using SPSS version 16 and Microsoft excels 2019. For data screened nonparametric Spearman correlation co˗ efficient test was used with level of significance kept at 5%. Results showed that there is strong positive correlation between trunk control and upper limb function (r ₌ 0.773 p ₌ 0.05) in subjects with cerebral palsy. Study concluded that Trunk Control is highly correlated with upper limb function in subjects with CP. Therefore, it is important in NeuroRehabilitation applications to improve upper limb function along with control of trunk.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131315288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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