{"title":"A Date with Wisdom","authors":"A. Cherian","doi":"10.18231/j.ijn.2022.001","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.001","url":null,"abstract":"","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132586177","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}
This study was conducted at a medical university tertiary care hospital and research center of dedicated Parkinson and movement disorders unit in Hyderabad (South India) with a purpose to optimize projection of STN by applying M.E.R patterns analytically. 52 locally anesthetized Parkinson`s (diseased subjects/patients) underwent bilateral S.T.N-D.B.S. Concurrent M.E.R signal recording was done in a Ben’s-gun pattern setup with a 5core-pentode (5microelectrodes were set in an array scenario). Using spikes and circumstantial (or contextual) background-activity dissimilar parameters plus their phantom estimates in various-frequency-bands which include low-frequency(2Hz–7Hz), :Hz–12Hz, (sub-divided as low-) and superior :21Hz–30Hz and :31Hz-49Hz were computed. The ideal electrode implantation through better clinical-effect/dyskinesia ratio given to the peak spike-rate(S.R) in 86% of the implant. The amplitude mean-background activity in low-chucked frequency-range(FR) was analogous to right depth in 86% and right-hemisphere position in 95% of the implantation.
{"title":"Subthalamic nucleus projection by SVM based MER Data via deep brain stimulation: A study of spike uncovering","authors":"V. R. Raju","doi":"10.18231/j.ijn.2022.011","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.011","url":null,"abstract":"This study was conducted at a medical university tertiary care hospital and research center of dedicated Parkinson and movement disorders unit in Hyderabad (South India) with a purpose to optimize projection of STN by applying M.E.R patterns analytically. 52 locally anesthetized Parkinson`s (diseased subjects/patients) underwent bilateral S.T.N-D.B.S. Concurrent M.E.R signal recording was done in a Ben’s-gun pattern setup with a 5core-pentode (5microelectrodes were set in an array scenario). Using spikes and circumstantial (or contextual) background-activity dissimilar parameters plus their phantom estimates in various-frequency-bands which include low-frequency(2Hz–7Hz), :Hz–12Hz, (sub-divided as low-) and superior :21Hz–30Hz and :31Hz-49Hz were computed. The ideal electrode implantation through better clinical-effect/dyskinesia ratio given to the peak spike-rate(S.R) in 86% of the implant. The amplitude mean-background activity in low-chucked frequency-range(FR) was analogous to right depth in 86% and right-hemisphere position in 95% of the implantation.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129386444","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. Kauser, S. Vandanapu, Ali Jrani, S. Karmakar, M. Yadav
This research assesses the viability of automated and computer generated reality advancements utilized for neurological recovery in stroke survivors. It analyzes every recovery innovation thusly prior to considering blends of these technologies and the intricacies of restoration result evaluation. There is great proof that upper-appendage mechanical recovery advancements further develop, strength and exercises of every day living, while the proof for automated lower-appendage restoration is as of now not as persuading. Augmented reality advances additionally further develop exercises of day by day living. While the advantage of these innovations over portion controlled regular restoration is probably going to be little, there is a job for the two advances as a component of a more extensive recovery program, where they might assist with expanding the force and measure of treatment conveyed. Joining mechanical and augmented reality advancements in a recovery program might additionally further develop restoration results and we would advocate randomized controlled preliminaries of these advances in mix.
{"title":"Role of virtual reality technology and robotic rehabilitation in post stroke rehabilitation: Short review","authors":"S. Kauser, S. Vandanapu, Ali Jrani, S. Karmakar, M. Yadav","doi":"10.18231/j.ijn.2022.002","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.002","url":null,"abstract":"This research assesses the viability of automated and computer generated reality advancements utilized for neurological recovery in stroke survivors. It analyzes every recovery innovation thusly prior to considering blends of these technologies and the intricacies of restoration result evaluation. There is great proof that upper-appendage mechanical recovery advancements further develop, strength and exercises of every day living, while the proof for automated lower-appendage restoration is as of now not as persuading. Augmented reality advances additionally further develop exercises of day by day living. While the advantage of these innovations over portion controlled regular restoration is probably going to be little, there is a job for the two advances as a component of a more extensive recovery program, where they might assist with expanding the force and measure of treatment conveyed. Joining mechanical and augmented reality advancements in a recovery program might additionally further develop restoration results and we would advocate randomized controlled preliminaries of these advances in mix.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126366656","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}
Even with recent advances in the management of ischemic stroke, incidence of recurrence is quite frequent. Identification of risk factors is of prime importance especially during the first episode of ischemic stroke. Imaging in stroke has pivotal role to play in understanding the stroke and also the recurrence risk. Hence we present a study about clinical and radiological profile of recurrent ischemic stroke patients. The study was conducted for a period of five consecutive years with a sample size of 100 patients. It is a cross sectional descriptive study where in data was collected and analysed among various variables necessary. Patients with recurrent ischemic stroke were examined and investigated. Continuous variable is expressed as mean +SD or median (Range) if non- normally distributed. Categorical data is expressed in proportions. Recurrence of the ischemic stroke was commonly seen in the patients with uncontrolled blood pressure, hyperglycemia, dyslipidemia, ischemic heart disease and patients with large artery atherosclerosis. Incidence was higher among male patients, patients above 60 years of age and stroke involving MCA and ACA territories. Identification of the risk factors responsible for the recurrence at the first episode of ischemic stroke and appropriate management are of prime importance. Apart from clinical and biochemical parameters, considering the radiological parameters like extent of stenosis and appropriate dosing and choice of medication also is of utmost importance in preventing the recurrence of stroke.
{"title":"Cross sectional descriptive study of clinical and radiological profile of patients presenting with recurrent ischemic stroke in a tertiary care centre of South India","authors":"A. Awati","doi":"10.18231/j.ijn.2022.006","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.006","url":null,"abstract":"Even with recent advances in the management of ischemic stroke, incidence of recurrence is quite frequent. Identification of risk factors is of prime importance especially during the first episode of ischemic stroke. Imaging in stroke has pivotal role to play in understanding the stroke and also the recurrence risk. Hence we present a study about clinical and radiological profile of recurrent ischemic stroke patients. The study was conducted for a period of five consecutive years with a sample size of 100 patients. It is a cross sectional descriptive study where in data was collected and analysed among various variables necessary. Patients with recurrent ischemic stroke were examined and investigated. Continuous variable is expressed as mean +SD or median (Range) if non- normally distributed. Categorical data is expressed in proportions. Recurrence of the ischemic stroke was commonly seen in the patients with uncontrolled blood pressure, hyperglycemia, dyslipidemia, ischemic heart disease and patients with large artery atherosclerosis. Incidence was higher among male patients, patients above 60 years of age and stroke involving MCA and ACA territories. Identification of the risk factors responsible for the recurrence at the first episode of ischemic stroke and appropriate management are of prime importance. Apart from clinical and biochemical parameters, considering the radiological parameters like extent of stenosis and appropriate dosing and choice of medication also is of utmost importance in preventing the recurrence of stroke.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129089301","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}
Generalised Tonic Clonic Convulsions are one of the common presentation to the emergency department. Proper understanding and approach to the same for a practicing doctor and education to the patient and its family helps in avoiding recurrence and the myths associated with it. Not many studies have studied the association of this clinical presentation in relation to neuroimaging and electroencephalography, hence this study. Study was conducted over a period of 2 years where in all patients presenting to the out patient and emergency department with first episode of generalized tonic clonic convulsion were taken into consideration. Necessary investigation were performed especially MRI Brain and EEG, the data was analysed across various variables and corelated. In present study it was noted around 34% of patients had no specific cause, 60% had normal MRI, 40% had abnormal EEG, incidence was higher in males and in patients in age group between 18-45 years. Stroke and alcohol withdrawal were other common causes followed by metabolic abnormalities, cerebral venous thrombosis, posterior reversible encephalopathy syndrome and cns infections. A detailed history regarding semiology has to be collected, even though sometimes it is difficult to obtain the same. In such situations neuroimaging like MRI Brain and Electroencephalography should be performed in every patient presenting with first episode of generalized tonic clonic convulsion. This approach helps in preventing the recurrences and identifying the exact cause and management of the patients.
{"title":"Study of clinical radiological and EEG profile of patients presenting with first episode of generalized tonic clonic convulsions to a tertiary care center","authors":"A. Awati","doi":"10.18231/j.ijn.2022.007","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.007","url":null,"abstract":"Generalised Tonic Clonic Convulsions are one of the common presentation to the emergency department. Proper understanding and approach to the same for a practicing doctor and education to the patient and its family helps in avoiding recurrence and the myths associated with it. Not many studies have studied the association of this clinical presentation in relation to neuroimaging and electroencephalography, hence this study. Study was conducted over a period of 2 years where in all patients presenting to the out patient and emergency department with first episode of generalized tonic clonic convulsion were taken into consideration. Necessary investigation were performed especially MRI Brain and EEG, the data was analysed across various variables and corelated. In present study it was noted around 34% of patients had no specific cause, 60% had normal MRI, 40% had abnormal EEG, incidence was higher in males and in patients in age group between 18-45 years. Stroke and alcohol withdrawal were other common causes followed by metabolic abnormalities, cerebral venous thrombosis, posterior reversible encephalopathy syndrome and cns infections. A detailed history regarding semiology has to be collected, even though sometimes it is difficult to obtain the same. In such situations neuroimaging like MRI Brain and Electroencephalography should be performed in every patient presenting with first episode of generalized tonic clonic convulsion. This approach helps in preventing the recurrences and identifying the exact cause and management of the patients.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125655489","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}
More than 15 million seizure-epileptic subjects (patients) do not respond to medication globally. Surgery necessitates thorough elimination or separation of the epileptic-seizure onset zone (ESoZ), regions of epileptic brains where seizures derive (come from). Sadly, the success rates of operation differ amongst 32% and 72% and this is due to clinically and hence prognostically no authenticated or substantiated (i.e., corroborated) biological or physiological indicator of the ESoZ exists. We discuss, as well as confirm a new electro encephalography indication neural vulnerability in a retroactive study of 90 subjects (patients) by applying neural instability of the interpreted ESoZ as a metrical to expect operational (invasive) results in retrospect (retrospectively). Susceptibility expects (43/47) surgical (invasive)-failures, as well as a total likelihood precision of 76% assessed through the precision of neuroscientists at 48% (positive-results).
{"title":"Neural instability and delicacy while the electro-encephalography indicator of epileptic seizure (e-seizure) on set zone","authors":"V. R. Raju","doi":"10.18231/j.ijn.2022.013","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.013","url":null,"abstract":"More than 15 million seizure-epileptic subjects (patients) do not respond to medication globally. Surgery necessitates thorough elimination or separation of the epileptic-seizure onset zone (ESoZ), regions of epileptic brains where seizures derive (come from). Sadly, the success rates of operation differ amongst 32% and 72% and this is due to clinically and hence prognostically no authenticated or substantiated (i.e., corroborated) biological or physiological indicator of the ESoZ exists. We discuss, as well as confirm a new electro encephalography indication neural vulnerability in a retroactive study of 90 subjects (patients) by applying neural instability of the interpreted ESoZ as a metrical to expect operational (invasive) results in retrospect (retrospectively). Susceptibility expects (43/47) surgical (invasive)-failures, as well as a total likelihood precision of 76% assessed through the precision of neuroscientists at 48% (positive-results).","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134430122","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}
Anupama Korlakunta, Dharaneedhar, P. Khairkar, S. D.
To assess the effect of COVID-19 lockdown period on seven domains of mental health of children. The study was a qualitative explorative research conducted in October 2020, using Snow ball method of sampling through online (Google form) questionnaire constructed to assess the mental health and wellbeing of children as perceived by their parents. The online questionnaire consisted of total 35 items presented under seven mental health dimensions. The responses received were 173 of which 17 were invalid and the total sample comprised of 156 parents of children (3-8 years). The data was subjected to statistical analysis using SPSS to examine the association between the age and mental health in seven domains and also the gender and mental health. In addition, the Kruskal -Wallis H test was used to test the seven null hypotheses formulated. The findings of the study showed that parents perceived mental health problems in their children in seven dimensions and they did not vary much in their perception of problems. There was strong relationship between the age of the children and five mental health dimensions studied, indicating the need for equipping the parents with necessary skills to help children cope with the mental health problems.
{"title":"Impact of COVID19 lockdown on seven dimensions of mental health of children (3 to 8 years) in Telengana and Andhra Pradesh states in India","authors":"Anupama Korlakunta, Dharaneedhar, P. Khairkar, S. D.","doi":"10.18231/j.ijn.2022.009","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.009","url":null,"abstract":"To assess the effect of COVID-19 lockdown period on seven domains of mental health of children. The study was a qualitative explorative research conducted in October 2020, using Snow ball method of sampling through online (Google form) questionnaire constructed to assess the mental health and wellbeing of children as perceived by their parents. The online questionnaire consisted of total 35 items presented under seven mental health dimensions. The responses received were 173 of which 17 were invalid and the total sample comprised of 156 parents of children (3-8 years). The data was subjected to statistical analysis using SPSS to examine the association between the age and mental health in seven domains and also the gender and mental health. In addition, the Kruskal -Wallis H test was used to test the seven null hypotheses formulated. The findings of the study showed that parents perceived mental health problems in their children in seven dimensions and they did not vary much in their perception of problems. There was strong relationship between the age of the children and five mental health dimensions studied, indicating the need for equipping the parents with necessary skills to help children cope with the mental health problems.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131330128","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}
Outcome assessment of thrombolysis with intravenous rt-PA in acute ischemic stroke.All patients with acute ischemic stroke patients who underwent IV thrombolysis with rt-PA from January 2019 to December 2021 were studied retrospectively. Clinical efficacy outcome was the favourable outcome on modified Rankin scale at 90 days defined as a score of ≤2. During our study period, a total of 50 patients with ischemic stroke thrombolysis underwent intravenous recombinant tissue plasminogen activator (rt‑PA). The study consisted of 33 males and 17 females with a mean age of 64.82 ( 12.21 standard deviation) years. The median time from onset of symptoms to IV rt-PA administration was 120 minutes (interquartile range 90 - 160). The mean door to needle time was 50.1 ( 21.32 SD) minutes. Favourable outcome (mRS score ≤2) was observed in 38 patients (76%) at three months’ follow-up. Poor outcome (mRS score >2) was seen in the remaining 12 patients (24%).Large artery atherosclerosis had the most favourable outcome followed by small vessel occlusive stroke. Factors predicting favourable outcome in our study were age <60 years (p = 0.03), female gender (p < 0.001) and large vessel occlusion (p < 0.001). Factors predicting poor outcome were hypertension (p < 0.001), dyslipidemia (p = 0.01), prior stroke (p < 0.001) and symptomatic haemorrhage (p = 0.02). Ischemic stroke patients can be thrombolysed in a safe and effective even in rural settings if proper institutional protocol is formulated and its implementation is ensured.
{"title":"Acute ischemic stroke thrombolysis- experience from a rural hospital in Kerala, India","authors":"V. Sanjeev, A. Thomas","doi":"10.18231/j.ijn.2022.008","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.008","url":null,"abstract":"Outcome assessment of thrombolysis with intravenous rt-PA in acute ischemic stroke.All patients with acute ischemic stroke patients who underwent IV thrombolysis with rt-PA from January 2019 to December 2021 were studied retrospectively. Clinical efficacy outcome was the favourable outcome on modified Rankin scale at 90 days defined as a score of ≤2. During our study period, a total of 50 patients with ischemic stroke thrombolysis underwent intravenous recombinant tissue plasminogen activator (rt‑PA). The study consisted of 33 males and 17 females with a mean age of 64.82 ( 12.21 standard deviation) years. The median time from onset of symptoms to IV rt-PA administration was 120 minutes (interquartile range 90 - 160). The mean door to needle time was 50.1 ( 21.32 SD) minutes. Favourable outcome (mRS score ≤2) was observed in 38 patients (76%) at three months’ follow-up. Poor outcome (mRS score >2) was seen in the remaining 12 patients (24%).Large artery atherosclerosis had the most favourable outcome followed by small vessel occlusive stroke. Factors predicting favourable outcome in our study were age <60 years (p = 0.03), female gender (p < 0.001) and large vessel occlusion (p < 0.001). Factors predicting poor outcome were hypertension (p < 0.001), dyslipidemia (p = 0.01), prior stroke (p < 0.001) and symptomatic haemorrhage (p = 0.02). Ischemic stroke patients can be thrombolysed in a safe and effective even in rural settings if proper institutional protocol is formulated and its implementation is ensured.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125728727","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}
To review recent clinical evidence available for levetiracetam in the treatment of various types of epileptic seizures. A literature search was conducted to identify clinical studies conducted after 2015 with Levetiracetam. In patients with focal epilepsy, Levetiracetam was found to be as effective as Carbamazepine, Clobazam, and Valproic acid but with better tolerability than Carbamazepine. Levetiracetam could be used as monotherapy in the treatment of new-onset focal epilepsy. It probably has a neuroprotective benefit, particularly important in neonates and children. The safety and tolerability of Levetiracetam are more apparent during pregnancy. Thus, the adverse event profile is largely in favor of Levetiracetam in comparison to standard older AEDs. Meta-analysis has confirmed that Levetiracetam is significantly better in terms of withdrawal rates compared to the older AEDs, hence may be considered as the first line in new-onset focal epilepsy in adults and the elderly. Levetiracetam may be a better option as an add-on treatment in children with partial seizures, due to its favorable efficacy and insignificant toxicity than Oxcarbazepine and Topiramate. Recent evidence suggests that Levetiracetam could be a potential first-choice, second-line AED for Benzodiazepine resistance status epilepticus with efficacy comparable to established older AEDs. It improves the quality of life due to higher rates of seizure freedom and favorable tolerability profile. Levetiracetam has the potential for being a first-line AED and has also proven to be a better adjunctive considering the recent efficacy and safety outcomes.
{"title":"Recent updates on Levetiracetam","authors":"Gajanan Panchal, Salil Uppal, S. Uppal","doi":"10.18231/j.ijn.2022.005","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.005","url":null,"abstract":"To review recent clinical evidence available for levetiracetam in the treatment of various types of epileptic seizures. A literature search was conducted to identify clinical studies conducted after 2015 with Levetiracetam. In patients with focal epilepsy, Levetiracetam was found to be as effective as Carbamazepine, Clobazam, and Valproic acid but with better tolerability than Carbamazepine. Levetiracetam could be used as monotherapy in the treatment of new-onset focal epilepsy. It probably has a neuroprotective benefit, particularly important in neonates and children. The safety and tolerability of Levetiracetam are more apparent during pregnancy. Thus, the adverse event profile is largely in favor of Levetiracetam in comparison to standard older AEDs. Meta-analysis has confirmed that Levetiracetam is significantly better in terms of withdrawal rates compared to the older AEDs, hence may be considered as the first line in new-onset focal epilepsy in adults and the elderly. Levetiracetam may be a better option as an add-on treatment in children with partial seizures, due to its favorable efficacy and insignificant toxicity than Oxcarbazepine and Topiramate. Recent evidence suggests that Levetiracetam could be a potential first-choice, second-line AED for Benzodiazepine resistance status epilepticus with efficacy comparable to established older AEDs. It improves the quality of life due to higher rates of seizure freedom and favorable tolerability profile. Levetiracetam has the potential for being a first-line AED and has also proven to be a better adjunctive considering the recent efficacy and safety outcomes.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126479116","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}
K. Madhavi, Balakrishnan Ramasamy, S. Perumal, K. Kannan
Tuberculosis of the nervous system constitutes about 10% of total cases and is more common in developing countries like India. Varied clinical presentations, ranging from meningoencephalitis, tuberculoma, multiple cranial palsies to myelo-radiculitis, are noted. Here we highlight central sleep apnoea as an acute presentation, which is unusual in a neurological setting. Here, we present a 49-year old male, presented with acute onset of excessive daytime sleepiness for two weeks. Clinically he had no focal deficits. MRI brain plain and contrast showed multiple conglomerate ring-enhancing lesions with vasculitic infarcts consistent with tuberculosis. CSF analysis was normal apart from slightly elevated protein. He was initiated on steroids and anti-tuberculous therapy. Hypersomnia as an acute and solitary neurological presentation secondary to subacute infections is a rarity. Apart from vascular insults, infections like tuberculosis needed to be considered as one of the differentials. Early evaluation helps in prevention of associated complications and improve the quality of life.
{"title":"A rare cause of acute onset central hypersomnia","authors":"K. Madhavi, Balakrishnan Ramasamy, S. Perumal, K. Kannan","doi":"10.18231/j.ijn.2022.015","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.015","url":null,"abstract":"Tuberculosis of the nervous system constitutes about 10% of total cases and is more common in developing countries like India. Varied clinical presentations, ranging from meningoencephalitis, tuberculoma, multiple cranial palsies to myelo-radiculitis, are noted. Here we highlight central sleep apnoea as an acute presentation, which is unusual in a neurological setting. Here, we present a 49-year old male, presented with acute onset of excessive daytime sleepiness for two weeks. Clinically he had no focal deficits. MRI brain plain and contrast showed multiple conglomerate ring-enhancing lesions with vasculitic infarcts consistent with tuberculosis. CSF analysis was normal apart from slightly elevated protein. He was initiated on steroids and anti-tuberculous therapy. Hypersomnia as an acute and solitary neurological presentation secondary to subacute infections is a rarity. Apart from vascular insults, infections like tuberculosis needed to be considered as one of the differentials. Early evaluation helps in prevention of associated complications and improve the quality of life.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131875827","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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