Annals of Indian Academy of Neurology最新文献

Background and objectives: Sensory neuronopathies (SNNs) are a rare group of pure sensory disorders causing asymmetrical, multifocal pattern of sensory loss with distinct clinical and electrophysiological features. We aimed to study the clinical features and etiology and share the experience of treating SNN from our center.

Methods: A prospective observational study was conducted over 3 years. Patients with predominant sensory complaints and electrophysiological evidence of neuropathy were evaluated. Possible/probable SNN was diagnosed using Camdessanch´e criteria. Detailed workup was done to determine the etiology and treatment given accordingly. Follow-up was done and response to treatment was assessed using modified Rankin Scale grading at 12 months.

Results: Fourteen patients with SNN were studied. Two (14.3%) patients were diagnosed with Sjogren's syndrome (SS-SNN), two (14.3%) with paraneoplastic syndrome, one (7.1%) with leprous ganglionitis, and nine (64.3%) were idiopathic sensory neuronopathy (I-SNN) cases. Improvement occurred in nine (64.3%), stability in three (21.4%), and worsening in two (14.3%) patients. Out of 11 SS-SNN and I-SNN patients, eight showed improvement on follow-up, seven with injection rituximab (RTX) and one with azathioprine. We found positive correlation between RTX treatment and improvement on follow-up ( P = 0.0256). Six (66.66%) out of nine I-SNN patients had early initiation of immunotherapy, of which all improved. There was positive correlation between early treatment initiation time in I-SNN patients and improvement ( P = 0.0119).

Conclusions: Promising results were noted in SS-SNN and I-SNN patients with intensive treatment approach using RTX. Hit hard and early treatment approach is crucial for achieving improvement in sensory neuronopathies.

Background and objectives: Ischemic stroke (IS) in young is increasingly recognized as an important health problem in low- and middle-income countries (LMICs). Limited data is available from LMICs about the predictors of outcome and recurrence of IS in young. The study aims to assess the predictors of short-term and long-term functional outcome and the recurrence of the first-ever IS and transient ischemic attack in young.

Methods: The clinical, radiological data, functional outcome, and recurrence of 569 IS patients aged 18-50 years were recorded. The etiological classification was done. The functional outcome was assessed using the modified Rankin scale (mRS), with a good outcome being mRS 0-2. Logistic regression was used to analyze the predictors of recurrence and outcome.

Results: The most common risk factors were hypertension (40.3%) and diabetes mellitus (34.3%). Stroke of undetermined etiology (33.6%) was the most common etiological subtype. Among the cardioembolic subtypes, rheumatic heart disease constituted 47.4%. A good functional outcome at 1 year was seen in 76.3%. While baseline stroke severity predicted both the 3-month and 1-year functional outcome, age ≥40 years and male gender predicted poor outcome at 1 year. The risk of recurrent strokes at 1 year was 2.5%. On multiple logistic regression analysis, diabetes mellitus independently predicted recurrent vascular events at 1 year (odds ratio = 2.43, 95% confidence interval 1.07-5.50).

Conclusions: We found a good functional outcome with a relatively low recurrence at 1 year among young IS patients. Baseline stroke severity, age, and male gender predicted a poor 1-year functional outcome.

Background and objectives: To compare the cognitive functions and trait anxiety in patients diagnosed with relapsing-remitting multiple sclerosis (RRMS) to those of matched healthy controls (HCs). In addition, the study aims to investigate the correlations among cognitive functions, anxiety, depression, and quality of life (QOL) in this clinical population.

Methods: The sample included RRMS patients ( n = 21) and an equal number of age-, education-, and sex-matched HCs. Participants were assessed on the Indian version of the Wechsler Adult Intelligence Scale-IV, auditory and visual learning and memory, and visual-spatial construction and memory. RRMS patients were also assessed for levels of anxiety, depression, and their QOL. Comparative analyses between RRMS patients and HCs were carried out for neuropsychological assessments. Correlations among cognitive functions, anxiety, depression, and QOL in RRMS patients were examined.

Results: RRMS patients showed significant deficits across various cognitive domains, including processing speed and verbal learning, compared to HCs ( P < 0.05). In addition, they reported higher levels of trait anxiety compared to HCs ( P < 0.01), along with moderate state anxiety and mild depression. A significant correlation among anxiety, depression, and QOL was observed in RRMS patients.

Conclusions: This study highlights significant cognitive impairments and psychological distress experienced by RRMS individuals, underscoring the critical need for comprehensive care addressing both cognitive impairments and psychological distress to enhance QOL.