Pub Date : 2024-01-01Epub Date: 2023-07-20DOI: 10.4103/aian.aian_338_23
Jitupam Baishya, Rajinder Kumar Basher
{"title":"Antibody-Specific PET Finding in Autoimmune Encephalitis: How Accurate?","authors":"Jitupam Baishya, Rajinder Kumar Basher","doi":"10.4103/aian.aian_338_23","DOIUrl":"10.4103/aian.aian_338_23","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48315663","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}
Pub Date : 2024-01-01Epub Date: 2023-06-12DOI: 10.4103/aian.aian_227_23
S Sheetal, Robert Mathew
{"title":"Cognitive Stimulation Therapy in Dementia - Are We Sufficiently Stimulated?","authors":"S Sheetal, Robert Mathew","doi":"10.4103/aian.aian_227_23","DOIUrl":"10.4103/aian.aian_227_23","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42443298","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}
Background: Cerebral venous sinus thrombosis (CVST) presents with a wide variety of neurological symptoms in various combinations and has a high mortality rate of up to 50%. Recent advances in neuroimaging and therapeutic interventions have brought it down to 10%-20%. The study aims to identify critical prognostic factors associated with poor outcomes in patients with CVST.
Materials and methods: All cases of CVST aged >18 years from July 2015 to July 2020 who were not terminally ill and bedridden before the illness were evaluated at the entry point for various risk factors and after 30 days for outcome assessment with the modified Rankin scale (mRS). The outcome was dichotomized, applying mRS <3 as a good outcome, and analyzed with the Chi-square test or the Fischer's exact test in a bivariate analysis to identify associated variables.
Results: A total of 149 subjects were studied. Glasgow Comma Scale (GCS) <9 (P<0.001), focal neurological deficits (P = 0.05), the presence of a mass effect (P<0.001), and the need for decompressive hemicraniectomy (P<0.001) were associated with poor outcomes. Age, gender, diagnostic delay, seizures at onset, papilledema, parenchymal lesions, deep sinus involvement, and multiple sinus thrombosis were not associated with a poor outcome.
Conclusion: In our study, early diagnosis and treatment of CVST is associated with an overall favorable outcome even in the presence of traditional poor prognostic factors such as age, seizures at onset, deep sinus involvement, and multiple sinus involvement in the face of conventional risk factors. A large country-wide prospective study might help in elucidating the poor prognostic factors.
{"title":"Critical Prognostic Factors in Cerebral Venous Sinus Thrombosis: An Observational Study.","authors":"Sandeep Gurram, Magith Thambi, Ashwini Naik, Sankar Prasad Gorthi","doi":"10.4103/aian.aian_820_23","DOIUrl":"10.4103/aian.aian_820_23","url":null,"abstract":"<p><strong>Background: </strong>Cerebral venous sinus thrombosis (CVST) presents with a wide variety of neurological symptoms in various combinations and has a high mortality rate of up to 50%. Recent advances in neuroimaging and therapeutic interventions have brought it down to 10%-20%. The study aims to identify critical prognostic factors associated with poor outcomes in patients with CVST.</p><p><strong>Materials and methods: </strong>All cases of CVST aged >18 years from July 2015 to July 2020 who were not terminally ill and bedridden before the illness were evaluated at the entry point for various risk factors and after 30 days for outcome assessment with the modified Rankin scale (mRS). The outcome was dichotomized, applying mRS <3 as a good outcome, and analyzed with the Chi-square test or the Fischer's exact test in a bivariate analysis to identify associated variables.</p><p><strong>Results: </strong>A total of 149 subjects were studied. Glasgow Comma Scale (GCS) <9 (<i>P</i><0.001), focal neurological deficits (<i>P</i> = 0.05), the presence of a mass effect (<i>P</i><0.001), and the need for decompressive hemicraniectomy (<i>P</i><0.001) were associated with poor outcomes. Age, gender, diagnostic delay, seizures at onset, papilledema, parenchymal lesions, deep sinus involvement, and multiple sinus thrombosis were not associated with a poor outcome.</p><p><strong>Conclusion: </strong>In our study, early diagnosis and treatment of CVST is associated with an overall favorable outcome even in the presence of traditional poor prognostic factors such as age, seizures at onset, deep sinus involvement, and multiple sinus involvement in the face of conventional risk factors. A large country-wide prospective study might help in elucidating the poor prognostic factors.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142683","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}
Pub Date : 2024-01-01Epub Date: 2023-05-22DOI: 10.4103/aian.aian_390_23
Jitupam Baishya
{"title":"Caregiver Burden and Stress in Caregivers of Stroke Survivors: Relevant but Neglected.","authors":"Jitupam Baishya","doi":"10.4103/aian.aian_390_23","DOIUrl":"10.4103/aian.aian_390_23","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45117884","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}
Pub Date : 2024-01-01Epub Date: 2024-02-22DOI: 10.4103/aian.aian_750_23
Sayooja Sachithanandan, Harikrishnan Ramachandran, E R Jayadevan, Santhosh K Kannath, Sapna E Sreedharan, P N Sylaja
Background: Identifying carotid pseudo-occlusion (PO) from true occlusion (TO) has implications in determining the candidacy and feasibility of successful endovascular thrombectomy (EVT) in acute ischemic stroke (AIS).
Purpose: We reviewed the computed tomography angiographic (CTA) patterns differentiating a PO from a TO and analyzed the rate of successful recanalization after EVT.
Materials and methods: Patients with AIS and proximal internal carotid artery (ICA) occlusion who underwent EVT from 2014 to 2021 were identified. The patterns of carotid occlusion in CTA were classified into beak, dome, and flat patterns and correlated with microcatheter digital subtraction angiography (DSA) as PO and TO. The rates of successful recanalization in PO and TO were analyzed.
Results: Of the 24 patients, 16 (66%) had ICA PO and eight (33%) had TO in DSA. A beak pattern of the proximal ICA on CTA was significantly higher among the PO group patients (87.5% vs. 25%, P = 0.005), and a flat pattern was significantly higher among the TO group patients (50% vs. 12%, P = 0.005). A gradual contrast decline of the proximal ICA on CTA images was seen only in PO group patients (85.7% vs. 0%, P = 0.05). There was no significant difference in the rate of successful recanalization between PO and TO group patients (81.25% vs. 62.5%, P = 0.362).
Conclusion: Beak pattern and gradual contrast decline at the proximal ICA occlusion site in CTA are suggestive of carotid PO. Identification of PO in CTA can help in planning intervention strategies and prognostication.
背景：目的：我们回顾了区分颈动脉假性闭塞（PO）和真性闭塞（TO）的计算机断层扫描血管造影（CTA）模式，并分析了EVT术后成功再通率：2014年至2021年期间接受EVT的AIS和近端颈内动脉（ICA）闭塞患者。CTA中的颈动脉闭塞模式分为喙状模式、圆顶模式和扁平模式，并与微导管数字减影血管造影（DSA）中的PO和TO相关联。结果：结果：在 24 名患者中，16 人（66%）在 DSA 中出现了 ICA PO，8 人（33%）出现了 TO。CTA上近端ICA的喙状模式在PO组患者中明显较高（87.5%对25%，P=0.005），而在TO组患者中平坦模式明显较高（50%对12%，P=0.005）。只有 PO 组患者在 CTA 图像上看到近端 ICA 的对比度逐渐下降（85.7% 对 0%，P = 0.05）。PO组和TO组患者的成功再通率无明显差异（81.25% vs. 62.5%，P = 0.362）：结论：CTA中ICA近端闭塞部位的喙状模式和对比度逐渐下降提示颈动脉PO。在 CTA 中识别 PO 有助于规划干预策略和预后。
{"title":"CT angiographic patterns predict carotid pseudo-occlusion in acute ischemic stroke.","authors":"Sayooja Sachithanandan, Harikrishnan Ramachandran, E R Jayadevan, Santhosh K Kannath, Sapna E Sreedharan, P N Sylaja","doi":"10.4103/aian.aian_750_23","DOIUrl":"10.4103/aian.aian_750_23","url":null,"abstract":"<p><strong>Background: </strong>Identifying carotid pseudo-occlusion (PO) from true occlusion (TO) has implications in determining the candidacy and feasibility of successful endovascular thrombectomy (EVT) in acute ischemic stroke (AIS).</p><p><strong>Purpose: </strong>We reviewed the computed tomography angiographic (CTA) patterns differentiating a PO from a TO and analyzed the rate of successful recanalization after EVT.</p><p><strong>Materials and methods: </strong>Patients with AIS and proximal internal carotid artery (ICA) occlusion who underwent EVT from 2014 to 2021 were identified. The patterns of carotid occlusion in CTA were classified into beak, dome, and flat patterns and correlated with microcatheter digital subtraction angiography (DSA) as PO and TO. The rates of successful recanalization in PO and TO were analyzed.</p><p><strong>Results: </strong>Of the 24 patients, 16 (66%) had ICA PO and eight (33%) had TO in DSA. A beak pattern of the proximal ICA on CTA was significantly higher among the PO group patients (87.5% vs. 25%, <i>P</i> = 0.005), and a flat pattern was significantly higher among the TO group patients (50% vs. 12%, <i>P</i> = 0.005). A gradual contrast decline of the proximal ICA on CTA images was seen only in PO group patients (85.7% vs. 0%, <i>P</i> = 0.05). There was no significant difference in the rate of successful recanalization between PO and TO group patients (81.25% vs. 62.5%, <i>P</i> = 0.362).</p><p><strong>Conclusion: </strong>Beak pattern and gradual contrast decline at the proximal ICA occlusion site in CTA are suggestive of carotid PO. Identification of PO in CTA can help in planning intervention strategies and prognostication.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142684","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}
Pub Date : 2023-12-20DOI: 10.4103/aian.aian_731_23
G. Puppala, S. Gorthi, Vijay Chandran, Ranjith Gandeti, Sai Sripad Rao
To study the prevalence of cognitive impairment in survivors of intracerebral hemorrhage (ICH). Survivors of spontaneous ICH were followed up in the neurology outpatient department when they reported for follow-up after 6 months. Neuroimaging records at the onset and at follow-up visits are studied for the location of ICH, volume of ICH, intraventricular extension, and hydrocephalus. The volume of ICH is calculated by ABC/2 method on a CT scan. All patients underwent cognitive assessment with Addenbrooke’s cognitive examination ACE III and were categorized as patients having cognitive impairment (or) no cognitive impairment. A total of 120 patients were studied, out of which 77 (64%) are males and 43 (36%) are females with age groups ranging from 26 to 75 years. In the study population, the mean age was found to be 62.3 years. Specifically, the mean age for males was 56.9 years, while for females it was 63.4 years. Cognitive impairment was noted in 34 of 120 patients (28%) during 6 to 12 months of examination, of which 11 of 19 were in lobar location, 21 of 94 were in sub-cortical location, and 2 of 7 were in infratentorial location. It was found that 28% of survivors of ICH were cognitively impaired. Hence, it is essential to assess cognition in post-ICH patients during follow-up, so that suitable adjustments can be made in their employment, and also in educating family members in providing a good quality of life.
{"title":"Prevalence of Cognitive Impairment and Dementia After Intracerebral Hemorrhage","authors":"G. Puppala, S. Gorthi, Vijay Chandran, Ranjith Gandeti, Sai Sripad Rao","doi":"10.4103/aian.aian_731_23","DOIUrl":"https://doi.org/10.4103/aian.aian_731_23","url":null,"abstract":"\u0000 \u0000 \u0000 To study the prevalence of cognitive impairment in survivors of intracerebral hemorrhage (ICH).\u0000 \u0000 \u0000 \u0000 Survivors of spontaneous ICH were followed up in the neurology outpatient department when they reported for follow-up after 6 months. Neuroimaging records at the onset and at follow-up visits are studied for the location of ICH, volume of ICH, intraventricular extension, and hydrocephalus. The volume of ICH is calculated by ABC/2 method on a CT scan. All patients underwent cognitive assessment with Addenbrooke’s cognitive examination ACE III and were categorized as patients having cognitive impairment (or) no cognitive impairment.\u0000 \u0000 \u0000 \u0000 A total of 120 patients were studied, out of which 77 (64%) are males and 43 (36%) are females with age groups ranging from 26 to 75 years. In the study population, the mean age was found to be 62.3 years. Specifically, the mean age for males was 56.9 years, while for females it was 63.4 years. Cognitive impairment was noted in 34 of 120 patients (28%) during 6 to 12 months of examination, of which 11 of 19 were in lobar location, 21 of 94 were in sub-cortical location, and 2 of 7 were in infratentorial location.\u0000 \u0000 \u0000 \u0000 It was found that 28% of survivors of ICH were cognitively impaired. Hence, it is essential to assess cognition in post-ICH patients during follow-up, so that suitable adjustments can be made in their employment, and also in educating family members in providing a good quality of life.\u0000","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956589","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}
Pub Date : 2023-12-20DOI: 10.4103/aian.aian_432_23
Qiang Zhang, Yuhuan Li, Xiaozan Chang
Traumatic brain injury (TBI) is a serious medical condition that often leads to significant morbidity and mortality. Decompressive craniectomy (DC) is now widely recognized as a primary or secondary treatment option for managing intracranial pressure (ICP) in patients with severe TBI. However, there is a lack of clarity in reviews regarding the impact of DC on TBI outcomes. The aim of this study is to evaluate the effectiveness of DC in terms of overall mortality and long-term prognosis among patients with TBI. We conducted a systematic search of four common databases to include all parallel-arm randomized controlled trials (RCTs). We selected studies that reported outcomes for TBI cases, with DC as a treatment option. The outcomes examined included reduction in mortality, ICP levels, and the proportion of patients with a Glasgow Outcome Scale score >4. Our review finally included eight RCTs [n = 1458, with 749 and 709 patients in the DC and control groups, respectively]. The weighted mean difference for ICP was estimated at -4.01 (95% Confidence interval [CI -5.31–-2.71), indicating a statistically significant reduction in ICP levels in the DC group compared to the control group. The pooled risk ratio was 0.67 (95% CI 0.51–0.89), suggesting a statistically significant 31% decrease in mortality levels in the DC group. Subgroup and sensitivity analyzes were also conducted to address heterogeneity. In conclusion, based on our meta-analysis, we find that DC can be considered a crucial surgical intervention for reducing mortality among patients with TBI when compared to control groups.
创伤性脑损伤（TBI）是一种严重的内科疾病，通常会导致严重的发病率和死亡率。目前，减压开颅术（DC）被广泛认为是控制严重 TBI 患者颅内压（ICP）的主要或辅助治疗方案。然而，有关减压开颅术对创伤性脑损伤预后影响的综述尚不明确。 本研究旨在评估 DC 对创伤性脑损伤患者总死亡率和长期预后的有效性。 我们对四个常用数据库进行了系统性检索，以纳入所有平行臂随机对照试验（RCT）。我们选择了以 DC 作为治疗方案的创伤性脑损伤病例的结果报告研究。我们的综述最终纳入了 8 项 RCT [n = 1458，DC 组和对照组分别有 749 和 709 名患者]。ICP的加权平均差估计为-4.01（95% 置信区间[CI -5.31--2.71]），表明与对照组相比，DC组ICP水平的下降具有统计学意义。汇总风险比为 0.67 (95% CI 0.51-0.89)，表明 DC 组的死亡率在统计学上显著降低了 31%。我们还针对异质性进行了分组分析和敏感性分析。 总之，根据我们的荟萃分析，我们发现与对照组相比，直流电可被视为降低创伤性脑损伤患者死亡率的重要外科干预措施。
{"title":"Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury - A Meta-Analysis of Randomized Controlled Trials","authors":"Qiang Zhang, Yuhuan Li, Xiaozan Chang","doi":"10.4103/aian.aian_432_23","DOIUrl":"https://doi.org/10.4103/aian.aian_432_23","url":null,"abstract":"\u0000 \u0000 \u0000 Traumatic brain injury (TBI) is a serious medical condition that often leads to significant morbidity and mortality. Decompressive craniectomy (DC) is now widely recognized as a primary or secondary treatment option for managing intracranial pressure (ICP) in patients with severe TBI. However, there is a lack of clarity in reviews regarding the impact of DC on TBI outcomes.\u0000 \u0000 \u0000 \u0000 The aim of this study is to evaluate the effectiveness of DC in terms of overall mortality and long-term prognosis among patients with TBI.\u0000 \u0000 \u0000 \u0000 We conducted a systematic search of four common databases to include all parallel-arm randomized controlled trials (RCTs). We selected studies that reported outcomes for TBI cases, with DC as a treatment option. The outcomes examined included reduction in mortality, ICP levels, and the proportion of patients with a Glasgow Outcome Scale score >4.\u0000 \u0000 \u0000 \u0000 Our review finally included eight RCTs [n = 1458, with 749 and 709 patients in the DC and control groups, respectively]. The weighted mean difference for ICP was estimated at -4.01 (95% Confidence interval [CI -5.31–-2.71), indicating a statistically significant reduction in ICP levels in the DC group compared to the control group. The pooled risk ratio was 0.67 (95% CI 0.51–0.89), suggesting a statistically significant 31% decrease in mortality levels in the DC group. Subgroup and sensitivity analyzes were also conducted to address heterogeneity.\u0000 \u0000 \u0000 \u0000 In conclusion, based on our meta-analysis, we find that DC can be considered a crucial surgical intervention for reducing mortality among patients with TBI when compared to control groups.\u0000","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955133","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}
Pub Date : 2023-12-15DOI: 10.4103/aian.aian_677_23
Suna Aşkın Turan, Şenay Aydın, M. G. Gözükara, Murat Çabalar
Chronic migraine (CM) patients with cutaneous allodynia (CA) show a poor response to treatment. Long-term studies have yet to be conducted to demonstrate the efficacy of blocks on CA. This study evaluated the improvement in allodynia and disability in CM treated with ultrasound (US)-guided blocks. In this prospective, non-randomized comparative study, 60 CM patients with CA were evaluated for the clinical effectiveness of the therapy using the numeric rating scale (NRS), headache impact test-6 (HIT-6), brush allodynia test, and allodynia symptom checklist (ASC-12). At the first visit, tenderness in the nerve or trapezius muscle was confirmed in the intervention group. US-guided greater occipital nerve block (GONB), GONB, and trapezius muscle injection (TPI), or GONB, TPI, and peripheral trigeminal nerve block (PTNB), respectively, were performed four times once a week for a month. Initial and third-month assessments were performed. The ASC-12 scores decreased in the GONB+TPI+PTNB and GONB groups more than the GONB+TPI group (mean rank, respectively, 26.86, 27.40, 38.39; P = 0.018). The decrease in HIT-6 scores was greater in the GONB+TPI+PTNB group than in the GONB group (mean rank, respectively, 21.98, 39.95, P < 0.017) in the first month. In the third month, the GONB+TPI+PTNB group scored HIT-6 significantly lower than GONB and GONB+TPI (mean rank: 18.84, 38.73, 35.61; P < 0.001). GONB+TPI+PTNB was more successful in alleviating allodynia and disability.
{"title":"Ultrasound-Guided Combined Greater Occipital Nerve Block at the C2 Level with Trapezius Trigger Point Injection and Supraorbital-Supratrochlear Nerve Block: More Effective on Allodynia and Disability in Chronic Migraine","authors":"Suna Aşkın Turan, Şenay Aydın, M. G. Gözükara, Murat Çabalar","doi":"10.4103/aian.aian_677_23","DOIUrl":"https://doi.org/10.4103/aian.aian_677_23","url":null,"abstract":"\u0000 \u0000 \u0000 Chronic migraine (CM) patients with cutaneous allodynia (CA) show a poor response to treatment. Long-term studies have yet to be conducted to demonstrate the efficacy of blocks on CA. This study evaluated the improvement in allodynia and disability in CM treated with ultrasound (US)-guided blocks.\u0000 \u0000 \u0000 \u0000 In this prospective, non-randomized comparative study, 60 CM patients with CA were evaluated for the clinical effectiveness of the therapy using the numeric rating scale (NRS), headache impact test-6 (HIT-6), brush allodynia test, and allodynia symptom checklist (ASC-12). At the first visit, tenderness in the nerve or trapezius muscle was confirmed in the intervention group. US-guided greater occipital nerve block (GONB), GONB, and trapezius muscle injection (TPI), or GONB, TPI, and peripheral trigeminal nerve block (PTNB), respectively, were performed four times once a week for a month. Initial and third-month assessments were performed.\u0000 \u0000 \u0000 \u0000 The ASC-12 scores decreased in the GONB+TPI+PTNB and GONB groups more than the GONB+TPI group (mean rank, respectively, 26.86, 27.40, 38.39; P = 0.018). The decrease in HIT-6 scores was greater in the GONB+TPI+PTNB group than in the GONB group (mean rank, respectively, 21.98, 39.95, P < 0.017) in the first month. In the third month, the GONB+TPI+PTNB group scored HIT-6 significantly lower than GONB and GONB+TPI (mean rank: 18.84, 38.73, 35.61; P < 0.001).\u0000 \u0000 \u0000 \u0000 GONB+TPI+PTNB was more successful in alleviating allodynia and disability.\u0000","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995710","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}
Pub Date : 2023-12-15DOI: 10.4103/aian.aian_566_23
Satish Khadilkar, Saurabh Kamat, Narayan Deshmukh, Neha Shah, Vanaja Shetty, Swati Shah, Hiral A. Halani, K. Mansukhani
Common etiologies of sciatic mononeuropathy are compressive, infiltrative, traumatic, or diabetic. However, in a proportion of patients, the etiology remains elusive despite extensive serological, electrophysiological, radiological, and histological investigations. Patients with unexplained sciatic mononeuropathy were studied with regard to their clinical, radiological, pathological, and treatment aspects. We could identify five cases of sciatic mononeuropathy wherein the etiology remained unknown even after a comprehensive evaluation. The compressive, metabolic, hematological, and immune causes were ruled out with necessary investigations. The clinical, electrophysiological, radiological, and histological features of these patients are discussed. The etiology of sciatic mononeuropathy can remain obscure in certain instances in spite of the comprehensive workup. The role of investigations and the exclusion process of various diagnostic entities are discussed.
{"title":"Five Cases of Idiopathic Sciatic Mononeuropathy: Clinical, Electrophysiological, Radiological, and Histological Features","authors":"Satish Khadilkar, Saurabh Kamat, Narayan Deshmukh, Neha Shah, Vanaja Shetty, Swati Shah, Hiral A. Halani, K. Mansukhani","doi":"10.4103/aian.aian_566_23","DOIUrl":"https://doi.org/10.4103/aian.aian_566_23","url":null,"abstract":"\u0000 \u0000 \u0000 Common etiologies of sciatic mononeuropathy are compressive, infiltrative, traumatic, or diabetic. However, in a proportion of patients, the etiology remains elusive despite extensive serological, electrophysiological, radiological, and histological investigations.\u0000 \u0000 \u0000 \u0000 Patients with unexplained sciatic mononeuropathy were studied with regard to their clinical, radiological, pathological, and treatment aspects.\u0000 \u0000 \u0000 \u0000 We could identify five cases of sciatic mononeuropathy wherein the etiology remained unknown even after a comprehensive evaluation. The compressive, metabolic, hematological, and immune causes were ruled out with necessary investigations. The clinical, electrophysiological, radiological, and histological features of these patients are discussed.\u0000 \u0000 \u0000 \u0000 The etiology of sciatic mononeuropathy can remain obscure in certain instances in spite of the comprehensive workup. The role of investigations and the exclusion process of various diagnostic entities are discussed.\u0000","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995997","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}
Pub Date : 2023-12-13DOI: 10.4103/aian.aian_772_23
V.K. Gowda, Viveka-Santhosh Reddy, Varunvenkat M Srinivasan, Dhananjaya K. Vamyanmane
{"title":"The Combined Neurogenetic Disorders; Blended Phenotype of Metachromatic Leukodystrophy (MLD) and Glutaric Aciduria Type 1 (GA -1) in an Indian Child","authors":"V.K. Gowda, Viveka-Santhosh Reddy, Varunvenkat M Srinivasan, Dhananjaya K. Vamyanmane","doi":"10.4103/aian.aian_772_23","DOIUrl":"https://doi.org/10.4103/aian.aian_772_23","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139006118","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}
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