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Indian Journal of Neurosciences
Editor in chief:Dr. Brijendra Singh
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Intracranial Ganglioglioma: A Rare Case Report
Author:S Varun Kumar, K Sriniwaas Rao, Lalitha Kundumula, Sayed Ameer Basha
Volume: 2 | Issue no: 3-2016 | Pagination: 74-76
Gangliogliomas are considered rare tumors which account for 0.4-0.9% of intracranial neoplasms. The peak of its incidence occurs between 10 and 20 years of age. These tumors are composed of glial and ganglion cells and they are relatively low grade neoplasms associated with good prognosis. We report a rare case of intracranial ganglioglioma in a 10 year old boy who underwent surgery and adjuvant radiotherapy.
Can We Predict Recurrence In Ocular Motor Palsies? Clinico-Investigational Study Of 34 Patient
Author:Haresh Kumar Bharote, Rahul Chakor, Chetan Chaudhari
Volume: 2 | Issue no: 3-2016 | Pagination: 69-73
Introduction: Ocular motor nerve palsies are common and disabling. Nearly 25% cases remain undiagnosed. Study of factors which predict recurrence and increase diagnostic yield, is important for prognostic and therapeutic purpose. Methodology: Prospective study done in the period from Jan 2009 to Dec 2015. Inclusion-Patient presenting with diplopia and/or 3, 4 or 6 nerve palsy. Exclusion-Congenital ocular motor palsy, birth injuries, neuromuscular disorder, myopathies, inherited disorders, brainstem lesions and head trauma. History, examination noted and all patients were followed up for 1 year from enrolment. Investigations included serum biochemistry, ESR, complete blood count, antinuclear antibody (ANA) and CSF in selected patients and Magnetic resonance imaging (MRI) of the brain with thin T1 weighted coronal post gadolinium cuts through the cavernous sinus. Asymmetric thickening of cavernous sinus ipsilateral to nerve palsy is considered pathological. Results and Conclusion: Total 34 patients studied. Aetiology could be ascertained in 85 %. Single nerve palsy in 20 and multiple nerve palsy was found in 14 patients. Ten patients had a recurrent palsy and 24 had a single episode. Recurrence was significantly associated with cavernous sinus thickening/ pachymeningitis and in higher proportion with multiple cranial nerve palsy as well as ANA positive patients. Keywords: Ocular motor palsy, Cavernous sinus thickening, Oachymeningitis, Recurrence, Pachymeningitis.
A 6 Week Prospective Randomized Comparative Study Of Metabolic Adverse Effects Of Risperidone And Iloperidone In Patients With Schizophrenia
Author:Anil Kumar Mysore Nagaraj, Priya Janardhan, Basavanna Pl, Rajendra Rajagopal
Volume: 2 | Issue no: 3-2016 | Pagination: 64-68
Introduction: The antipsychotics Risperidone and Iloperidone are the two different benzisoxazole derivatives that are structurally different and metabolized differently. Risperidone has moderate effects on metabolic parameters. Iloperidone is comparable to placebo in this regard according to western literature. We wish to study this on Indian population. Methods: it is a prospective randomized study having three visits, on day 1, 21 and 42. Forty patients with schizophrenia, 20 each on Risperidone and Iloperidone were compared for weight, BMI, FBS, PPBS and fasting lipid profile using repeated measures ANOVA and t test. Results: Ten percent of subjects on Risperidone and 15% on Iloperidone had significant weight gain. The mean weight gain was 2.5 kg and 2.75 kg with Risperidone and Iloperidone respectively. Both weight and BMI were comparable. Within the group, Risperidone caused significant rise in lipids; where as Iloperidone caused significant increase in both lipids and sugar. Across the groups there was no significant difference. Conclusions: The study reveals that Iloperidone is associated with weight gain, change in BMI as well as alteration in blood sugar and lipids that is comparable with Risperidone, even at a lower chlorpromazine equivalent dose, in contrast to the western literature where, its impact on metabolic parameters are said to be at placebo level.
A Study On Pediatric Epilepsy And Its Main Psychiatric Comorbidities
Author:Niranjan Nagaraj, Promod Kumar Berwal, Monika Sharma, Ayush Berwal
Volume: 2 | Issue no: 3-2016 | Pagination: 60-63
Background: Epilepsy is a common neurological problem. It has deleterious effects on the developing brain leading to significant psychosocial and economic burden. It is a treatable neurological problem and judicious approach will lead to early diagnosis and treatment, thus preventing significant morbidity. This study aims to study the psychiatry comorbidities in epilepsy children. Methods: This study was conducted as a comparative study in Department of pediatrics in collaboration with Department of Psychiatry, S.P. M.C Bikaner (Rajasthan) from 2015 January to 2015 September. All the patients and control group were evaluated on Revised Child Anxiety and Depression Scale All the collected data was tabulated and statically analyzed by using SPSS software. Results: In the case group 62% of the patients were having one or more of the psychiatric problem, including major depression, anxiety, behavioral problem or low I.Q. (<80), while the same in the control group was found to be 36% with significant p values. It was found that males were having more psychiatric problem. In our study, 30.8% patients were found to have depression as compared to 12% in the control group and anxiety was found twice (36%) in the case group as compared to control group (18%). Conclusion: Depression, anxiety and behavioral problems are present in large rates in the epileptic patients. Hence involvement of a psychiatrist while dealing with a patient of epilepsy can be done for early recognition and treatment of the disease.
Neuroplasticity In Play: Outcomes After Hemispherectomy In Rasmussen Encephalitis
Author:Isaiah Baiyekusi, Durga Prasad S.
Volume: 2 | Issue no: 3-2016 | Pagination: 56-59
Introduction: A key property of the brain is its capacity to change after injury to enable at least some behavioral compensation. There are spontaneous reparative changes following injury, some of these changes are sufficient to support significant functional recovery. Rasmussen Encephalitis: Rasmussen Encephalitis is a rare but severe immune-mediated brain disorder leading to unilateral hemispheric atrophy, associated progressive neurological dysfunction and intractable seizures. Hemispherectomy in one of its modern variants offers a very high chance of seizure freedom and it is highly probable that the unaffected hemisphere compensates and takes over the functions of the removed hemisphere. Outcomes after Hemispherectomy: We review the some cases of positive outcomes after removal of a hemisphere in patients suffering from Rasmussen encephalitis. Discussion: Neuroplasticity is the key for a functional motor shift to the normal hemisphere to happen. Removal of a hemisphere dramatically illustrates the resilience of the brain to extensive damage. Conclusion: Research on the basic principles of brain plasticity is leading to new approaches to treating the injured brain. The power of neuroplasticity that is play in RE can be harnessed for intervention and rehabilitation in the field of neurology.
Augmentation Strategy With Low Dose Aripiprazole In Long Standing Persistent Depressive Disorder: A Case Report From India
Author:Sompur V Sushil K.
Volume: 2 | Issue no: 1-2016 | Pagination: 31-33
Depression is the leading cause of disability among women in the world, frequently under recognized and inadequately treated. In spite of the different antidepressants available at the present time, they are far from ideal and show a similar slow & frequently incomplete response. This case report describes a 75 yr. old woman with persistent depressive disorder with intermittent major depressive episodes lasting for almost 40 years who was inadequately treated. It highlights the effectiveness of augmentation of low dose Aripiprazole in long standing persistent depressive disorder with intermittent major depressive episodes. After optimization of treatment with a known anti-depressant the augmentation strategy can produce a therapeutic response as early as 2 weeks with more than 50% reduction in symptoms on PHQ-9 scores.
Alcohol Related Brain Damage In Young Alcoholic
Author:Sharma Ram A., Rozatkar Abhijit R., Sood Shashank
Volume: 2 | Issue no: 1-2016 | Pagination: 28-30
Alcohol is the most commonly abused legal substance in the world. Long term implication of alcohol addiction and its withdrawal have been evident in the past century, since medical science evolved from medieval era to modernistic diagnostic and intervention approach & various research work were carried out to study how alcohol affects human mind and body. Although it is known that alcohol intoxication impairs judgment but its long term effect on developing brain of teenager has not been much documented. Contrary to the popular belief that alcohol only affects cerebellar functions and structure, this study highlights cerebral cortical brain atrophy (ARBD) in young individual secondary to alcohol abuse since his preteen age and thus affecting his cognitive abilities.
Lacosamide Induced Hyperactivity In A Mental Retarded Child With Seizure Disorder: A Case Report
Author:Thamke Snehal V., Singh Harful, Verma Kamal K., Saini Vijay K., Kesharwani Santosh K., Nagaraj Niran
Volume: 2 | Issue no: 1-2016 | Pagination: 26-27
Lacosamide is a novel anticonvulsant that modulates voltage gated sodium channels. Although it is known to cause few side effects like dizziness, headache, nystagmus, diplopia, nausea, somnolence, insomnia, drowsiness, hyperactivity, weight gain, very few cases have been reported of the same. We describe a case of 11 year old girl with severe mental retardation with behavioral problems and generalized tonic clonic seizure (GTCS). She was started Lacosamide for her uncontrolled seizures, 2 weeks after which she developed hyperactivity, inattention and restlessness. Discontinuation of Lacosamide made the patient like before. We conclude that this novel drug, Lacosamide should be used cautiously in children and concerned family members should be advised about the drug reaction and adverse effects.
Role Of Serum Cpk And Serum Magnesium Level As A Predictor Of Impending Intermediate Syndrome In Patients Of Op Poisoning
Author:Singla Rahul, Singh Veer B., Meena Babu L., Kumar Harish, Kumar Deepak, Sidana Shivani, Chandra Subh
Volume: 2 | Issue no: 1-2016 | Pagination: 22-25
troduction: Organophosphorus poisoning is one of the most common and deadliest poisoning especially in country like India. The intermediate syndrome occurred after the acute cholinergic syndrome but before organophosphate-induced delayed Polyneuropathy is characterised by the weakness of the muscles of respiration and of proximal limb muscles. Early identification can reduce morbidity and mortality. Aim: To assess importance of serum CPK and serum Magnesium level in patients of OP poisoning as marker OP intermediate syndrome. Material method: This was cross sectional study in PBM hospital over 93 patients over a period of 1 year. Serum CPK and magnesium level were assessed on admission and day 5 and were compared in patients who developed and didn?t intermediate syndrome. Result: Thus, CPK level on day 1 as well as day 5 but not magnesium can be used as a predictor for the intermediate syndrome.
Epidemiology Of Guillain Barre Syndrome In North Western Part Of Rajasthan
Author:Nagaraj Niranjan, Swami Sarika, Berwal Pramod K., Sharma Manjulatha, Saini Tara C., Chaudhary Lokesh
Volume: 2 | Issue no: 1-2016 | Pagination: 19-21
Background: Guillain-Barre syndrome is an autoimmune disorder and is an important cause of acute flaccid paralysis. This study was carried out to determine the prevalence and epidemiology of Guillain Barre Syndrome. Methods: This is a retrospective study conducted in the Department of Paediatrics, Sardar Patel Medical College & A.G. Hospitals, Bikaner. All the cases of Acute Flaccid Paralysis are reported under the AFP surveillance Program. Records of all the patients of AFP in years 2012 to 2015 were analysed. Among these, cases diagnosed as Guillain-Barre syndrome were taken into consideration. The diagnosis was made on the basis of history, clinical examination, CSF studies, nerve conduction velocity and MRI of spinal cord when required. All the collected data was tabulated and stastically analyzed by using SPSS software. Results: In our study, Total 130 cases were reported as having Acute Flaccid Paralysis in years 2012 to 2015.Of these 54 cases were diagnosed to have Guillain-Barre syndrome. In our study prevalence of GBS was 41.5%. Most cases were in the age range of 13-60 months. In these study males (68.5%) were more affected than girls (31.5%). Lower limb weakness is the common presentation in GBS patients. Out of 54 reported GBS cases, 9 cases were expired. Conclusion: Future research needs to be focused on developing accurate diagnostic methods as well as protocols to identify at-risk patients. The role of immunotherapy in patients with GBS needs to be fully established, and effective therapies are yet to be developed.
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