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2021| November-December | Volume 24 | Issue 6
Online since
December 17, 2021
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EDITORIAL COMMENTARY
COVID-19 associated neurological manifestations
Rahul Kulkarni, Shripad Pujari
November-December 2021, 24(6):847-848
DOI
:10.4103/aian.aian_1016_21
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High-resolution vessel wall MRI: A new armamentarium for diagnosis of primary angiitis of CNS
Vikas Bhatia
November-December 2021, 24(6):845-846
DOI
:10.4103/aian.aian_236_21
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AIAN REVIEW
Neurological facets of scrub typhus: A comprehensive narrative review
Divyani Garg, Abi Manesh
November-December 2021, 24(6):849-864
DOI
:10.4103/aian.aian_739_21
Scrub typhus is one of the most frequent causes of acute febrile illness in South and South-east Asian countries. Neurological features accompany 20% of scrub typhus infections, and may affect the central or peripheral nervous system, and sometime, may even occur in combination. Of late, its recognition among clinicians has increased with widening detection of its cutaneous hallmark, called eschar. Multiple mechanisms underlie neurological involvement, including direct invasion (meningitis, encephalitis), vasculitis (myositis) or immune-mediated mechanisms (opsoclonus, myoclonus, optic neuritis, Guillain–Barre syndrome). Despite an immunological basis for several neurological manifestations, response to doxycycline is remarkable, although immune therapy may be necessary for severe involvement. Scientific literature on scrub typhus neurology chiefly emanates from case reports, case series and small studies, and a comprehensive review is warranted to aid clinicians in recognising neurological involvement. This review aims at enriching this gap, and summarises clinical features, laboratory findings, and treatment options for various neurological facets of scrub typhus.
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ORIGINAL ARTICLES
A clinical and neurophysiological analysis of idiopathic carpal tunnel syndrome with respect to gender and occupation
Asha Elizabeth Mathew, Thomas John
November-December 2021, 24(6):865-872
DOI
:10.4103/aian.AIAN_148_21
Background:
Carpal tunnel syndrome (CTS) predominantly affects women. Previous studies observed more intense symptoms among women without a corresponding increase in disease severity and attributed it to reporting bias. In this study, we examined whether women are inherently more vulnerable to work related median nerve dysfunction at wrist and whether reported CTS symptoms among women correspond to the degree of median neuropathy at wrist.
Methods:
A cross-sectional study was designed for outpatients (aged 25-59 years) diagnosed with CTS. Occupational categorisation was done based on the analysis of their individual job tasks. Symptom severity (Boston Symptom Severity Scale – SSS), functional disability (Boston Functional Status Scale - FSS), and clinical (Hi – Ob scale) and neurophysiological severity (NCS grade) were determined, compared among occupational groups and were statistically analysed.
Results:
A total of 454 patients (348 women and 106 men; F: M ratio 3.28:1) were included. Among them, 191 were housewives. Female manual workers and housewives reported significantly more intense symptoms with a corresponding increase in clinical and electrophysiological severity (p < 0.001) when compared to female non-manual workers. However, no significant difference in symptoms, clinical or neurophysiological severity was found between male non-manual and manual workers. Among manual workers, women were more symptomatic than men, but clinical and neurophysiological severities were significantly higher only in the older age groups.
Conclusion:
The differential vulnerability of the female population to hand-intensive work predisposes them to severe median nerve dysfunction at wrist with proportionately higher CTS symptoms. Therefore, working women need focussed attention for remedial measures.
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Duchenne muscular dystrophy: Genetic and clinical profile in the population of Rajasthan, India
Manisha Goyal, Ashok Gupta, Kamlesh Agarwal, Seema Kapoor, Somesh Kumar
November-December 2021, 24(6):873-878
DOI
:10.4103/aian.AIAN_126_21
Background:
Duchenne Muscular Dystrophy (DMD) is an X-linked recessive muscular dystrophy that affects young boys and is caused by mutation of the dystrophin gene located over X chromosome.
Materials and Methods:
In this prospective study, 120 clinically diagnosed DMD patients were tested for exon deletions, duplication or point mutation.
Results:
Of the 120 clinically suspected DMD patients, the diagnosis of DMD was confirmed by the genetic study or muscle biopsy in 116 patients. The mean age of onset was 3.2 years and the mean age at presentation was 7.2 years. 110/120 cases were confirmed by genetic testing and six were by absence of staining for dystrophin on muscle biopsy. DMD gene deletion was present in 78.5%, duplication in 5.3% and point mutation in 11.2% cases. 70.3% of patients had deletion located at a distal hot spot region. Single exon deletion was found in 16.5%. Distal hotspot exons 47, 48 and 50 were the commonly deleted exons.
Conclusions:
In our study, 94.8% cases showed genetic change in the DMD gene. Muscle biopsy was the choice of investigation in earlier days. Detection of DMD by DNA based method eliminates the need to do an invasive procedure for diagnosis. Hence the genetic testing should be the investigation of choice in suspected cases of DMD. The pattern of deletion, obtained in the population of Rajasthan was similar when compared with other ethnic groups of the Indian population. It would be helpful for researchers to develop drugs specific to exons or for ongoing mutation-specific therapies.
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Rescue strategies in anterior circulation stroke with failed mechanical thrombectomy—A retrospective observational study (RAFT)
Amit Ashok Bhatti, Niranjan P Mahajan, Devashish Dhiren Vyas, Mudasir Mushtaq Shah, Vikram Huded
November-December 2021, 24(6):885-890
DOI
:10.4103/aian.AIAN_87_21
Context:
Recanalization failure rate in mechanical thrombectomy (MT) for large vessel occlusions is up to 30%. Outcome greatly depends on recanalization success and, thus, there is an urgent need to adopt new strategies to improve recanalization.
Aims:
To report on the feasibility, safety, and outcome of rescue strategies (stenting and/or angioplasty) in cases of failed MT for acute ischemic stroke (AIS) in anterior circulation.
Materials and Methods:
It was a retrospective observational study where patients undergoing MT were divided into two groups. The first group (MT-only) was of patients who had undergone only MT with the standard tools (stentriever and/or aspiration). The second group (MT-plus) consisted of patients who underwent a rescue procedure after failure of the standard MT. The two groups were compared based on the demographics, risk factors, stroke severity, and the extent of infarct on imaging. The angiographic findings, procedural details, periprocedural care, and angiographic and clinical outcome were also compared.
Results:
Out of 181 cases, 142 were in MT-only while 39 were included in MT-plus group. The two groups had comparable baseline stroke severity, extent of infarct on imaging and door to puncture time. The MT-plus patients had significantly longer time of onset and puncture to recanalization time. The clinical outcome was favorable in both groups with 57.7% and 59% patients achieving mRS 0–2 in MT-only and MT-plus groups, respectively. Successful recanalization was achieved in 80.3% and 89.7% in MT-only and MT-plus groups, respectively. There was no significant increase in symptomatic intracranial hemorrhage and mortality after rescue procedures.
Conclusions:
Rescue stenting and/or angioplasty after failed MT is a safe and effective recanalization method for AIS in anterior circulation without increasing mortality or morbidity.
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Neurological disorders seen during second wave of SARS-CoV-2 pandemic from two tertiary care centers in central and Southern Kerala
Minu George, Neena Baby, Ameen Azad, Aswathy Rajan, Suresh Kumar Radhakrishnan
November-December 2021, 24(6):917-926
DOI
:10.4103/aian.aian_541_21
Background and Objective:
SARS-CoV-2 infections present with predominant respiratory symptoms. Only a few anecdotal reports of neurological involvement have come out from India so far. Adverse neurological events following immunization (AEFI) were also reported. We present the neurological symptoms seen either in association with vaccination or COVID-19 infection during the second wave.
Methods:
This was a retrospective study that included consecutive COVID-19 patients' admissions during the second wave of COVID-19 pandemic in two tertiary health care centres in Kerala. Neurological symptoms two weeks prior or thirty days after a positive status of antigen or RTPCR was termed as COVID-19-Associated Neurological Disorders (CAND) and those with neurological symptoms within one month of COVID-19 vaccination was termed as Post-Vaccinal Neurological Disorders (PVND).
Results:
During the study period, 1270 COVID-19 admissions were reported. We identified neurological symptoms in 42 patients (3.3%), of which 35 were CAND and 7 were PVND. Stroke was the most common (50%), followed by seizures and peripheral nervous system disorders (14.2% each). Encephalitis/demyelination (11.9%) and COVID-19-associated infections (9.5%) were also seen.
Conclusion:
During the SARS-CoV-2 pandemic, CAND and PVND have been emerging. Association of some of these may be fortuitous; however it is worth mentioning as pathogenic mechanisms of COVID-19 affecting various organ systems still remain unclear. Moreover, this may be helpful in future studies designing management options.
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Factors affecting adherence to pharmacotherapy in parkinson's disease
Shivaansh Aggarwal, Gunchan Paul, Birinder S Paul, Diksha Mahendru, Shriya Goyal
November-December 2021, 24(6):879-884
DOI
:10.4103/aian.AIAN_143_21
Background:
The goal of dopaminergic replacement therapy to achieve good clinical outcome in Parkinson's disease (PD) patients largely depends on the pattern of adherence to the pharmacological treatment. This study aims to find the factors affecting medication adherence in patients with PD keeping in mind the cultural, economic, and social diversities so that preventive steps can be taken to fill these gaps.
Methods:
Demographic data, disease parameters, treatment-related factors, family characteristics, educational, and employment status were assessed for relationship with the medication adherence pattern in a cohort of non-demented PD patients. Medication adherence was measured by MMAS-8; depression, and socioeconomic status were assessed by GDS-SF and Kuppuswamy scales respectively.
Results:
From 134 PD subjects, high adherence was observed in 43.2%, 18.2% had moderate, and 38.6% reported low adherence level to their pharmacotherapy. The sub-optimal level of adherence was significantly correlated to compliance of follow up with the physician (p 0.03), presence of adverse events related to drugs (p 0.03), and depressive symptoms (p < 0.0001). Also, there was significant negative co-relationship between poor adherence and depression on Spearman's rank coefficient (0.702). There was no effect of demographic factors, living conditions, family type, educational qualification, associated comorbid conditions, and socioeconomic status on adherence to dopaminergic treatment in patients with PD.
Conclusion:
Poor adherence to prescribed medication is a menace that is more than just oversimplification of forgetfulness which should be evaluated at each visit to improve efficacy of the prescribed regimen to achieve better treatment result and thus quality of life of PD patients.
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Clinical, biochemical, radiological, and genetic profile of patients with homocysteine remethylation pathway defect and spastic paraplegia
Hansashree Padmanabha, Rohan Mahale, Rita Christopher, Gautham Arunachal, Maya Bhat, Mahammad Samim Mondal, Ram Murthy Anjanappa, Ravindranadh Chowdhary Mundlamuri, Ravi Yadav, Seena Vengalil, Pooja Mailankody, Pavagada S Mathuranath, Sadanandavalli R Chandra, Atchayaram Nalini
November-December 2021, 24(6):908-916
DOI
:10.4103/aian.AIAN_223_21
Objectives:
The objective of this study is to describe the clinical, biochemical, radiological, and genetic profile of patients presenting with progressive spastic paraparesis due to homocysteine remethylation pathway defect.
Methods:
This was a retrospective study conducted by reviewing the medical records of patients with serum homocysteine levels >50 μmol/L between January 2015 and January 2019 at our hospital. We included patients presenting with progressive spastic paraparesis, having serum homocysteine >50 μmol/L with low or normal blood methionine suggesting disorders of homocysteine remethylation. Demographic details, clinical manifestations, biochemical abnormalities, neuroimaging findings, and genetic profile were analyzed.
Results:
A total of seven patients (M: F = 5:2) fulfilled the study eligibility criteria. The mean age at onset of the disease was 13.4 ± 2.4 years (range: 9–17 years). Spastic paraparesis was the presenting manifestation in 4/7 (57.1%) patients. Other manifestations included cognitive decline, poor scholastic performance, behavioral disturbances, seizures, and spastic bladder. Severe hyperhomocysteinemia (>100 μmol/L) was noted in 6/7 (85.7%) patients with median levels of serum homocysteine being 185.7 μmol/L (range: 85.78–338.5 μmol/L). Neuroimaging showed parieto-occipital predominant leukoencephalopathy in 5/7 (71.4%) and diffuse cerebral atrophy in 1/7 (14.2%). Genetic analysis in three patients revealed pathogenic missense variants c.459C >G (p.Ile153Met), c.973C >T (p.Arg325Cys), and c.1031G >T (p.Arg344Met) in
MTHFR
gene. All the patients received vitamin B12 (injection and oral), folic acid, and pyridoxine and two patients received betaine. At the last follow-up of a median duration of 12 months, there was a good clinical and biochemical response with reduction in the median value of serum homocysteine by 77.5 μmol/L.
Conclusion:
Evaluation of serum homocysteine and blood methionine in adolescents presenting with progressive spastic paraparesis gives clue to a treatable homocysteine remethylation disorders.
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Clinico-etiological factors, neuroimaging characteristics and outcome in pediatric cerebral venous sinus thrombosis
Leema P Cornelius, Neeraj Elango, Venkateswaran Kuttava Jeyaram
November-December 2021, 24(6):901-907
DOI
:10.4103/aian.AIAN_221_21
Background:
Cerebral venous sinus thrombosis (CVST) is rare in children, increasingly being recognized of late due to advances in neuroimaging. The aim of the study was to describe the clinical, etiological, and imaging characteristics of CVST and its outcome in children.
Study Design:
A retrospective chart review of children with CVST in a tertiary hospital from January 2011 to December 2020.
Results:
Of the 35 patients enrolled, 26 (74.3%) patients were males. The mean age was 5.03 years with a range of 0.17–12 years. The common presenting symptoms were seizures in 18 (51.4%) followed by headache in 17 (48.6%), fever in 16 (45.7%), and vomiting in 15 (42.9%) children. Superior sagittal sinus was the commonest site of thrombus occlusion in 20 (57%), followed by transverse sinus in 18 (51.4%) patients. Multiple sinus involvement was noticed in one-half of the patients. The risk factors associated with CVST were head and neck infections in 15 (42.9%) children, inherited thrombophilia in 4 (11.6%), head trauma, iron deficiency anemia, leukemia with l-asparaginase therapy, acquired thrombophilia in 3 (8.6%) each, dehydration in 2 (5.7%), and dural arteriovenous fistula in one child. Two children (5.7%) died and one-third of the cohort had a poor outcome.
Conclusions:
Head and neck infections continue to be the common cause of CVST in children. Though mortality is low, CVST is associated with significant morbidity in children.
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LETTERS TO THE EDITOR
Batten's disease: A seizure disorder's battle for diagnosis
Nishanth Dev, Rahul Kumar, Shruti Sharma, MC Sharma
November-December 2021, 24(6):953-955
DOI
:10.4103/aian.AIAN_769_20
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ORIGINAL ARTICLES
Semantic fluency predicts gait velocity in PSP
Koustav Chatterjee, Supriyo Choudhury, Ummatul Siddique, Banashree Mondal, Marium U Kulsum, Saptak Haldar, Purba Basu, Rebecca Banerjee, Hrishikesh Kumar
November-December 2021, 24(6):896-900
DOI
:10.4103/aian.AIAN_71_21
Context:
Progressive supranuclear palsy (PSP) is a large-scale network disease resulting in variable signs and symptoms including gait impairment and higher order cognitive dysfunction. Despite few studies showing the association of falls and cognitive dysfunction, the existing literature is yet to establish the exact relationship of discrete characteristics of gait with cognitive function in PSP.
Aims:
In this cross-sectional study, we aimed to characterize and explore the relationship of these two apparently distinct physiological phenomena in patients with PSP and across its different variants.
Methods and Material:
Quantitative assessment of two-dimensional gait parameters was measured using an electronic walkway (GAITRite®). Dementia Rating Scale-2 was used to assess global as well as higher order cognitive functions.
Statistical Analysis Used:
A regression model was used to interpret results.
Results:
We observed that the variability domain of gait was significantly impaired in PSP patients with severe cognitive impairment compared to that of intact cognition. Moreover, initiation/perseveration (I/P), a higher order cognitive process, and one of its specific components, i.e., complex verbal task (
β
= 2.39,
P
< 0.001), significantly predict gait velocity in PSP [
F
(1, 40) = 16.102,
P
< 0.001].
Conclusions:
Our findings indicate that the severity of cognitive functions affects gait variability, which might lead to frequent falls as observed in PSP. Furthermore, semantic fluency task of I/P function may act as a predictor of gait velocity. We suspect that higher order cognitive dysfunction through the damage of frontal lobe structure including dorsolateral prefrontal cortex or related network may influence gait in PSP.
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LETTERS TO THE EDITOR
Cobalamin c disease: Cognitive dysfunction, spastic ataxic paraparesis, and cerebral white matter hyperintensities in a genetic but easily treatable cause!
Ayush Agarwal, Vibhor Upadhyay, Anu Gupta, Ajay Garg, Venugopalan Y Vishnu, Roopa Rajan, Mamta Bhushan Singh, Rohit Bhatia, MV Padma Srivastava
November-December 2021, 24(6):997-999
DOI
:10.4103/aian.AIAN_729_20
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A neurocysticercosis infestation masquerading as malignant brain tumour
Madan Mohan Gupta, Ajay Garg, Khushpreet Kaur, Leve Joseph, Vinay Goyal, Achal Kumar Srivastava
November-December 2021, 24(6):970-972
DOI
:10.4103/aian.AIAN_725_20
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Tele-child-neurology in the era of COVID-19: A developing nations' Perspective
Chaithanya Reddy, Priyanka Madaan, Lokesh Saini
November-December 2021, 24(6):944-945
DOI
:10.4103/aian.AIAN_786_20
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Subacute sclerosing panencephalitis with an atypical presentation
Ram Bhupal Reddy, Deepika Joshi, Anand Kumar
November-December 2021, 24(6):946-947
DOI
:10.4103/aian.AIAN_791_20
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Cryptococal meningitis presenting as acute cerebellar syndrome
Kiren George Koshy, Ravindranadh C Mundlamuri, Seena Vengalil, Ravi Yadav, S Nagarathna, Rose D Bharath, Nalini Atchayaram
November-December 2021, 24(6):983-984
DOI
:10.4103/aian.AIAN_733_20
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Nummular headache: A rare headache type in a child responding to carbamazepine and gabapentin
Prateek Kumar Panda, Vetoni Moirangthem, Indar Kumar Sharawat
November-December 2021, 24(6):943-944
DOI
:10.4103/aian.AIAN_722_20
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Cervical radiculopathy as the inaugural manifestation of non-hodgkin's lymphoma of rib
Monika Puranik, Krati Khandelwal, Swapnil Puranik, Pragya Saxena, Prateekz Bapat, Gaurav Khandelwal
November-December 2021, 24(6):975-977
DOI
:10.4103/aian.AIAN_5_21
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857
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Treating triple thrombus-pulmonary, cardiac, and cerebral: A case management with calculated conscience
Ashok V R. Taallapalli, Mahammad S Mondal, Reshma S Shaik, PR Srijithesh, Girish B Kulkarni
November-December 2021, 24(6):962-965
DOI
:10.4103/aian.AIAN_771_20
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IMAGES IN NEUROLOGY
Moebius syndrome
Arjimand Yaqoob, Waseem Dar, Adnan Raina, Amit Chandra, Zubair Khawaja, Immia Bukhari, Hilal Ganie, Maqbool Wani, Ravouf Asimi
November-December 2021, 24(6):929-929
DOI
:10.4103/aian.AIAN_182_21
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LETTERS TO THE EDITOR
Thrombolysis in ischemic stroke after bee sting: A rare scenario
B Ram Abhishek, S Sakthi Velayutham, K Malcolm Jeyaraj, PR Sowmini, M Sathish Kumar, S Viveka Sarvanan, K Mugundhan
November-December 2021, 24(6):985-986
DOI
:10.4103/aian.AIAN_770_20
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CErebral dysgenesis, neuropathy, ichthyosis, and keratoderma (CEDNIK) syndrome with brain stem malformation
Sudhakar Karunakaran, Bejoy Thomas, Ramshekhar Menon, Muralidharan Nair, Sruthi S Nair, Soumya Sundaram
November-December 2021, 24(6):979-981
DOI
:10.4103/aian.AIAN_673_20
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A rare treatable and under recognized cause of recurrent convexity subarachnoid hemorrhage: Lupus anticoagulant hypoprothombinemia syndrome
Shikha Jain, Karthik Muthusamy, TS Bernice, Himanshu Pansuriya, Anu Punnen, Sathish Kumar, Maya Mary Thomas
November-December 2021, 24(6):986-989
DOI
:10.4103/aian.AIAN_804_20
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Relapse in stuttering with the onset of primary progressive aphasia
Nikita Dadlani, Prathiksha Vaidhyanathan, Divya Swaminathan, Nagarajarao Shivashankar, Rose Dawn Bharath, Shoba S Meera
November-December 2021, 24(6):981-983
DOI
:10.4103/aian.AIAN_865_20
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Recurrent posterior circulation stroke as an initial manifestation of atlantoaxial dislocation in a child
N Devavrat, Karthik K, J Shumyla, K Neeraja, M Netravathi
November-December 2021, 24(6):965-967
DOI
:10.4103/aian.AIAN_744_20
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Pemetrexed-induced pseudotumor cerebri syndrome: A rare complication
Saroja Aralikatte Onkarappa, Rekha Bellulli Kotrappa, Siddharth Singh, Karkal Ravishankar Naik
November-December 2021, 24(6):947-949
DOI
:10.4103/aian.AIAN_628_20
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Symptomatic female spastic paraplegia patient with a novel heterozygous variant of the PLP1 gene
Ae Ryoung Kim, Yun-Jeong Lee, Mi Hee Kwack, Jong-Mok Lee
November-December 2021, 24(6):958-960
DOI
:10.4103/aian.AIAN_793_20
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Child with D-2-hydroxyglutaric aciduria type II: A rare neurometabolic disorder
Rangan Srinivasaraghavan, Suvasiniz Sharma, Lisa Kratz, Prateek Malik, Sangeetha Yoganathan, Sumita Danda, Samuel Philip Oommen
November-December 2021, 24(6):933-934
DOI
:10.4103/aian.AIAN_231_20
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Clinical presentation and outcome of children with brain abscess
Prateek Kumar Panda, Vivekanand Natarajan, NK V. Vigneshwar, Indar Kumar Sharawat
November-December 2021, 24(6):951-952
DOI
:10.4103/aian.AIAN_794_20
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Expanding mad hatter's shakes: Peripheral nerve hyperexcitability syndrome with artefactual-looking lung lesions
Ayush Agarwal, Ayush M Makkar, Venugopalan Y Vishnu, Anu Gupta, Roopa Rajan, Mamta B Singh, Rohit Bhatia, MV Padma Srivastava
November-December 2021, 24(6):993-994
DOI
:10.4103/aian.AIAN_727_20
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Tubercular rhombencephalitis: A clinical challenge
Laxmikant Ramkumarsingh Tomar, Dhrumil Jatinbhai Shah, Poojan Agarwal, Anshu Rohatgi, CS Agrawal
November-December 2021, 24(6):960-962
DOI
:10.4103/aian.AIAN_685_20
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Post-operative seizure freedom need not be elusive in mild oligodendroglial hyperplasia and epilepsy (MOGHE)
Aparajita Chatterjee, Ravindranadh C Mundlamuri, Ajay Asranna, Raghavendra Kenchaiah, GK Bhargava, Mariyappa Narayanan, Radhika Mhatre, Karthik Kulanthaivelu, Sandhya Mangalore, Chandana Nagaraj, Rose Dawn Bharath, Jitender Saini, Nishanth Sadashiva, A Arivazhagan, Malla Bhaskara Rao, Anita Mahadevan, Sanjib Sinha
November-December 2021, 24(6):1009-1011
DOI
:10.4103/aian.AIAN_1155_20
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Young stroke and systemic manifestations: Deficiency of adenosine deaminase-2 (DADA-2)
Smruti Babtiwale, Venugopalan Y Vishnu, Ajay Garg, Vinay Goyal, Mamta B Singh, MV Padma Srivastava
November-December 2021, 24(6):977-979
DOI
:10.4103/aian.AIAN_657_20
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IMAGES IN NEUROLOGY
Preferential corticospinal tract involvement in a case of neuromelioidosis
Sundar Shanmugam, Rithvik Ramesh, Raj Kumar, Prabhu Radhan, Bodapati Pawan Kumar
November-December 2021, 24(6):927-928
DOI
:10.4103/aian.AIAN_1200_20
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710
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LETTERS TO THE EDITOR
Von hippel lindau disease presenting as cervical compressive myelopathy
Aminu Aliyar, Ayush Agarwal, Venugopalan Y Vishnu, Anu Gupta, Ajay Garg, Mamta Bhushan Singh, Rohit Bhatia, MV Padma Srivastava, Roopa Rajan
November-December 2021, 24(6):999-1001
DOI
:10.4103/aian.AIAN_1052_20
[FULL TEXT]
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709
68
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Granulomatous amebic encephalitis presenting like a tumor-chasing a diagnostic conundrum
Ashok V R. Taallapalli, Saraswati Nashi, Girish B Kulkarni, Suvarna Alladi, Yasha T Chickabasaviah
November-December 2021, 24(6):968-970
DOI
:10.4103/aian.AIAN_994_20
[FULL TEXT]
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[EPub]
660
71
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A case of opercular-subopercular syndrome with favorable prognosis
Anand Sivaprasad, Prasanth Sudhakaran, Shaji C Velayudhan, Kabeer K Abdulkhayarkutty
November-December 2021, 24(6):957-958
DOI
:10.4103/aian.AIAN_658_20
[FULL TEXT]
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650
64
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Parkinsonism, olivary hypertrophy and cerebellar atrophy with
TTC19
gene mutation
Rohan R Mahale, Gautham Arunachal, Jyothi Gautam, Debayan Dutta, Jennifer Kovoor, Pooja Mailankody, Hansashree Padmanabha, PS Mathuranath
November-December 2021, 24(6):991-993
DOI
:10.4103/aian.AIAN_625_20
[FULL TEXT]
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[EPub]
636
73
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A case of relapsing - remitting CIDP with sixth nerve palsy
Arikrishnan Thelengana, Vinay Goyal
November-December 2021, 24(6):939-941
DOI
:10.4103/aian.AIAN_731_20
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602
107
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ORIGINAL ARTICLES
Neurologic manifestations of COVID 19 in children: Prospective study in a single center
Esra Gürkas, Betül Dünya, Özlem Y Köken, Tugba B Demirdağ, Deniz Yilmaz, Hamit Özyürek, Aysegül N Ç. Kurt
November-December 2021, 24(6):891-895
DOI
:10.4103/aian.AIAN_225_21
Background:
The data related to the neurologic manifestations of coronavirus disease 2019 (COVID-19) in children are limited. The frequency of the neurologic manifestations and the risk factors in the development of these symptoms are not clear.
Objectives:
We aimed to determine the exact frequency of the neurological symptoms in pediatric patients with confirmed COVID-19 and to identify the risk factors for the development of neurological manifestations.
Materials and Methods:
We included pediatric Covid-19 patients admitted to the Children's Hospital of Ankara City Hospital between March 22 and June 1, 2020. Neurological findings were questioned by interviewing the patients and their families and detailed neurologic examinations were performed within protection measures.
Results:
A total of 312 pediatric patients with the diagnosis of COVID-19 were enrolled in the study. Sixty-six participants (21.15%) showed neurologic symptoms during COVID-19. Headache was the most common neurologic symptom and present in 14% (
n
: 44) of the cases. The other neurologic symptoms were myalgia (
n
: 30, 9.6%), anosmia/hyposmia (
n
: 6, 1.9%), ageusia (
n
: 2, 0.6%), and vertigo (
n
: 1, 0.3%). Neutrophil-to-lymphocyte ratio (NLR) (
P
= 0.002) and platelet-to-lymphocyte ratio (PLR) (
P
= 0.001) were significantly elevated in patients with neurological symptoms when compared to the patients without the symptoms.
Conclusions:
Physicians should be alert to the neurologic involvement of COVID-19 disease in children. NLR and PLR ratios could have a predictive value for the development of neurological manifestations.
[ABSTRACT]
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690
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LETTERS TO THE EDITOR
Clinico-pathological features in köhlmeier–degos disease with cutaneous and neurological involvement
Dodmallur Mallikarjuna Sindhu, Sumanth Shivaram, Shilpa Rao, Madhu Nagappa, Doniparthi V Seshagiri, Vani Santosh, J Madhukara, AS Shreedhara, Maya D Bhat, Rose D Bharath, Sanjib Sinha
November-December 2021, 24(6):1005-1009
DOI
:10.4103/aian.AIAN_1004_20
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623
81
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SEPN1-related myopathy: The importance of diagnosis and challenges to management of CMD in resource poor settings
Siddhartha Gajam, Madhuri Maganthi, Ann Agnes Mathew, Suman Rath
November-December 2021, 24(6):955-956
DOI
:10.4103/aian.AIAN_655_20
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582
99
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Early infantile onset non-5q spinal muscular atrophies: A diagnostic odyssey
Renu Suthar, Chandana Bhagwat, Pradip Paria, Divya Aggarwal, Namita Ravi Kumar, Debajyoti Chatterjee, Arushi G Saini, Suresh Kumar Angurana, Naveen Sankhyan
November-December 2021, 24(6):995-997
DOI
:10.4103/aian.AIAN_680_20
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594
82
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Creutzfeldt-jakob disease in nonagenarian: A rare presentation from India
Shubhakaran P Khichar, Nirav L Sutariya, Amita N Bhargava, Sangeeta R Pradhan
November-December 2021, 24(6):1012-1014
DOI
:10.4103/aian.AIAN_1069_20
[FULL TEXT]
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571
84
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Childhood myocerebrohepatopathy spectrum disorder due to polymerase gamma pathogenic variant
Vykuntaraju K Gowda, Varunvenkat M Srinivasan, Sanjay K Shivappa
November-December 2021, 24(6):942-943
DOI
:10.4103/aian.AIAN_607_20
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562
78
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COVID-19: Neuromuscular manifestations
Rajesh Benny, Satish V Khadilkar
November-December 2021, 24(6):935-935
DOI
:10.4103/aian.AIAN_614_20
[FULL TEXT]
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546
87
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LIGHTER MOMENTS (ARTWORK OR PHOTOGRAPHY)
“Man in the broken mirror”
Ajith Cherian
November-December 2021, 24(6):931-931
DOI
:10.4103/aian.aian_692_21
[FULL TEXT]
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514
96
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LETTERS TO THE EDITOR
Impact of disrupted botulinum toxin therapy in movement disorders due to COVID-19 pandemic
Koti Neeraja, Bharath Kumar Surisetti, Nisha Mol, Shweta Prasad, Vikram Venkappayya Holla, Nitish Kamble, Rohan Mahale, Pramod Kumar Pal, Ravi Yadav
November-December 2021, 24(6):1001-1002
DOI
:10.4103/aian.AIAN_573_20
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522
78
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Impact of Levodopa in Lung Functions in Patients with Parkinson's Disease
Mahmood D Al-Mendalawi
November-December 2021, 24(6):935-936
DOI
:10.4103/aian.AIAN_600_20
[FULL TEXT]
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503
95
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LIGHTER MOMENTS (ARTWORK OR PHOTOGRAPHY)
Amidst the embers
Divyani Garg
November-December 2021, 24(6):930-930
DOI
:10.4103/aian.aian_507_21
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514
83
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LETTERS TO THE EDITOR
Acute encephalopathy following measles vaccination: A novel entity
Ananthanarayanan Kasinathan, Jaya Madhava Reddy Chilukula, Satheesh Ponnarmeni, Peter Prasanth Kumar Kommu
November-December 2021, 24(6):950-951
DOI
:10.4103/aian.AIAN_592_20
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518
71
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Cerebral venous thrombosis associated with COVID-19 infection
Islam Y Yasiev, Aishat T Haibulaeva, Dmitry A Demin, Ekaterina V Nikolaeva, Islam S Mintulaev, Vladimir V Belopasov
November-December 2021, 24(6):972-974
DOI
:10.4103/aian.AIAN_703_20
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470
74
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Atypical subacute sclerosing panencephalitis (SSPE): All postpartum altered behavior isn't CVT!
Ayush Agarwal, Parkipandla Sathish, Manish Salunkhe, Anu Gupta, Ajay Garg, Roopa Rajan, Venugopalan Y Vishnu, Rohit Bhatia, Mamta Bhushan Singh, MV Padma Srivastava
November-December 2021, 24(6):1002-1004
DOI
:10.4103/aian.AIAN_1313_20
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476
67
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LIGHTER MOMENTS (ARTWORK OR PHOTOGRAPHY)
You are not less than you; Defeat the disability
Pallerla Srikanth
November-December 2021, 24(6):932-932
DOI
:10.4103/aian.aian_998_21
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480
59
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LETTERS TO THE EDITOR
Effect of different wrist positions on median nerve conduction in patients with and without carpal tunnel syndrome – a comparative study
Vidhi M Garala, Mansi K Soni
November-December 2021, 24(6):936-938
DOI
:10.4103/aian.AIAN_708_20
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456
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Bilateral facial palsy in neuroborreliosis
Shambaditya Das, Arpan Dutta, Peyalee Sarkar, Souvik Dubey, Durjoy Lahiri, Alak Pandit, Goutam Gangopadhyay, Biman Kanti Ray
November-December 2021, 24(6):990-991
DOI
:10.4103/aian.AIAN_698_20
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458
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© 2006 - Annals of Indian Academy of Neurology | Published by Wolters Kluwer -
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