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Background and Objective: Few dating back, the role of visual evoked potentials changes and reduced level of intracellular magnesium have appeared in migraine patients both throughout the attacks and in the interictal periods. Moreover, there is a lack of evidence regarding the correlation between magnesium levels and visual evoked potentials. To assess the changes in the levels of magnesium in migraineurs compared to a healthy control group is our prime intention. Also, to correlate serum magnesium levels with visual evoked potentials changes within the migraineurs is a secondary part of the study. Materials and Methods: After applying inclusion and exclusion criteria as per the study protocol, in total, 80 subjects were enrolled in the study. Of which 40 were migraineurs diagnosed as per the International Headache Society criteria for severe migraine headache. Rest of 40 was nonmigraineurs served as a control group of the study. All included patient was submitted to demographic profile, previous history of the disease and drug intake, thorough clinical investigation and baseline laboratory parameters. Apart from this, the measurement of visual evoked potentials changes (4th block) and magnesium levels were done as per our standard operating procedures. Results: In migraineurs, serum total Mg level was considerably lower compared to the control group (1.79 ± 0.14 mg/dl versus 2.10 ± 0.17 mg/dl, P < 0.0001) and amplitude of P100 (P < 0.0001) was negatively correlated to reduced serum Mg level (P < 0.0001). Conclusions: As expected, both elevated visual evoked potential amplitude and reduced level of brain magnesium can be a demonstration of neuronal hyperexcitability of the optic pathways associated with a dropped threshold for migraine attacks. [ABSTRACT FROM AUTHOR]

Byline: Saumya. Mittal, K. Rakshith, Z. Misri, Shivanand. Pai, Nisha. Shenoy Sir, Guillain–Barré (GB) syndrome was described by the French neurologists Guillain, Barre, and Strohl. It is an acute autoimmune [...]

Byline: Saumya. Mittal, Shivanand. Pai, K. Rakshith, Z. Misri Sir, A 49-year-old, nondiabetic and normotensive gentleman presented to the hospital with progressive distal weakness of both the upper limbs. This [...]

Genetic disorders with predominant central nervous system white matter abnormalities (CNS WMAs), also called leukodystrophies, are heterogeneous entities. We ascertained 117 individuals with CNS WMAs from 104 unrelated families. Targeted genetic testing was carried out in 16 families and 13 of them received a diagnosis. Chromosomal microarray (CMA) was performed for three families and one received a diagnosis. Mendeliome sequencing was used for testing 11 families and all received a diagnosis. Whole exome sequencing (WES) was performed in 80 families and was diagnostic in 52 (65%). Singleton WES was diagnostic for 50/75 (66.67%) families. Overall, genetic diagnoses were obtained in 77 families (74.03%). Twenty‐two of 47 distinct disorders observed in this cohort have not been reported in Indian individuals previously. Notably, disorders of nuclear mitochondrial pathology were most frequent (9 disorders in 20 families). Thirty‐seven of 75 (49.33%) disease‐causing variants are novel. To sum up, the present cohort describes the phenotypic and genotypic spectrum of genetic disorders with CNS WMAs in our population. It demonstrates WES, especially singleton WES, as an efficient tool in the diagnosis of these heterogeneous entities. It also highlights possible founder events and recurrent disease‐causing variants in our population and their implications on the testing strategy. [ABSTRACT FROM AUTHOR]

Byline: Saumya. Mittal, K. Rakshith, Z. Misri, Shivanand. Pai, Nisha. Shenoy, Gautam. Gundabolu Sir, A 48 year old gentleman developed sudden onset of right-sided hemiparesis associated with slurred speech, facial [...]

Abstract Background: Reduced respiratory muscle strength leads to reduced pulmonary function, chest wall movements in the affected side, and increased chest infections, which thereby reduces oxygenation and ventilation. Respiratory muscle training can be used in acute stroke subjects to increase their pulmonary function. Purpose: To compare the short-term effects of diaphragmatic breathing exercise, flow, and volume-oriented incentive spirometry on respiratory function following stroke. Methods: A non-randomized hospital-based study was conducted at Kasturba Medical College Hospitals, Mangalore, India. Forty-two sub-acute subjects of either gender, with the first episode of stroke within six months, were assigned to three groups by the consultant, i.e., diaphragmatic breathing group (DBE), Flow oriented-incentive spirometry group (FIS), and volume oriented-incentive spirometry group (VIS; N = 14) each. All subjects received intervention thrice daily, along with conventional stroke rehabilitation protocols throughout the study period. Pre- and post-intervention values were taken on alternate days until day 5 for all the three groups. Results: The pulmonary function and maximal respiratory pressures were found to be significantly increased by the end of intervention in all three groups, but FIS and DBE groups had better results than VIS (FVC = FIS group, 13.71%; VIS group, 14.89%; DBE group, 21.27%, FEV1 = FIS group, 25.97%; VIS group, 22.52%; DBE group, 19.38%, PEFR = FIS group, 38.76%; VIS group,9.75%; DBE group, 33.16%, MIP = FIS group, 28.23%; VIS group, 19.36%; DBE group, 52.14%, MEP = FIS group, 43.00%; VIS group, 22.80%; DBE group, 28.68%). Conclusion: Even though all interventions had positive outcomes in all variables, flow incentive spirometry had better results across all outcomes (pulmonary function and maximal respiratory pressures) when compared to the other two interventions making it a valuable tool for stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Perampanel is a noncompetitive a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid glutamate receptor antagonist used in the management of seizure disorder. Management of uncontrolled seizures is a challenging task. Perampanel is a recent antiepileptic which comes with a warning of causing behavioral and psychological adverse effects. Here, the authors report an interesting case where the perampanel was started to control refractory seizures and the person developed severe behavioral disturbances. The condition warranted a psychiatry referral, and the problems subsided after stopping perampanel. Clinicians need to be vigilant about perampanel-associated behavioral and psychiatric problems which can become a serious clinical concern. [ABSTRACT FROM AUTHOR]

Byline: Lekha. Pandit, Sharik. Mustafa, Ramya. Kunder, Rajesh. Shetty, Zulkifly. Misri, Shivanand. Pai, Rakshith. Shetty Background: In resource-poor settings, the management of neuromyelitis optica (NMO) and NMO spectrum (NMOS) disorders [...]

A series of Cu–Co ferrites with the general formula Cu1-xCoxFe2O4 (x = 0, 0.25, 0.50, 0.75 and 1.0) was prepared by a low-temperature hydroxide coprecipitation route. The catalyst systems were characterized by adopting various physicochemical techniques. The acid–base properties were studied in detail, and the catalytic activity as well as the selectivity for oxidative dehydrogenation of ethylbenzene was compared for various compositions. FTIR adsorption of pyridine is carried out to understand the relative acidity of various compositions of the systems. IR studies of spinel surface with adsorbed CO2 and adsorption studies of electron acceptors such as 7,7,8,8-tetracyanoquinodimethane, 2,3,5,6-tetrachloro-1-4-benzoquinone and p-dinitrobenzene are carried out to evaluate the nature of basic sites and the strength and distribution of electron donor sites present on the spinel surface. It is found that acidity (basicity) of the Cu1-xCoxFe2O4 spinel system increases (decreases) from x = 0 to 1. A good correlation was found between the activity for this reaction and the surface acid–base properties of the catalysts. Intermediate compositions show better catalytic performance, among which x = 0.50 is superior and demonstrates an intermediate acid–base character. It was observed that dehydrogenation of ethylbenzene to styrene proceeds mainly on an acid–base pair site. [ABSTRACT FROM AUTHOR]

Angiostrongylus cantonensis is one of the causative agents of eosinophilic meningitis. Humans get infected when they ingest raw or partially cooked snails or monitor lizards (Varanus bengalensis). There is a popular belief that the tongue and the liver of the monitor lizard has aphrodisiac properties. A 20-year-old man was admitted to our hospital with a history of fever, headache and vomiting. His cerebrospinal fluid revealed eosinophilia. He gave a history of the ingestion of a monitor lizard, ten days prior to the onset of the symptoms. So, a diagnosis of eosinophilic meningitis due to Angiostrongylus cantonensis was made. He was treated with oral albendazole and prednisolone. His symptoms improved gradually within two weeks from his admission. [ABSTRACT FROM AUTHOR]

Background & Objective: Many studies demonstrated that migraine patients have an interictal habituation and deficit of visual evoked potentials. Controversially, other studies could not reproduce similar finding. Hence, there is a dilemma regarding what should be the ultimate conclusions. The purpose of this study was to compare amplitude and habituation of pattern reversal visual evoked potentials in migraine with aura patients and healthy volunteers. Methods: A total of 40 migraine with aura patients and 40 controls were prospectively enrolled in this cross-sectional study. Using the pattern reversal stimuli, visual evoked potential were estimated in all the participants and abnormalities were noted. Results: In migraine with aura patients, there was a statistically significant increase in the amplitude of the P100 wave due to deficient habituation after 15 min stimulation. In normal subjects, there was a decrease in the amplitude of the P100 wave due to the effect of habituation. The deficient habituation can be because of decreased serotonin levels resulting in reduced pre-activation of the cortex. Conclusion: Migraine with aura patients show evidence of abnormal cortical processing with interictal hyperactivity seen in heightened responsiveness and lack of habituation to visual evoked responses. [ABSTRACT FROM AUTHOR]

A case study of nine-year-old female child with history of seizures is presented. It mentions that the child was born of first degree consanguineous marriage and was found to have mental retardation, abnormal eye movements, and truncal ataxia. Her investigations revealed renal failure and magnetic resonance imaging (MRI) showed absence of superior vermis, elongated cerebellar peduncles and dilated fourth ventricle. It adds that the patient was diagnosed of Joubert syndrome.

Eosinophilic meningitis may be caused by non-infectious and infectious agents. Angiostrongylus cantonensis is the commonest causative agent of eosinophilic meningitis. Rats are the primary hosts of this parasite. Humans get infected by ingestion of raw or inadequately cooked hosts (snails or monitor lizard) or food contaminated with the infective third-stage larvae. A 16-year-old boy was admitted to our hospital with history of fever, headache, and altered sensorium. Magnetic resonance imaging of the brain showed unique findings. Cerebrospinal fluid (CSF) examination showed eosinophilia and the CSF wet mount identified a larva. Patient history revealed ingestion of monitor lizard 2 weeks prior to onset of symptoms. Hence, a diagnosis of eosinophilic meningitis caused by A. cantonensis was made. He was treated with oral albendazole and steroids, resulting in gradual improvement. A. cantonensis as a cause of eosinophilic meningitis is a possibility in patients who present with headache and vomiting after eating raw meat (monitor lizard). To the best of our knowledge, this is a very rare case being reported from India where the larva was identified during the microscopic examination of the CSF.