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Introduction: Cerebral Venous Thrombosis (CVT) poses a rare but life-threatening challenge, warranting meticulous treatment approaches. Traditional therapy involves Vitamin K Antagonists (VKAs), but Newer Oral Anticoagulants (NOACs) offer potential advantages. This study addresses a crucial knowledge gap in the Indian context, analyzing real-world data to guide CVT management decisions. Methods: A single-center, ambispective cohort study included consecutive adult CVT patients. Data collection encompassed demographics, clinical data, imaging, and treatment details. Patients were categorized into VKA and NOAC groups. Outcomes measured recanalization status, functional outcomes, bleeding events, and adverse drug reactions. Results: Among 181 enrolled patients, NOAC-treated (Group B) individuals had significantly higher rates of complete recanalization (58.5% vs. 31.1%) with a similar incidence of adverse events and also displayed better functional outcomes at weeks 8 and 12 compared to VKA-treated (Group A) patients. Recurrent thromboembolic events were absent in both groups during follow-up. Conclusion: This study highlights NOACs’ potential advantages in CVT management, including improved functional outcomes, enhanced recanalization, and similar bleeding risk. Adverse events were milder with NOACs. While acknowledging limitations, these findings support NOACs as a promising alternative to VKAs, advancing CVT care and outcomes.

Abstract Background Ever since AE was acknowledged as a potentially treatable cause of encephalitis, it has been increasingly recognised worldwide. Data suggests that these disorders are under-recognized, which calls for an increased awareness of the varying clinical, laboratory, electrophysiological and radiological presentations of the different types of autoimmune encephalitis. This cross-sectional observational study included all patients diagnosed with AE, who presented to a tertiary care centre from June 2016 to January 2021. Data were collected including patient’s demography, clinical, laboratory, radiological and electrophysiology studies, management and outcomes. Results 31 study participants were included, of which 13 patients were anti-NMDA antibody positive, 12 patients were anti-LGI1 antibody positive, 2 patients were anti-CASPR2 antibody positive, 2 were positive for dual positive status (anti-LGi1 and anti-CASPR2), and one each for anti-GABA-B and anti-GAD 65. There was a marginal male predilection with overall seizures being the most common symptom (68%) followed by behavioural disturbance (64.5%), and impairment of consciousness (32.3%). Patients with Anti-NMDA encephalitis were likely to be young females, with CSF pleocytosis, a more protracted hospital course with more chances of relapse and residual disease, while the patients with anti-Lgi1 encephalitis were likely to be older males with a shorter, less severe hospital course. Conclusion The present study detailed the demographic, clinical, imaging, laboratory and EEG characteristics of 31 AE patients from a tertiary centre. The findings concurred with the literature and demonstrate the diverse spectrum of clinical manifestations of patients with AE, present with.

Background. Idiopathic intracranial hypertension (IIH) also termed pseudotumor cerebri syndrome (PTCS). It mainly affects young overweight women of the reproductive age group. There is a scarcity of literature on IIH among the Indian population. Objective. To evaluate the clinical, demographic profile, laboratory parameters and outcomes of Idiopathic Intracranial hypertension (IIH) patients. Materials and method. The current study was a prospective observational study on 43 patients who were diagnosed as primary PTCS presenting to the neurology department of Sri Ramachandra Medical College and Research Institute from December 2019 to August 2021. Patients were assessed for BMI, papilledema, CSF manometry, MRI brain with MR venography was done. Co-guide software, V.1.03, was used for statistical analysis. Results. The mean age was 33.12 ± 12.29 years (ranged 14 to 55) in the study population. There were 5(11.63%) males and 38(88.37%) females. The mean BMI was 26.72 ± 3.56 kg/m2 (ranged from 17.40 to 34.20). The mean duration of headache was 28.41 ± 26.23 days (ranged 3 to 120) in the study population, and 39(90.69%) had papilledema. The mean CSF manometry was 29.6 ± 5.88(ranged from 16 to 42) cmH2O. Conclusion. In the Indian subcontinent, obesity may not be considered as a major risk factor in the causation of IIH.

Introduction: Diabetic distal symmetrical polyneuropathy (DSPN) can be categorized as small fibre, large fibre, and mixed neuropathy. Even though small fibre neuropathy is the most prevalent, unfortunately it is usually not recognized by routine electrophysiologic studies. In this study, we intend to examine the slow velocity small fibres responsible for small fibre DSPN, by isolating them using collision technique principle in patients with diabetes. Methods: This is an observational case-control study designed to compare nerve conduction values with application of collision technique in 60 patients with T2D and in 60 age and sex matched controls.Results: The collision study in patients with Type 2 Diabetes showed mean Latency of 10.5 ± 1.7 ms and mean Amplitude of 3.4 ± 2.3 mV on the right side and mean Latency of 10.5 ± 1.7 ms and the mean Amplitude of 3.5 ± 2.2 mV on the left side. There was a statistically significant difference (P value < 0.001) in the amplitute and latency of CNAPs of small fibres in median nerve innervated APBs of both arms between those with T2D and controls. Discussion and Conclusion: Collision study helps to examine the slower conducting fibres of the larger nerves. Our study suggests that the Collision Technique can be used to identify early peripheral neuropathy regardless of the diabetes status, thus making it more practically feasible and cost-effective.

Introduction. Frontotemporal dementia (FTD) is a common cause of cognitive impairment, behavioral changes and language deficits. in this study we assessed the clinical and FDG-PET characteristics of our patients and compared them with available international and Indian data on FTD. Methods. All patients were evaluated with a neuropsychological battery followed by 18F-FDG-PET scan, in addition to all necessary dementia work-up. Results. 15 FTD patients (m:f = 11:4) had a mean age of presentation of 67.4 (8.6) years, with a mean interval of 1.7 (0.7) years from the symptom onset to diagnosis. those with 10 or less years of education had an earlier presentation. a positive family history was present in 20%. The mean MMSE score was 18.8 (4.6). Disinhibition was the most common symptom seen in 60%. Apathy was less frequently noted. FDG-PET scan showed predominantly anterior cingulate and anterior temporal hypometabolism, with asymmetry in 67%. 2 cases diagnosed as fvAD had a revised diagnosis of bvFTD after FDG-PET scan. 1 patient of nfvPPA was mute at presentation with a history of agrammatism with hypometabolism in left inferior frontal and superior temporal regions. Conclusions. There were significant variations compared to international/Western literature, with later age of presentation, shorter interval from onset to presentation, lower MMSE scores, with disinhibition rather than apathy as the commonest symptom. FDG-PET showed similar areas of involvement but with less extensive hypometabolism compared to other studies with a lesser frequency of asymmetry. FDG-PET scan is a useful adjunct for evaluation of FTD patients.

Background and Objective: A significant number of migraine patients do not find effective and safe treatment to reduce the frequency and severity of their migraine attacks. Hence, a need for newer therapeutic agent exists. In this study, we examined the efficacy and safety of memantine for the treatment of migraine. Materials and Methods: It was a randomized, placebo-controlled, double-blind study including adult patients with 3–12 migraine headache for the last 6 months conducted in India. Patients received memantine (10 mg/day, once a day) or placebo for the period of 24 weeks after a washout period. Migraine frequency per month, the 50% responder rate, rescue medication use, and adverse events were recorded every 4 weeks. Results: Among 81 patients screened, 60 were enrolled for the study. Thirty patients received memantine and other 30 received placebo. Data were analyzed for 28 patients in memantine group and 29 patients in placebo group. At the baseline, all the parameters were similar in both groups. By 24 weeks, migraine frequency/4 weeks was memantine group versus placebo; 2.57 (±0.38) versus 5.07 (±0.69), P = 0.003 and rescue medication use was 0.75 (±0.23) versus 3.72 (±0.63) P = 0.0001. The 50% responder rate was 85.7% versus 51.7% (P = 0.005). Only a few mild adverse events were recorded in both the groups. No severe adverse events and death were recorded during the study. Conclusion: Memantine (10 mg oral, once daily) is effective, well tolerated, and safe for patients with migraine.

Objectives: People with epilepsy have greater cognitive and behavioral dysfunction than the general population. There is no specific treatment available for cognitive impairment of these patients. We aimed to evaluate the effects of memantine, an N-methyl-D-aspartate-type glutamate receptor noncompetitive antagonist, on improving cognition and memory functions in epileptic patients with cognitive and memory impairment, who received anti-epileptic drugs (AEDs). Methods: We did a randomized, double-blind, placebo-controlled parallel group trial, in SRM Medical College Hospital and Research Centre, Kattankulathur, Kancheepuram, Tamil Nadu, India between April 2013 and September 2013. Fifty-nine epileptic patients taking AEDs with subjective memory complaints were recruited and randomized to either Group 1 to receive 16 weeks of once-daily memantine, (5 mg for first 8 weeks, followed by memantine 10 mg for next 8 weeks) or Group 2 to receive once daily placebo. This trial is registered with Clinical Trial Registry of India CTRI/2013/04/003573. Results: Of 59 randomized patients, 55 patients completed the study (26 memantine and 29 placebo). Memantine group showed statistically significant improvement in total mini mental state examination score from baseline (P = 0.765) to 16 th week (P < 0.001) in comparison with the placebo. The Weshler′s Memory Scale total score in memantine group improved significantly after 8 weeks (P = 0.002) compared with baseline (P = 0.873) and highly significant at the end of 16 th week (P < 0.001). The self-rated quality of life and memory in memantine group also significantly improved at the study end. Conclusion: We conclude that once-daily memantine (10 mg) treatment significantly improved cognition, memory and quality of life in epileptic patients with mild to moderate cognitive impairment and was found to have a favorable safety profile.