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42 results on '"Sangeeta Ravat"'

1. Efficacy and Safety of Zonisamide as Initial Monotherapy in Indian Patients with Epilepsy: A Subgroup Analysis of Prospective, Multicentre, Post-marketing Surveillance Study

Author

Boby Varkey Maramattom, Parvan Shetty, Nanjappa C Manjunath, Amitabh Dash, Balaji Patil, Randhi Venkata Narayana, Vivek Narain Mathur, Vivek Kumar, Avathvadi Venkatesan Srinivasan, Ashutosh Shetty, Darshana Dighe, Sangeeta Ravat, Renu Achtani, and Veeresh Bajpai

Subjects
Economics and Econometrics, Pediatrics, medicine.medical_specialty, business.industry, Postmarketing surveillance, Zonisamide, Forestry, Subgroup analysis, medicine.disease, Epilepsy, Materials Chemistry, Media Technology, medicine, business, medicine.drug
Published
2021
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2. Impact of COVID-19 pandemic on epilepsy practice in India: A tripartite survey

Author

Neeraj N Baheti, Kurupath Radhakrishnan, Sita Jayalakshmi, Fayaz Khan, Dinesh S Nayak, Shaik Afshan Jabeen, Turaga Suryaprabha, Sandeep Patil, Chaturbhuj Rathore, Sanjay Prakash, Kaushik Rana, Atma Ram Bansal, Sangeeta Ravat, Shyam K Jaiswal, Siby Gopinath, Sujit Jagtap, and Jagarlapudi M. K. Murthy

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Adolescent, Population, Clinical Neurology, COVID-19 pandemic, India, Hospitals, Special, Article, Health Services Accessibility, 03 medical and health sciences, Epilepsy, Young Adult, 0302 clinical medicine, Pandemic, Lockdown, Outpatients, Seizure control, Medicine, Humans, Epilepsy surgery, Neurologists, Young adult, education, Child, Aged, education.field_of_study, business.industry, Teleconsultation, Remote Consultation, COVID-19, Infant, Electroencephalography, General Medicine, Middle Aged, medicine.disease, Outpatient visits, Neurology, Child, Preschool, Health Care Surveys, Emergency medicine, Anticonvulsants, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Objective To assess the impact of ongoing COVID-19 pandemic on epilepsy care in India. Methods We conducted a three-part survey comprising neurologists, people with epilepsy (PWE), and 11 specialized epilepsy centers across India. We sent two separate online survey questionnaires to Indian neurologists and PWE to assess the epilepsy practice, seizures control, and access to care during the COVID-19 pandemic. We collected and compared the data concerning the number of PWE cared for and epilepsy procedures performed during the 6 months periods preceding and following COVID-19 lockdown from epilepsy centers. Results The survey was completed by 453 neurologists and 325 PWE. One third of the neurologist reported >50 % decline in outdoor visits by PWE and EEG recordings. The cumulative data from 11 centers showed 65–70 % decline in the number of outdoor patients, video-EEG monitoring, and epilepsy surgery. Working in a hospital admitting COVID-19 patients and use of teleconsultation correlated with this decline. Half of PWE had postponed their planned outpatient visits and EEG. Less than 10 % of PWE missed their antiseizure medicines (ASM) or had seizures due to the nonavailability of ASM. Seizure control remained unchanged or improved in 92 % PWE. Half of the neurologists started using teleconsultation during the pandemic. Only 4% of PWE were afflicted with COVID-19 infection. Conclusions Despite significant decline in the number of PWE visiting hospitals, their seizure control and access to ASMs were not affected during the COVID-19 pandemic in India. Risk of COVID-19 infection in PWE is similar to general population.

Published
2021

3. A case of anti-NMDAR encephalitis with peculiar gyratory events that reignites the epilepsy versus movement disorders debate

Author

Karan Desai, Mayur Thakkar, Akash Chheda, Rajit Pillai, Priyanka Walzade, Neeraj Jain, Rishikesh Joshi, and Sangeeta Ravat

Subjects
Anti-N-Methyl-D-Aspartate Receptor Encephalitis, Epilepsy, Movement Disorders, Movement disorders, business.industry, General Medicine, Anti-NMDAR Encephalitis, medicine.disease, Neurology, Humans, Medicine, Neurology (clinical), Nmdar encephalitis, medicine.symptom, business, Neuroscience
Published
2020
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4. Does Tc-99m ECD ictal brain SPECT have incremental value in localization of epileptogenic zone and predicting postoperative seizure freedom in cases with discordant video electroencephalogram and MRI findings?

Author

Dattatraya Muzumdar, Akash Chheda, Shilpa Sushilkumar Sankhe, Ashmi S Manglunia, Shwetal Uday Pawar, Sangeeta Ravat, and Arnaaz Noormohamed Maldar

Subjects
Adult, Male, Adolescent, Clinical Decision-Making, Single-photon emission computed tomography, Ictal-Interictal SPECT Analysis by SPM, 030218 nuclear medicine & medical imaging, Young Adult, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Seizures, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Ictal, Epilepsy surgery, Cysteine, Postoperative Period, Child, Retrospective Studies, Tomography, Emission-Computed, Single-Photon, medicine.diagnostic_test, business.industry, Electroencephalography, Organotechnetium Compounds, General Medicine, Seizure freedom, medicine.disease, Magnetic Resonance Imaging, 030220 oncology & carcinogenesis, Video electroencephalogram, Female, business, Nuclear medicine, Mri findings
Abstract

OBJECTIVE Localization of epileptogenic focus in drug-refractory epilepsy using Tc-99m ethylene cystine dimer (ECD) brain single photon emission computed tomography (SPECT) is less studied in patients with discordant findings on video electroencephalogram (VEEG) and MRI. The study was done to evaluate brain SPECT for epileptogenic focus localization and postoperative seizure freedom. METHODS Epilepsy patients with discordant VEEG and MRI findings underwent brain SPECT at ictal and interictal phases. Various groups unilateral/bilateral mesial temporal sclerosis (MTS), solitary and multifocal lesional, nonlesional epilepsy were studied for localization of epileptogenic focus and postoperative seizure freedom (>2 years) using Engels classification. Reasons for nonoperability was evaluated in nonoperated group. RESULTS SPECT could localize epileptogenic focus in 49/67 (73.13%) and guided surgery in 19/33 (57.57%) patients in operated group. SPECT was useful in 12 (46.12%) of unilateral (2)/bilateral (10) MTS. Postoperative seizure freedom of Engels Class I and II in 22 (66.67%), III in six (18.2%) and IV in one patient based on SPECT findings (P = 0.0086). Overall sensitivity and specificity were 79.3% and 85.7%, respectively. SPECT could localize epileptogenic focus in 23/34 (67.64%) patients in nonoperated group; 10 (29.41%) patients refused for surgery and no epileptogenic focus was localized in the rest of 14 (41.2%). CONCLUSION Ictal SPECT showed incremental value and was found necessary for epileptogenic focus localization and subsequent surgery in unilateral/bilateral MTS in this study. Seizure freedom in patients undergoing epilepsy surgery based on ictal SPECT assistance was comparable to the surgical group not requiring ictal SPECT.

Published
2020
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5. Epidemiological and Clinical Status of Neurocysticercosis in a Tertiary Healthcare Centre- A Prospective, Cross-Sectional Study

Author

Sangeeta Ravat, Suvarna Shinde, Ganesh Gore, Ravindra Sonawane, Riyaz Shaikh, and Pravin Shelke

Subjects
raised intracranial tension, medicine.medical_specialty, Cross-sectional study, business.industry, lcsh:R5-130.5, granulomas, Neurocysticercosis, neurocysticercosis (ncc), socioeconomic status (ses), Family medicine, Epidemiology, parasitic diseases, medicine, epilepsy, business, seizure disorder, Tertiary healthcare, lcsh:General works
Abstract

BACKGROUND Neurocysticercosis (NCC) is most common parasitic infection of the CNS & an important cause for epileptic seizures. It is caused by the larva of the pork tapeworm, T. solium. We wanted to study the epidemiology, clinical status, distribution, magnitude, pathogenesis, of neurocysticercosis in neurology OPD of a tertiary care hospital and provide data to improve health services towards NCC patients. METHODS Patients who had attended epilepsy outpatient department (OPD) with complaints of seizure and confirmed by neurologist were included in the study (sample size 100) as per criteria. The CRFs were filled from case paper & patients were interviewed for personal history and socioeconomic status. The assessment of socioeconomic status was recorded as per Kuppuswamy Socio Economic Scales. Analysis was performed using descriptive statistics. RESULTS Clinical presentation was studied for seizure types and other symptoms. The mean magnitude of NCC patients was found to be 11.97% in an epileptic patient population. Most patients of NCC were put on AED & some on Albendazole & steroids. CONCLUSIONS The major presenting symptom in all patients was epilepsy & raised ICT. Calcified granulomas can also be potential triggers for epilepsy. Majority of patients were on mixed diet, but those who were pure vegetarians were also exposed to NCC. Poor sanitation facility was also a major risk factor. The majority of population which was affected by NCC belonged to the lower socioeconomic class as per Kuppuswamy SES scale. Migrants from North India were more frequently affected by NCC. All patients presenting with seizures required to be treated with antiepileptic drugs & Albendazole with or without steroids.

Published
2020

6. Ofatumumab versus Teriflunomide in Multiple Sclerosis

Author

Hauser S. L., Bar-Or A., Cohen J. A., Comi G., Correale J., Coyle P. K., Cross A. H., de Seze J., Leppert D., Montalban X., Selmaj K., Wiendl H., Kerloeguen C., Willi R., Li B., Kakarieka A., Tomic D., Goodyear A., Pingili R., Haring D. A., Ramanathan K., Merschhemke M., Kappos L., Stephen L Hauser, Ludwig Kappos, Amit Bar-Or, Jeffrey A Cohen, Giancarlo Comi, Jorge Correale, Patricia K Coyle, Anne Cross, Jerome de Seze, Xavier Montalban, Krzysztof Selmaj, Heinz Wiendl, Stephen C Reingold, Garry R Cutter, Thomas Doerner, Hans-Peter Hartung, Per Soelberg Sørensen, Israel Steiner, Jerry S Wolinsky, Carlos Ballario, Christian Calvo Vildoso, Jorge Gustavo Jose, Norma Haydee Deri, Susana Liwacki, Jeannette Lechner-Scott, John Parratt, Suzanne Hodgkinson, Eva-Maria Maida, Fritz Leutmezer, Barbara Willekens, Bart Van Wijmeersch, Guy Laureys, Jo Caekebeke, Karine Geens, Ludo Vanopdenbosch, Olivier Deryck, Valerie Delvaux, Vincent Van Pesch, Ivan Milanov, Ivaylo Tarnev, Lyubomir Haralanov, Maria Manova Slavova, Penko Shotekov, Francois Emond, Francois Grandmaison, Francois Jacques, Liesly Lee, Marie Sarah Gagne Brosseau, Mark Freedman, Martin Cloutier, Robert Carruthers, Sarah Morrow, Yves Lapierre, Anton Vladic, Hana Bokun, Igor Antoncic, Marija Bosnjak Pasic, Mario Habek, Silva Butkovic Soldo, Vladimira Vuletic, Alena Martinkova, Eva Meluzinova, Ivana Stetkarova, Jan Mares, Jolana Markova, Marta Vachova, Martin Valis, Michaela Tyblova, Michal Dufek, Ondrej Skoda, Pavel Hradilek, Ana Voldsgaard Jensen, Helle Hvilsted Nielsen, Kristina Svendsen, Mads Ravnborg, Peter Vestergaard Rasmussen, Katrin Gross-Paju, Sulev Haldre, Juha Pekka Eralinna, Marja-Liisa Sumelahti, Bruno Brochet, Celine Louapre, Christine Lebrun-Frenay, David Axel Laplaud, Gilles Edan, Giovanni Castelnovo, Marc Debouverie, Patrick Vermersch, Pierre Clavelou, Pierre Labauge, Achim Berthele, Aiden Haghikia, Anselm Kornhuber, Arnfin Bergmann, Benedikt Frank, Birte Elias-Hamp, Bjoern Tackenberg, Brigitte Wildemann, Erik Strauss, Eugen Schlegel, Florian Then Bergh, Gereon Nelles, Hayrettin Tumani, Karl-Otto Sigel, Martin Stangel, Matthias Boehringer, Olaf Martin Hoffmann, Patrick Oschmann, Reinhard Hohlfeld, Silke Walter, Sylvia Menck, Till Sprenger, Tjalf Ziemssen, Veit Ulrich Becker, Vera Straeten, Konstantinos Kilidireas, Konstantinos Voumvourakis, Nikolaos Fakas, Nikolaos Grigoriadis, Agnes Koves, Csilla Rozsa, Krisztina Kovacs, Laszlo Vecsei, Satori Maria, Zita Biro, Anshu Rohatgi, Dheeraj Khurana, Jeyaraj Durai Pandian, Joy Dev Mukherji, Lekha Pandit, Meena Angamuthu Kanikannan, Pahari Ghosh, Rahul Chakor, Rahul Kulkarni, Roopkumar Gursahani, Sangeeta Ravat, Srinivasa Rangasetty, Suresh Kumar, Alla Shifrin, Arnon Karni, Radi Shahien, Ron Milo, Antonio Uccelli, Carlo Pozzilli, Francesco Sacca, Giacomo Lus, Girolama Alessandra Marfia, Laura Brambilla, Marco Salvetti, Massimo Filippi, Mauro Zaffaroni, Paolo Gallo, Silvia Rossi, Simona Bonavita, Valeria Studer, Andrejs Millers, Guntis Karelis, Jolanta Kalnina, Dalia Mickeviciene, Rasa Kizlaitiene, Angelica Carbajal Ramirez, Juan Jose Lopez Prieto, Beatrijs Wokke, Bob W Van Oosten, Peter Van Domburg, Raymond Hupperts, Rogier Q Hintzen, Astrid Edland, Cesar Castaneda, Julio Perez, Martin Gavidia, Andrzej Wiak, Bartosz Karaszewski, Elzbieta Jasinska, Halina Bartosik Psujek, Iwona Jastrzebska, Jaroslaw Slawek, Maciej Maciejowski, Miroslaw Dziki, Monika Adamczyk Sowa, Robert Bonek, Waldemar Fryze, Ana Martins Da Silva, Angela Timoteo, Antonio Vasco Salgado, Carlos Capela, Carlos Veira, Filipe Correia, Joao Cerqueira, Joao De Sa, Livia De Sousa, Raquel Gouveia, Alina Sergeevna Agafina, Anna Naumovna Belova, Denis Viktorovich Sazonov, Dmitry Pokhabov, Ekaterina Igorevna Kairbekova, Elena Gennadievna Arefieva, Farit Axatovich Khabirov, Igor Vyacheslavovich Litvinenko, Igor Stolyarov, Irina Aleksandrovna Sokolova, Larisa Ivanovna Volkova, Maria Vafaevna Davydovskaya, Maria Nikolaevna Zaharova, Nadezhda Alekseevna Malkova, Natalia Agafonovna Totolyan, Nikolay Vasilievich Dorogov, Stella Anatolievna Sivertseva, Egon Kurca, Georgi Krastev, Miroslav Brozman, Peter Koleda, Peter Turcani, Peter Valkovic, Viera Hancinova, Vladimir Donath, Chris Retief, Michael Isaacs, Albert Saiz Hinarejos, Alfredo Rodriguez Antigüedad, Bonaventura Casanova Estruch, Celia Oreja-Guevara, Gemma Reig Rosello, Jose Carlos Alvarez Cermeño, Jose Martinez Rodriguez, Jose Meca Lallana, Juan Antonio Garcia Merino, Lucia Forero Diaz, Lucienne Costa Frossard Franca, Luis Querol Gutierrez, Lluis Ramio Torrenta, Pedro Serrano Castro, Rafael Arroyo Gonzalez, Sara Eichau Madueño, Sergio Martinez Yelamos, Tamara Castillo Trivino, Virgina Meca Lallana, Xaviere Montalban Gairin, Fredrik Piehl, Jan Lycke, Chiara Zecca, Tobias Derfuss, Thy-Sheng Lin, Somsak Tiamkao, Ayse Nur Yuceyar, Aysun Soysal, Belgin Petek Balci, Cavit Boz, Husnu Efendi, Murat Terzi, Serhan Sevim, Serkan Ozakbas, Andrew Gale, Ben Turner, David Barnes, David Paling, Eli Silber, James Overell, Matthew Craner, Aaron Carlson, Adam Wolff, Adaeze Onuoha, Adnan Subei, Ahmad Ata, Aimee Borazanci, Akram Dastagir, Alberto Vasquez, Alison Brooke Allen, Andrew P Keegan, Angel Carrasco, Angel R Chinea Martinez, Ann Bass, Annette Okai, April Erwin, Ariel Antezana-Antezana, Barbara Green, Bharathy E Sundaram, Bhupendra Khatri, Bhupesh Dihenia, Bogdan Gheorghiu, Brian Costell, Brian Steingo, Bruce L Hughes, Carrie M Hersh, Christopher Laganke, Christopher Luzzio, Corey Ford, Craig Edward Herrman, Craig Senzon, Cynthia Huffman, Daniel R Wynn, David D O Bear, David Lesch, David H Mattson, David Weisman, Deborah A Burke, Dennis W Dietrich, Deren Huang, Derrick Robertson, Djamchid Lotfi, Don Joseph Alfonso, Dusan Stefoski, Edward J Fox, Emily Pharr, Enrique Alvarez, Evanthia Bernitsas, Faria Amjad, Gabriel Pardo, Geoffrey Eubank, Gerald Mcintosh, Giles F Crowell, Hemanth Rao, J Michael Hemphill, Jack H Florin, Jacqueline Nicholas, James Napier, James Scott, Jason M Silversteen, Javier Vasallo, Jean-Raphael Schneider, Jeanette Wendt, Jeffrey Cohen, Jeffrey Gross, Jeffrey Groves, Jeffrey Kaplan, Jessica Stulc, Joanna A Cooper, John Foley, John Scagnelli, Jonathan C Calkwood, Jose Pizarro Otero, Jose Rafecas, Joshua Katz, Juliette S Saad, Katherine Standley, Keith Edwards, Kenneth Sharlin, Khurram Bashir, Kimberly Wagner, Kore Liow, Larry Lee Blankenship Jr, Laszlo Mate, Liliana Montoya, Lon D Lynn, Mark Agius, Mark Cascione, Mark Allan Goldstein, Mark Janicki, Martin R Bialow, Mary Denise Hughes, Matthew J Baker, Michelle Apperson, Michelle B Kuczma, M Mateo Paz Soldan, Mirela Cerghet, Nathaniel Robb Whaley, Paul K Winner, Pavle Repovic, Praful Kelkar, Romero Rekha Pillai, Ricardo Ayala, Richard Sater, Randall Trudell, Robert Fairborn Armstrong, Robert Thomas Nahouraii, Robert Naismith, Ronald S Murray, Samuel Hunter, Sara Qureshi, Sharon Lynch, Sibyl Wray, Silvia R Delgado, Stacy Donlon, Stanley Cohan, Stanya Smith, Stuart James Shafer, Susan Azalone, Susan Hibbs, Tamara A Miller, Thomas Giancarlo, Troy Desai, Varun K Saxena, Virginia Simnad, William David Honeycutt, William Logan, William E McElveen, William Wagner, University of California [San Francisco] (UCSF), University of California, Perelman School of Medicine, University of Pennsylvania [Philadelphia], Cleveland Clinic, IRCCS Ospedale San Raffaele [Milan, Italy], Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia [Buenos Aires] (FLENI), FLENI, Stony Brook University [SUNY] (SBU), State University of New York (SUNY), Washington University School of Medicine in St. Louis, Washington University in Saint Louis (WUSTL), CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P) ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA)-Hôpital de Hautepierre [Strasbourg]-Nouvel Hôpital Civil de Strasbourg, University Hospital Basel [Basel], Vall d'Hebron University Hospital [Barcelona], University of Warmia and Mazury [Olsztyn], University of Münster, Novartis Pharma S.A.S., Novartis Pharmaceuticals, University of Basel (Unibas), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Willekens, Barbara, ASCLEPIOS I and ASCLEPIOS II Trial Groups, Hauser, S. L., Bar-Or, A., Cohen, J. A., Comi, G., Correale, J., Coyle, P. K., Cross, A. H., de Seze, J., Leppert, D., Montalban, X., Selmaj, K., Wiendl, H., Kerloeguen, C., Willi, R., Li, B., Kakarieka, A., Tomic, D., Goodyear, A., Pingili, R., Haring, D. A., Ramanathan, K., Merschhemke, M., Kappos, L., Asclepios, I and ASCLEPIOS II Trial Group, Filippi, M, L Hauser, Stephen, Kappos, Ludwig, Bar-Or, Amit, A Cohen, Jeffrey, Comi, Giancarlo, Correale, Jorge, K Coyle, Patricia, Cross, Anne, de Seze, Jerome, Montalban, Xavier, Selmaj, Krzysztof, Wiendl, Heinz, C Reingold, Stephen, R Cutter, Garry, Doerner, Thoma, Hartung, Hans-Peter, Soelberg Sørensen, Per, Steiner, Israel, S Wolinsky, Jerry, Ballario, Carlo, Calvo Vildoso, Christian, Gustavo Jose, Jorge, Haydee Deri, Norma, Liwacki, Susana, Lechner-Scott, Jeannette, Parratt, John, Hodgkinson, Suzanne, Maida, Eva-Maria, Leutmezer, Fritz, Van Wijmeersch, Bart, Laureys, Guy, Caekebeke, Jo, Geens, Karine, Vanopdenbosch, Ludo, Deryck, Olivier, Delvaux, Valerie, Van Pesch, Vincent, Milanov, Ivan, Tarnev, Ivaylo, Haralanov, Lyubomir, Manova Slavova, Maria, Shotekov, Penko, Emond, Francoi, Grandmaison, Francoi, Jacques, Francoi, Lee, Liesly, Sarah Gagne Brosseau, Marie, Freedman, Mark, Cloutier, Martin, Carruthers, Robert, Morrow, Sarah, Lapierre, Yve, Vladic, Anton, Bokun, Hana, Antoncic, Igor, Bosnjak Pasic, Marija, Habek, Mario, Butkovic Soldo, Silva, Vuletic, Vladimira, Martinkova, Alena, Meluzinova, Eva, Stetkarova, Ivana, Mares, Jan, Markova, Jolana, Vachova, Marta, Valis, Martin, Tyblova, Michaela, Dufek, Michal, Skoda, Ondrej, Hradilek, Pavel, Voldsgaard Jensen, Ana, Hvilsted Nielsen, Helle, Svendsen, Kristina, Ravnborg, Mad, Vestergaard Rasmussen, Peter, Gross-Paju, Katrin, Haldre, Sulev, Pekka Eralinna, Juha, Sumelahti, Marja-Liisa, Brochet, Bruno, Louapre, Celine, Lebrun-Frenay, Christine, Axel Laplaud, David, Edan, Gille, Castelnovo, Giovanni, Debouverie, Marc, Vermersch, Patrick, Clavelou, Pierre, Labauge, Pierre, Berthele, Achim, Haghikia, Aiden, Kornhuber, Anselm, Bergmann, Arnfin, Frank, Benedikt, Elias-Hamp, Birte, Tackenberg, Bjoern, Wildemann, Brigitte, Strauss, Erik, Schlegel, Eugen, Then Bergh, Florian, Nelles, Gereon, Tumani, Hayrettin, Sigel, Karl-Otto, Stangel, Martin, Boehringer, Matthia, Martin Hoffmann, Olaf, Oschmann, Patrick, Hohlfeld, Reinhard, Walter, Silke, Menck, Sylvia, Sprenger, Till, Ziemssen, Tjalf, Ulrich Becker, Veit, Straeten, Vera, Kilidireas, Konstantino, Voumvourakis, Konstantino, Fakas, Nikolao, Grigoriadis, Nikolao, Koves, Agne, Rozsa, Csilla, Kovacs, Krisztina, Vecsei, Laszlo, Maria, Satori, Biro, Zita, Rohatgi, Anshu, Khurana, Dheeraj, Durai Pandian, Jeyaraj, Dev Mukherji, Joy, Pandit, Lekha, Angamuthu Kanikannan, Meena, Ghosh, Pahari, Chakor, Rahul, Kulkarni, Rahul, Gursahani, Roopkumar, Ravat, Sangeeta, Rangasetty, Srinivasa, Kumar, Suresh, Shifrin, Alla, Karni, Arnon, Shahien, Radi, Milo, Ron, Uccelli, Antonio, Pozzilli, Carlo, Sacca, Francesco, Lus, Giacomo, Alessandra Marfia, Girolama, Brambilla, Laura, Salvetti, Marco, Filippi, Massimo, Zaffaroni, Mauro, Gallo, Paolo, Rossi, Silvia, Bonavita, Simona, Studer, Valeria, Millers, Andrej, Karelis, Gunti, Kalnina, Jolanta, Mickeviciene, Dalia, Kizlaitiene, Rasa, Carbajal Ramirez, Angelica, Jose Lopez Prieto, Juan, Wokke, Beatrij, W Van Oosten, Bob, Van Domburg, Peter, Hupperts, Raymond, Q Hintzen, Rogier, Edland, Astrid, Castaneda, Cesar, Perez, Julio, Gavidia, Martin, Wiak, Andrzej, Karaszewski, Bartosz, Jasinska, Elzbieta, Bartosik Psujek, Halina, Jastrzebska, Iwona, Slawek, Jaroslaw, Maciejowski, Maciej, Dziki, Miroslaw, Adamczyk Sowa, Monika, Bonek, Robert, Fryze, Waldemar, Martins Da Silva, Ana, Timoteo, Angela, Vasco Salgado, Antonio, Capela, Carlo, Veira, Carlo, Correia, Filipe, Cerqueira, Joao, De Sa, Joao, De Sousa, Livia, Gouveia, Raquel, Sergeevna Agafina, Alina, Naumovna Belova, Anna, Viktorovich Sazonov, Deni, Pokhabov, Dmitry, Igorevna Kairbekova, Ekaterina, Gennadievna Arefieva, Elena, Axatovich Khabirov, Farit, Vyacheslavovich Litvinenko, Igor, Stolyarov, Igor, Aleksandrovna Sokolova, Irina, Ivanovna Volkova, Larisa, Vafaevna Davydovskaya, Maria, Nikolaevna Zaharova, Maria, Alekseevna Malkova, Nadezhda, Agafonovna Totolyan, Natalia, Vasilievich Dorogov, Nikolay, Anatolievna Sivertseva, Stella, Kurca, Egon, Krastev, Georgi, Brozman, Miroslav, Koleda, Peter, Turcani, Peter, Valkovic, Peter, Hancinova, Viera, Donath, Vladimir, Retief, Chri, Isaacs, Michael, Saiz Hinarejos, Albert, Rodriguez Antigüedad, Alfredo, Casanova Estruch, Bonaventura, Oreja-Guevara, Celia, Reig Rosello, Gemma, Carlos Alvarez Cermeño, Jose, Martinez Rodriguez, Jose, Meca Lallana, Jose, Antonio Garcia Merino, Juan, Forero Diaz, Lucia, Costa Frossard Franca, Lucienne, Querol Gutierrez, Lui, Ramio Torrenta, Llui, Serrano Castro, Pedro, Arroyo Gonzalez, Rafael, Eichau Madueño, Sara, Martinez Yelamos, Sergio, Castillo Trivino, Tamara, Meca Lallana, Virgina, Montalban Gairin, Xaviere, Piehl, Fredrik, Lycke, Jan, Zecca, Chiara, Derfuss, Tobia, Lin, Thy-Sheng, Tiamkao, Somsak, Nur Yuceyar, Ayse, Soysal, Aysun, Petek Balci, Belgin, Boz, Cavit, Efendi, Husnu, Terzi, Murat, Sevim, Serhan, Ozakbas, Serkan, Gale, Andrew, Turner, Ben, Barnes, David, Paling, David, Silber, Eli, Overell, Jame, Craner, Matthew, Carlson, Aaron, Wolff, Adam, Onuoha, Adaeze, Subei, Adnan, Ata, Ahmad, Borazanci, Aimee, Dastagir, Akram, Vasquez, Alberto, Brooke Allen, Alison, P Keegan, Andrew, Carrasco, Angel, R Chinea Martinez, Angel, Bass, Ann, Okai, Annette, Erwin, April, Antezana-Antezana, Ariel, Green, Barbara, E Sundaram, Bharathy, Khatri, Bhupendra, Dihenia, Bhupesh, Gheorghiu, Bogdan, Costell, Brian, Steingo, Brian, L Hughes, Bruce, M Hersh, Carrie, Laganke, Christopher, Luzzio, Christopher, Ford, Corey, Edward Herrman, Craig, Senzon, Craig, Huffman, Cynthia, R Wynn, Daniel, O Bear, David D, Lesch, David, H Mattson, David, Weisman, David, A Burke, Deborah, W Dietrich, Denni, Huang, Deren, Robertson, Derrick, Lotfi, Djamchid, Joseph Alfonso, Don, Stefoski, Dusan, J Fox, Edward, Pharr, Emily, Alvarez, Enrique, Bernitsas, Evanthia, Amjad, Faria, Pardo, Gabriel, Eubank, Geoffrey, Mcintosh, Gerald, F Crowell, Gile, Rao, Hemanth, Michael Hemphill, J, H Florin, Jack, Nicholas, Jacqueline, Napier, Jame, Scott, Jame, M Silversteen, Jason, Vasallo, Javier, Schneider, Jean-Raphael, Wendt, Jeanette, Cohen, Jeffrey, Gross, Jeffrey, Groves, Jeffrey, Kaplan, Jeffrey, Stulc, Jessica, A Cooper, Joanna, Foley, John, Scagnelli, John, C Calkwood, Jonathan, Pizarro Otero, Jose, Rafecas, Jose, Katz, Joshua, S Saad, Juliette, Standley, Katherine, Edwards, Keith, Sharlin, Kenneth, Bashir, Khurram, Wagner, Kimberly, Liow, Kore, Lee Blankenship Jr, Larry, Mate, Laszlo, Montoya, Liliana, D Lynn, Lon, Agius, Mark, Cascione, Mark, Allan Goldstein, Mark, Janicki, Mark, R Bialow, Martin, Denise Hughes, Mary, J Baker, Matthew, Apperson, Michelle, B Kuczma, Michelle, Mateo Paz Soldan, M, Cerghet, Mirela, Robb Whaley, Nathaniel, K Winner, Paul, Repovic, Pavle, Kelkar, Praful, Rekha Pillai, Romero, Ayala, Ricardo, Sater, Richard, Trudell, Randall, Fairborn Armstrong, Robert, Thomas Nahouraii, Robert, Naismith, Robert, S Murray, Ronald, Hunter, Samuel, Qureshi, Sara, Lynch, Sharon, Wray, Sibyl, R Delgado, Silvia, Donlon, Stacy, Cohan, Stanley, Smith, Stanya, James Shafer, Stuart, Azalone, Susan, Hibbs, Susan, A Miller, Tamara, Giancarlo, Thoma, Desai, Troy, K Saxena, Varun, Simnad, Virginia, David Honeycutt, William, Logan, William, E McElveen, William, Wagner, William, Stephen, L Hauser, Ludwig, Kappo, Amit, Bar-Or, Jeffrey, A Cohen, Giancarlo, Comi, Jorge, Correale, Patricia, K Coyle, Anne, Cro, Jerome de Seze, Xavier, Montalban, Krzysztof, Selmaj, Heinz, Wiendl, Stephen, C Reingold, Garry, R Cutter, Thomas, Doerner, Hans-Peter, Hartung, Per Soelberg Sørensen, Israel, Steiner, Jerry, S Wolinsky, Carlos, Ballario, Christian Calvo Vildoso, Jorge Gustavo Jose, Norma Haydee Deri, Susana, Liwacki, Jeannette, Lechner-Scott, John, Parratt, Suzanne, Hodgkinson, Eva-Maria, Maida, Fritz, Leutmezer, Barbara, Willeken, Bart Van Wijmeersch, Guy, Laurey, Karine, Geen, Ludo, Vanopdenbosch, Olivier, Deryck, Valerie, Delvaux, Vincent Van Pesch, Ivan, Milanov, Ivaylo, Tarnev, Lyubomir, Haralanov, Maria Manova Slavova, Penko, Shotekov, Francois, Emond, Francois, Grandmaison, Francois, Jacque, Liesly, Lee, Marie Sarah Gagne Brosseau, Mark, Freedman, Martin, Cloutier, Robert, Carruther, Sarah, Morrow, Yves, Lapierre, Anton, Vladic, Hana, Bokun, Igor, Antoncic, Marija Bosnjak Pasic, Mario, Habek, Silva Butkovic Soldo, Vladimira, Vuletic, Alena, Martinkova, Eva, Meluzinova, Ivana, Stetkarova, Jan, Mare, Jolana, Markova, Marta, Vachova, Martin, Vali, Michaela, Tyblova, Michal, Dufek, Ondrej, Skoda, Pavel, Hradilek, Ana Voldsgaard Jensen, Helle Hvilsted Nielsen, Kristina, Svendsen, Mads, Ravnborg, Peter Vestergaard Rasmussen, Katrin, Gross-Paju, Sulev, Haldre, Juha Pekka Eralinna, Marja-Liisa, Sumelahti, Bruno, Brochet, Celine, Louapre, Christine, Lebrun-Frenay, David Axel Laplaud, Gilles, Edan, Giovanni, Castelnovo, Marc, Debouverie, Patrick, Vermersch, Pierre, Clavelou, Pierre, Labauge, Achim, Berthele, Aiden, Haghikia, Anselm, Kornhuber, Arnfin, Bergmann, Benedikt, Frank, Birte, Elias-Hamp, Bjoern, Tackenberg, Brigitte, Wildemann, Erik, Strau, Eugen, Schlegel, Florian Then Bergh, Gereon, Nelle, Hayrettin, Tumani, Karl-Otto, Sigel, Martin, Stangel, Matthias, Boehringer, Olaf Martin Hoffmann, Patrick, Oschmann, Reinhard, Hohlfeld, Silke, Walter, Sylvia, Menck, Till, Sprenger, Tjalf, Ziemssen, Veit Ulrich Becker, Vera, Straeten, Konstantinos, Kilidirea, Konstantinos, Voumvouraki, Nikolaos, Faka, Nikolaos, Grigoriadi, Agnes, Kove, Csilla, Rozsa, Krisztina, Kovac, Laszlo, Vecsei, Satori, Maria, Zita, Biro, Anshu, Rohatgi, Dheeraj, Khurana, Jeyaraj Durai Pandian, Joy Dev Mukherji, Lekha, Pandit, Meena Angamuthu Kanikannan, Pahari, Ghosh, Rahul, Chakor, Rahul, Kulkarni, Roopkumar, Gursahani, Sangeeta, Ravat, Srinivasa, Rangasetty, Suresh, Kumar, Alla, Shifrin, Arnon, Karni, Radi, Shahien, Ron, Milo, Antonio, Uccelli, Carlo, Pozzilli, Sacca', Francesco, Giacomo, Lu, Girolama Alessandra Marfia, Laura, Brambilla, Marco, Salvetti, Massimo, Filippi, Mauro, Zaffaroni, Paolo, Gallo, Silvia, Rossi, Simona, Bonavita, Valeria, Studer, Andrejs, Miller, Guntis, Kareli, Jolanta, Kalnina, Dalia, Mickeviciene, Rasa, Kizlaitiene, Angelica Carbajal Ramirez, Juan Jose Lopez Prieto, Beatrijs, Wokke, Bob, W Van Oosten, Peter Van Domburg, Raymond, Huppert, Rogier, Q Hintzen, Astrid, Edland, Cesar, Castaneda, Julio, Perez, Martin, Gavidia, Andrzej, Wiak, Bartosz, Karaszewski, Elzbieta, Jasinska, Halina Bartosik Psujek, Iwona, Jastrzebska, Jaroslaw, Slawek, Maciej, Maciejowski, Miroslaw, Dziki, Monika Adamczyk Sowa, Robert, Bonek, Waldemar, Fryze, Ana Martins Da Silva, Angela, Timoteo, Antonio Vasco Salgado, Carlos, Capela, Carlos, Veira, Filipe, Correia, Joao, Cerqueira, Joao De Sa, Livia De Sousa, Raquel, Gouveia, Alina Sergeevna Agafina, Anna Naumovna Belova, Denis Viktorovich Sazonov, Dmitry, Pokhabov, Ekaterina Igorevna Kairbekova, Elena Gennadievna Arefieva, Farit Axatovich Khabirov, Igor Vyacheslavovich Litvinenko, Igor, Stolyarov, Irina Aleksandrovna Sokolova, Larisa Ivanovna Volkova, Maria Vafaevna Davydovskaya, Maria Nikolaevna Zaharova, Nadezhda Alekseevna Malkova, Natalia Agafonovna Totolyan, Nikolay Vasilievich Dorogov, Stella Anatolievna Sivertseva, Egon, Kurca, Georgi, Krastev, Miroslav, Brozman, Peter, Koleda, Peter, Turcani, Peter, Valkovic, Viera, Hancinova, Vladimir, Donath, Chris, Retief, Michael, Isaac, Albert Saiz Hinarejos, Alfredo Rodriguez Antigüedad, Bonaventura Casanova Estruch, Celia, Oreja-Guevara, Gemma Reig Rosello, Jose Carlos Alvarez Cermeño, Jose Martinez Rodriguez, Jose Meca Lallana, Juan Antonio Garcia Merino, Lucia Forero Diaz, Lucienne Costa Frossard Franca, Luis Querol Gutierrez, Lluis Ramio Torrenta, Pedro Serrano Castro, Rafael Arroyo Gonzalez, Sara Eichau Madueño, Sergio Martinez Yelamos, Tamara Castillo Trivino, Virgina Meca Lallana, Xaviere Montalban Gairin, Fredrik, Piehl, Jan, Lycke, Chiara, Zecca, Tobias, Derfu, Thy-Sheng, Lin, Somsak, Tiamkao, Ayse Nur Yuceyar, Aysun, Soysal, Belgin Petek Balci, Cavit, Boz, Husnu, Efendi, Murat, Terzi, Serhan, Sevim, Serkan, Ozakba, Andrew, Gale, Ben, Turner, David, Barne, David, Paling, Eli, Silber, James, Overell, Matthew, Craner, Aaron, Carlson, Adam, Wolff, Adaeze, Onuoha, Adnan, Subei, Ahmad, Ata, Aimee, Borazanci, Akram, Dastagir, Alberto, Vasquez, Alison Brooke Allen, Andrew, P Keegan, Angel, Carrasco, Angel, R Chinea Martinez, Ann, Ba, Annette, Okai, April, Erwin, Ariel, Antezana-Antezana, Barbara, Green, Bharathy, E Sundaram, Bhupendra, Khatri, Bhupesh, Dihenia, Bogdan, Gheorghiu, Brian, Costell, Brian, Steingo, Bruce, L Hughe, Carrie, M Hersh, Christopher, Laganke, Christopher, Luzzio, Corey, Ford, Craig Edward Herrman, Craig, Senzon, Cynthia, Huffman, Daniel, R Wynn, David D, O Bear, David, Lesch, David, H Mattson, David, Weisman, Deborah, A Burke, Dennis, W Dietrich, Deren, Huang, Derrick, Robertson, Djamchid, Lotfi, Don Joseph Alfonso, Dusan, Stefoski, Edward, J Fox, Emily, Pharr, Enrique, Alvarez, Evanthia, Bernitsa, Faria, Amjad, Gabriel, Pardo, Geoffrey, Eubank, Gerald, Mcintosh, Giles, F Crowell, Hemanth, Rao, J Michael Hemphill, Jack, H Florin, Jacqueline, Nichola, James, Napier, James, Scott, Jason, M Silversteen, Javier, Vasallo, Jean-Raphael, Schneider, Jeanette, Wendt, Jeffrey, Cohen, Jeffrey, Gro, Jeffrey, Grove, Jeffrey, Kaplan, Jessica, Stulc, Joanna, A Cooper, John, Foley, John, Scagnelli, Jonathan, C Calkwood, Jose Pizarro Otero, Jose, Rafeca, Joshua, Katz, Juliette, S Saad, Katherine, Standley, Keith, Edward, Kenneth, Sharlin, Khurram, Bashir, Kimberly, Wagner, Kore, Liow, Larry Lee Blankenship Jr, Laszlo, Mate, Liliana, Montoya, Lon, D Lynn, Mark, Agiu, Mark, Cascione, Mark Allan Goldstein, Mark, Janicki, Martin, R Bialow, Mary Denise Hughes, Matthew, J Baker, Michelle, Apperson, Michelle, B Kuczma, M Mateo Paz Soldan, Mirela, Cerghet, Nathaniel Robb Whaley, Paul, K Winner, Pavle, Repovic, Praful, Kelkar, Romero Rekha Pillai, Ricardo, Ayala, Richard, Sater, Randall, Trudell, Robert Fairborn Armstrong, Robert Thomas Nahouraii, Robert, Naismith, Ronald, S Murray, Samuel, Hunter, Sara, Qureshi, Sharon, Lynch, Sibyl, Wray, Silvia, R Delgado, Stacy, Donlon, Stanley, Cohan, Stanya, Smith, Stuart James Shafer, Susan, Azalone, Susan, Hibb, Tamara, A Miller, Thomas, Giancarlo, Troy, Desai, Varun, K Saxena, Virginia, Simnad, William David Honeycutt, William, Logan, William, E McElveen, William, Wagner, University of California [San Francisco] (UC San Francisco), University of California (UC), University of Pennsylvania, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg-Hôpital de Hautepierre [Strasbourg], Westfälische Wilhelms-Universität Münster = University of Münster (WWU), Herrada, Anthony, and UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire

Subjects
Male, MESH: Multiple Sclerosis, Relapsing-Remitting, T-Lymphocytes, Hydroxybutyrates, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Pharmacology, Relapsing-Remitting, MESH: Magnetic Resonance Imaging, chemistry.chemical_compound, 0302 clinical medicine, Teriflunomide, Monoclonal, MESH: Double-Blind Method, 030212 general & internal medicine, Humanized, MESH: Toluidines, B-Lymphocytes, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, biology, Subcutaneous, B-Lymphocyte, Brain, General Medicine, Magnetic Resonance Imaging, MESH: Crotonates, Crotonates, Pyrimidine metabolism, Disease Progression, Female, MESH: Disease Progression, Antibody, Human, Adult, Multiple Sclerosis, Toluidines, medicine.drug_class, Injections, Subcutaneous, Injections, Subcutaneou, Monoclonal antibody, Ofatumumab, Settore MED/26, Antibodies, Monoclonal, Humanized, Crotonate, Antibodies, Injections, 03 medical and health sciences, MESH: Brain, Multiple Sclerosis, Relapsing-Remitting, Double-Blind Method, MESH: B-Lymphocytes, Nitriles, medicine, Humans, MESH: Kaplan-Meier Estimate, MESH: Humans, business.industry, Multiple sclerosis, MESH: Injections, Subcutaneous, MESH: Adult, medicine.disease, MESH: Male, MESH: T-Lymphocytes, T-Lymphocyte, Multicenter study, chemistry, MESH: Antibodies, Monoclonal, Humanized, biology.protein, Human medicine, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background: Ofatumumab, a subcutaneous anti-CD20 monoclonal antibody, selectively depletes B cells. Teriflunomide, an oral inhibitor of pyrimidine synthesis, reduces T-cell and B-cell activation. The relative effects of these two drugs in patients with multiple sclerosis are not known.Methods: In two double-blind, double-dummy, phase 3 trials, we randomly assigned patients with relapsing multiple sclerosis to receive subcutaneous ofatumumab (20 mg every 4 weeks after 20-mg loading doses at days 1, 7, and 14) or oral teriflunomide (14 mg daily) for up to 30 months. The primary end point was the annualized relapse rate. Secondary end points included disability worsening confirmed at 3 months or 6 months, disability improvement confirmed at 6 months, the number of gadolinium-enhancing lesions per T1-weighted magnetic resonance imaging (MRI) scan, the annualized rate of new or enlarging lesions on T2-weighted MRI, serum neurofilament light chain levels at month 3, and change in brain volume.Results: Overall, 946 patients were assigned to receive ofatumumab and 936 to receive teriflunomide; the median follow-up was 1.6 years. The annualized relapse rates in the ofatumumab and teriflunomide groups were 0.11 and 0.22, respectively, in trial 1 (difference, -0.11; 95% confidence interval [CI], -0.16 to -0.06; P

Published
2020
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7. Current practices in epilepsy monitoring units (EMU) in India

Author

Atma Ram Bansal, Shaik Afshan Jabeen, Sandeep Patil, Kaushik Rana, Neeraj N Baheti, Chaturbhuj Rathore, Fayaz Khan, Ashok Pillai, Kurupath Radhakrishnan, Sujit Jagtap, Sita Jayalakshmi, Dinesh S Nayak, Lakshminarayanan Kannan, Jagarlapudi M. K. Murthy, Turaga Suryaprabha, Siby Gopinath, Jayanti Mani, Sangeeta Ravat, Atam Preet Singh, Vrajesh Udani, Urvashi Shah, and Sanjay Prakash

Subjects
Response rate (survey), Epilepsy, business.industry, Seizure clusters, Developing country, Economic shortage, Electroencephalography, General Medicine, medicine.disease, Status Epilepticus, Neurology, Seizures, medicine, Epilepsy monitoring, Humans, Neurology (clinical), Medical emergency, business, Risk assessment, Developed country, Face validity, Monitoring, Physiologic
Abstract

As an initial step to develop guidelines for epilepsy monitoring units (EMUs) appropriate for developing countries, we inquired the existing practices in EMUs in India.After checking for the content and face validity as well for clarity, we sent a 52-item online non-anonymized questionnaire to all the 52 EMUs in India.The questionnaire was completed by 51 of the 52 EMUs (98% response rate). The majority of the EMUs are located in major cities and 51% are located in non-governmental corporate hospitals. There are total of 122 prolonged video-EEG monitoring (PVEM) beds in India and 70% EMUs have ≤2 beds. Approximately two-thirds of the EMUs have defined protocols for pre-procedure consent and risk assessment, management of seizure clusters and status epilepticus, continuous observation of patients, and peri‑ictal testing. Only one-third of the EMUs have protocols for management of post-ictal psychosis, anti-suffocation pillows, and protected environment within bathrooms. The waiting period for PVEM is more (49.9 ± 101 vs. 4.9 ± 10.9 days; p = 0.04) and mean cost for 3-day PVEM is less (INR 8311 ± 9021 vs. 30,371 ± 17,563; p0.0001) in public as compared to private hospitals. There was a negative correlation between cost of PVEM and the waiting period (r=-0.386; p = 0.01). Safety practices are similar in public and private hospitals.Although practices in EMUs in India vary widely, they are comparable to those in developed countries. India has severe shortage of EMUs and long waiting lists for affordable PVEM.

Published
2021

12. B12 deficiency presenting as sensory neuronopathy

Author

Sangeeta Ravat, Rishikesh Joshi, Santosh Sriram Andugulapati, Rahil Ansari, Neeraj Jain, Parag Maheshkar, and Piyush Anshu

Subjects
Neurology, business.industry, Medicine, Sensory system, Neurology (clinical), B12 deficiency, business, Neuroscience
Published
2021
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17. A case of recurrent thymoma with double paraneoplastic syndromes: are antibodies better than clinical judgement in predicting thymoma relapse?

Author

Sangeeta Ravat, Mayur Thakkar, Karan Desai, Akash Chheda, Neeraj Jain, Dnyaneshwar Jadhav, and Rahil Ansari

Subjects
medicine.medical_specialty, Thymoma, biology, business.industry, Clinical judgement, medicine.disease, Dermatology, Recurrent thymoma, Neurology, medicine, biology.protein, Neurology (clinical), Antibody, business
Published
2021
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19. Thrombolysis in acute ischemic stroke: Experience in tertiary care center in developing country

Author

Priyanka Walzade, Gajanan Panandikar, Piyush Anshu, Rahil Ansari, Sangeeta Ravat, Karan Desai, and Neeraj Jain

Subjects
medicine.medical_specialty, Neurology, business.industry, medicine.medical_treatment, Emergency medicine, medicine, Developing country, Center (algebra and category theory), Neurology (clinical), Thrombolysis, business, Tertiary care, Acute ischemic stroke
Published
2021
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22. HD like presentation of HIV in adult: Rare case report

Author

Sangeeta Ravat, Rushikesh Joshi, Dnyaneshwar Jadhav, and Neeraj Jain

Subjects
Pediatrics, medicine.medical_specialty, Neurology, business.industry, Rare case, Human immunodeficiency virus (HIV), medicine, Neurology (clinical), Presentation (obstetrics), medicine.disease_cause, business
Published
2021
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23. Progressive Myoclonic Epilepsy’-like presentation of Cerebrotendinous Xanthomatosis in an Indian Family with A Novel C.646+1G>A Splice Site Mutation

Author

Rahil Ansari, Karan Desai, Neeraj Jain, Sangeeta Ravat, Piyush Kumar, Parthvi S. Ravat, and Shruti Agrawal

Subjects
Neurophysiology and neuropsychology, Proband, congenital, hereditary, and neonatal diseases and abnormalities, Pathology, medicine.medical_specialty, Ataxia, Case Report, Progressive myoclonus epilepsy, Progressive myoclonic epilepsy, Cerebrotendinous Xanthomatosis, Behavioral Neuroscience, Epilepsy, polycyclic compounds, medicine, Generalized epilepsy, RC346-429, business.industry, QP351-495, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, medicine.disease, Neurology, Myoclonic epilepsy, Neurology. Diseases of the nervous system, Neurology (clinical), medicine.symptom, business, Myoclonus
Abstract

Highlights • Epilepsy is rarely a presenting neurological feature of CTX, but a progressive myoclonic epilepsy. • A 'progressive myoclonic epilepsy'-like presentation of Cerebrotendinous Xanthomatosis (CTX) is novel to the best of our knowledge., Cerebrotendinous Xanthomatosis (CTX) is a rare autosomal-recessive inborn disorder of bile acid metabolism due to mutations in the CYP27A1 gene. It presents with a diverse range of neurological and non-neurological symptoms. We present a case of CTX with a progressive myoclonic epilepsy (PME) like phenotype and a family history of CTX. The proband had a generalized epilepsy with prominent myoclonus. He also had intellectual decline, ataxia, bipyramidal dysfunction and peripheral neuropathy. The younger sibling had a milder generalized epilepsy without myoclonus along with behavioral issues, ataxia, neuropathy, and prominent tendon xanthomas. Both the siblings had developmental cataracts. MRI Brain of both had dentate hyperintensities with cerebellar atrophy. The proband’s EEG showed severe background slowing with multifocal interictal discharges. Targeted gene of analysis proband revealed a novel homozygous 5′ splice site variation in intron 3 of the CYP27A1 gene. We present a novel phenotype and genotype of CTX presenting with a syndrome of myoclonic epilepsy. This is the first PME-like presentation of CTX to the best of our knowledge. CTX may present with a PME-like clinical phenotype and should be considered as a treatable cause within the differential diagnostic evluation of syndromic epilepsies involving an atypical familial myoclonic epilepsy.

Published
2021
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24. Surgical outcomes in patients with intraoperative Electrocorticography (EcoG) guided epilepsy surgery-experiences of a tertiary care centre in India

Author

Keyurkumar Panchal, Abhijit Kulkarni, Dattatraya Muzumdar, Vivek Iyer, and Sangeeta Ravat

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Electroencephalography, 030218 nuclear medicine & medical imaging, Tertiary Care Centers, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, medicine, Humans, Epilepsy surgery, Child, Electrocorticography, Anterior temporal lobectomy, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, General Medicine, Middle Aged, Cortical dysplasia, Drug Resistant Epilepsy, medicine.disease, Magnetic Resonance Imaging, Surgery, Child, Preschool, Female, business, 030217 neurology & neurosurgery
Abstract

The Comprehensive Epilepsy Surgery Program was started in 2001 at K.E.M. Hospital, Mumbai with the aim of performing epilepsy surgeries at highly concessional rates. We have started using intraoperative Electrocorticography (EcoG) since 2009 in patients with tumors, Mesial Temporal Sclerosis (MTS) plus and focal cortical dysplasia (FCD). This study highlights our experience with EcoG and it's utility in epilepsy surgery.introduction METHODS: 51 patients with drug resistant epilepsy due to temporal and extra-temporal tumors, MTS plus and FCD underwent pre-surgical evaluation and ECoG guided epilepsy surgery through our program. The surgical procedures employed included intraoperative EcoG guided lesionectomy or a lesionectomy with Anterior Temporal Lobectomy (ATL). Postoperative MRI and EEG were done. Seizure freedom was categorized as per Engel's classification.At a mean follow up of 33 months (range: 14-69 months), 43 out of 51(84.31%) patients were completely seizure free post-surgery (Engel's Class I). Among the patients who were not seizure free, 3 patients were in Engel's Class II and 5 patients were in Engel's Class III. Presence of a residual lesion on postoperative MRI (p 0.001), abnormal postoperative EEG (p 0.001) and persistent spikes on post-resection EcoG (p 0.05) had a significant statistical association with poor seizure freedom post-surgery.The success of epilepsy surgery depends upon accurate localization and complete resection of the epileptogenic tissue, both of which are aided by intraoperative EcoG.Thus, intraoperative EcoG is a useful adjunct in epilepsy surgery to achieve optimal seizure freedom in cases of MTS plus, focal cortical dysplasia and tumors. Even the patients who are not seizure free can achieve worthwhile improvement post surgery.

Published
2016
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25. Ictal asystole: A rare cardiac manifestation of temporal lobe epilepsy, treated with epilepsy surgery

Author

Mansi Shah, Amit Ashok Bhatti, Shreyas Hasmukh Ravat, Sangeeta Ravat, and Dattatraya Muzumdar

Subjects
Bradycardia, medicine.medical_specialty, mesial temporal sclerosis, medicine.medical_treatment, Case Report, lcsh:RC346-429, Temporal lobe, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Internal medicine, medicine, Ictal, Epilepsy surgery, 030212 general & internal medicine, Asystole, Anterior temporal lobectomy, lcsh:Neurology. Diseases of the nervous system, business.industry, temporal lobe epilepsy, medicine.disease, ictal asystole, Frontal lobe seizures, Cardiology, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Seizures are associated with fascinatingly varied cardiac and autonomic manifestations, of which ictal tachycardia is common, and asystole and bradycardia are rare. Ictal asystole (IA), an often unsought autonomic phenomenon, occurs most commonly with temporal followed by frontal lobe seizures. Prolonged IA may lead to cerebral anoxic ischemia. As the mysteries of sudden unexplained death in epilepsy are unraveled, it is quite possible that the key to it lays within these seizure-induced cardiac rhythm abnormalities. We present a case of a young male with temporal lobe epilepsy due to left mesial temporal sclerosis with prolonged IA, which was successfully managed with epilepsy surgery.

Published
2017

26. Status epilepticus related to pregnancy

Author

Mansi Shah, Karan Desai, and Sangeeta Ravat

Subjects
Pregnancy, Pediatrics, medicine.medical_specialty, business.industry, Status epilepticus, medicine.disease, Intensive Care Units, Text mining, Status Epilepticus, Neurology, Medicine, Humans, Anticonvulsants, Female, Neurology (clinical), medicine.symptom, business
Published
2018

28. Phenobarbitone: Indian Epilepsy Society- Consensus Document

Author

Sheffali Gulati, Sita Jayalakshmi, Parampreet S Kharbanda, Manjari Tripathi, Man Mohan Mehndiratta, Pravina Shah, Satish Jain, Sangeeta Ravat, and Suvasini Sharma

Subjects
Epilepsy, medicine.medical_specialty, business.industry, Medicine, Neurology (clinical), business, medicine.disease, Psychiatry
Published
2015
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29. The effect of phenobarbitone on cognition in adult patients with new onset epilepsy: A multi-centric prospective study from India

Author

M.S. Shunmukhi, Sangeeta Ravat, Q. Mukaddam, Urvashi Shah, D.K. Subbakrishna, Aparna Dutta, M. Naik, A. Senapathy, Sanjib Sinha, S. Jayalakhsmi, Shobini L. Rao, and P. Satischandra

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Time Factors, India, Neuropsychological Tests, Epilepsy, Cognition, Seizures, medicine, Humans, Prospective Studies, Neuropsychological assessment, Prospective cohort study, Psychiatry, Adult patients, medicine.diagnostic_test, Neuropsychology, medicine.disease, Treatment Outcome, Neurology, Phenobarbital, Anticonvulsants, Female, Neurology (clinical), Psychology, Psychosocial, medicine.drug
Abstract

In view of the conflicting results of cognitive and behavioral consequences of PB, the present study was planned to analyze its efficacy, serial neuropsychological functions and its impact on psychosocial functioning in adults with epilepsy while on phenobarbitone (PB).This prospective multi-centric study carried out across 4 centers in India included 75 adult patients of ≥18 years (M:F=52:23; age: 27.3 ± 8.5 years) with epilepsy who were prescribed phenobarbitone and underwent serial standardized neuropsychological assessment (NIMHANS battery for adults) at baseline, 1 month, 3 months, 6 months and 12 months. The demographic, seizure details and outcome measures were recorded.Of the 75 patients, 63 had completed clinical and neuropsychological assessment, i.e. visit 1 (baseline), visit 4 (6 months) and visit 5 (12 months). There was no deterioration rather an improvement during the follow visits in all the neuropsychological functions. The results indicate that 16 neuropsychological variables changed significantly, viz. mental speed (p0.001), sustained attention (p0.001), focused attention (p0.002), planning (p0.001), concept formation (p0.05), set shifting (p0.001), verbal learning (p0.0001), verbal memory (p0.0001), visual memory (p0.0001) and intelligence (p0.001). The scales measuring the outcome of psychosocial functioning significantly changed during follow up included happiness (p0.002), Impact of Epilepsy on patient's life (p0.02), A-B Neuropsychological Assessment (p0.015), HADS anxiety (p0.001) and emotional disorder (p0.006). There was a significant reduction in seizure severity as measured by Liverpool Seizure Severity Scale (p0.002) and seizure freedom was maintained.This study demonstrated that phenobarbitone is effective, well tolerated AED and do not have cognitive impairment over one year. There was variable but distinct improvement in cognition and psychosocial functioning, and effective seizure control could be one of the factor for it.

Published
2014
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30. Mesial temporal lobe epilepsy - An overview of surgical techniques

Author

Sangeeta Ravat, Nina Sawant, Atul Goel, Urvashi Shah, Manoj Patil, and Dattatraya Muzumdar

Subjects
Adult, Male, medicine.medical_specialty, Drug Resistant Epilepsy, medicine.medical_treatment, education, Context (language use), Electroencephalography, Hippocampus, Temporal lobe, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Humans, Epilepsy surgery, Ictal, Anterior temporal lobectomy, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, Magnetic Resonance Imaging, Temporal Lobe, Surgery, Epilepsy, Temporal Lobe, 030220 oncology & carcinogenesis, Female, business, 030217 neurology & neurosurgery
Abstract

Mesial temporal lobe epilepsy is one of the commonest indications for epilepsy surgery. Presurgical evaluation for drug resistant epilepsy and identification of appropriate candidates for surgery is essential for optimal seizure freedom. The anatomy of mesial temporal lobe is complex and needs to be understood in the context of the advanced imaging, ictal and interictal Video_EEG monitoring, neuropsychology and psychiatric considerations. The completeness of disconnection of epileptogenic neural networks is paramount and is correlated with the extent of resection of the mesial temporal structures. In the Indian subcontinent, a standard but extended anterior temporal lobectomy is a viable option in view of the diverse socioeconomic, cultural and pathological considerations. The maximum utilization of epilepsy surgery services in this region is also a challenge. There is a need for regional comprehensive epilepsy care teams in a tertiary care academic hospital to form centers of excellence catering to a large population.

Published
2016

31. Evaluation of safety and efficacy of zonisamide in adult patients with partial, generalized, and combined seizures: an open labeled, noncomparative, observational Indian study

Author

Avathvadi Venkatesan Srinivasan, Renu Achtani, Amitabh Dash, Nanjappa C Manjunath, Ashutosh Shetty, Vivek Kumar, Suyog Mehta, Veeresh Bajpai, Vivek Narain Mathur, Sangeeta Ravat, Randhi Venkata Narayana, and Bobby Varkey Maramattom

Subjects
Pediatrics, medicine.medical_specialty, Therapeutics and Clinical Risk Management, adjunctive therapy, Sedation, Zonisamide, Pharmacology, 03 medical and health sciences, 0302 clinical medicine, Weight loss, partial onset seizures, medicine, Pharmacology (medical), 030212 general & internal medicine, General Pharmacology, Toxicology and Pharmaceutics, Adverse effect, Original Research, Chemical Health and Safety, Adult patients, business.industry, responder rate, General Medicine, Discontinuation, Tolerability, monotherapy, Observational study, zonisamide, generalized seizures, medicine.symptom, business, Safety Research, 030217 neurology & neurosurgery, medicine.drug
Abstract

Amitabh Dash,1 Sangeeta Ravat,2 Avathvadi Venkatesan Srinivasan,3 Ashutosh Shetty,4 Vivek Kumar,5 Renu Achtani,6 Vivek Narain Mathur,7 Boby Varkey Maramattom,8 Veeresh Bajpai,9 Nanjappa C Manjunath,10 Randhi Venkata Narayana,11 Suyog Mehta12 1Eisai Co. Ltd., 2Department of Neurology, Seth GS Medical College & KEM Hospital, Mumbai, 3Department of Neurology, Trinity Acute Care Hospital, Chennai, 4Department of Neurology, Criticare Multispeciality Hospital& Research Centre, Mumbai, 5Department of Neurology, Metro Multispeciality Hospital, Noida, 6Department of Neurology, Mata Chanan Devi Hospital, New Delhi, 7Department of Neurology, Vivekananda Hospital, Hyderabad, 8Department of Neurology, Lourdes Hospital, Kochi, 9Department of Neurology, Sai Neurology Clinic, Lucknow, 10Department of Neurology, Brain and Nerve Care, Bangalore, 11Department of Neurology, Seven Hills Hospital, Visakhapatnam, 12Department of Pharmacology & Therapeutics,Government Medical College, Solapur, India Abstract: A prospective, multicentric, noncomparative open-label observational study was conducted to evaluate the safety and efficacy zonisamide in Indian adult patients for the treatment of partial, generalized, or combined seizures. A total of 655 adult patients with partial, generalized, or combined seizures from 30 centers across India were recruited after initial screening. Patients received 100 mg zonisamide as initiating dose as monotherapy/adjunctive therapy for 24 weeks, with titration of 100 mg every 2 weeks if required. Adverse events, responder rates, and seizure freedom were observed every 4 weeks. Efficacy and safety were also assessed using Clinicians Global Assessment of Response to Therapy and Patients Global Assessment of Tolerability to Therapy, respectively. Follow-up was conducted for a period of 24weeks after treatment initiation. A total of 655 patients were enrolled and received the treatment and 563 completed the evaluation phase. A total of 20.92% of patients received zonisamide as monotherapy or alternative monotherapy and 59.85% patients received zonisamide as first adjunctive therapy. Compared with baseline, 41.22% of patients achieved seizure freedom and 78.6% as responder rate at the end of 24 week study. Most commonly reported adverse events were loss of appetite, weight loss, sedation, and dizziness, but discontinuation due to adverse events of drug was seen in 0.92% of patients. This open label real-world study suggests that zonisamide is an effective and well-tolerated antiepileptic drug in Indian adults for treatment of partial, generalized as well as combined seizures type. No new safety signals were observed. Keywords: zonisamide, partial onset seizures, generalized seizures, responder rate, monotherapy, adjunctive therapy

Published
2016

32. Role of pyridoxine in the management of infantile spasms

Author

Sangeeta Ravat and Mansi Shah

Subjects
Pediatrics, medicine.medical_specialty, business.industry, MEDLINE, Infant, Pyridoxine, Aldehyde Dehydrogenase, Neurology, Mutation, Vitamin B Complex, medicine, Humans, Neurology (clinical), business, Spasms, Infantile, medicine.drug
Published
2018
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33. Memory outcomes in mesial temporal lobe epilepsy surgery

Author

Neeraj Jain, Neena S Sawant, Yogesh Godge, Dattatraya Muzumdar, Aishani Desai, Mayuri Jain, Urvashi Shah, and Sangeeta Ravat

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Verbal learning, 050105 experimental psychology, 03 medical and health sciences, 0302 clinical medicine, Visual memory, Memory, medicine, Humans, 0501 psychology and cognitive sciences, Epilepsy surgery, Anterior temporal lobectomy, Retrospective Studies, Hippocampal sclerosis, business.industry, 05 social sciences, Retrospective cohort study, General Medicine, Middle Aged, Verbal Learning, medicine.disease, Anterior Temporal Lobectomy, Surgery, Treatment Outcome, Epilepsy, Temporal Lobe, Female, Verbal memory, business, 030217 neurology & neurosurgery, Mesial temporal lobe epilepsy
Abstract

Introduction Decline in verbal memory after dominant mesial temporal lobe surgery is a concern. Outcomes primarily reported by group data analysis do not address issues of practice effects and measurement errors and also do not provide information about individual meaningful change after surgery. Reliable Change Indices (RCI's) are regarded to be robust statistical methods for reporting individual change and have not been hitherto derived in patient populations in India. Aim Report memory outcomes for patients after surgery using group data as well as RCI score analyses using RCI scores derived in a control patient population. Method Retrospective data analysis of 106 selected patients who underwent Anterior Temporal Lobectomy (ATL) surgery. RCI scores derived from a control group of 44 non-operated patients. Outcomes based on score shifts on the various measures of two verbal and visual memory tests. Results Group mean score analysis revealed no significant shifts in verbal or visual memory scores after left ATL, but significant improvements in verbal memory after right ATL. RCI score analysis revealed decline and improvements in a small percentage of patients for both left and right ATL groups. Percentage of patients showing decline was much less than reported in western literature although percentage improved was comparable. Discussion Differences in decline percentage may be due to RCI scores and clinical characteristics of our sample (impaired pre-operative functioning, majority seizure free post surgery, moderate hippocampal sclerosis, early onset, long duration of seizures). Conclusion Group analyses mask individual change. Therefore, to report memory outcomes and counsel patients about relative risk-benefits of surgery, RCI scores derived from our patient populations should be used.

Published
2015

34. Clinical characteristics, surgical and neuropsychological outcomes in drug resistant tumoral temporal lobe epilepsy

Author

Urvashi Shah, Vivek Iyer, Pranjali Pradhan, Yogesh Godge, Dattatraya Muzumdar, Sangeeta Ravat, and Neeraj Jain

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Drug Resistance, Hippocampus, Electroencephalography, Temporal lobe, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Quality of life, Monitoring, Intraoperative, Medicine, Humans, Child, Anterior temporal lobectomy, medicine.diagnostic_test, business.industry, Neuropsychology, General Medicine, Drug Resistant Epilepsy, medicine.disease, Surgery, 030104 developmental biology, Epilepsy, Temporal Lobe, Quality of Life, Female, business, 030217 neurology & neurosurgery
Abstract

Glioneuronal tumors are found in nearly one third patients who undergo surgery for pharmacoresistant epilepsy with temporal lobe being the most common location. Few studies, however have concentrated on the neurological and neuropsychological outcomes after surgery, hitherto none from India.We studied 34 patients with temporal lobe tumors and drug resistant epilepsy. These patients underwent anterior temporal lobectomy or lesionectomy based on the involvement of the hippocampus and mesial temporal structures. The clinical history, EEG, neuropsychology profile and MRI were compared. Seizure outcome was categorized using Engel's classification.At a mean follow up of 62 months, 85.29% of the patients were seizure free (Engel's Class I). All 8 patients with intraoperative electrocorticography (ECoG) guided resection were seizure free.Presence of a residual lesion was significantly associated with persistence of seizures post surgery (p = 0.002). Group analysis revealed no significant shifts in IQ and memory scores postoperatively. There was a significant improvement in the quality of life scores (total and across all subdomains) in all patients (p 0.001). Postoperative EEG abnormalities predicted unfavorable ​seizure outcome.Surgery for temporal lobe tumors and refractory epilepsy offers complete seizure freedom in majority. Complete surgical excision of the epileptogenic zone is of paramount importance in achieving seizure freedom. Intraoperative electrocorticography (EcoG) is a useful adjunct to ensure complete removal of epileptogenic zone, thus achieving optimal seizure freedom. There is a significant improvement in the quality of life scores (p 0.001) with no negative impact of surgery on memory and intelligence. Even the patients who are not seizure free can achieve worthwhile improvement post surgery.

Published
2015

35. Surgical outcomes with non-invasive presurgical evaluation in MRI determined bilateral mesial temporal sclerosis: A retrospective cohort study

Author

Sangeeta Ravat, Vivek Iyer, Neeraj Jain, Prajwal Rao, Urvashi Shah, Dattatraya Muzumdar, Yogesh Godge, and Shraddha Shah

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Electroencephalography, Hippocampus, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Quality of life, medicine, Humans, Epilepsy surgery, Ictal, 030212 general & internal medicine, Child, Anterior temporal lobectomy, Retrospective Studies, Hippocampal sclerosis, Sclerosis, medicine.diagnostic_test, business.industry, Neuropsychology, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Anterior Temporal Lobectomy, Magnetic Resonance Imaging, Surgery, Epilepsy, Temporal Lobe, Female, business, 030217 neurology & neurosurgery
Abstract

Background & objective Epilepsy surgery for bilateral hippocampal sclerosis continues to pose a challenge and outcomes even with invasive evaluations have not been very promising. Very few studies have analyzed surgery outcomes for patients with MRI determined, bilateral mesial temporal sclerosis (MTS) after non-invasive pre-surgical evaluation. Material and methods We studied 35 patients with bilateral MTS who underwent anterior temporal lobectomy (ATL) after non-invasive pre-surgical evaluation. Clinical history, EEG, neuropsychology profile and symmetry of MTS on MRI were reviewed in the groups of ‘seizure free' and ‘not seizure free' patients. Results At an average follow up of 44 months (range 12–110 months), 26 out of 35 patients (74%) were seizure free. Unilateral interictal discharges were seen in 57% patients. 94% patients had unilateral ictal EEG onset. Bilateral interictal discharges were significantly associated with ‘not seizure free' outcome (p = 0.02). Pre-operatively, 24 (71%) patients had bilateral (verbal and visual) memory impairment while 10 (28%) patients had unilateral (verbal or visual) memory impairment and 1 patient had a normal memory profile. Overall, no significant decline in memory was seen in left or right surgery groups post-operatively. There was significant improvement in Quality of Life scores in all patients (p = Conclusion Patients with bilateral MTS on MRI can be unilateral on electro physiology and neuropsychology, and can have a very good surgical outcome. In a setting of limited resources, a noninvasive pre-surgical protocol can be used. With proper patient selection, the outcomes may be comparable to those reported with invasive pre-surgical protocols. Patients with unilateral interictal and ictal EEG have the best outcome. Up to 50% patients with bilateral interictal discharges can have a seizure free outcome. Patients with bilateral independent seizure onset have a less favourable prognosis. Patients who are not seizure free can still attain worthwhile improvement in seizure frequency without significant decline in memory and some improvement in quality of life.

Published
2015

36. Is psychiatric assessment essential for better epilepsy surgery outcomes?

Author

Neena S Sawant, Urvashi Shah, Sangeeta Ravat, and Dattatraya Muzumdar

Subjects
medicine.medical_specialty, Post surgical, Poor quality, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Quality of life (healthcare), medicine, Humans, Epilepsy surgery, Intensive care medicine, Psychiatry, Pre and post, business.industry, Psychiatric assessment, Mental Disorders, General Medicine, Seizure freedom, medicine.disease, 030227 psychiatry, Treatment Outcome, Quality of Life, Surgery, business, 030217 neurology & neurosurgery
Abstract

Epilepsy surgery is one of the most accepted and beneficial treatment for resistant epilepsies. However there is some variability in the comprehensive epilepsy care programs offered globally. Many centers do not do a psychiatric assessment unless required. It is now evident from a large body of research that epilepsy is associated with psychiatric morbidity which is also seen in patients considered for epilepsy surgery. There is also evidence to state that the risk for worsening or de novo psychiatric disorders is often seen post surgery. This calls for a comprehensive psychiatric assessment of all patients enrolled for the epilepsy surgery program to be evaluated pre and post surgically to minimize the risk of post surgical psychological disturbances and/or poor quality of life. Efficacious treatment of psychiatric disorders in those having psychiatric morbidity contributes to improved patient wellbeing, seizure freedom and better quality of life. Hence there is a need for most centers globally to include regular psychiatric assessment of epilepsy surgery patients as a protocol.

Published
2015

37. Undue regulatory control on phenobarbital--an important yet overlooked reason for the epilepsy treatment gap

Author

Donna Bergen, Phetvongsinh Chivorakoun, Gretchen L. Birbeck, Dismand Houinato, Peter Odermatt, Hasan Aziz, Sangeeta Ravat, Esper A. Cavalheiro, Pierre-Marie Preux, Charles R. Newton, J. Helen Cross, Devender Bhalla, Erich Schmutzhard, Arturo Carpio, Neuroépidémiologie Tropicale ( NET ), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ), Swiss Tropical Institute ( STI ), Department Public Health and Epidemiology, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] ( SIME ), CHU Limoges, Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges ( UNILIM ), Grelier, Elisabeth, Neuroépidémiologie Tropicale (NET), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-CHU Limoges-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Swiss Tropical and Public Health Institute [Basel], Université de Limoges (UNILIM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), and Swiss Tropical Institute (STI)

Subjects
medicine.medical_specialty, Treatment outcome, Antiepileptic drug, Epilepsy treatment, Article, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Epilepsy Treatment, medicine, Humans, 030212 general & internal medicine, Psychiatry, ComputingMilieux_MISCELLANEOUS, business.industry, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.disease, 3. Good health, Clinical neurology, Treatment Outcome, Regulatory control, Neurology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Phenobarbital, Drug and Narcotic Control, Anticonvulsants, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, 030217 neurology & neurosurgery, medicine.drug
Abstract

International audience; Epilepsy is a major chronic noncommunicable neurologic disorder. Although a simple, safe, efficacious, and low-cost treatment has been available for nearly 100 years, the treatment gap remains disturbingly high in many low- and middle-income countries (LMICs).[1] Treatment gap is generally defined as a “difference between the number of people with active epilepsy and the number being appropriately treated.” There are many reasons for this treatment gap; one important reason is an overly restrictive regulation on barbiturates such as phenobarbital (PB). These restrictive regulations deserve a wider and open discussion, even though epileptologists and others are intensely engaged on reducing the epilepsy treatment gap. With this article, we provide our viewpoint with an aim of raising an extremely important issue: undue regulatory restriction on phenobarbital, an essential lifesaving antiepileptic drug (AED).

Published
2015
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38. Subacute sclerosing panencephalitis presenting as schizophreniform disorder

Author

K. N. Roy Chengappa, Pradyumna J. Oak, Pravina U. Shah, Yogesh Godge, Sangeeta Ravat, and Thimmaiah G. Theethira

Subjects
Psychiatry and Mental health, Pathology, medicine.medical_specialty, business.industry, Medicine, Schizophreniform disorder, business, medicine.disease, Biological Psychiatry, Subacute sclerosing panencephalitis
Published
2009
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39. Childhood Absence Epilepsy with Tonic-Clonic Seizures and Electroencephalogram 3–4-Hz Spike and Multispike–Slow Wave Complexes: Linkage to Chromosome 8q24

Author

Hongyu Zhao, G. C. Y. Fong, Antonio V. Delgado-Escueta, José M. Serratosa, Youda Huang, Pravina U. Shah, Gregorio Pineda, Ignacio Pascual Castroviejo, Manyee N. Gee, Sangeeta Ravat, Sonia Khan, Marco T. Medina, Jayanthi Mani, and Lucy J. Treiman

Subjects
Male, Idiopathic generalized epilepsy, Genotype, Genetic Linkage, Saudi Arabia, India, Locus (genetics), Biology, California, Childhood absence epilepsy, Epilepsy, Seizures, Genetic linkage, Haplotype analysis, Genetics, medicine, Humans, Genetics(clinical), Child, Genetics (clinical), Recombination, Genetic, Haplotype, Chromosome Mapping, Chromosome, Electroencephalography, medicine.disease, Penetrance, Pedigree, Haplotypes, Spain, Chromosome 8q24, Female, Epilepsy, Tonic-Clonic, Lod Score, Linkage analysis, Chromosomes, Human, Pair 8, Research Article
Abstract

SummaryChildhood absence epilepsy (CAE), a common form of idiopathic generalized epilepsy, accounts for 5%–15% of childhood epilepsies. To map the chromosomal locus of persisting CAE, we studied the clinical and electroencephalographic traits of 78 members of a five-generation family from Bombay, India. The model-free affected–pedigree member method was used during initial screening with chromosome 6p, 8q, and 1p microsatellites, and only individuals with absence seizures and/or electroencephalogram 3–4-Hz spike– and multispike–slow wave complexes were considered to be affected. Significant P values of .00000–.02 for several markers on 8q were obtained. Two-point linkage analysis, assuming autosomal dominant inheritance with 50% penetrance, yielded a maximum LOD score (Zmax) of 3.6 for D8S502. No other locus in the genome achieved a significant Zmax. For five smaller multiplex families, summed Zmax was 2.4 for D8S537 and 1.7 for D8S1761. Haplotypes composed of the same 8q24 microsatellites segregated with affected members of the large family from India and with all five smaller families. Recombinations positioned the CAE gene in a 3.2-cM interval.

Published
1998
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40. Adolescent spinal muscular atrophy with calf hypertrophy and a deletion in the SMN gene

Author

Lindsay J Smith, Sangeeta Ravat, Monique M. Ryan, Eppie M. Yiu, Lloyd K. Shield, and Andrew J. Kornberg

Subjects
Male, medicine.medical_specialty, Weakness, Adolescent, Physiology, Nerve Tissue Proteins, Spinal Muscular Atrophies of Childhood, Muscle hypertrophy, Central nervous system disease, Cellular and Molecular Neuroscience, Exon, Degenerative disease, Physiology (medical), Internal medicine, Medicine, Humans, Cyclic AMP Response Element-Binding Protein, Leg, Muscle Weakness, business.industry, RNA-Binding Proteins, SMN Complex Proteins, Spinal muscular atrophy, DNA, Exons, Hypertrophy, Motor neuron, medicine.disease, SMA, Endocrinology, medicine.anatomical_structure, Neurology (clinical), medicine.symptom, business, Gene Deletion
Abstract

Spinal muscular atrophy (SMA) is generally associated with proximal weakness and muscle wasting. An X-linked variant with calf hypertrophy has been reported. We describe a young man with SMA type 4 with prominent calf hypertrophy in whom DNA analysis showed a homozygous deletion of exons 7 and 8 in the telomeric copy of the survival motor neuron gene. Calf hypertrophy may be seen uncommonly in autosomally inherited SMA.

Published
2008

41. Madelung's disease with myopathy

Author

Yogesh Godge, CJ Suresh Chandran, Pradyumna J. Oak, and Sangeeta Ravat

Subjects
Images in Neurology, business.industry, Medicine, Neurology (clinical), Disease, medicine.symptom, business, Bioinformatics, Myopathy
Published
2008

42. Hot cross bun sign

Author

YR Godge, CJ Suresh Chandran, Sangeeta Ravat, and PJ Oak

Subjects
Nuclear magnetic resonance, Neurology, business.industry, Medicine, Neurology (clinical), business, Hot cross bun sign
Published
2008
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