93 results on '"Vikram V Holla"'
Search Results
52. Acute Stroke Presenting as Isolated Orthostatic Negative Myoclonus
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Vikram V, Holla, Shailesh Shivraj, Pene, and Naveen, Kumar
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Myoclonus ,Stroke ,Electromyography ,Tremor ,Humans - Published
- 2020
53. The Spectrum of Movement Disorders in Cases with Osmotic Demyelination Syndrome
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Manjunath Netravathi, Ravi Yadav, Vikram V. Holla, Pramod Kumar Pal, Dodmalur Mallikarjuna Sindhu, Nitish Kamble, and Shweta Prasad
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Dystonia ,Pediatrics ,medicine.medical_specialty ,Movement disorders ,business.industry ,Parkinsonism ,Postural tremor ,medicine.disease ,Neurology ,Time course ,medicine ,Central pontine myelinolysis ,Neurology (clinical) ,medicine.symptom ,Hyponatremia ,business ,Neurological impairment ,Research Articles - Abstract
Background Osmotic demyelination syndrome (ODS) can be a central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) based on the regions involved even though they share the same disease process, aetiopathogenesis and time course. Objectives Present study aims to characterize the clinical, radiological features and the outcome of patients with ODS with movement disorders as the forthcoming manifestation. Methods Chart review of patients with ODS with movement disorders. Demographic, clinical and radiological details of the patients were reviewed. Results Eleven patients (six females; mean age: 48.3 ± 17.6 years) were included in the study. Parkinsonism alone and parkinsonism with dystonia was noted in four patients each (36.4%) while dystonia alone was noted in the other 3 (27.3%). Five patients (45.5%) had postural tremors. While 5 patients had dystonia early in the course of illness (3-7 days), it was delayed (6-9 months) in the other 2. A triphasic course was noted in two patients. The first phase of hyponatremia induced neurological impairment was followed by a second phase of worsening due to the immediate effect of ODS and a third delayed phase of worsening due to delayed effect of ODS. MRI showed both EPM and CPM in eight patients, EPM alone in two patients and CPM alone in 1 patient. Nine patients had a good outcome with mRS Conclusion Parkinsonism and dystonia are important manifestations of ODS. Triphasic course with a delayed phase of worsening of movement disorders is probably due to the maladaptive neuronal repair. The concept of triphasic ODS is first being described in our series.
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- 2020
54. Myelin oligodendrocyte glycoprotein-antibody-associated disorder: a new inflammatory CNS demyelinating disorder
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Seena Vengalil, Vikram V. Holla, Bhat Maya, Manjunath Netravathi, Priya Treesa Thomas, Pramod Kumar Pal, Sultana Shaik Reshma, Ravi Yadav, Nitish Kamble, Abel Thomas Oommen, Atchayaram Nalini, and Anita Mahadevan
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Adult ,medicine.medical_specialty ,Pathology ,Neurology ,Optic Neuritis ,Encephalomyelitis ,Myelin oligodendrocyte glycoprotein ,White matter ,03 medical and health sciences ,Myelopathy ,Young Adult ,0302 clinical medicine ,medicine ,Humans ,Optic neuritis ,030212 general & internal medicine ,Child ,Neuroradiology ,Autoantibodies ,biology ,business.industry ,Leukodystrophy ,Neuromyelitis Optica ,medicine.disease ,medicine.anatomical_structure ,biology.protein ,Myelin-Oligodendrocyte Glycoprotein ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Demyelinating Diseases - Abstract
Myelin oligodendrocyte glycoprotein (MOG) is an oligodendrocytopathy resulting in demyelination. We aimed to determine the frequency of MOG-associated disorders (MOGAD), its various clinical phenotypes, and imaging characteristics. All patients with MOGAD were included. Description of the various clinical phenotypes, investigation profile, therapeutic response, differences between pediatric and adult-onset neurological disorders, determination of poor prognostic factors was done. The study population consisted of 93 (M:F = 45:48) (Pediatric:40, Adult-onset:47, Late-onset:7) patients with a median age of 21 years. Among the 263 demyelinating episodes; 45.8% were optic neuritis (ON), 22.8% were myelopathy, 17.1% were brainstem, 7.6% were acute demyelinating encephalomyelitis(ADEM), 4.2% were opticomyelopathy and 2.3% with cerebral manifestations. There was exclusive vomiting in 24.7% prior to onset of clinical syndrome, none of them had area postrema involvement. ADEM was exclusively seen in pediatric patients. Poor prognostic indicators included: (i) incomplete recovery from an acute attack, (b) brainstem syndrome, (c) ADEM with incomplete recovery, (d) MRI suggestive of leukodystrophy pattern, (e) severe ON, (f) ADEMON. The Spectrum of MOG-associated disorders is wider affecting the brain (grey and white matter) and the meninges. There are various clinical phenotypes and MRI patterns, recognition of which may help in the determination of therapeutic strategies, and long-term prognosis.
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- 2020
55. Impact of Prolonged Lockdown due to COVID-19 in Patients with Parkinson's Disease
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Ravi Yadav, Koti Neeraja, Shweta Prasad, Nitish Kamble, Bharath Kumar Surisetti, Vikram V. Holla, and Pramod Kumar Pal
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Adult ,Male ,medicine.medical_specialty ,Parkinson's disease ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,Acute diseases ,Disease ,Motor symptoms ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Pandemic ,Health care ,medicine ,Humans ,In patient ,Intensive care medicine ,Pandemics ,business.industry ,SARS-CoV-2 ,COVID-19 ,Parkinson Disease ,Middle Aged ,medicine.disease ,Hospitals ,Neurology ,Caregivers ,Female ,Neurology (clinical) ,business ,Coronavirus Infections ,Delivery of Health Care ,030217 neurology & neurosurgery - Abstract
Background: The COVID-19 pandemic has compelled countries to impose lockdowns to curb the spread. As a result of the lockdown and need for health care services to cater to acute diseases on priority, patients with chronic illnesses such as Parkinson's disease (PD) may be facing several difficulties. Aims: This study aimed to explore the effects of prolongation of lockdown on patients with PD by evaluating possible problems faced during a lockdown and worsening of symptoms if any. Materials and Methods: One hundred patients with PD and their caregivers were contacted. Results: We observed a significant increase in problems faced due to this pandemic, specifically, the inability to access health care, and difficulty procuring medication. Patients also reported worsening of motor symptoms. Conclusions: The present findings highlight the need for health care systems to consider a plan of action for chronic neurological diseases like PD, which are worsening in the absence of regular hospital visits.
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- 2020
56. The Spectrum of Movement Disorders in Neuroacanthocytosis Syndromes: A Video Series
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Pramod Kumar Pal, Vikram V. Holla, Koti Neeraja, Shweta Prasad, Ravi Yadav, and Nitish Kamble
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medicine.medical_specialty ,Movement disorders ,business.industry ,Chorea ,Oromandibular dystonia ,medicine.disease ,Letters: New Observations ,Physical medicine and rehabilitation ,Neurology ,Neuroacanthocytosis ,Medicine ,Neurology (clinical) ,medicine.symptom ,business - Published
- 2020
57. Comparison of effectiveness of trihexyphenidyl and levodopa on motor symptoms in Parkinson's disease
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Lulup Kumar Sahoo, Pramod Kumar Pal, Dhruv Batra, Amitabh Bhattacharya, Vikram V. Holla, Ravi Yadav, Shweta Prasad, and Nitish Kamble
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0301 basic medicine ,medicine.medical_specialty ,Levodopa ,Parkinson's disease ,Neurology ,Trihexyphenidyl ,Hypokinesia ,Gastroenterology ,Motor symptoms ,Antiparkinson Agents ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Tremor ,medicine ,Humans ,In patient ,Biological Psychiatry ,business.industry ,Infant, Newborn ,Mean age ,Parkinson Disease ,medicine.disease ,Psychiatry and Mental health ,030104 developmental biology ,Treatment Outcome ,Carbidopa ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Despite anti-cholinergics being the oldest type of medication used for the treatment of Parkinson’s disease (PD), the mechanism of action and exact benefit is unclear. This study compared the effectiveness of trihexyphenidyl (THP) and levodopa (LD) on motor symptoms in patients with PD. Patients with PD who are currently taking or had taken THP were recruited. UPDRS-III was done following overnight medication OFF state and 30 min, 60 min, 90 min, and 120 min after THP (4 mg). After a forty-eight-hour interval, UPDRS-III was assessed one hour after Levodopa/carbidopa (200/50 mg) in an overnight OFF state. Twenty patients with a mean age of 57.9 ± 7.8 years and mean duration of illness of 5.1 ± 3.6 years were recruited. UPDRS-III score reduction (%) with THP was maximum in the tremor sub-score (53.8 ± 22.8) and was significantly better compared to improvement in total-UPDRS-III (27.0 ± 14.7), bradykinesia-UPDRS-III (22.2 ± 27.2), rigidity-UPDRS-III (29.5 ± 28.0) and axial-UPDRS-III (8.1 ± 13.3) sub-score. In comparison, respective LD improvement was 67.1 ± 22.9 (tremor-UPDRS-III), 61.3 ± 14.4 (total-UPDRS-III), 67.9 ± 32.1 (bradykinesia-UPDRS-III), 65.3 ± 25.5 (rigidity-UPDRS-III) and 50.7 ± 16.0 (axial-UPDRS-III). Improvement (%) in tre-UPDRS-III post-THP was comparable to that of post-LD (53.8 ± 22.8 vs. 67.1 ± 22.9, p = 0.057). Those with same or better tremor response with THP had significantly milder baseline tremor severity than those who had better response with LD (tre-UPDRS-III-OFF, 10.0 ± 2.8 vs. 5.8 ± 4.0, p = 0.013). Both THP and LD showed significant improvement in UPDRS-III. With THP, the maximum degree of improvement was in the tremor sub-score and not significantly different to that obtained by LD. Those with better tremor response on THP had milder tremor severity.
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- 2020
58. Speech-Induced Task-Specific Cranio-Cervical Tardive Dystonia: An Unusual Phenomenology
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Vikram V. Holla
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medicine.medical_specialty ,Neurology ,business.industry ,Task-Specific Dystonia ,lcsh:RC346-429 ,Task (project management) ,lcsh:RC321-571 ,medicine ,Neurology (clinical) ,Tardive Dystonia ,business ,Phenomenology (particle physics) ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Letter to the Editor ,lcsh:Neurology. Diseases of the nervous system ,Cognitive psychology - Published
- 2020
59. Disabling Myoclonus in a Case of Joubert Syndrome
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Ravi Yadav, Pramod Kumar Pal, S.P. Chaithra, Nitish Kamble, Albert Stezin, and Vikram V. Holla
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medicine.medical_specialty ,Neurology ,business.industry ,Molar tooth sign ,medicine ,Neurology (clinical) ,Case Reports ,medicine.symptom ,business ,medicine.disease ,Dermatology ,Myoclonus ,Joubert syndrome - Published
- 2020
60. SITUS INVERSUS WITH ATRIAL SEPTAL DEFECT AND PULMONARY STENOSIS PRESENTING AS CORTICAL BLINDNESS
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Vikram V Holla, Rajesh Verma, and Rahul Gupta
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medicine.medical_specialty ,medicine.diagnostic_test ,Cortical blindness ,business.industry ,Electroencephalography ,medicine.disease ,Lobe ,Cardiac surgery ,Stenosis ,Situs inversus ,medicine.anatomical_structure ,Internal medicine ,medicine ,Cardiology ,Occipital lobe ,business ,Cerebral angiography - Abstract
Cortical blindness is a rare form of blindness characterized by the normal anterior visual afferent system. Cerebrovascular diseases, tumor involving bilateral occipital lobe, cardiac surgery or cerebral angiography are common causes for cortical blindness. Some cases may be associated with denial of blindness when it is called Anton syndrome. We came across a 9-year-old male child presenting to us for evaluation of blindness which turned out to be cortical blindness after the examination. EEG and VEP were consistent with cortical blindness with MRI showing parieto-occipital lobe signal intensity alterations. Evaluation for the cause of cortical blindness led to the diagnosis of situs inversus in the patient with an atrial septal defect. The patient had an episode of dehydration due to gastroenteritis which resulted in vascular compromise thereby leading to hypoxic damage to the brain and cortical blindness. Presentation of cortical blindness in a patient of situs inversus is unique and hence being reported.
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- 2019
61. Adopted COVID Care Centre Model with Mental Health Promotion at a Non-COVID Hospital: NIMHANS Experience
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V Bhadrinarayan, Vikram V. Holla, B.N. Gangadhar, Muralidharan Kesavan, Banu Manickam Rajalu, Arvinda Hanumanthapura Ramalingaiah, Arun Kandasamy, Kadarapura Nanjundaiah Gopalakrishna, Jessy Jacob, Shashidhara Nagabhushana Harihara, and Gyani Js Birua
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Psychiatry ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,media_common.quotation_subject ,MEDLINE ,RC435-571 ,Mental health ,Clinical Psychology ,Psychiatry and Mental health ,Promotion (rank) ,Family medicine ,Medicine ,business ,Letters to the Editor ,media_common - Published
- 2020
62. ADCY5-Related Dyskinesia in a Child with Sleep Related Paroxysmal Dyskinesia
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Shweta Prasad, Koti Neeraja, Nitish Kamble, Pramod Kumar Pal, and Vikram V. Holla
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Pediatrics ,medicine.medical_specialty ,Dyskinesias ,ADCY5 ,business.industry ,MEDLINE ,Paroxysmal dyskinesia ,Sleep in non-human animals ,Pedigree ,Dyskinesia ,Chorea ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Family ,medicine.symptom ,Child ,Sleep ,business - Published
- 2020
63. Late adulthood onset DYT-THAP1 secondary to a novel splice site mutation-A report from India
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Nitish Kamble, Ravi Yadav, Koti Neeraja, Vikram V. Holla, Pramod Kumar Pal, and Shweta Prasad
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Genetics ,Splice site mutation ,Neurology ,Late-adult onset ,business.industry ,Medicine ,Neurology (clinical) ,Geriatrics and Gerontology ,business - Published
- 2020
64. Asymmetric Limb Dystonia in Progressive Supranuclear Palsy: Conundrum in Nosology
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Pramod Kumar Pal, Nitish Kamble, S.P. Chaithra, Jitender Saini, Ravi Yadav, Albert Stezin, and Vikram V. Holla
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Nosology ,medicine.medical_specialty ,Physical medicine and rehabilitation ,Neurology ,business.industry ,medicine ,Neurology (clinical) ,Limb dystonia ,business ,medicine.disease ,Letters: New Observations ,Progressive supranuclear palsy - Published
- 2019
65. Re-emergent Tongue Tremor in Neuroleptic-induced Parkinsonism
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Shweta Prasad, Vikram V. Holla, and Pramod Kumar Pal
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levosulpiride ,Re-emergent tremor ,Case Reports ,drug-induced parkinsonism ,tongue tremor ,nervous system diseases - Abstract
Background A re-emergent tremor is suggested to be specific to Parkinson’s disease and although a tongue tremor has been reported in levosulpiride-induced parkinsonism (LIP), re-emergence has never been reported. Case Report A 59-year-old female presented with a 3-month history of bradykinesia, 2-week history of right-leg tremor, and 10-day history of lip and tongue tremor. A review of the medication revealed a 15-month history of levosulpiride consumption. On examination, asymmetric bradykinesia, rigidity, rest tremor of the right leg, and re-emergent tongue tremor were observed. The parkinsonism subsided after levosulpiride was stopped. Discussion This is the first report of re-emergent tongue tremor in LIP.
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- 2019
66. A Case of Subacute Progressive Cerebellar Ataxia: Brownell-Oppenheimer Variant of Sporadic Creutzfeldt-Jakob Disease
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Ravindra Kumar Garg, Vikram V Holla, Neeraj Kumar, and Shuchit Pandey
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Pathology ,medicine.medical_specialty ,Neurology ,business.industry ,Progressive cerebellar ataxia ,Medicine ,Neurology (clinical) ,Sporadic Creutzfeldt-Jakob disease ,business - Published
- 2021
67. Chronic Cervical Dystonia Complicating Cervical Myelopathy—A Therapeutic Challenge Managed by Botulinum Toxin and Surgical Intervention
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Vikram V. Holla, Nupur Pruthi, S.P. Chaithra, Akshay V Kulkarni, Pramod Kumar Pal, and Ravi Yadav
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medicine.medical_specialty ,business.industry ,MEDLINE ,Spinal Cord Diseases ,medicine.disease ,Botulinum toxin ,Surgery ,Myelopathy ,Neurology ,Intervention (counseling) ,medicine ,Humans ,Neurology (clinical) ,Cervical dystonia ,Botulinum Toxins, Type A ,business ,Torticollis ,medicine.drug - Published
- 2021
68. Acute Necrotizing Encephalopathy as a Complication of Chikungunya Infection
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Manjunath Netravathi, Abhishek Gohel, Vikram V. Holla, and N Kartik
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Pediatrics ,medicine.medical_specialty ,business.industry ,viruses ,Viral encephalitis ,medicine.disease ,medicine.disease_cause ,Central necrosis ,Virus ,High morbidity ,Neurology ,medicine ,Neurology (clinical) ,Chikungunya ,business ,Complication ,Thalamic lesions ,Acute necrotizing encephalopathy - Abstract
Background Acute necrotizing encephalopathy (ANE) is a rapidly progressive encephalopathy seen commonly in children triggered by various prodromal viral infections, most common being influenza virus and Human herpes virus-6. Objective We report two rare cases of ANE preceded by Chikungunya infection. Cases A 13-year old girl presented with a three-day history of headache, fever, seizures, and altered sensorium. Another 42-year old man presented with two days history of fever and altered sensorium. Both were suspected to have viral encephalitis. Evaluation revealed serum positivity for Chikungunya virus. In both cases, diagnosis was clinched by characteristic bilateral symmetrical thalamic lesions with central necrosis and hemorrhage along with lesions in cerebral white matter, brainstem, and cerebellum. Conclusions ANE is reported to have high morbidity and mortality. To the best of our knowledge, this is the first report of ANE post-Chikungunya infection. Apart from being rare etiologically, the patients had excellent response to steroids.
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- 2021
69. Hirayama Disease with Periscapular Involvement: A Rare Association
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Rakesh Shukla, Suresh Kumar, and Vikram V Holla
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Weakness ,medicine.medical_specialty ,business.industry ,General Neuroscience ,Scapular winging ,Case Report ,Disease ,030204 cardiovascular system & hematology ,Hirayama disease ,Surgery ,Anterior horn cell disorder ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Cervical collar ,medicine.symptom ,business ,030217 neurology & neurosurgery ,MRI ,Rare disease ,Male predominance - Abstract
Hirayama disease (HD) is a rare disease commonly seen in India and Japan typically presenting in adolescent age group with male predominance and asymmetrical distal pure motor, lower-motor neuron-type weakness. We report a patient of HD who had significant involvement of proximal periscapular muscles along with typical distal involvement. The patient also had scapular winging, which is rare in HD. He was treated conservatively with physiotherapy and hard cervical collar and is presently under follow-up during the static phase of disease.
- Published
- 2016
70. Neuroacanthocytosis: Beyond movement disorders
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Bharath Kumar Surisetti, Vikram V. Holla, Ravi Yadav, Nitish Kamble, Koti Neeraja, Pramod Kumar Pal, and Shweta Prasad
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medicine.medical_specialty ,Movement disorders ,Physical medicine and rehabilitation ,Neurology ,business.industry ,Neuroacanthocytosis ,Medicine ,Neurology (clinical) ,Geriatrics and Gerontology ,medicine.symptom ,business ,medicine.disease - Published
- 2020
71. Utility of clinical exome sequencing in dystonia: A report from India
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M. Nethravathi, Ravi Yadav, Vikram V. Holla, Koti Neeraja, Pramod Kumar Pal, Albert Stezin, Nitish Kamble, and Shweta Prasad
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Dystonia ,Neurology ,business.industry ,Medicine ,Neurology (clinical) ,Computational biology ,Geriatrics and Gerontology ,business ,medicine.disease ,Exome sequencing - Published
- 2020
72. A case of late-onset dopa-responsive isolated dystonia secondary to a novel tyrosine hydroxylase gene variant
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S.P. Chaithra, Albert Stezin, Vikram V. Holla, Pramod Kumar Pal, Ravi Yadav, Abhishek Lenka, Nitish Kamble, and Shweta Prasad
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Dystonia ,Dopa-Responsive Dystonia ,medicine.medical_specialty ,Tyrosine hydroxylase ,business.industry ,Tyrosine Hydroxylase Gene ,Case Report ,Late onset ,General Medicine ,medicine.disease ,Novel variant ,lcsh:RC346-429 ,Endocrinology ,Internal medicine ,medicine ,Dopa responsive dystonia ,business ,lcsh:Neurology. Diseases of the nervous system - Published
- 2020
73. Paroxysmal kinesigenic dyskinesia: A frequently misdiagnosed movement disorder
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Abdul Qavi, Shuchit Pandey, Rakesh Shukla, and Vikram V Holla
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medicine.medical_specialty ,Dystonia ,Movement disorders ,Physical medicine and rehabilitation ,Movement Disorders ,Neurology ,business.industry ,medicine ,Humans ,Neurology (clinical) ,Paroxysmal dyskinesia ,medicine.symptom ,business - Published
- 2016
74. Can vitamin B12 deficiency manifest with acute posterolateral or posterior cord syndrome?
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Abdul Qavi, Shuchit Pandey, Imran Rizvi, Rakesh Shukla, and Vikram V Holla
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medicine.medical_specialty ,Cord ,Case Report ,Dermatology ,Cobalamin ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,Vitamin B12 ,business.industry ,medicine.disease ,Spinal cord ,Posterior column ,Posterior cord syndrome ,medicine.anatomical_structure ,Neurology ,chemistry ,Anesthesia ,Gait Ataxia ,business ,030217 neurology & neurosurgery ,Subacute combined degeneration of spinal cord - Abstract
Vitamin B12 deficiency can cause varied neurological manifestations which are subacute to chronic in onset. Subacute combined degeneration of spinal cord is one such characteristic neurological manifestation of vitamin B12 deficiency. We report a case series of five patients who presented with acute onset (
- Published
- 2016
75. Paraneoplastic Cerebellar Degeneration: A Rare but Important Consideration
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Vikram V Holla, Prithvi Giri, Rakesh Shukla, and Vinod Kumar Mehta
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0301 basic medicine ,Pathology ,medicine.medical_specialty ,Ataxia ,business.industry ,Advanced stage ,030105 genetics & heredity ,Bioinformatics ,Malignancy ,medicine.disease ,Paraneoplastic cerebellar degeneration ,Occult ,03 medical and health sciences ,0302 clinical medicine ,nervous system ,medicine ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Paraneoplastic cerebellar degeneration is an uncommon autoimmune disorder characterized clinically by progressive, ultimately incapacitating ataxia and pathologically by destruction of cerebellar Purkinje cells, with variable loss of other cell populations. The paraneoplastic cerebellar degeneration can antedate the recognition of malignancy and hence can be a warning sign for occult tumor. We are reporting two cases of paraneoplastic cerebellar degeneration that presented before any evidence of tumor and later developed advanced stage of malignancy not amenable for surgery.
- Published
- 2016
76. Venous Infarcts Mimicking Large Vessel Arterial Disease: Watershed Lesions in Deep Cerebral Venous Thrombosis
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Vikram V. Holla, Jitender Saini, Ravinder-Jeet Singh, and Nitish Kamble
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medicine.medical_specialty ,medicine.diagnostic_test ,Arterial disease ,business.industry ,Rehabilitation ,Magnetic resonance imaging ,Large vessel ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,Venous thrombosis ,0302 clinical medicine ,medicine ,Surgery ,Neurology (clinical) ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Published
- 2017
77. Reversible opercular syndrome secondary to osmotic demyelination
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Rakesh Shukla, Imran Rizvi, Shuchit Pandey, and Vikram V Holla
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Weakness ,Emotions ,Facial Paralysis ,03 medical and health sciences ,Dysarthria ,0302 clinical medicine ,Tongue ,Osmotic Pressure ,Medicine ,Humans ,030212 general & internal medicine ,Cerebral Cortex ,business.industry ,General Medicine ,Anatomy ,Middle Aged ,medicine.disease ,Facial paralysis ,Masticatory force ,medicine.anatomical_structure ,Cerebral cortex ,Surgery ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Deglutition Disorders ,030217 neurology & neurosurgery ,Demyelinating Diseases - Abstract
Opercular syndrome (OPS) is characterized by weakness of facial, masticatory, pharyngeal, laryngeal, tongue and brachial muscles on voluntary command with preservation of emotional and reflexive movements. We report a case of 45year old female who developed the features of OPS due to lesions of bilateral frontal opercular region induced by osmotic demyelination secondary to hyperosmolar hyperglycaemia. On follow up at 6 months, she had complete recovery.
- Published
- 2015
78. A study of acute muscle dysfunction with particular reference to dengue myopathy
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Neeraj Kumar, Praveen Kumar Sharma, Ravindra Kumar Garg, Nuzhat Husain, Hardeep Singh Malhotra, Rajesh Verma, Amita Jain, Vijay Kumar, Kiran Preet Malhotra, and Vikram V Holla
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myalgia ,medicine.medical_specialty ,Weakness ,dengue myositis ,Acute myopathy ,Polymyositis ,lcsh:RC346-429 ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,muscle histopathology ,medicine ,030212 general & internal medicine ,Myopathy ,lcsh:Neurology. Diseases of the nervous system ,Muscle biopsy ,medicine.diagnostic_test ,business.industry ,Hyporeflexia ,Dermatomyositis ,electrophysiology ,medicine.disease ,Hypokalemia ,Surgery ,Original Article ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Background: Acute myopathy is a common cause of acute motor quadriparesis which has various etiologies with different courses of illness and prognosis depending on the cause. Understanding this diversity helps us in proper approach toward diagnosis, predicting the prognosis, and possible complications and in improving the treatments that are being provided. This study was planned to study the clinical, electrophysiological, and etiological profile of patients presenting with acute myopathy. We also studied how dengue-related acute myopathy differs from other causes and also difference between myopathy due to myositis and hypokalemia in cases of dengue. Materials and Methods: This was a prospective, observational study involving all clinically suspected cases of acute myopathy of not more than 4 weeks duration with raised serum creatine kinase (CK) level. They were subjected to detailed clinical evaluation along with hematological, biochemical, microbiological, and electrophysiological studies and followed-up for outcome at 1 and 3 months. Muscle biopsy and histopathological examination were done in selected patients after taking informed consent. Statistical analysis was performed by appropriate methods using SPSS version 16.0 (Chicago, IL, USA). Results: We evaluated thirty patients of acute myopathy with raised CK level. Seventeen patients had fever, 11 had myalgia, and 5 had skin lesions. All presented with symmetric weakness, 17 (56.7%) patients having predominantly proximal weakness, neck or truncal weakness in 6 (20%), hyporeflexia in 12 (40%), with mean Medical Research Council (MRC) sum score of 46.67 ± 6.0. Eight (mean modified Barthel index [MBI] at presentation - 15 ± 3.7) patients had poor functional status according to MBI and 15 according to modified Rankin scale (MRS) (mean MRS score - 2.5 ± 1.2). Etiology was dengue viral infection in 14 patients; hypokalemia due to various causes other than dengue in 8; pyomyositis in 3; dermatomyositis, polymyositis, thyrotoxicosis, systemic lupus erythematosus, and unknown etiology in one each. Only eight patients had abnormal electrophysiology and seven among nine biopsies done were abnormal. At 1 month, 24 (80.0%) and 23 (76.7%) patients had achieved normal MBI and MRS scores with 28 (93.3) and 27 (90%) patients, respectively, at 3 months. Dengue with hypokalemia had less myalgia, more of hyporeflexia, and lower serum CK compared to those without hypokalemia. Conclusion: Dengue infection and hypokalemia due to various causes are the most common causes of acute myopathy and are associated with rapid and complete recovery within 1 month. Shorter duration of illness, higher MRC sum score, better disability status at presentation, lower serum CK correlate with better outcome. Biopsy was decisive in
- Published
- 2017
79. Neurological manifestations of dengue infection: a review
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Vikram V Holla, Ritesh Sahu, and Rajesh Verma
- Subjects
Pediatrics ,medicine.medical_specialty ,Myelitis ,Dengue virus ,medicine.disease_cause ,Dengue fever ,Dengue ,Medicine ,Animals ,Humans ,Myositis ,Aedes ,biology ,Guillain-Barre syndrome ,business.industry ,Neglected Diseases ,Dengue Virus ,biology.organism_classification ,medicine.disease ,Neurology ,Immunology ,Etiology ,Neurology (clinical) ,Nervous System Diseases ,business ,Encephalitis - Abstract
Dengue is a common arboviral infection in tropical and sub-tropical areas of the world transmitted by Aedes mosquitoes and caused by infection with one of the 4 serotypes of dengue virus. Neurologic manifestations are increasingly recognised but the exact incidence is unknown. Dengue infection has a wide spectrum of neurological complications such as encephalitis, myositis, myelitis, Guillain-Barre syndrome (GBS) and mononeuropathies. Encephalopathy is the most common reported complication. In endemic regions, dengue infection should be considered as one of the aetiologies of encephalitis. Even for other neurological syndromes like myelitis, myositis, GBS etc., dengue infection should be kept in differential diagnosis and should be ruled out especially so in endemic countries during dengue outbreaks and in cases where the aetiology is uncertain. A high degree of suspicion in endemic areas can help in picking up more cases thereby helping in understanding the true extent of neurological complications in dengue fever. Also knowledge regarding the various neurological complications helps in looking for the warning signs and early diagnosis thereby improving patient outcome.
- Published
- 2014
80. Multifocal myoclonus as a heralding manifestation of Wilson disease
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Suchit Pandey, Vikram V Holla, Rajesh Verma, and Imran Rizvi
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,Pathology ,Movement disorders ,Case Report ,Disease ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Associated finding ,Female patient ,medicine ,Cognitive decline ,Wilson disease ,Dystonia ,business.industry ,General Neuroscience ,medicine.disease ,myoclonus ,nervous system diseases ,Pediatrics, Perinatology and Child Health ,epilepsy ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Myoclonus ,030217 neurology & neurosurgery - Abstract
Wilson disease (WD) is one of the few curable movement disorders that manifests with varied presentations so that WD needs to be considered in any patient with a movement disorder under the age of 50 years. Although WD is one of the causes of myoclonus, it is rarely seen in WD and usually as an associated finding. We report a case of an adolescent female patient of WD who presented with cortical multifocal myoclonus of 6-month duration with later development of generalized dystonia, extrapyramidal syndrome, and cognitive decline. Kayser–Fleischer ring was present on slit lamp examination. Serum copper, urine copper, serum ceruloplasmin, and magnetic resonance imaging brain were consistent with the diagnosis of WD. Copper chelation was started along with other symptomatic treatments and diet modifications. Myoclonus had resolved by 3-month follow-up with the improvement of other symptoms. This case report emphasizes that myoclonus can be the main and presenting feature of WD.
- Published
- 2016
81. Patient Knowledge, Attitude and Perceptions towards Botulinum Toxin Treatment for Movement Disorders in India
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Thavasimuthu Nisha Mol, Nitish Kamble, Vikram V. Holla, Rohan Mahale, Pramod Kumar Pal, and Ravi Yadav
- Subjects
knowledge ,attitude ,perception ,botulinum toxin ,movement disorders ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Objective There is limited literature on the knowledge, attitude, and perceptions (KAP) of botulinum toxin (BoNT) treatment among patients and caregivers. The objective of this study was to assess the KAP in patients undergoing BoNT treatment for movement disorders. Methods One hundred patients with movement disorders from National Institute of Mental Health and Neurosciences Hospital in Bengaluru, South India, were recruited. The patients underwent demographic, clinical, and Patient Knowledge Questionnaire on Botulinum Toxin Use in Movement Disorders (PKQ-BMD)-based evaluations. Results The mean age of patients at the time of presentation was 47.97 ± 14.19 years (range, 12–79). Of all the patients, 26 (28%) patients were anxious, and 86% of these patients were reassured after appropriate counseling. There were 83 (89%) patients who found BoNT to be a costlier option. Education and previous Internet searches influenced positive performance in the “knowledge” domain and overall PKQ-BMD scores. The “number of injections” was also positively correlated with KAP performance. Conclusion This study showed that knowledge and perceptions about BoNT treatment need to be further improved. Wider availability of the Internet has provided a positive impact on patients’ and carers’ KAP. Internet-based information, higher educational qualifications of the patients, and a higher number of BoNT injection sessions are the most important predictors of satisfactory KAP related to BoNT injection treatment in patients with movement disorders.
- Published
- 2021
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82. Fast Orthostatic Tremor in Parkinson’s Disease: Case Report and Comprehensive Review of Literature
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Sudhakar Pushpa Chaithra, Shweta Prasad, Vikram V. Holla, and Pramod Kumar Pal
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Orthostatic tremor ,fast orthostatic tremor ,Parkinson’s disease ,asymmetry ,unsteadiness ,Diseases of the musculoskeletal system ,RC925-935 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background: Orthostatic tremor (OT) is a rare symmetric tremor disorder occasionally observed in association with other movement disorders. Case report: We report the presence of a fast OT in a case of Parkinson’s disease (PD), and provide a comprehensive review of the literature. Discussion: A fast OT presenting as unsteadiness may be a presenting symptom of PD. This symptom may be nonresponsive to levodopa, and benzodiazepines should be prescribed to adequately control the OT and reduce disability.
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- 2019
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83. Dysregulated Cerebrospinal Fluid Proteome of Spinocerebellar Ataxia Type 2 and its Clinical Implications.
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Stezin A, Sathe GJ, Gajbhiye A, Bharadwaj S, Ghose V, Bellad A, Malo PK, Holla V, Hegde S, Bharath RD, Saini J, Jain S, Yadav R, Pandey A, and Pal PK
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- Humans, Male, Female, Middle Aged, Adult, Ataxin-2 genetics, Ataxin-2 cerebrospinal fluid, Aged, Spinocerebellar Ataxias cerebrospinal fluid, Spinocerebellar Ataxias genetics, Proteome
- Abstract
Background: Abnormalities in ataxin-2 associated with spinocerebellar ataxia type 2 (SCA2) may lead to widespread disruptions in the proteome. This study was performed to identify dysregulated proteome in SCA2 and to explore its clinical-radiological correlations., Methods: Cerebrospinal fluid (CSF) samples from 21 genetically confirmed SCA2 were subjected to shotgun proteome analysis using mass spectrometry (MS) and tandem mass tag (TMT)-based multiplexing. Proteins with at least 1.5-fold change in abundance were identified. Their relative abundance was measured using parallel reaction monitoring (PRM) and correlated against disease-related factors., Results: Eleven proteins were significantly upregulated in SCA2. They belonged to the family of cell adhesion molecules and granins. Their fold changes showed significant clinical, genetic, and radiological correlations., Conclusions: Significant dysregulation of CSF proteome is seen in SCA2. The dysregulated protein may have potential use in clinical evaluation of patients with SCA2., (© 2024 International Parkinson and Movement Disorder Society.)
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- 2024
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84. Generation of induced pluripotent stem cells (NIMHi015-A) from a Parkinson's Disease patient harbouring a homozygous Exon 3 deletion in the PRKN gene.
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Banerjee R, Ghanty R, Jagtap S, Holla V, Kamble N, Yadav R, Pal PK, and Datta I
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- Humans, Male, Young Adult, Cell Differentiation, Homozygote, Leukocytes, Mononuclear metabolism, Exons, Induced Pluripotent Stem Cells metabolism, Parkinson Disease genetics, Parkinson Disease pathology, Ubiquitin-Protein Ligases genetics, Ubiquitin-Protein Ligases metabolism
- Abstract
The Parkin (PRKN) gene mutation is prevalent in young-onset Parkinson's disease (PD), typically emerging before age 30, accompanied by early motor symptoms. Induced pluripotent stem cells (iPSCs) were derived from peripheral blood mononuclear cells of a PD patient with an exon 3 deletion in PRKN using Sendai-virus reprogramming. PD diagnosis was confirmed via the Unified Parkinson's Disease Rating Scale (UPDRS). Characterization of the iPSC line ensured self-renewal and pluripotency. This resource serves as a valuable platform for drug screening and elucidating the pathophysiology of this mutation, facilitating advancements in PD research., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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85. Revisiting Friedreich's Ataxia: Phenotypic and Imaging Characteristics.
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Mahale R, Purushottam M, Singh R, Yelamanchi R, Kamble N, Holla V, Pal PK, Jain S, and Yadav R
- Abstract
Background and Aim: Friedreich's ataxia (FRDA) is a common cause of autosomal recessive cerebellar ataxia. The phenotype is dependent on the repeat size and duration of the disease. We aimed to study the clinical, electrophysiologic, and radiologic profiles in a large Indian cohort of genetically proven FRDA patients., Subjects and Methods: A retrospective cross-sectional, descriptive analysis of genetically proven FRDA patients was performed. A detailed review of all the hospital case records was done to analyze the clinical, radiologic, and electrophysiologic details., Results: A total of 100 FRDA patients were selected for the analysis. Eighty-six patients had an age at onset between 5 and 25 years. Eight patients (8%) were classified as late-onset FRDA and six patients (6%) as early-onset FRDA. The median age at presentation was 19 years. The median age at onset was 14 years, and the median duration of illness was 4 years. All patients had gait ataxia as the initial symptom. Gait ataxia, loss of proprioception, and areflexia were seen in all patients. Dysarthria, nystagmus, amyotrophy, spasticity, extensor plantars, pes cavus, and scoliosis occurred in one-third of patients. Cardiomyopathy (18%) and diabetes (5%) were less common. Sensory polyneuropathy (87.5%) was the most common nerve conduction abnormality. Cortical somatosensory evoked responses were absent in all 43 tested patients (100%). Brainstem auditory evoked response test was done in 24 patients and it showed absent reactions in six patients (25%). Visual evoked potential was tested in 24 patients and it showed absent P100 responses in five patients (21%). Cerebellar and cord atrophy was seen on magnetic resonance imaging in 50% of patients., Conclusion: Most FRDA patients (86%) had an age at onset of less than 25 years, with typical symptoms of gait ataxia, areflexia, and loss of proprioception found in all patients. Dysarthria, nystagmus, amyotrophy, spasticity, extensor plantars, pes cavus, scoliosis, cardiomyopathy, and diabetes were not seen in all patients. Cerebellar atrophy can occur in FRDA patients. Knowledge regarding the clinical, radiologic, and electrophysiologic profile of FRDA will aid in proper phenotypic characterization., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Annals of Indian Academy of Neurology.)
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- 2024
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86. Impact of Non-Motor Symptoms on Quality of Life in Patients with Early-Onset Parkinson's Disease.
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Patwardhan A, Kamble N, Bhattacharya A, Holla V, Yadav R, and Pal PK
- Abstract
Background: Early-onset Parkinson's disease (EOPD) refers to patients with Parkinson's disease (PD) whose age at disease onset is less than 50 years. Literature on the non-motor symptoms (NMS) in these patients is very limited in the Indian context. We aimed to study the NMS in patients with EOPD and its impact on the quality of life (QoL)., Methods: We included 124 patients with EOPD with a mean age at disease onset between 21 and 45 years and 60 healthy controls (HC). NMS were assessed using validated scales, and the QoL domains were evaluated using the PD QoL-39 scale (PDQ-39)., Results: The mean age at disease onset in EOPD patients was 37.33 ± 6.36 years. Majority of the patients were male (66.12%). The average disease duration was 6.62 ± 5.3 years. EOPD patients exhibited a significantly higher number of NMS per patient (7.97 ± 4.69) compared to HC (1.3 ± 1.39; p < 0.001). The most common NMS reported were urinary dysfunction, body pain, poor sleep quality, constipation, anxiety, depression, cognitive impairment, and REM sleep behavior disorder. The total NMS burden correlated with the QoL measures. Distinctive patterns of QoL subdomain involvement were identified, with sleep/fatigue, mood/cognition, and urinary dysfunction independently influencing QoL metrics., Conclusions: Our study provides valuable insights into the NMS profile and its impact on QoL in patients with EOPD, addressing an important knowledge gap in the Indian context. By understanding the specific NMS and their influence on QoL, healthcare professionals can develop targeted interventions to address these symptoms and improve the overall QoL.
- Published
- 2024
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87. Astrocytes Differentiated from LRRK2-I1371V Parkinson's-Disease-Induced Pluripotent Stem Cells Exhibit Similar Yield but Cell-Intrinsic Dysfunction in Glutamate Uptake and Metabolism, ATP Generation, and Nrf2-Mediated Glutathione Machinery.
- Author
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Banerjee R, Raj A, Potdar C, Kumar Pal P, Yadav R, Kamble N, Holla V, and Datta I
- Subjects
- Humans, Glutamic Acid metabolism, Glutamine metabolism, Astrocytes metabolism, NF-E2-Related Factor 2 metabolism, Glutathione metabolism, Adenosine Triphosphate metabolism, Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 genetics, Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 metabolism, Induced Pluripotent Stem Cells metabolism, Parkinson Disease metabolism
- Abstract
Owing to the presence of multiple enzymatic domains, LRRK2 has been associated with a diverse set of cellular functions and signaling pathways. It also has several pathological mutant-variants, and their incidences show ethnicity biases and drug-response differences with expression in dopaminergic-neurons and astrocytes. Here, we aimed to assess the cell-intrinsic effect of the LRRK2-I1371V mutant variant, prevalent in East Asian populations, on astrocyte yield and biology, involving Nrf2-mediated glutathione machinery, glutamate uptake and metabolism, and ATP generation in astrocytes derived from LRRK2-I1371V PD patient iPSCs and independently confirmed in LRRK2-I1371V-overexpressed U87 cells. Astrocyte yield (GFAP-immunopositive) was comparable between LRRK2-I1371V and healthy control (HC) populations; however, the astrocytic capability to mitigate oxidative stress in terms of glutathione content was significantly reduced in the mutant astrocytes, along with a reduction in the gene expression of the enzymes involved in glutathione machinery and nuclear factor erythroid 2-related factor 2 (Nrf2) expression. Simultaneously, a significant decrease in glutamate uptake was observed in LRRK2-I1371V astrocytes, with lower gene expression of glutamate transporters SLC1A2 and SLC1A3. The reduction in the protein expression of SLC1A2 was also directly confirmed. Enzymes catalyzing the generation of γ glutamyl cysteine (precursor of glutathione) from glutamate and the metabolism of glutamate to enter the Krebs cycle (α-ketoglutaric acid) were impaired, with significantly lower ATP generation in LRRK2-I1371V astrocytes. De novo glutamine synthesis via the conversion of glutamate to glutamine was also affected, indicating glutamate metabolism disorder. Our data demonstrate for the first time that the mutation in the LRRK2-I1371V allele causes significant astrocytic dysfunction with respect to Nrf2-mediated antioxidant machinery, AT -generation, and glutamate metabolism, even with comparable astrocyte yields.
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- 2023
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88. Oculomotor abnormalities and its association with sleep stages in progressive supranuclear palsy.
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Boini SY, Mahale R, Doniparthi Venkata S, Kamble N, Holla V, Pal PK, Kutty B, and Yadav R
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- Cross-Sectional Studies, Eye Movements, Humans, Saccades, Sleep Stages, Supranuclear Palsy, Progressive complications
- Abstract
Background: Oculomotor abnormalities are one of the cardinal clinical features of progressive supranuclear palsy (PSP). Vertical saccadic slowing is an early sign of PSP. The association between oculomotor abnormalities and sleep architecture has not been studied so far., Objectives: To study the association of oculomotor abnormalities of PSP with the sleep stages by using video polysomnography (vPSG)., Methods: This was a cross-sectional single-center study. Twenty-two patients with PSP and 15 age and gender-matched controls were recruited. Saccades, vestibulo-ocular reflex, and optokinetic nystagmus were assessed and graded clinically in all patients and one overnight vPSG was done in all cases., Results: Vertical saccades, upward more than downwards, were affected in all cases. While horizontal saccades were normal only in 41% of cases. Vertical optokinetic nystagmus (OKN) was affected in all cases. Horizontal OKN was normal in 36% of patients. The vertical upward saccades had a negative correlation with N1% and duration (r = -0.418; p = 0.05, r = -0.457; p = 0.03), N3% and duration (r = -0.486; p = 0.02, r = -0.510; p = 0.01), REM% (r = -0.449; p = 0.04), total sleep time (r = -0.487; p = 0.02) and sleep efficiency (r = -0.444; p = 0.04). There was a positive correlation between horizontal OKN and sleep onset latency (r = 0.432; p = 0.05)., Conclusions: Vertical saccadic restriction in PSP has significant negative correlation with total sleep time and sleep efficiency. The oculomotor and sleep abnormalities in PSP are probably interlinked and their assessment is useful in determining the characteristics of the disease., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
- Full Text
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89. Spectrum of Movement Disorder Emergencies in a Tertiary Care Center in India: A Prospective Observational Study.
- Author
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Bhoyar AP, Mahale R, Kamble N, Holla V, Pal PK, and Yadav R
- Abstract
Introduction: Movement disorders can present in emergency services in an acute severe form which can be life threatening if not recognized. The relative frequency and spectrum of movement disorder emergencies have not been studied extensively. We studied the frequency, spectrum, and outcome of patients presenting with movement disorders emergencies., Methods: This was a prospective, descriptive single center study. Patients presenting with acute movement disorders to the neurology emergency services of the institute during the study period from April 2019 to June 2021 were analyzed., Results: A total of 71 patients presented with acute movement disorders during the study period. Out of them, 65 patients had hyperkinetic and 6 patients had hypokinetic movement disorders emergencies. Fifteen patients were below the age of 18 years. Chorea (59.1%) was the most common movement disorder emergencies followed by dystonia and myoclonus in adults. Dystonia (33.3%) was the common movement disorder emergencies in children. Hyperglycemia followed by stroke was the most common etiology of acute movement disorders., Conclusion: This study brings out some novel findings on the movement disorders emergencies in Indian scenario. Chorea was the most common movement disorder emergencies presenting to the neurology emergency services. Early recognition and management of movement disorders emergencies help in reducing morbidity., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Annals of Indian Academy of Neurology.)
- Published
- 2022
- Full Text
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90. Cognition in Patients With Multiple System Atrophy (MSA) and Its Neuroimaging Correlation: A Prospective Case-Control Study.
- Author
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Dash S, Mahale R, Netravathi M, Kamble NL, Holla V, Yadav R, and Pal PK
- Abstract
Objective Cognition has been reported to be involved in patients with multiple system atrophy (MSA), although initially it was considered an exclusion in the diagnosis of MSA. We assessed cognition in these patients and compared it with age and education matched healthy controls and correlated with the gray matter volume using voxel-based morphometry (VBM). Materials and methods This was a prospective, case-control, single-center study. Thirty patients with MSA (20 MSA-C (cerebellar variant) and 10 MSA-P (Parkinsonian variant)) and 25 age- and educational level-matched healthy controls were included. All the patients and controls underwent detailed neuropsychological tests and MRI brain. A battery of neuropsychological tests like Stroop test, digit span forward and backward, digit symbol substitution time test, animal naming test, color trail test and auditory verbal learning test were used to assess the various domain of cognition, which include mainly attention, executive function, memory, new learning, mental and motor speed. The gray matter volume was determined using VBM and correlated with neuropsychological scores. Results Attention, execution, verbal and visual memory, verbal fluency, and new learning were impaired in patients with MSA. MSA-P had more impairment in motor and mental speed, working memory, executive functions, and focused attention compared to MSA-C. Patients with MSA-C had more impairment in new learning, immediate recall, verbal fluency, and sustained attention compared to MSA-P. However, it was not statistically significant. There was a significant correlation between the various cognitive domains and atrophy of frontotemporal cortical areas, insula, caudate, thalamus, and cerebellum. Conclusion Cognition is impaired in patients with MSA-C and MSA-P and is likely due to the neurodegenerative process involving the cortical and subcortical structures. Long-term follow-up studies are required to find out the progression of these cognitive changes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Dash et al.)
- Published
- 2022
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91. Chronic Cervical Dystonia Complicating Cervical Myelopathy-A Therapeutic Challenge Managed by Botulinum Toxin and Surgical Intervention.
- Author
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Chaithra SP, Holla V, Kulkarni A, Pal PK, Yadav R, and Pruthi N
- Subjects
- Humans, Botulinum Toxins, Type A, Spinal Cord Diseases, Torticollis
- Abstract
Competing Interests: None
- Published
- 2021
- Full Text
- View/download PDF
92. Adopted COVID Care Centre Model with Mental Health Promotion at a Non-COVID Hospital: NIMHANS Experience.
- Author
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Rajalu BM, Jacob J, Harihara SN, Kandasamy A, Ramalingaiah AH, Gopalakrishna KN, Holla V, Birua GJ, Bhadrinarayan V, Kesavan M, and Gangadhar BN
- Abstract
Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2020
- Full Text
- View/download PDF
93. Neurological manifestations of dengue infection: a review.
- Author
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Verma R, Sahu R, and Holla V
- Subjects
- Animals, Humans, Neglected Diseases virology, Nervous System Diseases virology, Dengue complications, Dengue Virus pathogenicity, Neglected Diseases complications, Nervous System Diseases etiology
- Abstract
Dengue is a common arboviral infection in tropical and sub-tropical areas of the world transmitted by Aedes mosquitoes and caused by infection with one of the 4 serotypes of dengue virus. Neurologic manifestations are increasingly recognised but the exact incidence is unknown. Dengue infection has a wide spectrum of neurological complications such as encephalitis, myositis, myelitis, Guillain-Barré syndrome (GBS) and mononeuropathies. Encephalopathy is the most common reported complication. In endemic regions, dengue infection should be considered as one of the aetiologies of encephalitis. Even for other neurological syndromes like myelitis, myositis, GBS etc., dengue infection should be kept in differential diagnosis and should be ruled out especially so in endemic countries during dengue outbreaks and in cases where the aetiology is uncertain. A high degree of suspicion in endemic areas can help in picking up more cases thereby helping in understanding the true extent of neurological complications in dengue fever. Also knowledge regarding the various neurological complications helps in looking for the warning signs and early diagnosis thereby improving patient outcome., (Copyright © 2014 Elsevier B.V. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
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