Background. Migraine headache may have a substantial bearing on the brain functions and rhythms. Electrophysiological methods can detect changes in brain oscillation. The present work examined the ...frequency band power through quantitative electroencephalogram (qEEG) and density spectral array (DSA) to elucidate the resting state neuronal oscillations in migraine. Methods. Clinical details were inquired, and EEG was recorded in migraineurs and healthy controls. The acquired data were analyzed to determine power spectral density values and obtain DSA graphs. The absolute and relative powers for the alpha, theta, and delta frequencies in frontocentral, parieto-occipital, and temporal regions were determined. A correlation of significant EEG findings with clinical features of migraine was sought. Results. Forty-five participants were enrolled in the study. The spectrum analysis revealed an increase in the relative theta power (P < .001) and a reduction in relative alpha power (P < .001) in the observed cortical areas among the migraineurs as compared to the healthy controls. Relative delta power was increased over the frontocentral region (P = .001), slightly more on the symptomatic side of the head. In addition, frontocentral delta power had a moderate positive correlation (r = .697, n = 22, P = .000) with migraine severity. Conclusion. The study supports the evidence of a neuronal dysfunction existing in the resting state during the ictal phase of migraine. qEEG can reveal these aberrant oscillations. Utility of DSA to depict the changes in brain activity in migraine is a potential area for research. The information can help formulate new therapeutic strategies towards alteration in cortical excitability using brain stimulation techniques.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Narcolepsy, one of the important causes of hypersomnia, is an under diagnosed sleep disorder. It has a bimodal age of onset around 15 and 35 years. It is characterized by the tetrad of excessive ...daytime sleepiness, cataplexy, hypnagogic/ hypnopompic hallucinations, and sleep paralysis. Cataplexy is by far the most predictive feature of narcolepsy. Status cataplecticus is the occurrence of cataplexy repeatedly for hours or days, a rare presentation of narcolepsy. This report describes an elderly gentleman with late onset narcolepsy in the sixth decade of life presenting with initial and chief symptom of status cataplecticus.
Understanding the correlation between pathological changes and the type of brain injury is pivotal in mitigating the damage and planning reliable and improved treatment strategies. Swift ...identification of the underlying mechanisms behind brain injury is essential for early diagnosis, surgical planning, and post-operative therapies. Brain injury may stem from various sources, including trauma (resulting in traumatic brain injury), treatment (leading to surgical brain injury), and neurodegenerative mechanisms. These injuries can manifest spatially, affecting individual neurons to the entire organ and temporally, ranging from immediate to long-term degeneration. However, direct evidence linking injury mechanisms to short and long-term tissue damage in the human population is limited, posing challenges in establishing a clear clinicopathological connection. Recently, in silico modeling has emerged as a cost-effective approach that can assist clinicians in gaining deeper insights and uncover new injury pathways. Physics and machine learning-based in silico modeling offers valuable contributions to injury prevention, diagnosis, prognosis, treatment planning, and patient monitoring, especially given the complexities of acquiring patient-specific clinical data related to brain injuries. Considering the spatiotemporal complexity of brain tissue damage, developing a comprehensive, multiscale, and multiphysics model is imperative for a better understanding. This study aims to categorize and explore strategies for modeling brain injuries across three distinct time scales, review damage mechanisms at various length scales, and recommend the development of a comprehensive biomechanical model that integrates multimodal data and multiphysics. Such an integrated approach will provide personalized diagnosis and treatment strategies tailored to individual patients.
Statement of Significance: The connection between clinical observations and brain pathology is crucial for managing brain injuries. Brain injuries result in brain damage via diverse factors across scales, from neurons to organs, from initial trauma to neurodegeneration. However, limited direct evidence linking injury mechanisms to long-term human tissue damage hinders clinicopathological connections. In silico modeling, a cost-effective approach utilizing physics and machine learning-based principles, can aid clinicians in uncovering injury pathways. A comprehensive, multimodal, and multiphysics model is vital for understanding complex brain tissue damage. This study categorizes modeling strategies, reviews damage mechanisms across scales, and recommends comprehensive biomechanical models for personalized treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Acute dystonic reactions are characterized by involuntary contraction of the muscles of the extremities, face, neck, abdomen, pelvis or larynx, in either sustained or intermittent patterns, that lead ...to abnormal movements or postures 1. These reactions are common with drugs that block dopamine D2 receptors, causing dopaminergic-cholinergic imbalance in the basal ganglia. These include typical antipsychotics; some atypical antipsychotics, such as risperidone and olanzapine; antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs); and some antiepileptic drugs, such as carbamazepine and phenytoin. Bupropion belongs to a group of aminoketones used widely for major depressive disorders, smoking cessation and sexual dysfunction secondary to SSRIs. KCI Citation Count: 1
Optical coherence tomography (OCT) is a non-invasive tool to measure thickness of various layers of retina. Recently, retinal nerve fibre layer (RNFL) and ganglion cell and inner plexiform layer ...(GCIP) thinning has been observed in OCT in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), This study compared OCT profile, along with visual acuity (VA), color vision (CV), contrast saturation (CS) and visual evoked potentials (VEP) in two main cohorts of MS and NMOSD and with controls, during acute episode of optic neuritis (ON), at 3 and 6 months.
We found that changes of ON were present in 75% of MS eyes and in 45% of NMOSD patients. Of these, subclinical involvement was present in 56.25% of MS eyes and only in 5% of NMOSD eyes suggesting frequent subclinical involvement in the former. Mean RNFL was 95.23 ± 15.53 in MS and 66.14 ± 43.73 in NMOSD after 6 months of ON episode. Thinning of NQ and IQ was observed in NMOSD eyes in the immediate period after ON attack. At 6 months relative sparing of RNFL in TQ was observed in NMOSD ON eyes and MS ON showed predilection for involvement of TQ.
•Sequential OCT examination highlights severity and topographical characteristics of changes in NMOSD which differ from MS.•Thinning of NQ and IQ is observed in NMOSD eyes in the immediate period after ON attack.•After 6 months, a relative sparing of RNFL in TQ is observed in NMOSD while MS shows predilection for involvement of TQ.•GCL thinning is more in NMOSD as compared to MS.•Therefore, differential involvement of various quadrants in OCT may aid diagnosis of the central immune mediated demyelinating diseases.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Herniation of brain parenchyma outside its normal enclosure (also known as encephalocele) has long been known to occur at certain classic sites and is classified accordingly. With widespread ...use of modern neuroimaging, the previously unknown atypical and rare sites of encephalocele have now been identified. Brain herniation into a dural venous sinus is one such recently described entity with case reports extending only upto the earlier part of this decade. With no definite clinical symptomatology, imaging is crucial to diagnose this lesion accurately and differentiate it from the more familiar entity in this region of the brain, the arachnoid granulations. Also known as occult encephalocele, focal brain herniation into dural venous sinus has few specific imaging features and characteristic sites. We report a case of a 21-year-old man with partial seizures in whom MRI of the brain revealed focal herniation of the normal temporal lobe parenchyma into the left transverse sinus and discuss the key imaging features and pathophysiology of this entity.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Subacute sclerosing panencephalitis (SSPE), an insidiously progressive slow viral infection of the central nervous system caused by the mutated measles virus, is invariably fatal. Various medications ...have been tried unsuccessfully till date with rare remissions. A case of 21-year woman with adult-onset SSPE who improved after treatment is reported. She had seizures, psychosis, and extrapyramidal symptoms and was on multiple anti-seizure medications without response. She was given a trial of levamisole with gradual escalation and achieved complete clinical remission by 21 months. This case demonstrates the curative potential of levamisole in adult-onset SSPE. A review of previous treatments attempted in cases who underwent remission of SSPE is also presented.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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