Praziquantel in neurocysticercosis.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to B S Singhal.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The clinical features in a 42 year old man with malignant atrophic papulosis with CNS involvement are described. They included mental dysfunction, paraesthesiae, weakness of left limbs, with pyramidal tract signs, bilateral ptosis, progressing to total ophthalmoplegia and obtundation. There were two crops of characteristic papular lesions on trunk and limbs, with terminal evidence of a coagulopathy and bruises, resulting in death in six months. Papular biopsy revealed multiple microinfarcts in the dermal collagen. The brain showed multiple small haemorrhagic infarcts of both hemispheres, the lower mid-brain, pons and a cerebellar peduncle. Microscopy showed fibrin exudation in the leptomeninges, various stages of thrombosis of small arteries without inflammatory reaction, and corresponding acute and subacute microinfarcts. The pathogenetic basis of the disease appeared to be a combined vasculopathy and coagulopathy.
Explore the source record for details and available documents.
Cases of multiple sclerosis were collected by Asian neurologists from recognized medical centers, using standardized formats similar to those used for the Japan nationwide multiple sclerosis survey. As a result, information on a total of 61 cases was collected from six neurologic centers in five Asian countries excluding Japan. Multiple sclerosis appears to be a rare disease throughout Asia. Certain clinical characteristics that had been previously noted in Japanese and other individual Asian series were again observed in the present Asian series. When compared with Western multiple sclerosis, the Asian multiple sclerosis cases showed a relatively higher frequency of optic nerve involvement, frequently bilateral and severe, at the onset, as well as during the course of illness, and no rare occurrence of Devic's syndrome.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Nine patients with characteristic changes of Eales' disease in the eye in whom there was neurological involvement, have been described. The characteristic neurological picture comprised an acute or subacute myelopathy occurring at an interval of a few weeks to a few years after the eye episode; in only 1 patient was there cerebral involvement without any evidence of myelopathy. Besides the involvement of spinal cord at the dorsal level in the 8 patients, there was evidence of additional lesions in the brain stem in 1 patient and in the cervical cord in another.
Detailed neuropathologic examination was carried out on 1 case of Eales' disease with CNS involvement, in the form of retinal vasculopathy, followed first by signs of brain stem and cerebellar disease and then by a myelopathy, with death 4 years later from retinal infection. There was mild chronic inflammation in the retina, and sub-total demyelination of one optic nerve. The brain stem and cerebellum showed extensive vasculopathy, with various stages of venous change extending from proliferation and dilatation to haemorrhage, or to thickening with hyalinisation. The perivenular brain tissue, particularly of the cerebellum, often showed demyelination, with relative axon preservation, but no inflammation. Similar, but less pronounced venopathy was seen in the dorsal cord. There was ascending degeneration of Goll's columns and descending degeneration of the lateral columns.
Explore the source record for details and available documents.
Using internationally accepted strict clinical criteria, 30 patients with probable multiple sclerosis (MS) fron the Bombay region have been described. They were personally studied and followed up over a period of 15 years. In addition, 9 patients with neuromyelitis optica and 6 with a mixed neurological picture of MS and neuromyelitis optica have been described. As in Japan, the neuromyelitis optica type of presentation was relatively more frequent in our material than in the West. In this small series MS was more frequent in patients with a better socio-economic status, in the Parsee community and in patients with a fair complexion, whereas neuromyelitis optica was more frequent in patients with poor socio-economic status. A relatively high proportion of patients (nearly half of the MS patients with optic nerve involvement and two-thirds of the MS--neuromyelitis optica group) had bilateral optic nerve involvement. Except in 2 patients, the tempo and course of the disease in our patients with MS was comparable to that seen in the West. In 3 patients with MS the initiation of symptoms or appearance of fresh symptoms was related to vaccination. In addition to the above 45 patients, 29 other cases of possible demyelination have been reviewed. Nine of these had one or more remission and relapse but in the same site as the first episode. Seventeen had a solitary episode of spinal cord or brainstem disturbance with some remission and 3 had multiple lesions but without remission or clear dissemination in time. In the absence of a specific diagnostic test or autopsy, such atypical cases will remain unclassified. To conclude, MS does occur in the Bombya region and elsewhere in India but the incidence is much less than in the West. Further studies and especially careful follow-up of atypical cases may show that the prevalence is higher than it seems today.
Five patients presenting clinically with a form B12-deficiency neuromyelopathy, with cord involvement in all and proximal muscle weakness in two of them, were investigated for their neurologic, hematologic and vitamin status. Megaloblastosis and achlorhydria were present in all, and impaired absorption of 57Co vitamin B12 and of D-xylose was detected in four. Total cyanide extracted vitamin B12 (A) was lowered in all cases and noncyanide extractable (B) in four of the five, being zero in three. All five responded to injections of hydroxocobalamin. In two patients sequential estimations showed that both A and B, especially the latter, rose steeply initially, normalizing at 50% of A after some weeks. Moiety B is suggested to be physiologically the more active and dissociable form of vitamin B12. Markedly elevated initial serum folate levels, and their subsequent fall under treatment with B12, indicated the operation of the "methyltetrahydrofolate trap". Blood levels of thiamin, nicotinic acid and pantothenic acid were within normal limits. However, serum riboflavin (B2) total vitamin B6 and pyridoxal were reduced in all where tested. Vitamin B6 deficiency could have resulted from its own malabsorption and have contributed to be B12 deficiency. Vitamin B2 and B6 levels also corrected themselves on B12 therapy. The B-vitamin deficiencies in our patients probably resulted from intestinal malabsorption, with a possible factor of malnutrition consequent to their strictly vegetarian diet.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.