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Biomedical subjects

P Satishchandra

Publications and source records attributed to P Satishchandra.

At least 55 records · Page 3Linked to original sources
PubMed1993

Persistence of Japanese encephalitis virus in the human nervous system.

Immunological and virological evidence for persistence of Japanese encephalitis virus (JEV) in the human nervous system is described in 16/323 (5%) laboratory-confirmed cases of Japanese encephalitis. In 9/16 patients, JEV specific IgM antibodies were detected in the CSF even at 50-180 days after the onset of symptoms. Similarly, in 7/16 patients, apart from IgM antibodies, viral antigen was also present in the CSF beyond the third week of illness and in one patient it could be detected even at 117 days. Infectious virus could be isolated from the CSF beyond the third week of illness in 3/16 patients. In one patient, JEV was isolated from the CSF on three consecutive occasions at 90, 110, and 117 days after onset of clinical symptoms. These findings suggest that JEV persists in the nervous system of a small proportion of patients.

Adult↗
PubMed1993

Visual and auditory evoked potentials in early onset Parkinson's disease and their relationship to cerebrospinal fluid monoamine metabolites.

We studied visual (VEP) and brainstem auditory (BAEP) evoked potential changes in 23 patients with early onset Parkinson's disease (EOPD) to establish the nature of the changes as well as their relationship to dopaminergic (DA) and serotonergic (5-HT) disturbances, as determined by cerebrospinal fluid levels of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA). We also compared these parameters between the young onset (YOPD) and juvenile Parkinsonism (JP), the two subgroups of EOPD, to look for any possible differences between the two. In EOPD, the mean P100 latency of the VEP was significantly prolonged compared to controls (p < 0.001). However, within EOPD the evoked potential parameters were not significantly different between YOPD and the JP subgroups. P100 latency was abnormal in six patients (YOPD: 5, JP: 1) (26%). Six patients (YOPD: 3, JP:3) (26%) had abnormal BAEP. A significant negative correlation (r: -0.89, p < 1%) was observed between the P100 latency and CSF HVA levels. No correlation was observed between the BAEP interpeak latencies and either CSF HVA or 5-HIAA levels. This study suggests that VEP and BAEP abnormalities do occur in EOPD (in both YOPD and JP), and that the prolongation of P100 latency is secondary to DA deficiency as in PD. The cause of BAEP abnormalities is probably independent of DA and 5-HT disturbances. The only difference between EOPD and classical PD was the higher incidence of BAEP abnormalities in EOPD. There was no correlation between the VEP or BAEP changes to either the age at onset or duration of EOPD.

Acoustic Stimulation↗
PubMed1993

Prognosis of single unprovoked seizure.

201 patients (131 males and 70 females) with mean age of 18 years (range 5-55 years) who presented at median of 6 days after the onset of first unprovoked seizure were studied. They were followed for a mean period of 60 months (range 12-84 months). One hundred and fifty four (76%) patients were treated with anticonvulsant medication (group A) on a non-randomized basis and the remaining 47 patients (24%) were not treated (group B). Both the groups were comparable for age, sex, type of seizure and interval between onset of seizure and consultation. The cumulative risk of recurrence for entire study group was 24% at 1 month, 32% at 6 months, 34% at 12 months, 35% at 24 months and 36% at 36 months. The cumulative risk of recurrence in group A was 23%, 30%, 32%, 33% and 33% as compared to 28%, 36%, 40%, 43% and 45% at 1, 6, 12, 24 and 36 months respectively (p > 0.05). Maximum number of recurrences (67%) occurred within 1 month. No recurrence occurred after 36 months after the onset of first seizure. Age at onset, sex, seizure type, family history of seizure, EEG abnormalities and nature of antiepileptic drugs did not influence the risk of recurrence.

Adolescent↗
PubMed1993

Herpes simplex encephalitis: a diagnostic and therapeutic reapprisal.

Herpes Simplex Encephalitis (HSE) appears to be underdiagnosed in India, though viral encephalitides constitutes an important entity with significant morbidity. With an upsurge in AIDS, HSE may perhaps emerge as an important opportunistic infection in future. We discuss the clinical features and laboratory evaluation of nine cases of HSE seen in the last 12 years at our center. Diagnosis was established by brain biopsy in one, virological studies in six and at autopsy in three. Immunocytochemically viral antigens could be localized in 4 biopsied/autopsied brain tissue and in CSF cells on a cytospin preparation in one. This has facilitated rapid diagnosis in our cases. Virus isolation was successful in two. Three subjects were treated with acyclovir and all survived with variable morbidity. Four patients expired and none of them had received any specific antiviral drugs. Rapid diagnosis and early treatment with acyclovir has been highlighted.

Acyclovir↗
PubMed1992

Correlates of hot water epilepsy in rural south India: a descriptive study.

Seizures precipitated by the stimulus of hot water known as 'hot water epilepsy' (HWE) have been commonly reported from South India. The present report outlines certain descriptive epidemiological aspects of 78 cases from two rural satellite clinics of National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India. Geographical clustering was observed in one of the centres. HWE was common in the age group of 26-35 years with a male to female ratio of 3.6:1. The frequency of seizure occurrence was more than 1-4 attacks/month in 89% of cases. Past history of febrile convulsions and family history of HWE was noticed in 27 and 18% of our cases, respectively. The conversion of reflex to nonreflex epilepsy occurred in 30.8% of cases. Population-based epidemiological studies are essential for further understanding of HWE for developing strategies towards prevention and control.

Adolescent↗
PubMed1992

Progressive dystonia with marked diurnal fluctuation.

Two cases of dopa-responsive dystonia with marked diurnal fluctuations are reported. Of these, one was a 26 year old female who had progressive dystonia of more than 20 years' duration with classical diurnal fluctuations exacerbated by exercise and relieved with sleep; she also had significant worsening during menstruation and the later half of her pregnancy, resulting in a stillbirth. She responded remarkably to low doses of L-dopa.

Adult↗
PubMed1991

Hyaluronidase as an adjuvant in the management of tuberculous spinal arachnoiditis.

Spinal arachnoiditis, a complication of tuberculous meningitis, is not uncommon; it may develop despite specific chemotherapy and steroids, and existing avenues of treatment for it are unsatisfactory. The enzyme hyaluronidase, by virtue of its action of hydrolysing the glucosaminidic bonds of hyaluronic acid and other mucopolysaccharides of the ground substance, offers a promising mode of treatment. Sixty-six patients with spinal arachnoiditis secondary to tuberculous meningitis were seen over an 8-year period. All these patients received antituberculous drugs and steroids; 39 of them (group A), who, in addition, were given intrathecal hyaluronidase, fared better than the remaining 27 (group B), who did not receive this enzyme. This study was non-randomised. The disability and functional deficit score showed a significant decrease from 7.6 to 3.7 in the enzyme-treated group in contrast to a mild change from 8.1 to 6.9 in the untreated group. Further, in group A the mortality was 5.2% whereas in group B it was 25.9%. There was a marked 5-fold decrease in mean CSF protein in group A while in group B there was no significant change. There were no serious side effects due to repeated administration of intrathecal hyaluronidase. Thus this study provides convincing evidence of the therapeutic role of hyaluronidase in the management of tuberculous spinal arachnoiditis and replicates our earlier observation of the safety of hyaluronidase given intrathecally.

Adolescent↗
PubMed1991

Creutzfeldt-Jakob disease in India (1971-1990).

Thirty cases including 20 definite and 10 probable cases of Creutzfeldt-Jakob disease (CJD) seen in India between 1971 and 1990 are reported. Demographic analysis has shown similarities to the previously published reports from other parts of the world. Though 21 (70%) of cases were from two centers--Bombay and Bangalore-, suggesting clustering, this seems to be more apparent than real. One subject worked in the medical field, where possibility of iatrogenic transmission could not be ruled out. None of the cases had positive family history of CJD. There is no epidemiological data of CJD from India so far and hence this report is one such pilot study.

Adult↗
PubMed1989

Visual and brain stem auditory evoked responses in Wilson's disease.

Sensory evoked potentials were studied in 15 patients with Wilson's disease. Thirteen patients were investigated with pattern reversal visual stimulation. A prolonged P 100 latency of the VEP was present in 7 patients. Brain stem auditory responses were evoked in 12 patients. Prolongation of III-V and I-V interpeak latency was found in 8 patients. The evoked potential studies demonstrated subclinical disturbances in optic and caudal brainstem auditory pathways. Further studies are in progress to evaluate the role of these techniques in monitoring the therapy of newly diagnosed cases.

Adolescent↗
PubMed1988

Evaluation of brainstem auditory evoked responses in congenital hydrocephalus.

Brainstem auditory evoked responses (BAER) were studied in 20 children with clinically diagnosed and CT-confirmed congenital hydrocephalus before and after shunt surgery. Ninety-five percent of the children showed abnormal responses preoperatively. Prolonged wave V latency was the most common abnormality, followed by increased interwave latencies. Total absence of evoked responses was more common in children with communicating hydrocephalus. Following shunt surgery 50% of cases returned to normal and 20% showed a significant improvement. Abnormalities persisted in 10% of cases. BAER abnormalities referrable to caudal brainstem dysfunction recovered first, following CSF diversion. Study of BAER is useful for identifying physiological brainstem abnormalities in hydrocephalic children and promises to be a sensitive non-invasive diagnostic tool for the detection of "non-infective complications" of shunt surgery, if performed serially during follow up.

Brain Stem↗
PubMed1988

Case-control study of associated conditions at the time of death in patients with epilepsy.

Analysis of mortality data based on underlying cause of death in epileptic patients is of limited value in view of the low case-fatality ratio of epilepsy. Recently the National Center for Health Statistics has made available all conditions mentioned on each death certificate for the entire US population. Using a case-control study design, we have analyzed all the associated conditions at the time of death in patients with epilepsy for the year 1978. Association between epilepsy and the following conditions reached statistical significance: mental retardation, cerebral palsy, cerebrovascular disease, myocardial ischemia, dementia, foreign body in pharynx and larynx, pneumonia, alcoholism and cirrhosis of liver. Early recognition and proper management of some of these factors could significantly reduce the mortality and morbidity in epileptic patients.

Death Certificates↗
PubMedDate not supplied

Absence of GABRA1 Ala322Asp mutation in juvenile myoclonic epilepsy families from India.

An Ala322Asp mutation in the GABRA1 gene was recently reported to be responsible for causing the autosomal dominant (AD) form of juvenile myoclonic epilepsy (JME) in a French-Canadian family. To study if JME families from India exhibiting the AD mode of inheritance carry the Ala322Asp mutation, we examined 35 unrelated JME-affected individuals from such families for the Ala322Asp mutation in GABRA1. Ala322Asp mutation was not observed in any of these JME-affected individuals, suggesting that this mutation is unlikely to be a predominant mutation involved in causation of epilepsy. To evaluate the possibility of other mutation(s) in and around GABRA1 that may predispose to JME, we compared the allele frequencies at two marker loci, D5S2118 and D5S422, flanking GABRA1, in probands and 100 matched population controls. One of the allele frequencies at D5S422 shows a significant difference between the cases and controls (chi-square = 11.44, d.f. = 1, P = 0.0007), suggesting genetic association between JME and genes located in the proximity of the DNA marker.

Adolescent↗
PubMedDate not supplied

Hot-water epilepsy: a variant of reflex epilepsy in southern India.

"Hot water epilepsy" (HWE), precipitated by a bath or shower in hot water, has been described infrequently in the literature. We report 279 cases of HWE that were seen between 1980 to 1983 in Bangalore, South India. We found HWE to be more common in children, with cases more frequent among male than female patients (2.6:1). Complex partial seizures constituted the main clinical presentation (67.0%); HWE accounted for 4.4% of all complex partial seizures and generalize tonic-clonic seizures seen at our center during the 1980-1983 period. Although prognosis seems favorable 25.4% of our patients developed nonreflex epilepsy within 1-3 years. They were managed with antiepileptic drugs and the use of lukewarm water for bathing.

Adolescent↗
PubMedDate not supplied

Lafora's disease in south India: a clinical, electrophysiologic, and pathologic study.

Twenty-one cases (12 males, 9 females) of Lafora's disease in 16 families were studied at the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India, from 1982 to 1990. Mean age of onset was 13.5 years (range 9.5-18 years). First symptom was generalized tonic-clonic seizure (17), myoclonus (3), or dementia (1). All patients eventually developed the classical triad, except 1 who has had only myoclonus. Seven had occipital seizures. Other signs included behavioral changes (9), brisk tendon reflexes (11), cerebellar signs (8), and visual impairment (4). Patients from 14 of the 16 families (85%) were products of consanguineous marriage. More than 1 sibling was affected in 6 families. Scalp EEGs showed diffuse background slowing with epileptiform discharges in all and progressive slowing as the disease progressed in 3. Photosensitivity occurred in 4 of the 17 cases studied (23.5%). EEG abnormalities were documented in the presymptomatic stage in 2 cases 6 months and 6 years before clinical symptom onset. Visual evoked responses were abnormal in 4 of the 6 cases studied. Giant somatosensory evoked potentials (SSEP) were observed in all 8 cases studied. Lafora bodies were demonstrated in axillary skin in 14 of 17 (82.4%), in liver in 4 of 10 (40%), and in both brain biopsy specimens. In 2 cases, liver biopsy was positive while axillary skin biopsy was negative. In the brain, inclusions were evident in glial and capillary endothelial cells in addition to neurons. Although our cases were similar to those described earlier, the relative rarity of visual phenomena is emphasized. The clinical pattern was consistent with autosomal recessive inheritance. The high frequency of consanguinity in the South Indian population may be responsible for the many cases observed at our center.

Adolescent↗