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Biomedical subjects

S Mohandas

Publications and source records attributed to S Mohandas.

At least 19 recordsLinked to original sources

Clinical and electroencephalographic study of first-degree relatives and probands with juvenile myoclonic epilepsy.

PURPOSE: Juvenile myoclonic epilepsy (JME) is a common, well-defined epileptic syndrome. This study aims to examine the clinical and EEG features of probands with JME and to identify the incidence of different types of idiopathic generalized epilepsies (IGEs) and IGE trait in first-degree relatives. METHODS: Clinical and EEG data were collected from 132 first-degree relatives and 31 probands with JME. The data were analyzed using descriptive statistics, chi-square test, t-test and ANOVA. RESULTS: All probands had a history of generalized tonic clonic seizures (GTCS) and myoclonic jerks; 25.8% had a history of absence seizures. Family history of epilepsy was noted in 42% and epilepsy in first-degree relatives was reported in 38.7%. We found JME in 44% of the symptomatic first-degree relatives. The incidence of epilepsy was higher in siblings (19%) than in offspring (8%) or parents (4%), the difference between the groups being significant (p < 0.05). IGE trait was noted in 6% of the asymptomatic first-degree relatives. Finally, IGE features were found in 61%. Subjects with IGE features were younger (mean age 19.6 years) than those without IGE features (mean age 32.4 years) and the difference between the groups was significant. CONCLUSION: The incidence of different kinds of IGEs and typical EEG trait is high in first-degree relatives of JME probands. IGE features were noted in 61% of the families. JME is the most common type of IGE and IGE features were found to be more frequent among siblings than parents. These findings confirm familial susceptibility to IGE.

Adolescent↗

Pathology of fungal infections of the central nervous system: 17 years' experience from Southern India.

AIMS: To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India. METHODS AND RESULTS: This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n=73), zygomycosis (n=40), cryptococcosis (n=2), rhodotorulosis (n=1), candidiasis (n=5), maduramycosis (n=1), pheohyphomycosis (n=3) and mixed infections (n=5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%. CONCLUSION: Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.

Adolescent↗

Cerebral zygomycosis.

Fifty-six patients with cerebral zygomycosis (mucormycosis) were seen during the period 1971-2001 in two tertiary care hospitals located in south India with tropical climate and catering to neurological diseases. Forty-four patients had rhinocerebral and twelve patients had isolated central nervous system (CNS) zygomycosis. Of these, ten were culture proven (Rhizopus oryzae in eight and Mucor in two); 30 were diagnosed as probable and 16 were diagnosed possible; mixed infections were seen in three patients. Diabetes mellitus was the predisposing condition in a majority (31/44) of patients with the rhinocerebral form of zygomycosis. The tissue obtained at biopsy/autopsy in either form showed necrotic/infarcted tissue with neutrophilic infiltration with broad non-septate hyphae showing irregular branching. The outcome was poor despite surgical excision and antifungal therapy. The high concentration of spores in a mouldy environment, the bird population and improper disposal of hospital waste may facilitate healthy hosts presenting with primary CNS disease.

Adolescent↗

Genetic association analysis of KCNQ3 and juvenile myoclonic epilepsy in a South Indian population.

Juvenile myoclonic epilepsy (JME) is a common subtype of idiopathic generalized epilepsy that shows a complex pattern of inheritance. We have tested the association between JME phenotype and an intragenic marker in KCNQ3 by using the transmission disequilibrium test in 119 probands and their parents. Mutations in KCNQ3 are known to cause benign familial neonatal convulsions and are involved in the physiologically important M current in neurons. Our results provide suggestive evidence of allelic association between JME and KCNQ3 ( P-value=0.008) and raise an interesting possibility of a genetic contribution to JME, viz., of a gene that causes a monogenic form of human epilepsy.

Brain↗

Subacute encephalopathy with seizures in alcoholism.

Generalised seizures are a common manifestation of acute alcohol intoxication. Alcohol is known to precipitate generalised seizures in patients with focal brain pathology. A rare case of secondarily generalised seizures precipitated by alcohol in a patient without an underlying focal brain lesion is reported. Electroencephalopgraphy (EEG) showed periodic lateralised epileptiform discharges (PLEDs) on the side contralateral to the focal motor fits.

Alcoholism↗

Magnetic resonance imaging in rabies.

Rabies encephalitis has a classical clinical presentation and its diagnosis is unmistakable. In about a fifth of cases rabies occurs as its paralytic form, which lacks the classic symptoms and may mimic other diseases, especially acute disseminated encephalomyelitis (ADEM). Magnetic resonance imaging of the brain in rabies shows a distinct abnormal pattern that differentiates it from ADEM. Hence it may be a useful tool in diagnosis of paralytic rabies. Failure to administer post-exposure rabies immunoglobulin along with the rabies vaccine may result in vaccine failure.

Animals↗

Recurrent Miller fisher syndrome: a case report.

Miller fisher syndrome (MFS) is a variant of Guillain-Barre syndrome characterized by the triad of ophthalmoplegia, ataxia and areflexia. Recurrences are exceptional with MFS. A case with two episodes of MFS within four years is reported. He presented with findings of ophthalmoplegia, ataxia, areflexia, and oropharyngeal weakness and mild distal sensory impairment during both episodes. Electrophysiological findings showed reduced compound muscle action potentials and sensory nerve action potentials with no evidence of conduction blocks. Nerve biopsy showed segmental demyelination. MRI of brain was normal. He responded well to immunoglobulins during both episodes suggesting that immunomodulating drugs have a role in the treatment of MFS.

Adult↗

Quantitative ELISA for platelet m-calpain: a phenotypic index for detection of carriers of Duchenne muscular dystrophy.

In order to measure the amount of m-calpain in platelets from Duchenne muscular dystrophy (DMD) patients, carriers and controls, an enzyme linked immunosorbent assay (ELISA) has been developed using polyclonal antibodies raised against m-calpain (Calcium dependent neutral protease), purified from human placenta. Compared to controls a nine-fold increase in the level of m-calpain was observed in all 25 DMD patients and eight obligate carrier mothers studied. Serum creatine kinase (SCK) values of four of these obligate carriers were found to be overlapping with that of normal values, limiting its usefulness. Since calpain levels were found to be raised in all DMD patients and obligate carriers, the estimation of calpain in all female relatives of the ones affected with DMD (with or without raised serum CK) would prove a facile index. Population screening for carrier females using this cost and labour effective index may help in assessing the carrier status and counselling the at risk families.

Adolescent↗

Hemiballismus due to an ipsilateral striatal haemorrhage: an unusual localization.

Hemiballismus has been correlated clinico-anatomically with lesions of the contralateral side, most commonly of the subthalamic nucleus. Hemiballismus due to an ipsilateral lesion is extremely rare. We report the case of a 55 year old female who developed a right sided hemiballismus due to a right striatal haemorrhage, which simultaneously caused a left hemiplegia. The hemiballismus subsided on treatment with dopamine-blockers over the next two weeks.

Cerebral Hemorrhage↗

Delayed onset generalised dystonia after cyanide poisoning.

A 27 year old female developed delayed onset of persistent generalized dystonia following a suicidal attempt with potassium cyanide. Cranial CT scan showed bilateral putaminal hypodensities which were also seen on MRI scans to be hypointense on T1 and hyperintense on T2 weighted images. Multimodality evoked potentials were normal. An improvement was noted with levodopa.

Adult↗

A rare presentation of posterior communicating artery aneurysm.

This is a report of a successfully treated case of a 55-year-old woman with posterior communicating artery aneurysm who had a partial 3rd nerve palsy with pupillary sparing, temporal lobe intracerebral hematoma and a subdural hematoma. Such an association has not been reported earlier.

Carotid Artery Diseases↗

Visual evoked potentials and visual acuity after transurethral resection of the prostate.

Changes in visual evoked potentials, visual acuity, blood ammonia levels and serum electrolytes (Na+ and K+) after transurethral resection of the prostate using glycine as an irrigating fluid performed under subarachnoid block were studied in 12 patients, in the pre-operative and immediate postoperative periods. Visual evoked potentials (p100 latency), recorded by shift of a checkerboard pattern, increased significantly from a pre-operative value of mean (SEM) 101.18 (1.63) msec in the right eye, and 102.5 (1.47) msec in the left eye to 108.91 (1.8) msec (p less than 0.01) and 108.08 (2.53) msec (p less than 0.01) respectively in the postoperative phase. There were no changes in visual acuity as assessed by a Snellen's chart, blood ammonia levels and serum electrolyte concentrations. The amount of glycine used intra-operatively for irrigation ranged from 3 to 31 litres.

Aged↗