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Biomedical subjects

S Prabhakar

Publications and source records attributed to S Prabhakar.

At least 145 records · Page 8Linked to original sources
PubMed1990

High incidence of subacute sclerosing panencephalitis in south India.

During 1983-7 a clinical diagnosis of subacute sclerosing panencephalitis (SSPE) was confirmed by the detection of measles virus haemagglutination inhibiting antibody in the cerebrospinal fluid (CSF) in 81 subjects resident in Tamilnadu. The antibody titre (reciprocol of the end-point dilution) in the CSF ranged from 2 to 32 and in the sera from 8 to 2048. The CSF:serum ratios of titres were 1:4-1:64 in 80 cases and 1:128 in one case. The median age at onset of SSPE was 10 years and 97% of cases were diagnosed at stage 2 and beyond. Based on the geographic distribution of 72 cases in an estimated population of 8.4 million, the annual incidence of SSPE was calculated to be 2.14 per million population, or 4.3 cases per million children below 20 years. Assuming that only 10% of all cases would have reached the level of laboratory diagnosis, the incidence may be as high as 21 cases per million population.

Adolescent↗
PubMed1990

Blood-brain-barrier and intrathecal immunoglobulin changes in tuberculous meningitis and demyelinating disorders: a preliminary report from a south Indian hospital.

Sixty-three paired serum and CSF samples (15 controls and 48 patients) were studied for CSF albumin quotient, IgG index and synthesis rate. Control values for albumin quotient and IgG index were less than 10.0 and less than 0.6 respectively. IgG synthesis rate/day was calculated according to the Tourtellotte formula and a value of greater than 3.0 mg/day is considered high. Our findings in patients with central demyelinations, subacute sclerosing panencephalitis, Guillain Barré Syndrome and cerebrovascular accidents are comparable to earlier studies. Fifteen tuberculous meningitis patients were studied and could be separated into 2 groups, 9 with elevated albumin quotients and 6 with normal albumin quotients. Three patients with elevated albumin quotients and 4 with normal albumin quotients showed increased intrathecal IgG synthesis.

Adult↗
PubMed1987

ELISA using mycobacterial antigens as a diagnostic aid for tuberculous meningitis.

An enzyme-linked immunosorbent assay (ELISA) was studied as a possible laboratory test to aid in the diagnosis of tuberculous meningitis (TBM) in an Indian population. The assay detected mycobacterial antibodies in the cerebrospinal fluid (CSF) of TBM patients. Three antigens, PPD, BCG and M. tuberculosis were tested for use in the assay and of these, M. tuberculosis was found to be the most suited. A sensitivity of 72% and specificity of 92% with M. tuberculosis as antigen was obtained for the ELISA under discussion. The system therefore does hold promise as a diagnostic laboratory test for TBM.

Antigens, Bacterial↗
PubMed1986

Ataxia telangiectasia in identical twins: unusual features.

The cases of identical twins with ataxia telangiectasia, early intellectual impairment and progressive spasticity are reported. Immunological tests revealed reduced levels of serum and salivary IgA, increased B cells, reduced T cells and raised alpha-fetoprotein. CT scan performed in one of the twins was normal. The pathogenesis of the spasticity is discussed.

Ataxia Telangiectasia↗
PubMed1986

Neurological complications of acute haemorrhagic conjunctivitis.

Forty four cases of the neurological complications of acute haemorrhagic conjunctivitis (AHC) seen in India during 1981 epidemic are reported. The disease predominantly affected adult males. The preceding attack of AHC, a latent period, prodromal symptoms of fever, myalgia and root pains followed by acute onset of lower motor neurone paralysis of limbs and/or cranial nerves formed the classical picture of neurological involvement. The recovery was poor and nearly half of the patients remained severely handicapped. Electrophysiological studies showed early appearance of widespread fibrillations and fasciculations, large polyphasic potentials of increased amplitude and reduced interference pattern. Nerve conduction studies were normal in most of the cases. Cerebrospinal fluid (CSF) examination revealed lymphocytic pleocytosis and rise in protein content. Significant antibody titres against enterovirus type 70 (EV 70) were demonstrated in the serum and the CSF. HLA studies showed low occurrence of A2 and B15 HLA antigens. Muscle biopsies revealed neurogenic atrophy and sural nerve biopsies were histologically unremarkable. The similarities of this disease with poliomyelitis and its pathogenesis are discussed.

Adolescent↗
PubMed1986

Acute cerebellar ataxia in enteric fever.

Acute cerebellar ataxia as an isolated neurological manifestation of enteric fever is very rare. Three cases of acute cerebellar ataxia associated with enteric fever are reported. The diagnosis of enteric fever was confirmed by positive blood culture, strongly positive Widal test and rising antibody titres. The major clinical features were rapid development of gait ataxia, limb ataxia and dysarthria. None of the patients had altered sensorium. The cerebellar involvement was noticed on the second or third day of fever which progressed for one to two days. The symptoms remained static for one to two weeks and thereafter all the patients showed gradual recovery in a few weeks. Acute onset of cerebellar lesion, self limiting course and cerebrospinal fluid pleocytosis suggest par- or post-infectious demyelinating pathology in these patients, who were not related to each other.

Acute Disease↗
PubMed1986

Guillain-Barré syndrome. A clinical electrophysiological and biochemical study.

Fifty-six consecutive patients with Guillain-Barré syndrome representing 49% of all cases of peripheral neuropathy (except those due to diabetes mellitus and leprosy) admitted to the Postgraduate Institute of Medical Education and Research, Chandigarh over a period of three years were studied. All patients developed weakness of limbs within one day to three weeks. Attenuation of deep tendon jerks (98%) paresthesia (66%), cranial nerve involvement (41%) and antecedent infection (32%) were the common clinical features. The common patterns of motor weakness were predominantly proximal in all the four limbs (45%) or predominantly proximal in lower limbs along with distal muscles in upper limbs (29%). Electrodiagnostic studies revealed prolonged distal (motor) latency (82%), reduced motor nerve conduction velocity (74%), sensory nerve conduction abnormality (85%) and evidence of denervation (41%). Evoked motor response of median, ulnar, common peroneal and tibial nerves exhibited significant increase in duration and reduction in amplitude. The maximum incidence of electrophysiological abnormality occurred between four to 12 weeks after the onset of neurological symptoms. Four patients died and 11 showed poor recovery. Long intervals (greater than 3 weeks) between peak deficit and onset of recovery and coexistence of reduced motor nerve conduction velocity with evidence of denervation on EMG were found to be associated with poor recovery.

Adolescent↗
PubMed1984

Hemibase syndrome: an unusual presentation of intracranial paraganglioma.

A case of paraganglioma of parasellar origin in a 7-year-old girl is described. She presented with hemibase syndrome with involvement of a majority of the left cranial nerves. Three times in the past 2 years she had recurrent ophthalmoplegia with complete recovery. She was treated surgically and with postoperative radiotherapy. The site of origin of this paraganglioma as well as the clinical presentation are uncommon features in this case.

Child↗
PubMed1981

Wasted leg syndrome: a clinical, electrophysiological and histopathological study.

Forty cases of 'wasted leg syndrome' were studied clinically and electrophysiologically. Muscle biopsy was examined in nine cases, majority of patients were adults engaged in heavy manual work. The illness was noticed incidently with a strictly unilateral wasting of the whole lower limb (in 65% of cases), of all muscles below the knee (in 22.5% of cases) or of quadriceps muscles only (in 12.5% of cases). The nerve conduction studies and the electromyographic pattern suggested anterior horn cell disorder. Neurogenic atrophy was seen in 7 out of 9 muscle biopsies. A follow up in 12 patients (2-6 years) revealed no progression of the disease. It is suggested that possibly these cases represent an entity, clinically different from other anterior horn cell disorders.

Adult↗