Showing papers by "Garima Shukla published in 2005"

"Hot cross bun" sign in two patients with multiple system atrophy-cerebellar.

Abstract: The “hot cross bun” sign is characterized by cross-shaped T2 signal hyperintensity within the pons and has been said to be specific although not pathognomonic for multiple system …

Unidirectional whole body turning: a new lateralising sign in complex partial seizures.

Abstract: Background: The lateralising significance of unidirectional whole body turning in patients with complex partial seizures (CPS) arising from the temporal lobe was evaluated. Methods: A total of 330 patients undergoing long term video-EEG study were included. ‘‘Unidirectional whole body turning’’ was defined as rotation of the trunk, head, and limbs by .90˚ and lasting .10 s. EEG correlates, MRI, and SPECT findings were compared and outcome after surgery was noted for patients with follow up data for .1 year. Results: Unidirectional whole body turning was observed in 13 patients with a mean age of 18i8 years. Concordance of the side of whole body turning with the EEG focus and MRI findings was observed in 11 of the 13 patients (84.7%) and in 26 of 28 seizures (92.8%). The six patients who underwent temporal lobectomy or resection of lesion, opposite to the direction of body turning, had good seizure outcome. Conclusion: Unidirectional whole body turning is a new lateralising sign in temporal lobe CPS with good predictive value for epileptogenic focus contralateral to the direction of turning.

Quantitative thermal sensory testing in patients with monomelic amyotrophy.

Abstract: Background: Quantitative thermal sensory testing (QST) is a non-invasive method to assess somatic small fibre dysfunction, which is not evaluated with routine nerve conduction studies (NCS). Monomelic amyotrophy (MMA), is a pure motor disorder with no sensory abnormalities on routine NCS, and has not been evaluated using QST. Aims and objective: Present study aimed to evaluate somatic small fibre involvement in MMA patients. Forty patients with MMA with no sensory abnormalities or routine NCS were evaluated using QST for thresholds of cold sensation (CS), warm sensation (WS), cold pain (CP) and warm pain (WP), using method of limits. These were compared with 40 age-matched controls. Results: No abnormalities in thresholds for CS, WS, CP and WP were found in MMA group as compared to controls. Conclusion: QST thus failed to demonstrate any abnormality. Hence we conclude that MMA is a pure motor disorder, with no involvement of somatic small sensory fibres (A delta and C).

Widespread electromyographic abnormalities in patients with monomelic amyotrophy: a detailed EMG study.

Abstract: Objective To evaluate subclinical electromyographic changes in unaffected muscles of the patients with monomelic amyotrophy (MMA). Patients and methods 35 patients of MMA with single limb atrophy (30 patients with upper limb involvement and 5 patients with lower limb involvement) were studied at All India Institute of Medical Sciences, New Dellhi, from September 2000 to September 2002. All the patients were evaluated clinically, by detailed three limb electromyography (EMG) and by MRI scan of the spine to rule out other disorders. Results The mean age of 35 male patients was 24.17 (+/-6.8) years and the mean duration of illness was 3.64 (+/-2.7) years. Patients with upper limb involvement had segmental pattern of atrophy, predominantly distal or proximal. EMG revealed evidence of subclinical diffuse chronic reinnervative changes. All the patients (100%) had bilateral chronic reinnervative changes and 50% had chronic reinnervative changes in three limbs. Conclusions Patients with clinically single limb MMA were found to have evidence of widespread chronic reinnervative changes on EMG.