Neurology India 

About: Neurology India is an academic journal published by Medknow. The journal publishes majorly in the area(s): Medicine & Internal medicine. It has an ISSN identifier of 0028-3886. Over the lifetime, 5682 publications have been published receiving 46424 citations.

Neurological complications of HIV infection.

Abstract: More than half of HIV - infected persons develop symptomatic neurological disease. The nervous system is extensively involved with no part of the neuraxis being immune from the virus. Beisdes the brain and spinal cord, the peripheral nerves and muscles may be affected. Neurological complications typically occur with advanced disease and profound immunosuppression, hence a knowledge of the CD4 lymphocyte count is of paramount importance. Since many of the conditions are amenable to treatment, a proper diagnosis and therapy may decrease morbidity in the already curtailed life span of the patient. Some opportunistic neurological infection is a result of latent/persistent infection requiring lifelong secondary prophylaxis e.g. toxoplasma encephalitis and cryptococcal meningitis. Neuroaids does not follow the law of parsimony i.e. a single entity may not be responsible for the entire constellation of signs and symptoms. HIV infection is the commonest cause of dementia in people under the age 50 in thedeveloped world. Cryptococcosis is the commonest infection affecting the nervous system in HIV positive patients. Tuberculosis has seen a resurgence following the out break of AIDS. CNS lymphoma is the commonest cause of raised ICP followed by tuberculoma, toxoplasmosis and brain abscess. Most patients with paraparesis have a typical HIV associated vacuolar myelopathy. A distal predominantly sensory neuropathy is the initial feature of insult to peripheral nerves. Muscle involvement may be due to polymyositis and HIV associated wasting syndrome but may also be aggravated by drugs (e.g. zidoudine).

Parkinson's disease: A review.

Abstract: Parkinson's disease is a common movement disorder seen in neurological practice, but the diagnosis and management is challenging. The diagnosis is clinical and sometimes difficult, considering a large number of motor and non-motor symptoms in PD patients. The medical management of PD patients is difficult, as choices of drugs are limited and levodopa is the mainstay of treatment. However, levodopa-induced dyskinesia (LID) is commonly seen in Parkinson's disease patients treated with levodopa. This side effect is usually encountered after a long duration of treatment, but occasionally, this may be seen even after a few days or months of treatment. Different types of surgical approaches, including unilateral pallidotomy and deep brain stimulation, have given very good results in PD patients, who cannot be managed by medications alone.

Inflammatory muscle diseases

Abstract: The three major immune-mediated inflammatory myopathies, dermatomyositis (DM), polymyositis (PM) and inclusion body myositis (IBM), each have their own distinctive clinical features, underlying pathogenetic mechanisms and patterns of muscle gene expression. In DM a complement-dependent humoral process thought to be initiated by antibodies to endothelial cells results in a microangiopathy with secondary ischemic changes in muscles. On the other hand, in PM and IBM there is a T-cell response with invasion of muscle fibers by CD8+ lymphocytes and perforin-mediated cytotoxic necrosis. In IBM degenerative changes are also a feature and comprise autophagia with rimmed vacuole formation and inclusions containing β-amyloid and other proteins whose accumulation may be linked to impaired proteasomal function. The relationship between the inflammatory and degenerative component remains unclear, as does the basis for the selective vulnerability of certain muscles and the resistance to conventional forms of immunotherapy in most cases of IBM. Patients with DM or PM usually respond to treatment with glucocorticoids and immunosuppressive agents but their use remains largely empirical. Intravenous immunoglobulin therapy can be used to achieve disease control in patients with severe weakness or dysphagia, or in patients with immunodeficiency, but its use is limited by expense. Emerging therapies for resistant cases include TNFα inhibitors (etanercept, infliximab) and monoclonal antibodies (rituximab, alemtuzumab). However, experience with these therapies is still limited and there is a need for randomized trials to test their efficacy and establish guidelines for their use in clinical practice.

Neurological complications of Chikungunya virus infection.

Abstract: Background: In May 2006, there was a large Chikungunya virus infection (CHIKV) outbreak in the Nagpur district of Maharashtra, a province in western India. Usually, CHIKV is a self-limiting febrile illness. However, neurological complications have been described infrequently. Aim: To study the clinical characteristics of various neurological complications associated with CHIKV infections. Materials and Methods: Patients with neurological complications following CHIKV infection during the outbreak were the subjects of the study. On the basis of clinical features and investigative findings, patients were grouped into various neurological syndromes: Encephalitis, myelopathy, peripheral neuropathy, myeloneuropathy, and myopathy. Cerebrospinal fluid (CSF) samples were also collected for biochemical and serological studies. Results: Of the 300 patients with CHIKV infection seen during the study period, June-December 2006, 49 (16.3%) [M : F: 42:7] had neurological complications. The neurological complications included: Encephalitis (27, 55%), myelopathy (7, 14% ), peripheral neuropathy (7, 14%), myeloneuropathy (7, 14%), and myopathy (1, 2%). Reverse Transcriptase polymerase chain reaction (RT-PCR) and real-time PCR was positive in the CSF in 16% and 18%, respectively. Conclusion: Recent CHIKV infection was associated with various neurological complications, suggesting neurotropic nature of the virus. The outcome of the neurological complications is likely to be good.