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Management and control of traffic flow on urban arterial streets with traffic signals at intersections actualize platoons at the exit of a given traffic signal, which do not remain intact as they progress along the arterial link and tend to disperse. The platoon characterizing variables such as platoon size, intra-platoon headway, inter-platoon headway and platoon speed has been studied extensively under homogeneous traffic conditions but such similar studies have not been conducted adequately considering the diversity of traffic and lack of lane discipline exhibited under heterogeneous traffic conditions. This study enables better understanding of platoon characterizing variables under heterogeneous traffic conditions facilitating enhanced safety and better operation. Data were collected using video graphic survey technique. It was analyzed for each platoon upto 420m at every 30 m interval. The analyses revealed the trend and dispersion of platoons of vehicles and locations where initial platoon diffusion and higher platoon diffusion occur at downstream of traffic signals. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the clinical, video electroencephalographic and MRI attributes of patients with eating epilepsy (EE). Consecutive patients who were diagnosed with EE and underwent potential pre-surgical work-up from 2003 to 2012 formed the study cohort. Their electro-clinico-radiological and seizure outcome data were obtained from our prospectively maintained medical records. Out of 7094 patients who underwent evaluation for refractory seizures, 47 patients satisfied the criteria for EE. Twenty-three (48.9%) had exclusive EE; the remainder had a combination of predominantly eating-induced and unprovoked seizures with no differences noted in timing of seizures in relation to meals. Lesional epilepsy was seen in 34% of patients, with posterior cortex (PC; posterior temporo-parieto-occipital) predominance. In MRI negative patients, PC interictal epileptiform discharges were present in 34.4% of patients and multifocal in 20.6% of patients compared to the MRI positive group with 12.5% and 6.5%, respectively (p = 0.003). Among 24 patients (51.1%) with co-existent unprovoked seizures, developmental delay and PC ictal onset was more prevalent (p = 0.013 and 0.029) as compared to exclusive EE. The seizure frequency and outcome did not significantly differ between patients with or without MRI abnormality. Two patients underwent anterior temporal lobectomy, with persistence of their eating seizures postoperatively. EE is a complex reflex epilepsy of cryptogenic and symptomatic etiology. As opposed to the traditionally implied temporo-limbic mechanisms behind epileptogenesis, a multilobar network originating from the PC receiving sensory and visual inputs linked to the limbic-opercular pathways represents a plausible mechanism. Surgical selection should be diligent and cautious in this group of patients. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To describe the attributes of patients with Rasmussen''s encephalitis (RE) seen in a tertiary epilepsy referral center in southern India and to enquire factors helpful in predicting responsiveness to immunotherapy. Methods: We diagnosed RE based on the European consensus criteria. To assess the factors that could potentially predict the natural course and therapeutic outcome, we subcategorized our patients according to age at onset ( 6 years), duration from onset to presentation ( 2 years), immunotherapy versus surgery, and early (≤2 years from the onset) versus late surgery. Results: The median age at disease onset of 19 patients was 6.0 years (range 2.3–13 years). Epilepsia partialis continua (EPC) and hemiparesis were noted in 14 (73.6%) and 16 (84.2%) patients, respectively. One patient, who presented with dysarthria due to tongue EPC, did not have hemiparesis despite having had the disease for over 15 years. The MRI findings in majority conformed to stage 3 of Bien classification. While 9/10 patients treated by surgery achieved seizure-freedom, only 1/11 patients who received immunotherapy did so. One patient expired due to subsequent development of contralateral hemispheric disease following successful hemispherectomy. None of the factors such as age at onset, age at presentation, presence/absence of antecedents, seizure burden, MRI stage predicted responsiveness to immunotherapy. Conclusion: This study from a developing country, in addition to substantiating the well known characteristics of RE, noted the following unusual findings: isolated lingual EPC abolished by focal cortical resection, bilateral RE, putaminal atrophy and absence of hemiparesis despite long standing disease. [Copyright &y& Elsevier]

Abstract: Objective: Emergent EEG (eEEG) is increasingly used in critical care practice related to neurological disorders although it involves considerable reorganization in the neurophysiology department at high cost. There is little data regarding the usefulness of eEEG in acute care situations. Our objective was to audit the practice and utility of eEEG in critical care practice in a developing country. Methods: This study was carried out in a tertiary care neurological center situated in a developing country. We had defined eEEG as any EEG performed on a non-elective basis upon request from a clinician for a seemingly emergency indication. All eEEGs performed in the neurophysiology service between October 2002 and September 2003 were reviewed. Referral diagnosis, delay in execution, final diagnosis and outcome were analyzed. eEEG was classified as useful if it clinched a diagnosis, excluded a specific diagnosis or helped in management. Statistical analysis was performed using the χ 2 test or Fisher''s exact test when indicated. The referral diagnosis and eEEG characteristics were correlated with the utility of the eEEG. Those with P-value <0.05 were considered significant. Results: There were 286 eEEGs (males 160, mean age 40.6±23.5 years) among 2798 EEGs (10.2%) performed in the service. eEEG was performed within 24 h in 241 instances and the mean interval from request to formal reporting was 1.13 days. In 62.1% instances eEEG was classified as useful. Usefulness varied according to the referral diagnosis: status epilepticus (n=41, 100% useful; P=0.000), brain death (n=28, 100% useful; P=0.000), nonconvulsive status (n=54, 96.3% useful; P=0.000), recurrent seizures (n=42, 81% useful; P=0.006), hypoxic encephalopathy (n=36, 80.6% useful; P=0.016), encephalitis (n=63, 42.9% useful; P=0.001), metabolic encephalopathy (n=64, 37.4% useful; P=0.000) and acute demyelination (n=20, 25% useful; P=0.001). eEEG findings included epileptiform discharges (n=58), periodic lateralized epileptiform discharges (n=27), discrete seizures (n=28), nonconvulsive status (n=12), status epilepticus (n=8), triphasic waves (n=15), generalized suppression (n=22), burst suppression (n=9), alpha-theta coma (n=7), electro cerebral silence (n=2), focal and generalized slowing (n=172), focal and generalized nonspecific dysfunction (n=87), and no abnormalities (n=24). Only discrete seizures (P=0.000), nonconvulsive status (P=0.004), generalized suppression (P=0.004) epileptiform discharges (P=0.047), and alpha-theta coma pattern (P=0.047) were significantly correlated with usefulness. Conclusions: eEEG provided data that influenced clinical decision-making in the setting of epilepsy related situations, hypoxic encephalopathy and brain death examination. Significance: eEEG can provide useful information in selected clinical situations in neurological critical care. The service needs to be called upon judiciously in order to improve the efficacy of this service. [Copyright &y& Elsevier]

Abstract: Angiolipoma is a rare tumor of the spine commonly presenting with compressive myelopathy. We report a spinal angiolipoma in a 14-year-old patient with acute spinal subarachnoid hemorrhage (SAH). To our knowledge this is the first reported case of a spinal angiolipoma presenting with SAH, associated with post-subclavian coarctation with diffuse hypoplasia of the descending aorta. This association of coarctation of aorta, aortic hypoplasia and spinal angiolipoma has also not been reported previously. [Copyright &y& Elsevier]