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Background: Peripheral neuropathy is a result of damage to the nerves located outside of the brain and spinal cord. Over all prevalence in India varies from 5 - 2400 per 10,000 populations. Diabetic neuropathy is the most common type. Kinesthesia is the ability to sense the motion of a joint or limb. It is primarily influenced by muscle spindles and secondarily influenced by skin receptors and joint receptors. Objectives: To determine the effectiveness of sensory integration on kinesthesia in peripheral neuropathy and to compare the effect of sensory integration with conventional therapy on kinesthesia in peripheral neuropathy. Materials And Methods: This was an experimental study conducted on 68 subjects in which Group A received conventional therapy (control) and another group received sensory integration along with conventional therapy (experimental). Simple Random Sampling technique was used. Pre intervention assessment was done and treatment was given for 6 weeks. Post intervention assessment was done with help of outcome measures. Statistical analysis was done using students t test. Results:Among the 68 subjects, Group B which received sensory integration along with conventional therapy showed extremely significant improvement in impaired kinesthesia. In the Weber two point discrimination test, the post intervention comparison (8.6 with group A and 5.98 with group B) showed that group was extremely significant in improving joint position sense. In joint position sense for plantar flexion and dorsiflexion, Group B showed extremely proximate results to range which was asked and the range which was performed by the subjects. Conclusion: Sensory integration therapy was found to be significantly effective on impaired kinesthesia in peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Chronic pain has a huge global prevalence of 20% and in a country like India which has been labeled by the UN as the most populous country in April 2023, the problem is likely to explode and pose a huge challenge to Indian Practitioners. An addition to this can also be due to an expected doubling of individuals over 65 years of age by rises in the aging population. Pharmacotherapy which is the mainstay for conservative medical management (CMM) often seems to be inadequate and/or has a potential for a range of side effects. The patients who are refractory to all forms of CMM move up on the treatment algorithm for pain interventions. Implantable neuromodulation therapies can be of considerable help in patients who have significantly impaired quality of life due to unremitting severe pain, despite CMM and simpler pain interventions. These implanted devices provide ongoing satisfactory pain relief in select patients. This is for the 1st time that practice recommendations are published to guide practitioners offering this treatment in India. This can also be a reference for selecting the most appropriate patients to optimize outcomes. This can also provide motivation to start collecting information in their local database and also to convince our reimbursement agencies about incorporating this useful modality in the gamut of approved therapies. [ABSTRACT FROM AUTHOR]

Background: There are several studies which have studied large cohort of Neuro-Bechet's disease (NBD) patients worldwide However, there is sparse literature about NBD from India. We aimed to characterize the clinical, radiological characteristics, treatment response and outcome in NBD. Methods: The study was a retrospective descriptive analysis of a cohort of patients with NBD evaluated between January 2017 to June 2021, fulfilling the International Consensus Recommendation (ICR) criteria for NBD. Results: Twelve patients were diagnosed as NBD during the study period. The mean age of the patient was 34.7 ± 11.1 (range 21–59 years). The mean duration of illness was 1.4 ± 1.2 years. All 12 patients had neuroparenchymal NBD. Systemic symptoms were present in 6 patients (50%). Pyramidal tract involvement (67%) was the most common symptom and sign followed by cranial nerve, spinal cord and visual involvement. Pathergy test was positive in 6 patients (50%). Human leucocyte antigen (HLA) B51 positivity was seen in all patients. Thalamus (100%) was the most common area involved followed by pons (80%). Favourable outcome (modified Rankin Scale scores ≤ 2) was seen in 7 patients, poor outcome in 3 patients and 2 patients were lost to follow-up after first attack. Conclusion: NBD is prevalent in India and there is need for clinical suspicion. Brainstem and cerebral syndrome are the most common presentation of NBD and thalamus is the most common site of involvement in NBD. [ABSTRACT FROM AUTHOR]

While the loss of sensorimotor and autonomic function often occurs due to multiple trauma and pathologies, spinal cord injury is one of the few traumatic pathologies that severely affects multiple organ systems both upstream and downstream of the injury. Current standard of care therapies primarily maintains health and avoids secondary complications. They do not address the underlying neurological condition. Multiple modalities including spinal neuromodulation have shown promise as potential therapies. The objective of this study was to demonstrate the impact of activity-based neurorehabilitation in presence of epidural spinal stimulation to enable simultaneous global recovery of sensorimotor and autonomic functions in patients with complete motor paralysis due to spinal cord injury. These data are unique in that it quantifies simultaneously changes multiple organ systems within only 2 months of intense activity-based neurorehabilitation when also delivering epidural stimulation consisting of sub-motor threshold stimulation over a period of 12–16 hours/day to enable ‘self-training’ in 10 patients. Finally, these studies were done in a traditional neurorehabilitation clinical in India using off-the-shelf electrode arrays and pulse generators, thus demonstrating the feasibility of this approach in simultaneously enabling recoveries of multiple physiological organ systems after chronic paralysis and the ability to perform these procedures in a standard, well-controlled clinical environment. [ABSTRACT FROM AUTHOR]

Intramedullary spinal cord tumors constitute an uncommon group of central nervous system neoplasms which pose considerable diagnostic and management challenges. Often low grade, these tumors have an insidious onset and slow progression, which makes early diagnosis a challenge. Advances in magnetic resonance imaging technology have greatly aided the diagnosis and preoperative planning of intramedullary tumors. Yet, radiological diagnosis can be difficult in the presence of several tumor mimics. The introduction and advancement of microsurgical techniques have made surgery the preferred treatment modality. Timing of intervention, however, is contentious. Eloquence of the surrounding tissue and the unforgiving nature of the spinal cord adds to the surgical challenge. Their treatment and prognosis is largely dependent on tumor histology and patient functionality. Well-demarcated tumors like ependymomas and hemangioblastomas can be resected completely with good outcome. Infiltrative tumors such as high-grade astrocytomas are best managed with biopsies or limited resections. Postoperative deficits can be crippling and the use of intraoperative neurophysiologic monitoring and other adjuncts is mandatory. Subtotal resection carry a high risk of recurrence and gross total resection carries a high risk of operative morbidity. With the availability of newer imaging modalities and intraoperative adjuncts, the earlier pessimistic conservative approach has been replaced by an aggressive surgical approach. This review provides an overview on the entire spectra of spinal intramedullary tumors with particular focus on management strategies. [ABSTRACT FROM AUTHOR]

Endoscopic spine surgeries provide distinct advantages and is therefore a viable alternative to open or microscopic techniques. Indian surgeons have shown their expertise from craniovertebral junction to lumbosacral spine with these techniques. Many novel approaches like endoscopic transcervical, partial corpectomy, and others have been designed, and many technological innovations for these surgeries have been made. With different training programs attracting both native and international surgeons, the future of endoscopic spine surgery is bright. [ABSTRACT FROM AUTHOR]

Spinal cord stimulation is an established procedure for relieving chronic neuropathic pain conditions. Although it has been over five decades since the first spinal cord stimulation (SCS) was developed, it has only been used in a few cases in India. It is primarily based on the "Gate Theory" of pain. The mechanism of its action is not exactly clear, but reports have suggested that it plays the main role in selectively stimulating the large diameter pain fibers in the dorsal aspect of spinal cord. SCS procedure involves a very careful case selection, and current evidence suggests that only a few conditions of chronic refractory neuropathic pain are its established indications. In these patients too, the efficacy rate remains around 50 to 75%. The overall pain relief observed is around 50% decrease in visual analog scale (VAS) scores. It is a technically simple procedure involving placement of electrodes over the dorsal aspect of spinal cord in the epidural space. The procedure is a staged one in which trial lead electrodes are first implanted and stimulated with an external pulse generator (EPG). If the trial is successful and patient has acceptable pain relief over 1 week of stimulation at various settings, the patient undergoes the permanent implantation of electrodes at the same position. The permanent electrodes are then stimulated by an implantable pulse generator (IPG) in the subcutaneous pocket (abdominal or gluteal). Complications are rare and are more related to hardware like lead migration and breakage. Since it is does not damage the cord per se, its acceptance as a procedure for pain is known quite well in the Western world. Its availability and cost of implants is the major hurdle in its use in a developing nation like India. Here, we present a technical note and our experience of two cases of thoracic spinal cord stimulation for chronic neuropathic pain at our institution. [ABSTRACT FROM AUTHOR]

Background: Central nervous system (CNS) disorders are a group of neurological disorders concerned with behaviour, coordination and functioning of the brain and the spinal cord. The CNS is the site of processing various informations. It interprets and evaluates the information and as result, the CNS responds accordingly and controls the body. Any defects or disorders of the Central nervous system may cause degeneration of the organs and tissues associated with it, loss of coordination, paralysis, etc. These disorders may be hereditary or due to injuries to the brain and spinal cord. Although, these disorders are being cured with medicaments, many plant species are also seen to be effective in its treatment. Objective: the main objective of this article is to underline the potentials and the needs for the documentation of the ecological knowledge of herbal medicines of the north east India region, necessary for the greater well-being of mankind in the prevention and cure of CNS disorders. Methods: an extensive literature survey was carried out through various databases like Google Scholar, Pubmed, Sciencedirect etc to support this review. All the collected information was analyzed accordingly and the plants were enlisted based on the classes of CNS disorders for which they are used. Result and discussion: from the survey of the database being collected, it was found that many traditional and local plants of the northeast India region are therapeutically effective in the treatment and cure of many Central nervous system disorders. Conclusion:-It is now an accepted fact that many traditional plants found in the Northeast India have been acceptable within the human body and hence these can be used to replace many expensive medications available in the market. [ABSTRACT FROM AUTHOR]

Background: Spinal dysraphism occurs due to incomplete fusion of the midline mesenchymal, bony, or neural elements of the spine. The defects in the spinal cord can be associated with skin lesion since both have same embryonic origin. Aims and Objectives: This study was conducted to determine the association of midline and paramedian cutaneous lesions with spinal dysraphism by using spinal ultrasonography. Materials and Methods: Two thousand apparently healthy neonates were screened in the postnatal ward of a tertiary care center in South India. Those neonates with cutaneous lesions in the midline and paramedian region were screened for evidence of spinal dysraphism by using spinal ultrasonography. Results: Among 2000 neonates, 120 (6%) had at least one cutaneous lesion, of which 114 (5.7%) were in the midline and 6 (0.3%) were on the paramedian region of dorsal and ventral aspect of the body. Among these neonates, two cases had more than one skin lesions. The most common cutaneous lesion observed was typical dimple (82, 68%) followed by hypertrichosis (12, 10%). Ultrasonography revealed spinal anomaly in six (5%) of them. The cutaneous lesions associated with spinal dysraphism were obvious midline swelling, dermal sinus, and multiple skin lesions. Conclusion: Congenital midline and paramedian skin lesions may be the marker of spinal dysraphism. In the presence of such cutaneous lesions, only 5% of them had associated spinal anomaly in our study. [ABSTRACT FROM AUTHOR]

Anaesthesiology is an ever-changing science and amongst its sub-specialities, the field of neuroanaesthesia is making rapid strides. The fragility of the brain and spinal cord and the multitude of complexities involved in neurosurgery and interventional neuroradiological procedures demand dedicated training in neuroanaesthesia. With rapid advancement in other neuroscience specialties, neuroanaesthesia too has made outstanding progress, owing to establishment of structured training, publication of high-quality scientific research, and invention of novel medications and monitoring modalities. The opportunities for training in India and abroad and resources to broaden knowledge in neuroanaesthesia have increased over the last two decades. A career in neuroanaesthesia offers a great future for budding anaesthesiologists. [ABSTRACT FROM AUTHOR]

Aim: To collect and correlate the sociodemographic and clinical details of persons with spinal cord injury who were admitted to the Department of Neurological Rehabilitation. Objectives: To assess the sociodemographic characteristics and collect the clinical profiles of persons with spinal cord injury and to correlate their sociodemographic and clinical details. Materials and Methods: A retrospective file review was done over a period of 2 years from January 2017 to December 2018 to study patients with spinal cord injury who were admitted to the Neurological Rehabilitation ward of NIMHANS, Bengaluru, Karnataka, India. Results: A total of 60 patients were admitted with spinal cord injury. The mean age was 32.39 years and majority of the patients were young married males. Most of them belong to the low socioeconomic status and are housewives and daily wage laborers. Falls and road traffic accidents are the causes for the injury. Anxiety and depression are high among traumatic spinal cord injury patients. Conclusion: This information may contribute to prevent SCI and to improve the quality of life of patients with SCI. It has implications for the primary care physicians who are at first contact to identify and refer them for specialized super speciality district hospitals for further treatment as they pose a great threat to public health and their proportions are increasing. It is imperative that trauma care is included in graduate medical training as well to facilitate early intervention after initial screening. [ABSTRACT FROM AUTHOR]

Introduction: Paediatric brain tumours are the most common solid tumours in developing countries, leading to cancer related mortality in children globally. Enough data are available regarding the epidemiology of paediatric brain tumours in the western population. But limited data is available in India as only a few cases were reported. Aim: To evaluate the epidemiologic, clinicopathologic and histologic spectrum of paediatric brain and spinal cord tumours in a tertiary care referral centre of Southern India. Materials and Methods: This study was a retrospective, observational study which was undertaken at the Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India. It's a 25 years study from January 1993 to December 2017. Data were collected regarding the frequencies of primary brain and spinal cord tumours (diagnosed according to World Health Organisation (WHO) classification) in total of 151 paediatric patients (comprised of all children <18 years of age) from medical records in the tertiary centre. Results: Over a period of 25 years, a total of 151 paediatric brain tumours were identified. Among these 4 were metastatic and the remaining 147 were primary. Primary tumours of brain origin were 112 and the remaining 35 were spinal cord tumours. The mean age for primary paediatric CNS tumours was 11.06 years with a slight male preponderance i.e., male: female ratio of 1.1:1. The most common brain tumour was Astrocytoma with 42 cases (37.5%) and among spinal cord, the most common tumour was Nerve sheath tumour with 13 cases (37.1%). Conclusion: Demographics in the present study are comparable with similar studies from various medical centres on this topic. It is used as a reliable profile to set priorities for rationing the limited resources and thereby aid in developing national data. Various studies like this from different cancer centres across India will help to prepare an epidemiological profile of overall Indian as well as regional Paediatric brain tumours. [ABSTRACT FROM AUTHOR]

Introduction: Spinal tuberculosis is very common in developing countries like India and it has a wide spectrum of appearance on MRI ranging from simple marrow oedema to complete vertebral body collapse. Early diagnosis and intervention at initial period provide very good prognosis and very less morbidity. Aim: To demonstrate rare MRI features in cases of tubercular lesions in the spinal and paraspinal region without involvement of osseous components of the spine. Materials and Methods: This was a prospective descriptive study conducted in a Tertiary Care Hospital in India from June 2011 to December 2014 based on the MRI findings in patients with Tuberculosis of Spinal and Paraspinal region. Total 529 cases of tubercular spinal lesions were diagnosed. Out of which only 43 patients showed only extraosseous spinal and paraspinal lesions, these were included in the study. Patients with involvement of bony components or typical MRI pictures such as involvement of intervertebral disc and adjacent vertebral bodies were not included in the study. The diagnosis was confirmed by cytology, histopathology, serology and corroborative findings. Results: Various extraosseous changes involving spinal and paraspinal components in case of tubercular lesions, such as 27 cases of Paraspinal soft tissue lesions (62.8%)-Abscesses and Granulation tissue, 10 cases of Extradural and Intradural soft tissue component (23.2%), 4 cases of arachnoiditis (9.3%), 2 cases of Intramedullary Tuberculoma (4.6%) and 1 case of Spinal Cord Abscess (2.3%) were observed and the observed findings were tabulated. Conclusion: On MRI, Spinal Tuberculosis may have wide spectrum of appearance. Involvement of soft tissue without affecting the spinal bony component is quite rare. Hence, the possibility of tuberculosis should be considered even when the bony components are spared. Timely diagnosis and intervention will reduce the morbidity and avoids the complications. MRI plays key role in follow-up of patients to assess the response to treatment. [ABSTRACT FROM AUTHOR]

The sixth most common cancer in the world is head and neck squamous cell carcinoma with an annual estimated incidence of around 275,000 for oral carcinoma. India has been cited frequently as the country with the highest incidence in the world with over 100,000 cases noted every year. Recurrence of oral squamous cell carcinoma are commonly seen as locoregional failure which is at the primary site or in the neck lymph nodes. Distant metastasis incidence is very uncommon and they are reported in lung, liver, and spinal cord. There are few reported cases of squamous cell carcinoma from oral cavity which has shown metastasis over the chest skin. This case report highlights a rare metastasis which, in spite of good locoregional control with surgery and adjunctive radiotherapy, resulted in a poor outcome. [ABSTRACT FROM AUTHOR]

Introduction N ew criteria given by International Panel for NMO Diagnosis (IPND) for Neuromyelitis optica (NMO) & widespread availability of neuroimaging and diagnostic facilities, have changed the concepts of NMOSD. Objectives To study the clinico- radiological profile of patients of NMOSDs & categorize them into specific groups according to current diagnostic criteria. Materials and Methods This was a prospective study of 54 cases of NMOSDs admitted to the Department of Neurology of SMS Medical College, Jaipur, Rajasthan,from August 2014 to March 2017. Results Of the 54 cases, Female to Male ratio was 3.8:1 and mean age of the study population was 34.1 years. NMOSD with AQP4-IgG group constituted 42.5%(n = 23), NMOSD without AQP4-IgG group constituted 35.2% (n = 19), NMOSD with unknown AQP4-IgG status group constituted 22.2% (n = 12). Most common clinical presentation was myelitis (70.3%) followed by optic neuritis (48.12%), area postrema syndrome (29.6%), brainstem syndrome (24.07%), cerebral syndrome (9.25%) and diencephalic syndrome (1.8%). MRI brain & spine were abnormal in respectively 41.1% & 71.7% cases. Conclusion Revised diagnostic criteria for NMOSD enables them to diagnose early & classify even in absence of AQP4-IgG positivity. They have varied clinical presentation and neuro-imaging plays an important diagnostic role in defining these syndromes. [ABSTRACT FROM AUTHOR]

Background: The ability of diffusion tensor imaging (DTI) to complement conventional MR imaging by diagnosing subtle injuries to the spinal cord is a subject of intense research. We attempted to study change in the DTI indices, namely fractional anisotropy (FA) and mean diffusivity (MD) after traumatic cervical spinal cord injury and compared these with corresponding data from a control group of individuals with no injury. The correlation of these quantitative indices to the neurological profile of the patients was assessed.Material and Methods: 20 cases of acute cervical trauma and 30 age and sex matched healthy controls were enrolled. Scoring of extent of clinical severity was done based on the Frankel grading system. MRI was performed on a 3T system. Following the qualitative tractographic evaluation of white matter tracts, quantitative datametrics were calculated.Results: In patients, the Mean FA value at the level of injury (0.43+/-0.08) was less than in controls (0.62+/-0.06), which was statistically significant (p value <0.001). Further, the Mean MD value at the level of injury (1.30+/-0.24) in cases was higher than in controls (1.07+/-0.12, p value <0.001). Statistically significant positive correlation was found between clinical grading (Frankel grade) and FA values at the level of injury (r value=0.86). Negative correlation was found between clinical grade and Mean MD at the level of injury (r value=-0.38) which was however statistically not significant.Conclusion: Quantitative DTI indices are a useful parameter for detection of spinal cord injury. FA value was significantly decreased while MD value was significantly increased at the level of injury in cases as compared to controls. Further, FA showed significant correlation with clinical grade. DTI could thus serve as a reliable objective imaging tool for assessment of white matter integrity and prognostication of functional outcome. [ABSTRACT FROM AUTHOR]

Abstract Cladophialophora bantiana (C. bantiana) is a life-threatening melanized mycelial fungus causing brain abscess. C. bantiana is usually observed in tropical countries, including India. We report a Japanese case of C. bantiana presenting with myelitis mimicking neuromyelitis optica (NMO) and brain abscess. A 73-year-old man was administered prednisolone (30 mg/day) for antineutrophil cytoplasmic antibody (ANCA)-related vasculitis 100 days before admission. He had right side-dominant paraplegia and sensory loss in the right leg. T2-weighted spinal cord MRI revealed longitudinal high-intensity signals at the T7 to T12 levels. A ring-enhancing lesion at the T10 level was detected on gadolinium (Gd)-enhanced MRI. He was tentatively diagnosed with NMO, and steroid pulse therapy was performed. One month later, an abscess at the right cerebropontine angle was noted on Gd-enhanced brain MRI. Two months later, several subcutaneous intramuscular tumors were detected. Based on the morphological study of the cultured organelle obtained by tumor enucleation and the internal transcribed spacer sequence of ribosomal RNA, the pathogen was identified as C. bantiana. Although he received liposomal amphotericin B treatment, the patient died of respiratory insufficiency. C. bantiana infection should be considered in patients with myelitis presenting with longitudinal lesions and CNS abscess in an immunocompromised state. Highlights • Cladophialophora bantiana infection of the central nervous system in Japan. • Spinal cord lesion due to Cladophialophora bantiana mimicking neuromyelitis optica. [ABSTRACT FROM AUTHOR]

The concept of brain death has been a very intriguing topic and has taken many forms over the years. Brain stem death is a complex state of inactivity defined by the loss of reflexes of the pathways that pass through the brain stem, the 'shaft' of the brain which links the spinal cord to the cerebral cortex and the cerebellum where there is apnoea, loss of eye movement and pain sensation. There are many criteria, based on which a person can be said to be brain dead. The best recognised of these are the Harvard, Minnesota and Philadelphia criteria. India follows the UK notion of brain stem death, and the Transplantation of Human Organs Act was passed in 1994 by the Indian parliament, which legalised brain-stem death, and in 1995 ordered the brain death certification procedure, which is certified by a 'Board of Medical Experts'. Also, there are some legal and ethical implications that have to be considered in cases of disagreement in diagnosis among the panel of doctors, time of death in cases when patients' relatives disagree or request more time for organ donation or to disconnect the life support system. In routine clinical practice, the issues pertaining to brain stem death should be dealt with by experienced physicians, counselling the family members or relatives and educating them about organ donation. [ABSTRACT FROM AUTHOR]

Background and Objectives: Malignant spinal cord compression is an oncologic emergency, unless diagnosed early and treated appropriately, can lead to permanent neurological impairment and compromised quality of life of patients. We analyzed the epidemiology and the effect of common interventions on the outcome in these patients. Patients and Methods: We conducted a prospective study of 77 patients in the year 2014 and recorded relevant patient and disease characteristics. All patients received corticosteroids. Eight patients were operated upon, and radiotherapy was delivered in 62 patients. Results: Most of the patients were in the age group of 41-60 years and there was no gender preponderance in patients. Female breast cancer was the most common incident (15.5%) malignancy followed by multiple myeloma, lung, and prostatic carcinoma. Lower dorsal spine was the most common site of compression (35%) followed by lumbar (31%) and mid-dorsal (26%) spine. 70 (91%) patients had cord compression subsequent to bone metastasis while as other patients had leptomeningeal metastasis. In 31 (40%) patients, spinal cord compression was the presenting symptom. Overall, only 26 patients had motor improvement after treatment. Conclusion: Grade of power before treatment was predictive of response to treatment and overall outcome of motor or sensory functions. Neurodeficit of more than 10 days duration was associated with poor outcome in neurological function. [ABSTRACT FROM AUTHOR]

Background: Split cord malformation (SCM) is a rare condition. With decreasing incidence of neural tube defect (NTD) in the West, the reports of SCM are getting lesser and lesser. However, in India, spinal dysraphism is still a major problem encountered by the neurosurgeons. Objective: Our aim was to analyze 300 patients of SCM for their clinical features, radiological findings and outcome of surgery, which can throw light on the subject to others, who have less scope of finding these cases frequently. Materials and Methods: Over a 16-year period, we encountered 300 cases of SCM at AIIMS. Over the same period, more than 1500 cases of NTD were managed. SCM was noticed in 20% of cases with NTD. Skin stigmata were noted in two-third of the cases, and scoliosis and foot deformity were observed in 50% and 48% cases, respectively. Motor and sensory deficits were observed in 80% and 70% cases, respectively. Commonest site affected was lumbar or dorsolumbar (55% and 23%, respectively). In 3% cases, it was cervical in location. Magnetic resonance imaging (MRI) scan revealed a large number of anomalies like lipoma, neuroenteric cyst, thick filum and dermoid or epidermoid cysts. All the patients were surgically treated. In type I, bony spurs were excised, and in type II, bands tethering the cord were released. Associated anomalies were managed in the same sitting. Patients were followed up from 3 months to 3 years. Results: Overall improvement was noticed in 50% and stabilization in 44% cases and deterioration of neurological status was recorded in 6% cases. However, 50% of those who deteriorated improved to preop status prior to discharge, 7-10 days following surgery. Conclusions: SCM is rare and not many large series are available. We operated 300 cases and noticed a large number of associated anomalies and also multilevel and multisite splits. Improvement or stabilization was noted in 94% and deterioration in 6% cases. We recommended prophylactic surgery for our asymptomatic patients. [ABSTRACT FROM AUTHOR]

Abstract: Stings of Indian red scorpion (Mesobuthus tamulus, MBT) produce neurological abnormalities such as convulsions and paralysis. These parameters indicate the activity at α-motoneuron. The present study was therefore, undertaken to evaluate the effect of MBT-venom on spinal reflexes and the involvement of N-methyl-d-aspartate (NMDA) receptors. The experiments were performed on isolated hemisected spinal cords from 4 to 6 days old rats. Stimulation of a dorsal root with supramaximal strength at 0.1Hz evoked monosynaptic (MSR) and polysynaptic reflex (PSR) potentials in the corresponding segmental ventral root. Superfusion of MBT-venom depressed the spinal reflexes in a time- and a concentration-dependent (0.1–1μg/ml) manner. MBT-venom at 0.1, 0.3 and 1.0μg/ml produced maximal depression of 55, 75 and 90% at 30, 10 and 7min, respectively. The time required to produce 50% depression (T-50) of MSR was 19.0, 8.0, and 3.6min and for PSR was 15.0, 5.6, and 2.9min at 0.1, 0.3 and 1μg/ml of venom, respectively. Pre-treatment with DL-α-2-amino-5-phosphonovaleric acid (APV) decreased MSR by 26% and abolished PSR. In the presence of APV, the MBT-venom-induced depression of MSR was not different from the venom only group. The results indicate that venom-induced depression of spinal reflexes did not involve NMDA receptors. [Copyright &y& Elsevier]