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Byline: Ashwani. Bhat, Goutam. Das, Adreesh. Mukherjee, Diptasree. Mukherjee, Goutam. Gangopadhyay, Atanu. Biswas Background: Vascular dementia (VaD) is a clinically heterogeneous entity. There is a dearth of studies for comparison [...]

Byline: Shambaditya. Das, Arpan. Dutta, Peyalee. Sarkar, Souvik. Dubey, Durjoy. Lahiri, Alak. Pandit, Goutam. Gangopadhyay, Biman. Ray Sir, Bilateral facial nerve palsy (FNP) is an uncommon entity (incidence of 1 [...]

Byline: Arpan. Dutta, Souvik. Dubey, Alak. Pandit, Goutam. Gangopadhyay We hereby report two cases who had a prolonged history of headache which had characteristics of migraine; but subsequently, they developed [...]

Byline: Mrinal. Acharya, Subhadeep. Banerjee, Apratim. Chatterjee, Adreesh. Mukherjee, Samar. Biswas, Goutam. Gangopadhyay, Atanu. Biswas Objectives: The aim of this study was to evaluate the sensitivity and specificity of various [...]

Objective: The course of various cerebellar ataxia disorders in our population is relatively unexplored, especially beyond the hereditary spinocerebellar ataxias (SCA). This study was conducted to objectively assess the severity and progression of various disorders causing the cerebellar ataxia. Materials and Methods: This longitudinal prospective study evaluated the etiologies and the corresponding severity and progression of the cerebellar ataxia. Clinical examination and the relevant investigations were performed. The severity of ataxia was assessed using the Scale for Assessment and Rating of Ataxia (SARA) - at initial presentation and another at 6 months of follow-up, and the change in SARA scores were calculated to find the disease progression. Results: Out of 145 patients studied, SCA predominated followed by Autoimmune/paraneoplastic disorders, Multiple System Atrophy-Cerebellar (MSA-C), Wilson's disease, and Multiple sclerosis. On follow-up, human immunodeficiency virus (HIV) associated progressive multifocal leukoencephalopathy was the most rapidly advancing disease, followed by MSA-C, Friedreich's ataxia, and Huntington's disease, all of which progressed faster than SCA. SCA 3 emerged as the most progressive SCA followed by SCA 1, SCA 6, SCA 2, and SCA 12. The autoimmune etiologies showed favorable response to treatment, although with some variability across the different disorders. In the paraneoplastic category, anti Tr associated ataxia improved better than other disorders. Multiple sclerosis and other treatable disorders also responded to treatment. Conclusion: Cerebellar ataxia is the predominant clinical feature in a wide variety of disorders. While some are progressive, others are responsive to treatment, the extent of which differed according to the etiology. [ABSTRACT FROM AUTHOR]

Byline: Asutosh. Pal, Atanu. Biswas, Alak. Pandit, Arijit. Roy, Debsankar. Guin, Goutam. Gangopadhyay, Asit. Senapati Objectives: To assess the visuospatial function in different types of dementia with the visual object [...]

Byline: Tushar. Bandyopadhyay, Atanu. Biswas, Arijit. Roy, Deb. Guin, Goutam. Gangopadhyay, Sujit. Sarkhel, Malay. Ghoshal, Asit. Senapati Sir, We sincerely thank the reader(s) for his/her/their interest in our article entitled [...]

Byline: Tushar. Bandyopadhyay, Atanu. Biswas, Arijit. Roy, Deb. Guin, Goutam. Gangopadhyay, Sujit. Sarkhel, Malay. Ghoshal, Asit. Senapati Background/Aims: The aim of the following study is to compare the behavioral and [...]

Byline: Satyabrata. Pulai, Atanu. Biswas, Arijit. Roy, Deb. Guin, Alak. Pandit, Goutam. Gangopadhyay, Prabhat. Ghorai, Sujit. Sarkhel, Asit. Senapati Background: Magnetic resonance imaging (MRI) helps in the diagnosis of neurologic [...]

Byline: Atanu. Biswas, Namrata. Khandelwal, Alak. Pandit, Arijit. Roy, Deb. Guin, Goutam. Gangopadhyay, Asit. Senapati Background: Creutzfeldt-Jakob disease is a rapidly progressive, fatal, transmissible neurodegenerative disorder caused by prion protein. [...]

Background: The pattern of post-stroke aphasia in speakers of Bengali language has not previously been reported in the literature. Furthermore, the inter-relationship between age, gender, and level of education and aphasia typology has remained unsettled thus far. Aims: To investigate the incidence and type of aphasia in first-ever acute stroke patients who were speakers of Bengali language. Methods & Procedures: Bengali version of Western Aphasia Battery was used for language assessment in our study participants. Lesion localization was done by using magnetic resonance imaging(3T) for ischemic stroke (if not contraindicated) and computed tomography for hemorrhagic stroke. Among 515 screened cases of first-ever acute stroke, 208 presented with aphasia. Language assessment was done between 7 and 14 days in all study participants. Outcomes & Results: The incidence of post-stroke aphasia in our sample was found at 40.39%. Types of aphasia were – Broca's (38.5%) followed by global (27.9%); Wernicke's (12.5%); transcortical motor (9.6%); anomic (4.3%); transcortical sensory (3.8%); isolation (1.9%); and conduction (1.4%). Mean number of years of formal education was significantly higher in fluent aphasia group in comparison with non-fluent group (10.51 years versus 7.01 years, p = 0.003). In logistic regression analysis, location of lesion (posterior perisylvian) (p = 0.007, OR = 5.406, 95% CI, 1.602–18.240) and education (p = 0.044, OR = 1.097, 95% CI, 1.003–1.199) were two independent predictors favoring fluent aphasia. Conclusions: Aphasia among post-stroke Bengali patients is quite frequent. The commonest type of aphasia in our sample was Broca's aphasia. Bengali-speaking people with higher education were more likely to present fluent aphasia. [ABSTRACT FROM AUTHOR]

Background/Aims: The aim of the following study is to compare the behavioral and psychological symptoms of dementia (BPSD) in patients of Alzheimer disease (AD) and vascular dementia (VaD). Materials and Methods: We used National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for diagnosing AD and National Institute of Neurological Disorders and Stroke-Association International pour la Recherche et l'Enseignement en Neurosciences Criteria for diagnosing VaD. VaD cohort was further subcategorized into small vessel and large vessel disease. The severity of cognitive impairment and the BPSD were studied by means of the Clinical Dementia Rating Scale (CDR) and the Neuropsychiatric Inventory respectively. Results: We studied 50 AD and 50 VaD patients of whom 38 were small vessels and 12 were large vessels VaD. The severity of dementia was comparable in both groups. The agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, irritability, aberrant motor behavior, appetite and eating behavior and night-time behaviors occurred significantly more frequently in patients with VaD than AD. We found a weak positive correlation between the CDR score and the number of neuropsychiatric symptoms per patient in both cohorts. Elation/euphoria, agitation/aggression was significantly more frequent in patients with large vessel in comparison to small vessel VaD. Conclusions: BPSD are common in both types of dementia and they are more severe in VaD than AD when the groups have similar levels of cognitive impairment. [ABSTRACT FROM AUTHOR]

Background and Aims: Post-stroke complications can lead to frequent and major causes of death in the early phases after an acute stroke. Aims of the present study were to determine the association of several risk factors with the occurrence of poststroke complications, the predictors for the development of complications, and to evaluate how these complications affected the overall prognosis among subjects with the first ever acute stroke. This study is the pioneer study of this kind from Eastern India. Previous national and international studies on this lack uniformity in their results probably because of the following reasons: no standard definitions for complications following the stroke, varied follow-up periods ranging from 1 week to 30 months, type and severity of stroke affecting the incidence, and finally, the demographic variables. Methods: This was an observational, prospective study, in which a total of 521 adult male and female patients who had a first-ever acute stroke, aged between 12 years to 75 years were enrolled over a period of 2 years (September 2016 to September 2018), admitted in Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, India. Patients with first ever acute stroke were studied for post-stroke complications (predefined with standard criteria) during the hospital stay at Bangur Institute of Neurosciences (BIN), Kolkata, India, and their association with risk factors, severity of stroke (National Institutes of Health Stroke Scale Score, NIHSS), length of hospital stay (in days) and outcome (Modified Rankin Scale, MRS) were assessed. Results: A total of screened 498 patients who were admitted at Bangur Institute of Neurosciences (BIN), Kolkata, India, with first ever acute stroke were recruited. The mean age was 61.02 years (range 23-75 years), the majority being male (n = 307; 61.6%). Post-stroke complication during hospital stay was documented in 270 patients (54.2%) (males and females combined). In logistic regression analysis, multiple risk factors (OR, 1.571; 95% CI, 1.084-2.278; P-0.017), severity of stroke (National Institutes of Health Stroke Scale Score, NIHSS) (OR, 1.425; 95% CI, 1.027-1.976; P-0.034) and length of hospital stay (in days) (OR, 3.565; 95% CI, 2.029-6.264; P < 0.0001) were the most robust predictors of occurrence of complications. The independent predictors of poor outcome in subjects with complications were: chest infection (OR, 2.07; 95% CI, 1.006-4.26; P = 0.048), bedsores (OR, 2.26; 95% CI, 1.03-4.94; P-0.042), and seizures (OR, 5.072; 95% CI, 1.08-23.79; P-0.039). Conclusion: In our study, the most independent predictors of complications were severity of stroke and length of hospital stay. This observation might help clinicians in taking appropriate measures towards preventing post-stroke complications and thereby improving outcome following a stroke. [ABSTRACT FROM AUTHOR]

Introduction: Neurological disorders in pregnancy may be observed in patients with a pre-existing neurological disorder; patients developing a primary neurological disorder during the course of pregnancy or puerperium; and in patients with primary medical disorders presenting with neurological manifestations., Objectives: The objectives of the study were to find out the magnitude of neurological disorders in pregnancy in a tertiary care hospital along with assessment of proportion of women with particular disorders among total number of neurological disorders during the course of pregnancy or puerperium (6 weeks after child birth) and also to elicit the effect of neurological disorders on pregnancy outcome, if any., Methods: A prospective observational longitudinal study was carried out in a tertiary care centre of Eastern India from July 2018 to June 2020 including all pregnant women attending the department of Obstetrics and Gynaecology. We screened 886 pregnant women, out of which 91 cases were identified and investigated. For the purpose of comparison of fetal and maternal outcome, 91 control subjects were chosen from the screened patients in a randomized fashion, so that the baseline characteristics of the two groups were comparable Results: In our study, 10.3% population had neurological disorders, among which 30.8% had primary headache, 3.2% had secondary headache, 8.5% had neurological low back pain, 19.1% had epilepsy, 6.4% had cerebrovascular disorders, 27.6% had peripheral neuropathy, 4.2% had other disorders such as neuropsychiatric Wilson's disease, myasthenia gravis and compressive myelopathy. Moreover, 10.2% of the total study population was hypertensive and 2.9% were diabetic., Conclusion: 10.3% mothers did have some neurological disorder, the commonest of which was migraine (primary headache) followed by carpal tunnel syndrome (peripheral neuropathy) and neurological low back pain. Overall fetomaternal outcomes were favorable barring cerebro-vascular disorder and Posterior reversible encephalopathy syndrome (PRES). We recommend screening for neurological disorder from early pregnancy for early detection and appropriate management of that condition., (© Journal of the Association of Physicians of India 2011.)