Browsing by Author "Ashalatha, R"

Now showing 1 - 17 of 17
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    Atypical presentation of bilateral phrenic nerve palsy and its unusual recovery after coronary artery bypass grafting.
    (THORACIC AND CARDIOVASCULAR SURGEON, 2006) Duara, R; Sarma, AK; Sinha, PK; Ashalatha, R; Misra, M
    Bilateral phrenic nerve paralysis after coronary artery bypass surgery in a 47-year-old female patient is reported. This became evident on the 5th post-extubation day and mimicked acute coronary syndrome and led to difficulty in diagnosis. The patient required re-intubation and mechanical ventilation for only 6 days. The diagnosis of clinical and radiological abnormalities suggestive of bilateral phrenic nerve dysfunction was assisted by fluoroscopy, measurement of needle electromyography, and phrenic nerve motor conduction studies. The patient was followed up postoperatively for 14 weeks with complete regression of the neuropathy one month after surgery. An awareness of this complication should lead to improved care and successful postoperative management of patients.
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    Cerebral aneurysms in atrial myxoma: a delayed, rare manifestation.
    (Neurology India, 2005)
    Atrial myxomas are the most common primary tumors of the heart. Neurologic involvement usually occurs as a stroke with ischemic episodes. Following excision of cardiac myxomas, delayed neurologic events owing to aneurysms are rare and have not been reported from India. We report an operated case of left atrial myxoma. The patient initially presented with a stroke and 6 months after the surgery, developed multiple intracerebral hemorrhages due to the rupture of fusiform cerebral aneurysms, without recurrence of the cardiac tumor.
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    CIDP, Hashimoto's Thyroiditis and Nephropathy: Autoimmune Syndrome Complex?
    (CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES, 2009) Raghavendra, S; Sanjay, S; Somashekar, R; Ashalatha, R; Shankar, SK
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    Corpora amylacea (CoA) in refractory mesial temporal lobe epilepsy: Clinico-pathological correlations
    (EPILEPSIA, 2005) Ashalatha, R; Cherian, PJ; Radhakrishnan, VV; Radhakrishnan, K; Sarma, PS
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    Eating epilepsy revisited- an electro-clinico-radiological study
    (JOURNAL OF CLINICAL NEUROSCIENCE, 2016) Jagtap, S; Menon, R; Cherian, A; Baheti, N; Ashalatha, R; Thomas, SV
    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-parietooccipital) 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 limbicopercular pathways represents a plausible mechanism. Surgical selection should be diligent and cautious in this group of patients. (C) 2016 Elsevier Ltd. All rights reserved.
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    Emergent EEG is helpful in neurology critical care practice
    (CLINICAL NEUROPHYSIOLOGY, 2005) Khan, SF; Ashalatha, R; Thomas, SV; Sarma, PS
    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 X 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 It 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. (c) 2005 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
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    Emergent EEG is helpful in neurology critical care practice.
    (Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2005)
    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 chi2 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.
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    Functional and clinical outcome and its predictors in osmotic demyelination syndrome in 25 patients
    (JOURNAL OF THE NEUROLOGICAL SCIENCES, 2009) Ramesha, KN; Ashalatha, R; Fayaz, RK; Unnikrishnan, JP; Sankara, PS
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    Moya Moya disease : an unusual clinical presentation.
    (The Journal of the Association of Physicians of India, 2005)
    Moya Moya disease is a rare cause of stroke in adults, and is a rarity secondary to hepatitis C virus infection (HCV) and cryoglobulinemia (CG). We report such a rare association in a young patient who presented with intracerebral hemorrhage.
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    Periodic EEG pattern in neurodengue - a novel observation
    (EUROPEAN JOURNAL OF NEUROLOGY, 2005)
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    Rasmussen's encephalitis in India: Clinical features and treatment outcome
    (EPILEPSIA, 2005) Rajesh, B; Ashalatha, R; Keshavdas, C; Radhakrishnan, K
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    Satoyoshi syndrome
    (NEUROLOGY INDIA, 2004)
    Satoyoshi syndrome (Komuragaeri disease) is a rare disorder of presumed autoimmune etiology, characterized by painful muscle spasms, alopecia, diarrhea, endocrinopathy with amenorrhoea and secondary skeletal abnormalities. Most of the previous reports are of the Japanese people. We report the first case from India.
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    Satoyoshi syndrome: Comments - Reply
    (NEUROLOGY INDIA, 2004) Ashalatha, R; Kishore, A; Sarada, C; Nair, MD
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    SEXUALITY IN MALE PATIENTS AFTER ANTERIOR TEMPORAL LOBECTOMY (ATL) FOR MESIAL TEMPORAL LOBE EPILEPSY-HIPPOCAMPAL SCLEROSIS (MTLE): A CASE CONTROL STUDY
    (EPILEPSIA, 2009) Nekkare, RK; Ashalatha, R; Padickaparambal, S; Sankara, P; Radhakrishnan, K
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    Use of Electrographic Seizures and Interictal Epileptiform Discharges for improving performance in Seizure Prediction
    (PROCEEDINGS OF THE 2015 IEEE RECENT ADVANCES IN INTELLIGENT COMPUTATIONAL SYSTEMS (RAICS), 2015) Sudalaimani, C; Asha, SA; Parvathy, K; Thomas, ET; Devanand, P; Sasi, PM; Menon, RN; Ashalatha, R; Thomas, SV
    Electroencephalography (EEG) is an important tool in analyzing brain activity. EEG recording is effectively used for detection and prediction of electrophysiological abnormalities due to epilepsy. Epileptic seizure is a brain disorder which affects the patients acutely. Seizures are controllable with medication in 70% of the cases, however the rest may continue to have recurring epileptic seizures despite medications. Since seizures are unpredictable clinically, these patients will also live with perpetual anxiety about the onset of seizure, apart from being affected by the seizure consequences such as drowsiness, headache, vomiting, etc. The seizures can cause injury to the patients, and in some cases may even result in death. Seizure prediction can aid patients with disabling seizure by detecting the seizure precursors in advance and alerting the patients or their caregivers. If the seizure is predicted in advance it can be aborted by fast acting Anti-epileptic drugs (AEDs) or other treatment procedures. This will also aid pre-surgical video EEG monitoring wherein prediction of the ictal onset zone is paramount and machine alarms can be devised. In this paper, we are comparing the results of our research work related to the seizure prediction models. First model, as in usual practice, differentiates between preictal and interictal data segments only. The other seizure prediction model uses Interictal Epileptiform Discharges (IEDs), Electrographic Seizures (ES) and ictal data segments in addition to the first model. We found that the latter one provided better results and improved the seizure prediction performance.