Browsing by Author "Jagtap, S"

Now showing 1 - 8 of 8
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    EARLY ONSET FOCAL DYSTONIA IN A CASE OF YOUNG STROKE WITH HYPERHOMOCYST(E)INEMIA (HHCY)
    (INTERNATIONAL JOURNAL OF STROKE, 2016) Jagtap, S; Chaudhari, K; Tiwari, N
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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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    Epilepsy with myoclonic absences: Electroclinical characteristics in a distinctive pediatric epilepsy phenotype
    (EPILEPSY & BEHAVIOR, 2016) Zanzmera, P; Menon, RN; Karkare, K; Soni, H; Jagtap, S; Radhakrishnan, A
    Purpose: The purpose of this article was to study the electroclinical characteristics and seizure outcome of children with epilepsy with myoclonic absences (EMA). Method: In this descriptive cohort study, we reviewed clinical records of patients who met the criteria for EMA. Each patient's demographic data, birth/developmental history, seizure semiology/pattern, antiepileptic drugs (AED), clinical examination, video-electroencephalography (VEEG), and neuroimaging data were reviewed. Response to AED and change in seizure frequency/pattern on follow-up were noted. Responders were defined by seizure freedom/>50%.reduction.in seizure frequency on follow-up. Result: Twelve children were diagnosed with EMA between 2008 and 2013 [50% male; mean age of onset: 3.5 years]. Main seizure types were the characteristic myoclonic absences (100%) and generalized tonic-clonic seizures (42%). Ictal correlate on VEEG was 3- to 3.5-Hz spike-and-wave discharges (82%) and fast recruiting bifrontal rhythm (25%). One patient had specific MRI abnormalities. Mean duration of follow-up was 23.9 months. Seizure frequency had significantly improved on follow-up (p = 0.005), and at last follow-up, nine patients were in the responder group: four seizure-free for at least 1 year, two with >90%, and three with >50% reduction in seizure frequency. The number of AED reduced significantly between initial visit and last follow-up among responders. Two patients on follow-up developed different seizure patterns, with generalized tonic and complex partial seizures. One responder expired because of unprovoked generalized convulsive status epilepticus. Conclusion: This cohort, the largest from the Indian subcontinent on the rare syndrome of EMA, suggests mild heterogeneity in a seemingly homogenous electroclinical phenotype. Clinical semiology while unique may demonstrate focality and variable ictal patterns. Most patients respond to either valproate monotherapy or valproate-lamotrigine combination; however, the prognosis remains guarded. The seizures of a minority of patients remain drug-refractory and may evolve into tonic or complex partial seizures. (C) 2016 Elsevier Inc. All rights reserved.
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    Imaging of vascular causes of trigeminal neuralgia
    (JOURNAL OF NEURORADIOLOGY, 2012) Harsha, KJ; Kesavadas, C; Chinchure, S; Thomas, B; Jagtap, S
    Trigeminal neuralgia (TN) is a neuropathic disorder associated with severe recurrent episodic facial pain affecting predominantly elderly people. Though medical management is effective in pain control in first 2 years of symptom onset, many patients eventually require surgical intervention. Preoperative magnetic resonance imaging (MRI) evaluation of posterior fossa helps to identify major etiologies for TN. Neurovascular conflict is a common cause of TN. MRI is unique in imaging entire course of the trigeminal nerve, cisternal segment in particular. Microvascular decompressive (MVD) surgery is a safe and effective method for relieving neuralgic pain in neurovascular conflicts. We described vascular causes of TN, MR sequences useful in imaging of trigeminal nerve, the various vascular etiological possibilities, factors to be mentioned in MRI report. (C) 2012 Elsevier Masson SAS. All rights reserved.
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    LATERALIZING VALUE OF TEMPORAL NEOCORTICAL APPARENT DIFFUSION CO-EFFICIENT (ADC) AND T2 RELAXOMETRY VALUES IN MESIAL TEMPORAL LOBE EPILEPSY WITH HIPPOCAMPAL SCLEROSIS
    (EPILEPSIA, 2013) Hingwala, D; Rathore, C; Jagtap, S; Gautam, N; Abraham, J; Kesavadas, C; Radhakrishnan, K
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    Mucolipidosis and progressive myoclonus epilepsy: A distinctive phenotype
    (NEUROLOGY INDIA, 2013) Menon, RN; Jagtap, S; Thakkar, R; Narayanappa, G; Nair, M
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    Sturge-Weber Syndrome: Clinical Spectrum, Disease Course, and Outcome of 30 Patients
    (JOURNAL OF CHILD NEUROLOGY, 2013) Jagtap, S; Srinivas, G; Harsha, KJ; Radhakrishnan, N; Radhakrishnan, A
    Sturge-Weber syndrome is a heterogeneous neurocutaneous syndrome with facial and leptomeningeal angiomas, glaucoma, seizures, stroke-like episodes, and mental retardation. The authors critically evaluated the clinical manifestations, outcome, and natural history in 30 patients with Sturge-Weber syndrome followed up from January 1985 to May 2010. Of the patients, 15 were males, age at diagnosis ranged from 1 month to 43 years. Typical port-wine stain nevus occurred in 26 (86%), it was bilateral in 2 (8%), and it was absent in 4 (4%). Nine patients had glaucoma (30%), 3 required surgery. Four had transient hemiparesis. All patients had seizures; they were well controlled in 22 (73.3%); in 8 they remained drug resistant. Three patients underwent surgery and became seizure-free. Of the 17 who had mental subnormality, 14 (82.4%) had seizure onset before 2 years. An early age at seizure onset and those with drug-resistant seizures had more severe degree of mental subnormality. Uncontrolled seizures, mental subnormality, visual handicap, and cosmetic disfiguration were the major impediments in life.