Browsing by Author "Kannoth, S"

Now showing 1 - 4 of 4
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    Autoimmune encephalitis: Clinical diagnosis versus antibody confirmation
    (ANNALS OF INDIAN ACADEMY OF NEUROLOGY, 2015) Cyril, AC; Nair, SS; Mathai, A; Kannoth, S; Thomas, SV
    Context: Autoimmune encephalitis is a heterogeneous disorder which is being diagnosed with increasing frequency. The diagnosis of these disorders is based on the detection of autoantibodies and characteristic clinical profiles. Aims: We aimed to study the antibody profile in encephalitis patients with suspected autoimmune etiology presenting to a tertiary care center. Settings and Design: The subjects were selected by screening all patients with clinical profile suggesting autoimmune encephalitis admitted in the neuromedical intensive care unit (ICU) of a tertiary care center in South India. Materials and Methods: Patients who fulfilled modified Zuliani et al.'s, criteria for autoimmune encephalitis were identified during the period December 2009-June 2013. Blood samples from these subjects were screened for six neuronal antibodies. Statistical analysis used: Chi-square test was applied to compare the antibody positive and negative patients. Results: Out of 1,227 patients screened, 39 subjects (14 males: 25 females) were identified with a mean age of 15.95 years and 19 cases were assessed in the acute and 20 in the convalescent phase of the illness. Seizure (87.8 %) was the most common presenting symptom; status epilepticus occurred in 23 (60.5%) patients during the course of the illness. Fourteen (35.9%) patients were N-methyl-D-aspartate receptor (NMDAR) antibody-positive and all were negative for the other antibodies tested. Conclusions: One-third of patients presenting with acute noninfective encephalitis would be positive for NMDAR antibodies with the remaining two-thirds with clinically suspected autoimmune encephalitis being antibody-negative. There are few markers in the clinical and investigative profiles to distinguish antibody-positive and -negative patients.
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    Collateral Assessment by CT Angiography as a Predictor of Outcome in Symptomatic Cervical Internal Carotid Artery Occlusion
    (AMERICAN JOURNAL OF NEURORADIOLOGY, 2017) Sundaram, S; Kannoth, S; Thomas, B; Sarma, PS; Sylaja, PN
    BACKGROUND AND PURPOSE: Cervical internal carotid artery occlusion can present with varied clinical manifestations such as transient ischemic attack, stroke, and chronic ocular ischemia, or can be asymptomatic. The outcome in these patients is considerably influenced by cerebral hemodynamic compensatory adaptation of the intracranial collateral pathways. Our aim was to study whether collateral circulation as assessed by CT angiography can predict 3-month outcome and initial stroke severity in patients with symptomatic cervical ICA occlusion. MATERIALS AND METHODS: This was a retrospective study of 65 patients with symptomatic cervical ICA occlusion from January 2011 to December 2013. The collateral vessels (anterior and posterior communicating arteries, ophthalmic artery, and leptomeningeal arteries) were assessed by CTA. The outcome at 3 months was defined as poor if the modified Rankin Scale score was >= 3. RESULTS: The mean age of subjects was 57 +/- 11.6 years (range, 32-80 years), and 92% were men. Thirty-three (50.8%) patients had poor outcome. Absence of the ipsilateral ophthalmic artery, poor leptomeningeal collaterals, and <2 collaterals were predictors of stroke severity at onset and poor 3-month outcome in univariate analysis. In the multiple logistic regression analysis, inadequate flow through the secondary collaterals.(ipsilateral ophthalmic artery or leptomeningeal collaterals; OR, 4.5; 95% CI, 1.4-14.9; P =.01) and higher NIHSS score at stroke onset (OR, 19.2; 95% CI, 2.2-166.2; P =.007) independently predicted poor outcome at 3 months. CONCLUSIONS: Assessment of collateral circulation with CTA can be a useful predictor of 3-month outcome in patients with symptomatic cervical ICA occlusion.
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    CT angiogram as a predictor of outcome in symptomatic ICA occlusion
    (INTERNATIONAL JOURNAL OF STROKE, 2014) Sundaram, S; Sylaja, PN; Kannoth, S; Thomas, B
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    Primary CNS vasculitis presenting as intraventricular bleeding
    (ANNALS OF INDIAN ACADEMY OF NEUROLOGY, 2016) Pillai, SH; Sreedharan, SE; Menon, G; Kannoth, S; Sylaja, PN
    Primary angiitis of the central nervous system (PACNS) is a rare disorder affecting both medium- and small-sized vessels. Intracranial haemorrhages though less reported are in the form of parenchymal haemorrhage and subarachnoid haemorrhage. We report a case of PACNS with intraventricular haemorrhage due to aneurysms secondary to progression of vasculitis.