Browsing by Author "Khan, FR"

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    Can transcranial magnetic stimulation be used to evaluate patients with narcolepsy?
    (NEUROLOGICAL SCIENCES, 2013) Vijayakumari, AA; Khan, FR; Varma, RP; Radhakrishnan, A
    Narcolepsy is a rare, chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy and other manifestations of dissociated rapid eye movement in sleep. We assessed the utility of transcranial magnetic stimulation (TMS) as an objective tool to elucidate the cortical excitability changes and also to analyze its role in assessing the treatment efficacy in narcolepsy. Eight patients with narcolepsy under our regular follow-up from 2000 to 2009 at our Sleep disorder clinic were chosen. All of them underwent polysomnography, multiple sleep latency tests and TMS. Resting motor threshold (RMT), cortical silent period (CSP) and central motor conduction time (CMCT) were assessed using TMS in both drug-na < ve and post-treatment states. Eight controls were also subjected to all the three investigations. Appropriate statistical methods were used. The mean RMT (%) pre-treatment was higher in narcolepsy patients than that in controls, and it normalized following treatment. CSP and CMCT were unaffected in narcolepsy patients as compared to controls. This study shows that the cortical excitability is significantly low in narcolepsy patients. This motor cortex hypoexcitability becomes normal with the institution of treatment, pari passu with the control of symptoms. In future, TMS may be considered as an effective tool for documenting the treatment efficacy in patients with narcolepsy.
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    Physiotherapy Practice in Stroke Rehabilitation: A Cross-Sectional Survey of Physiotherapists in the State of Kerala, India
    (TOPICS IN STROKE REHABILITATION, 2012) Khan, FR; Vijesh, PV; Rahool, S; Radha, AA; Sukumaran, S; Kurupath, R
    Background: Physiotherapy, a major component of rehabilitation for stroke patients, has been shown to have a positive effect on outcome. However, there is debate over efficacy of different interventions related to stroke rehabilitation. Purpose: The purpose of this study was to compare knowledge and attitudes of physiotherapists working with stroke patients in Kerala, India, with emphasis on demographics, approach to treatment, and beliefs about stroke rehabilitation. Methods: Two hundred one physiotherapists in Kerala were surveyed using questionnaires, which were sent by post. Questionnaires consisted of items related to stroke rehabilitation such as approaches to physiotherapy, use of walking aids, and discharge issues. Data analysis was done using percentage-wise comparisons. Results: Examination of results showed variation in the beliefs held by physiotherapists about treatment of stroke patients. Of the 201 respondents, 153 (76.1%) used a conventional treatment approach. There was a strong disparity among physiotherapists regarding use of walking aids by stroke patients: 119 (59.2%) agreed that tripods or quadripods should be given to patients, but 55 (27.4%) disagreed and 27 (13.4%) were unsure. In response to questions about discharge issues, 30 (14.9%) of the 118 respondents agreed that they were actively involved in discharge planning for stroke patients, and 158(78.6%) agreed that skill of the physiotherapist influences outcomes. Conclusion: A great deal of variation among physiotherapists in treatment approaches and beliefs was revealed in this study, which indicates the need for development and implementation of a standardized protocol for stroke rehabilitation in Kerala.
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    Successful Treatment of Refractory Organic Catatonic Disorder With Repetitive Transcranial Magnetic Stimulation (rTMS) Therapy
    (JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES, 2011) Kate, MP; Raju, D; Vishwanathan, V; Khan, FR; Nair; Thomas, SV