Browsing by Author "Thomas, S. V."

Now showing 1 - 4 of 4
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    Accidents and injuries in people with epilepsy attending a tertiary care center in India
    (EPILEPTIC DISORDERS, 2008)
    People with epilepsy have a higher risk of accidents and injuries when compared to others in the community. Seizure frequency and other characteristics of epilepsy and its treatment are known to influence this risk. The risk of accidental injury to people with epilepsy may vary in different geographical areas, according to their life style, leisure activities and other pursuits. The objective was to ascertain the accidents and injuries experienced by a cohort of people with epilepsy in India, and to ascertain any possible predictors. The study was carried out in the Epilepsy Clinic of Sree Chitra Tirunal Institute for Medical Sciences and Technology between January and June 2007. Using a structured questionnaire, we interviewed all consenting adults attending this tertiary epilepsy center who had had active epilepsy for one or more years. Two hundred and fifty five patients completed the Study. The diagnoses included localization-related epilepsy for 62.61% of the patients and generalized epilepsy for the remainder. During the 12 months prior to the interview, 44.81% had had at least one injury; 7.8% had Sustained an accident. Road traffic accidents (3.11%), burns (2.5%), electric shocks (0.8%) and near drowning (0.49%) were the commonly reported accidents. Age, sex, type of epilepsy and type of medication had no significant association with the Occurrence of injuries or accidents. However, we found that a quarter of file people with epilepsy studied had experienced serious injuries.
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    Long-term visual outcome in idiopathic intracranial hypertension
    (ANNALS OF INDIAN ACADEMY OF NEUROLOGY, 2011)
    Objective: To characterize the course, outcome, and risk of relapse or late worsening in a clearly defined cohort of idiopathic intracranial hypertension (IIH) over a long period of follow-up. Materials and Methods: Retrospective chart review of patients with definite IIH was evaluated at the Sree Chitra Tirunal Institute for Medical Sciences and Technology between 1998 and 2006. Patients demographic data, clinical, neuro-ophthalmic examinations, and treatment details were abstracted. Patients were further categorized into three groups based on whether they improved, worsened, or relapsed on follow-up. Final visual outcome of each patient was defined according to grading of the worse eye at the last visit. Statistical analysis included t test to compare group means and chi-square test to compare proportions. Results: Of the 43 women included, visual impairment was observed in 80 eyes (93) at presentation and it was moderate to severe in 14. The mean CSF opening pressure at presentation did not differ significantly in those with visual impairment compared to those with normal vision. Those having early severe visual impairment had significantly higher (P = 0.015) likelihood of severe visual impairment on last follow-up. Of the total, 34 patients (79) improved, 4 (9.3) relapsed on follow-up after period of stability, and 5 (11.6) worsened over 56 months follow-up (range, 26-132 months). The groups were comparable, except those who improved were younger (P < 0.05). At last examination, 9 had significant vision loss. Conclusion: IIH patients can have delayed worsening or relapses and about tenth of patients can have permanent visual loss early or late in the course of the disease. All patients with IIH need to be kept under long-term follow-up, with regular monitoring of visual functions.
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    Maternal and obstetric outcome of women with epilepsy
    (SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 2009)
    Medical professionals and public are concerned about the complications of pregnancy and delivery in women with epilepsy (WWE).Purpose: Our aim was to prospectively ascertain Occurrence of these complications in a cohort of WWE enrolled in a pregnancy registry.Methods: All complications during pregnancy, delivery and first 48 h Of Postpartum period were recorded according to the registry protocol. This data were compared with similar statistics (for women without epilepsy) from a large teaching hospital.Results: Between April 1998 and March 2005, there were 643 completed pregnancies in this registry. (Mean age 25.7 +/- 4.43 years; generalized epilepsy 46%; localization related epilepsy 54%: primigravida 53%.) Their complications are compared with those of 18,272 pregnancies managed in the teaching hospital (in parentheses). Spontaneous abortions 4.2% (2.38%); medical termination of pregnancies 2.64% (7.71%); anemia 0,62% (0.22%); gestational diabetes 1.56% (3.09%); pregnancy induced hypertension 3.89% (6.45%): antepartum hemorrhage 0.93% (1.64%); preterm labor 1.87% (6.12%); obstructed labor 0.62% (3%): cesarean section 33.4% (29.5%): assisted delivery 2.8% (2.68%); postpartum hemorrhage 0.31% (0.64%): peripartum seizures 1.4% (0.04%); intrauterine death 1.56% (2.2%); fibroid uterus or ovarian cyst 2.33% (0.53%): other medical illness 2.5% (2.15%); TORCH infection 0.31% (0.01%); birth weight <2.0 kg 4.19% (7.66%).Conclusions: There was no significant increase in the risk of complications of pregnancy or delivery except for spontaneous abortions, anemia, ovarian cyst, fibroid uterus, and seizures in the peripartum period which were more frequent in WWE. Frequency of cesarean section is not increased in WWE. There is no undue risk to pregnancy and childbirth in most WWE. (c) 2008 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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    Reversible periictal MRI abnormalities: Clinical correlates and long-term outcome in 12 patients
    (EPILEPSY RESEARCH, 2007)
    Although a wide spectrum of reversible periictal magnetic resonance imaging (MRI) abnormalities (RPMA) are being increasingly identified, the clinicians are often in a dilemma about their localization significance. This prompted us to analyze the clinical, MRI, electroencephalographic (EEG) and follow-up data of 12 patients with RPMA seen in a tertiary referral epilepsy center. RPMA occurred after a single or a cluster of focal seizures with or without secondary generalization. The interictal and ictal EEG abnormalities were localized to the site of RPMA in nine patients. RPMA involved areas remote from the site of EEG abnormalities in four patients. We have developed a comprehensive classification to account for the wide spectrum of RPMA involving gray matter, white matter and teptomeninges with or without contrast enhancement or mass effect. Follow-up MRIs showed complete resolution of RPMA in all, except in four patients, who developed residual focal atrophy. During median follow-up period of 3 years, recurrence of RPMA was observed in two patients. Diffusion weighted MRI in two patients and histopathological finding in one patient favored causal rote of hypoxia in the pathogenesis of RPMA. Our observations help to understand the electroclinical profile, radiological spectrum, localization significance and natural history of RPMA better. (c) 2006 Elsevier B.V. All rights reserved.