Publications by authors named "Asranna Ajay"

Mitochondrial membrane protein-associated neurodegeneration (MPAN) is a rare neurodegenerative disorder characterized by spastic paraplegia, parkinsonism and psychiatric and/or behavioral symptoms caused by variants in gene encoding chromosome-19 open reading frame-12 (C19orf12). We present here seven patients from six unrelated families with detailed clinical, radiological, and genetic investigations. Childhood-onset patients predominantly had a spastic ataxic phenotype with optic atrophy, while adult-onset patients were presented with cognitive, behavioral, and parkinsonian symptoms.

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Objective: We aim to provide a pictorial representation of the broad spectrum of intracranial hemorrhages associated with cerebral venous thrombosis (CVT), emphasizing atypical locations and rare intracerebral hemorrhage (ICH) types. We also hypothesize the pathophysiology leading to atypical locations of the ICH in CVT and the outcomes with anticoagulation therapy.

Background: ICH complicates about 40% of cases with CVT and is known to cause various types of ICH, including subarachnoid hemorrhage (SAH) and subdural hemorrhage (SDH).

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  • The study investigated how COVID-19 disruptions affected neuroscience research projects and young researchers in India through an online survey targeting medical trainees, post-docs, PhD students, and early career faculty.
  • A total of 504 valid responses revealed that over 83% of participants experienced negative impacts on their research, with one-third noting delays and many adapting their methodologies due to the pandemic.
  • The findings highlighted significant challenges, particularly for those involved in prospective studies, emphasizing the need for focused support for neuroscience research in the post-pandemic landscape.
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  • Magnetoencephalography (MEG) can help identify regions of seizure activity in patients with drug-resistant epilepsy (DRE) who have normal MRI scans.
  • A study of 73 patients showed that MEG effectively localized seizure sources in 70% of cases, with a moderate agreement in findings when compared to video electroencephalography (VEEG).
  • The results suggest that MEG is a valuable tool for presurgical evaluations in DRE patients, especially when MRI results are inconclusive.
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Purpose: New onset status epilepticus (NOSE), a subtype of status epilepticus, is a neurological emergency associated with significant morbidity and mortality. This study aimed to analyze the phenotypic spectrum and outcomes of patients presenting with NOSE.

Methods: This prospective and retrospective descriptive study included patients presenting with NOSE over a 10-year period.

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Background: The analysis of EEG demands expertise and keen observation to distinguish epileptiform discharges from benign epileptiform variants (BEVs), a frequent source of erroneous interpretation. The prevalence of BEVs varies based on geographical, racial, and ethnic characteristics. However, most data on BEVs originates from Western populations, and additional studies on different cohorts would enrich the existing literature.

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  • Subacute sclerosing panencephalitis (SSPE) is a serious neurological disorder linked to persistent measles virus infection, with its effects on heart function remaining inadequately studied.
  • This research involved 30 SSPE patients and matched controls in Southern India, evaluating heart rate variability (HRV) through detailed electrocardiogram analysis.
  • The results showed that SSPE patients had significantly lower HRV compared to controls, indicating autonomic dysfunction, which may correlate with the severity of the disease.
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  • Approximately 40% of pediatric epilepsies are genetic, with sodium channel mutations being a common cause, particularly noted in the SCN1A gene, which is associated with various epilepsy types.
  • This study analyzed 23 children with sodium channel mutations attending a center in Southern India, documenting their clinical signs, EEG results, and treatment impacts.
  • The most frequent seizure type was focal with impaired awareness, and associated non-epileptic features included microcephaly and movement disorders, highlighting the need for personalized management in affected patients.
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Purpose: Study assessed the role of MSI in predicting the post-operative seizure outcome.

Methods: This retrospective study included patients who underwent MEG and epilepsy surgery and had a minimum 6 months of postoperative follow-up. Concordance of MEG cluster with post-surgical resection cavity was classified as follows Class I) Concordant and region-specific, Class II) Concordant and region non-specific, Class III) Concordant lateralization only and Class IV) Discordant lateralization.

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Acute toxic leukoencephalopathy and serotonin syndrome are rare neurological complications associated with various drugs and toxins, some of which overlap. However, the co-occurrence of these conditions is poorly documented. We present the case of a 14-year-old boy who suddenly developed altered consciousness and autonomic dysfunction after consuming excessive quantities of cough remedies containing dextromethorphan, chlorphenamine, dichlorobenzyl alcohol, and amylmetacreson.

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Objectives: This study aimed to localise the eloquent cortex and measure evoked field (EF) parameters using magnetoencephalography in patients with epilepsy and tumours near the eloquent cortex.

Methods: A total of 41 patients (26 with drug-refractory epilepsy and 15 with tumours), with a mean age of 33 years, were recruited. Visual evoked field (VEF), auditory evoked field (AEF), sensory evoked field (SSEF), and motor-evoked field (MEF) latencies, amplitudes, and localisation were compared with those of a control population.

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Objective: One of the objectives of the Intersectoral Global Action Plan on epilepsy and other neurological disorders for 2022 to 2031 is to ensure at least 80% of people with epilepsy (PWE) will have access to appropriate, affordable, and safe antiseizure medications (ASMs) by 2031. However, ASM affordability is a significant issue in low- and middle-income countries, preventing PWE from accessing optimal treatment. This study aimed to determine the affordability of the newer (second and third generation) ASMs in resource-limited countries in Asia.

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 The study explores whether the epileptic networks associate with predetermined seizure onset zone (SOZ) identified from other modalities such as electroencephalogram/video electroencephalogram/structural MRI (EEG/VEEG/sMRI) and with the degree of resting-state functional MRI/positron emission tomography (RS-fMRI/PET) coupling. Here, we have analyzed the subgroup of patients who reported having a seizure on the day of scan as postictal cases and compared the findings with interictal cases (seizure-free interval).  We performed independent component analysis (ICA) on RS-fMRI and 20 ICA were hand-labeled as large scale, noise, downstream, and epilepsy networks (Epinets) based on their profile in spatial, time series, and power spectrum domains.

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  • Corpus callosotomy (CC) is a surgical procedure that aims to help patients with drug-resistant epilepsy (DRE) by stopping drop attacks and preventing falls.* -
  • A study reviewed the records of 17 patients who underwent CC, with a majority being young children, and noted improvements in seizure control post-surgery, including complete cessation of drop attacks in all patients.* -
  • The findings suggest that complete CC is more effective for controlling drop attacks compared to partial CC and can lead to a significant reduction in overall seizure frequency.*
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Objective: Eating epilepsy presents various imaging and electrophysiological features along with various seizure triggers. As such, network changes in eating epilepsy have not been comprehensively explored. This study was conducted to illustrate resting state network changes in eating epilepsy and to study the changes in network configurations during eating.

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Background: High-level evidence for using steroids in epileptic encephalopathy (EE), other than West syndrome (WS), is lacking. This study investigated the efficacy and safety of pulse intravenous methylprednisolone (IVMP) in EE other than WS.

Methods: This is an open-label evaluator-blinded randomised controlled study.

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