Publications by authors named "Pakeeran Siriratnam"
Article Synopsis
- The study investigated the prevalence of two types of disability progression in patients with aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-IgG NMOSD): Progression Independent of Relapse Activity (PIRA) and Relapse-Associated Worsening (RAW).
- It included 181 patients from the MSBase registry, mostly females with an average age of 38.1 years, monitored for an average of 4.5 years, where only 2.2% experienced PIRA and 7.2% experienced RAW.
- The findings suggest PIRA is rare in AQP4-IgG NMOSD cases, but the study had limitations, such as using
Predictors of relapse risk and treatment response in AQP4-IgG positive and seronegative NMOSD: A multicentre study.
J Neurol Neurosurg Psychiatry
September 2024
Article Synopsis
Article Synopsis
- The study aimed to find an effective oral corticosteroid regimen for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) that extends the time to first relapse and reduces overall steroid exposure.
- In a retrospective study of 109 patients, higher doses of oral prednisone, particularly 12.5 mg/day or more for at least 3 months, significantly delayed the time to first relapse, with notable reductions in relapse risk.
- The findings suggest that a daily dose of 12.5 mg of prednisone for adults (or 0.16 mg/kg for children) at disease onset is optimal, showing no serious adverse effects in patients treated at this level.
Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system autoimmune disease. Aquaporin-4 antibody (AQP4-IgG) is present in over 75% of cases and criteria also exist for the diagnosis of seronegative NMOSD. AQP4-IgG NMOSD has a strong female predominance (9:1 ratio), with a median onset age of 40 years.
View Article and Find Full Text PDFNeuromyelitis optica spectrum disorder (NMOSD) is a rare relapsing neuroinflammatory autoimmune astrocytopathy, with a predilection for the optic nerves and spinal cord. Most cases are characterised by aquaporin-4-antibody positivity and have a relapsing disease course, which is associated with accrual of disability. Although the prognosis in NMOSD has improved markedly over the past few years owing to advances in diagnosis and therapeutics, it remains a severe disease.
View Article and Find Full Text PDFArticle Synopsis
- * A total of 22 studies involving 1104 participants were reviewed, revealing a wide variety of study designs and cognitive assessment methods, leading to varying results regarding cognitive performance post-treatment.
- * While cognitive issues are prevalent in the first two weeks after treatment, most deficits improve quickly; however, some patients report lasting issues, highlighting the need for further research on cognitive effects over different timeframes.
Background: Autoimmune encephalitis (AE) is an increasingly recognized neuroinflammatory disease entity in which early detection and treatment leads to the best clinical outcomes. Movement disorders occur in AE but their characteristics are not well defined.
Objectives: To identify the frequency, classification, and prognostic significance of movement disorders in AE.
A young woman presented with a syncopal episode. As part of the work-up for her presentation, an MRI of the brain was performed which showed a small acute stroke. She subsequently had a further embolic-appearing stroke 9 months later.
View Article and Find Full Text PDFImproved quality of life (QoL) is an important outcome goal following epilepsy surgery. This study aims to quantify change in QoL for adults with drug-resistant epilepsy (DRE) who undergo epilepsy surgery, and to explore clinicodemographic factors associated with these changes. We conducted a systematic review and meta-analysis using Medline, Embase, and Cochrane Central Register of Controlled Trials.
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- The research involved 850 adults from nine international epilepsy centers, focusing on those who were seizure-free besides minor types before withdrawing medication post-surgery.
- Predictive models were created to determine the risk of seizures returning, with key factors being certain types of seizures after surgery, prior history of specific seizures, the timing of medication withdrawal, and the number of meds taken at surgery, showing a moderate level of accuracy in predicting outcomes.
Objectives: An important but understudied benefit of resective epilepsy surgery is improvement in productivity; that is, people's ability to contribute to society through participation in the workforce and in unpaid roles such as carer duties. Here, we aimed to evaluate productivity in adults with drug-resistant epilepsy (DRE) pre- and post-resective epilepsy surgery, and to explore the factors that positively influence productivity outcomes.
Methods: We conducted a systematic review and meta-analysis using four electronic databases: Medline (Ovid), EMBASE (Ovid), EBM Reviews - Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Library.
We report a case of a 55-year-old man presenting with diplopia, masticatory weakness and dysarthria several weeks post multitrauma. The clinical suspicion of myasthenia gravis (MG) was supported with positive acetylcholine receptor antibodies and abnormal repetitive stimulation study. He responded well to pyridostigmine, intravenous immunoglobulin and oral prednisolone.
View Article and Find Full Text PDFBackground: Stroke and diabetes mellitus (DM) are significant interrelated healthcare issues but there is a dearth of data on the prevalence of DM among Australia's regional stroke population.
Aims: We aimed to determine the prevalence of DM in stroke patients at a large regional centre, including subanalyses on stroke subtypes, glycaemic control and renal function in ischaemic stroke (IS).
Methods: We conducted a retrospective analysis of all patients (n = 323) with IS or transient ischaemic attack (TIA) admitted to Ballarat Base Hospital from January 2015 to December 2016.
Background: Although there is an established association between cancer and stroke, the role of malignancy as a causative agent or comorbidity is not always clear. Moreover, there are no established guidelines on the acute treatment of cancer-associated stroke or optimal anticoagulation. This case report illustrates the significance of these practice gaps.
View Article and Find Full Text PDFBackground: There is no universally accepted age cut-off for defining young strokes.
Aims: We aimed to determine, based on the profile of young stroke patients in our regional centre, an appropriate age cut-off for young strokes.
Methods: A retrospective analysis of all ischaemic stroke patients admitted to our centre from 2015 to 2017.