Publications by authors named "Ramanujam Bhargavi"
Background: Hemispherotomy (HS) is an effective treatment for unilateral hemispheric onset epilepsy. There are few publications for HS in adults, and there is no series comparing adults and pediatric patients of HS.
Objective: To compare the hemispherotomies done in adult patients with pediatric ones in terms of efficacy and safety.
Background And Objectives: Persons with epilepsy are afflicted with comorbidities such as stigma, anxiety, and depression which have a significant impact on their quality of life. These comorbidities remain largely unaddressed in resource-limited countries. This randomized controlled trial (RCT) aimed to investigate whether yoga and psychoeducation were effective in reducing felt stigma (primary outcome), neuropsychiatric outcomes, and seizure frequency, as compared with sham yoga and psychoeducation in persons with epilepsy.
View Article and Find Full Text PDFIntroduction: Post-stroke sleep disorders (PSSD) are an important part of post-stroke disability. PSSD is neglected as a part of stroke rehabilitation. We aimed to study the prevalence and determinants of PSSD in a hospital based, single center setting.
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- The Theory of Mind deficit, linked to cognitive-affective disintegration in right temporal lobe epilepsy, is explored using a material-specific processing model.
- The study analyzed changes in first-order and second-order Theory of Mind pre- and post-surgery in three distinct groups based on seizure side and treatment type.
- Findings indicate significant deficits in non-verbal processing (first-order Theory of Mind) after amygdalohippocampectomy, highlighting the importance of understanding these cognitive consequences for improving post-surgery recovery.
Background And Objective: Hemispherotomy surgery in adults is shrouded in doubts regarding the functional outcome. The age at surgery alone should not be the deciding factor for surgery. Language paradigms were used in functional magnetic resonance imaging (fMRI) to confirm the role played by the age at the onset of seizures to predict the postoperative functional outcome.
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- The study aimed to compare neurological disorders and outcomes in patients with and without COVID-19 during the pandemic.
- A total of 235 patients were enrolled, with 34.5% testing positive for COVID-19; the most common diagnosis was acute ischemic stroke.
- Findings showed higher in-hospital mortality and worse 3-month outcomes for COVID-19 positive patients, indicating more severe complications linked to the infection.
Article Synopsis
- - The study presents a new surgical technique called minitemporal craniotomy for patients with temporal lobe epilepsy, analyzing outcomes in cases performed without navigation guidance between 2014 and 2019.
- - A total of 48 patients were operated on, with minimal complications, and an average hospital stay of 4 days, showing a high success rate for seizure control, particularly in those with mesial temporal sclerosis.
- - The findings suggest that this technique, which relies on surface landmarks, offers effective outcomes and can be implemented in smaller medical centers, improving accessibility to epilepsy surgery.
Background: Governments have imposed lockdowns in the wake of the COVID-19 pandemic. Hospitals have restricted outpatient clinics and elective services meant for non-COVID illnesses. This has led to patients facing unprecedented challenges and uncertainties.
View Article and Find Full Text PDFObjective: To measure the impact of 12 weeks of physical exercise as complementary management strategy on quality of life (QOL) in people with epilepsy (PWE).
Methods: In a parallel-group, randomized controlled study with blinded outcome assessment, PWE of 18-65 years old, smartphone users were randomized into two groups. The exercise group was advised minimum 150 min per week of moderate-intense aerobic activity, as per current WHO recommendation [1], in addition to standard medical care; the control group received only standard medical care.
Background: Stereoelectroencephalography (SEEG) has become an integral part of epilepsy surgery, often used in the localization of the epileptogenic zone. It is an essential modality not only in the evaluation of nonlesional but also lesional drug refractory epilepsy, especially in the presence of anatomo-electro-clinical discordance.
Objective: To describe our technique and the operative nuances involved in the performance of robotic SEEG placement.
Article Synopsis
- In a study assessing the role of magnetoencephalography (MEG) in epilepsy surgery, researchers aimed to determine if MEG offers significant advantages over traditional imaging methods in surgical decision-making.
- The observational study involved 102 patients who underwent MEG scanning, and the findings showed that MEG provided valuable insights that influenced surgical approaches in 33% of cases and eliminated the need for intracranial electrodes in 19% of patients.
- Overall, MEG's magnetic source imaging (MSI) was found to enhance the localization process, potentially improving surgical outcomes for patients with epilepsy.
We describe the metabolic phenotype on F-18 fluorodeoxyglucose positron emission tomography (PET) in a 13-year-old female with myelin oligodendrocyte glycoprotein (MOG) antibody-positive encephalitis. Unilateral hemispheric hypometabolism on PET may be the metabolic phenotype of autoimmune epilepsy associated with MOG antibody.
View Article and Find Full Text PDFThe ongoing COVID-19 pandemic has precipitated a global health crisis. Non-COVID diseases across specialties have been significantly compromised. The greatest challenge has been to continue providing care to non-COVID cases with minimum transmission risk to health care workers, patients, and caregivers.
View Article and Find Full Text PDFObjective: The authors present a new "bloodless" technique for minimally invasive robotic thermocoagulative hemispherotomy (ROTCH). Such a method is being described in the literature for the first time.
Methods: A robotic system was used to plan five sets of different trajectories: anterior disconnection, middle disconnection, posterior disconnection, corpus callosotomy, and temporal stem and amygdalar disconnection.
Purpose: The aim of this study was to compare the diagnostic value and accuracy of ictal SPECT and inter-ictal magnetoencephalography (MEG) in localizing the site for surgery in persons with drug resistant epilepsy.
Method: This was a prospective observational study. Patients expected to undergo epilepsy surgery were enrolled consecutively and the localization results from different imaging modalities were discussed in an epilepsy surgery meet.
Article Synopsis
- Teleneurology offers benefits for patients with neurological issues by improving access to specialists, particularly when traveling long distances is challenging.
- A study with 261 patients during the COVID-19 pandemic revealed that while overall satisfaction with tele-consults was moderate, many preferred this method for future follow-ups, particularly if their health was stable.
- Patients reported that while telemedicine was convenient and cost-effective, in-person visits allowed for better communication and a stronger patient-physician relationship, suggesting a need for improved telemedicine platforms.
Background: Vagal nerve stimulation (VNS) is a form of neuromodulation for patients with drug-refractory epilepsy (DRE), in whom extensive preoperative evaluation fails to localize the epileptogenic zone. VNS is often compared to Corpus callosotomy (CC) in terms of both indications and efficacy. However, VNS represents a less invasive and less morbid procedure compared to CC and is the preferred procedure in majority of patients with DRE.
View Article and Find Full Text PDFEpilepsy surgery currently offers the best treatment for patients with drug-refractory epilepsy (DRE). Resective surgery, in the presence of a well-localized epileptogenic focus, remains the best modality towards achieving seizure freedom. However, localization of the focus may not be possible in all the cases of DRE, despite comprehensive epilepsy workup.
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- - The study investigates the effectiveness of adding F-18 FDG-PET imaging to standard MRI in diagnosing autoimmune epilepsy (AE), focusing on its impact on antibody prevalence scoring.
- - In a retrospective analysis of 60 patients, combining PET and MRI improved diagnosis rates from 57% with MRI alone to 77% for antibody-negative patients, and from 35% to 60% for antibody-positive patients.
- - The results suggest that incorporating PET imaging enhances diagnostic accuracy for AE, particularly in patients without detectable antibodies, indicating a need for larger studies to establish it as a standard practice.
Background: The management of hypothalamic hamartomas (HH) rests upon the type of presentation. These are rare congenital benign lesions presenting either with central precocious puberty (CPP), drug refractory epilepsy (DRE) or combination of both. We present here our experience in the management of these lesions from a neurosurgeon's perspective and review the pertinent literature.
View Article and Find Full Text PDFStandard treatment of drug-refractory epilepsy, due to left mesial temporal sclerosis, is anterior temporal lobectomy with amygdalohippocampectomy (ATL). This carries a risk of cognitive deficits, including comprehension, verbal memory, and visual memory. Preoperative language lateralization and localization is important to preserve these functions.
View Article and Find Full Text PDFObjective: The authors sought to analyze the residual connections formed by the temporal stem as a cause for seizure recurrence following endoscopic vertical interhemispheric hemispherotomy and to review and compare lateral approach (perisylvian) with vertical approach surgical techniques to highlight the anatomical factors responsible for residual connections.
Methods: This study was a retrospective analysis of patients who underwent endoscopic hemispherotomy for drug-resistant epilepsy. Postoperative MR images were analyzed.