Publications by authors named "Vimal Paliwal"

Article Synopsis
  • - The study investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with new daily persistent headache (NDPH), focusing on reducing headache frequency and severity as well as alleviating anxiety and depression symptoms.
  • - Fifty participants (average age 35) underwent rTMS treatment over three consecutive days, with results showing that 70% experienced at least a 50% reduction in headache severity, and 76% had significant improvement in headache impact scores after four weeks.
  • - The study found the most significant benefits for NDPH patients who also had chronic migraines, while a small number of participants reported discomfort with the rTMS treatment.
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Background: Hemisensory syndrome is characterized by a nondermatomal sensory deficit involving one half of the body. With the conventional imaging techniques, researches find low diagnostic yield in this condition; however, with the advancements in MRI imaging, there is hope to find the pathophysiological basis of hemisensory symptoms.

Objective: To evaluate microstructural and perfusion changes in brain parenchyma in patients with hemisensory syndrome on MRI with diffusion tensor imaging (DTI) and arterial spin labeling (ASL).

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Thunderclap headache is a sudden severe headache with onset to peak within one minute. Multiple excruciating, short-lived thunderclap headaches over a few days to weeks are highly suggestive of reversible cerebral vasoconstriction syndrome (RCVS). RCVS can be primary or secondary to several factors, but it is rarely described after neuro-endovascular procedures using onyx material.

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Objective: This systematic review aimed to evaluate the published cases with miliary brain lesions and their etiological factors, clinical manifestations, diagnostic procedures, and outcomes.

Methods: A comprehensive search of PubMed, Scopus, Embase, and Google Scholar was conducted using the specified search strategy. Eligibility criteria included cases with miliary lesions in the brain confirmed through neuroimaging and various diagnostic procedures.

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Objective: We explored the blood neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker and its relation with mortality and Modified Rankin Scale (mRS) score at discharge and at 3 months following ICH and also compared NLR with intracerebral hemorrhage (ICH) score, Sequential Organ Failure Assessment (SOFA) score and National Institutes of Health Stroke Scale (NIHSS) score.

Methods: The investigators calculated the NIHSS score, SOFA score, ICH score and NLR of 90 adult patients within 3 days of onset of stroke with evidence of hemorrhagic stroke in brain imaging and correlated it with in-hospital mortality, 3-month mortality and mRS at 3 months following stroke using regression analysis.

Results: Out of 90 individuals, there were 54 (60%) males and 36 (40%) females.

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The clinical and radiological end points to stop anti-tubercular treatment in central nervous system (CNS) tuberculoma are not known. This retrospective study was done to determine end points to stop anti-tubercular treatment and find the predictors of poor outcome in patients with CNS tuberculoma. Patients who were admitted with a diagnosis of brain/spine tuberculoma between January 2015 and December 2019 and who completed a minimum of 1-year follow-up were enrolled.

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Background: ChatGPT is an artificial intelligence based tool developed by OpenAI (California, USA). This systematic review examines the potential of ChatGPT in patient care and its role in medical research.

Methods: The systematic review was done according to the PRISMA guidelines.

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Article Synopsis
  • * Methods: The review included data from multiple medical databases up until June 2023, focusing on demographic and clinical details regarding the lesions, diagnostic methods, and patient outcomes, with attention to the quality of the gathered information.
  • * Results: An analysis of 161 patients indicated that immunocompromised individuals often experienced lesions due to Toxoplasma gondii infections and CNS lymphoma, while immunocompetent patients had higher rates of Mycobacterium tuberculosis and other immune-related disorders; overall, improvement rates differed significantly between the two groups.
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Following vaccination with adenoviral vector-based ChAdOx1 nCoV-19, serious neurological adverse events have been reported. Here we report two cases who presented with quadriparesis following the adenoviral vector-based ChAdOx1 nCoV-19 vaccine. A 55-year-old male patient presented with quadriparesis after 8 days of the second dose of ChAdOx1 nCoV-19 vaccination.

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Background: Coronavirus disease (COVID-19) was a pandemic with many physical, psychological, and socioeconomic effects. COVID-19 caused a global increase in anxiety and depression because of its novelty, high infectivity, varied presentation, and unpredictable mortality. In the face of collapsing healthcare facilities, monetary setbacks, and loneliness because of lockdowns, people were anxious, and this was compounded by media sensationalism.

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Vision loss is a presenting complaint in many patients with subacute sclerosing panencephalitis (SSPE). Data related to vision loss in SSPE is available only in the form of case reports. In this systematic review, we evaluated characteristics of vision loss, affected anatomic site, and patient course and outcome.

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Article Synopsis
  • Indian studies on serious neurological and psychiatric adverse events after COVID-19 vaccination show a lack of comprehensive data, prompting a systematic review of reported cases.
  • A total of 136 instances of serious adverse events were identified, predominantly from states like Kerala, Uttar Pradesh, New Delhi, and West Bengal, mainly occurring within two weeks of the first dose of vaccine.
  • The most common complications included immune-mediated CNS disorders and herpes zoster, with the overall risk assessed to be low, and many cases responded positively to immunotherapy.
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Article Synopsis
  • Subacute sclerosing panencephalitis (SSPE) is a serious brain disease caused by the measles virus, with significant risks for pregnant women and their fetuses.
  • A systematic review of 21 cases found that most women showed symptoms before delivery, with many experiencing serious issues like vision loss, and a high mortality rate post-delivery.
  • The study suggests SSPE often goes unrecognized during pregnancy, emphasizing the importance of measles vaccination to prevent this severe condition.
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Recently, inflammation and free-radical release has been described in the surrounding brain parenchyma of seemingly inert calcified lesions of neurocysticercosis. These free radicals can induce migraine by stimulating calcitonin gene-related peptide release. This stipulated mechanism led us to hypothesize that calcified neurocysticercosis may increase migraine severity.

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Hereditary diffuse leukoencephalopathy with spheroids is a rare genetic disorder caused by mutations of the colony-stimulating factor 1 receptor gene. It is an adult-onset leukodystrophy, with a wide spectrum of neurological and psychiatric manifestations that includes Parkinsonism, dementia, seizures, limb weakness, spasticity and abnormal motor behaviour. Alien-hand syndrome and mirror movements are rare manifestations of this and other neurodegenerative disorders.

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Background And Aim: Restless leg syndrome (RLS) is common in patients with cirrhosis, but its treatment in such patients remains unclear. This pilot study assessed the clinical effectiveness of intravenous iron and a 6-week course of low-dose (75 mg/day) pregabalin for the treatment of RLS in patients with cirrhosis.

Methods: It was a prospective, interventional study that included adult patients with cirrhosis and RLS.

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Tuberculous meningitis (TBM) is associated with high mortality. A large proportion of patients with TBM, who survive, live with disabling neurological sequelae. Hydrocephalus is one of the common complications of TBM, seen in up to 80% of patients.

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Article Synopsis
  • The Lipid Association of India recommends specific LDL cholesterol targets for stroke patients, with high-intensity statins as the first-line treatment and the possibility of adding nonstatin therapies if necessary.
  • Continuing statins is crucial for patients with acute ischemic stroke; those who have their statins stopped usually experience worse outcomes, while statins should not be initiated in acute intracerebral hemorrhage cases but continued if already prescribed.
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COVID-19 vaccines have brought us a ray of hope to effectively fight against deadly pandemic of COVID-19 and hope to save lives. Many vaccines have been granted emergency use authorizations by many countries. Post-authorization, a wide spectrum of neurological complications is continuously being reported following COVID-19 vaccination.

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Background: Mesial temporal lobe epilepsy attributed to low-grade glioma is known for intractable seizures and choice of surgery range from lesionectomy (Lo) to lesionectomy with anteromesial temporal resection (L0 + AMTR) is still debatable. We intend to analyze the seizure outcome after lesionectomy alone or with AMTR.

Subjects And Methods: Retrospective analyses of patients operated for medial low-grade temporal lobe tumors with seizures were included in the study.

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Parkinson's disease (PD) and Parkinsonian syndromes; Progressive supranuclear palsy (PSP), and Multiple system atrophy (MSA) are debilitating neurodegenerative disorders. Fractalkine is a chemokine involved in neuroinflammation, whereas, 3-nitrotyrosine (3-NT) is a marker of early neurodegenerative cellular-damage. We measured Fractalkine and 3-NT levels in the serum of these patients to examine the neuroinflammation hypothesis and also to decipher the propensity of these biologics to be used as early (5 years from onset) biochemical markers in neurodegenerative Parkinsonism.

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Lower yield of available diagnostic tests for tuberculous meningitis (TBM) frequently causes delay in diagnosis. Recently, 18F-fluorodeoxyglucose positron emission tomography (FDG PET) has been used in infectious disorders such as pulmonary tuberculosis; however, it is rarely used in TBM. This study was aimed to ascertain the role of FDG PET in the diagnosis and determination of the extent of disease and prognosis in patients with TBM.

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