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Biomedical subjects

Abraham Kuruvilla

Publications and source records attributed to Abraham Kuruvilla.

5 recordsLinked to original sources

Guillain-Barre syndrome in children and adolescents--a retrospective analysis.

In this study, 55 cases of Guillain-Barre syndrome (GBS) in children and adolescents of 2-18 years of age were analysed retrospectively to study the clinical profile and to evaluate the prognostic value of reduced compound muscle action potential (CMAP) on the need for ventilation and functional outcome. Of the 28 boys and 27 girls 87.3% were bed-bound at peak deficit. Other features were as follows: Bifacial weakness-75%, bulbar weakness-56.4%, need for assisted ventilation-41.8% and albuminocytological dissociation-65.9%. In the ventilated and non-ventilated group no difference was noted in the incidence of reduced CMAP amplitude (p-value > 0.5). At 3 months 83.3% and at 6 months 80.8% cases were ambulant with support. Reduced CMAP amplitude of less than 20% of the lower limit of the normal in at least 2 nerves did not predict the need for ventilation or the chance of independent walking at 3 or 6 months.

Action Potentials↗

Intraoperative electrocorticography in epilepsy surgery: useful or not?

Intraoperative electrocorticography (ECoG) has been traditionally used in the surgical management of medically refractory partial epilepsies to identify the location and limits of the epileptogenic area, to guide the extent of resection, and to assess its completeness. Although in clinical use for many years, the basic questions regarding indications and limitations of this method has remained unanswered. ECoG plays a major role in tailored temporal lobectomies, whereas, it serves no practical purpose in standard resection of medial temporal lobe epilepsy (TLE) with magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS). Residual hippocampal spikes, unaltered by resection, correlate with a greater proportion of seizure recurrence. Intraoperative hippocampal ECoG can allow sparing of functionally important hippocampus, thus minimising postoperative memory decline. ECoG eminently aids removal of developmental malformations of brain, and most importantly, the excision of highly epileptogenic cortical dysplasias (CDs) for deciding the extent of resection for best seizure control. The ECoG can be a valuable tool during multiple subpial transections (MST).

Anesthesia↗

Anomalous superficial radial nerve: a patient with probable autosomal dominant inheritance of the anomaly.

The sensory symptoms due to lesions of the superficial branch of the radial nerve are usually limited to the dorsolateral area of the hand. We describe a 40-year-old woman who presented with numbness of the dorsomedial aspect of the right hand following arthroplasty of the wrist. Clinically, the sensory loss suggested a lesion of the dorsal branch of the ulnar nerve. However, nerve conduction studies showed that the sensory loss was due to a lesion of a branch of the superficial branch of the radial nerve. The patient had bilateral, anomalous innervation of the dorsum of the hand-the dorsal branch of the ulnar nerve could not be demonstrated with nerve conduction techniques and the superficial branch of the radial nerve innervated most of the dorsum of the hand. Antidromic stimulation of the dorsal branch of the ulnar nerve and superficial branch of the radial nerve with paired surface recording of sensory nerve action potentials from the dorsolateral (radial side) and dorsomedial (ulnar side) hand is useful for evaluating this anomaly. Our patient had two children, one of them with a similar anomaly. This suggests an autosomal dominant inheritance of the anomaly.

Action Potentials↗

Focal fast rhythmic epileptiform discharges on scalp EEG in a patient with cortical dysplasia.

A distinctive scalp electroencephalographic (EEG) pattern of focal fast rhythmic epileptiform discharges (FREDs) in a 23-year-old man with symptomatic localization related epilepsy is presented. Magnetic resonance imaging (MRI) of the brain revealed cortical dysplasia over the right temporal region where the peculiar EEG abnormality was detected. We suggest that this characteristic EEG pattern may be predictive of focal cortical dysplasia (FCD). A brief review of the rhythmic EEG abnormalities in FCDs is also presented.

Adult↗