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M V Padma

Publications and source records attributed to M V Padma.

18 recordsLinked to original sources
PubMed1998

Epilepsies among twins born in families of Indian probands with epilepsy.

Twins have a high frequency of adverse perinatal events and have been reported to have an increased risk of seizures. Contrary to popular belief, a recent study reported that twins do not have an increased risk of seizures. We studied the relationship of twinning and epilepsy in India. The frequency of twinning in families of probands with epilepsy was compared with the frequency of twinning among hospital births in the same region of India. We also compared consecutively ascertained probands with epilepsy for their twin status and the occurrence of epilepsies in their twin and non-twin relatives. The frequency of twin births in families of 524 probands with epilepsy was comparable to the twin births among consecutive deliveries over a 3-year period in another government hospital in the same catchment area (1:99 vs. 1:75). Every 1 in 58 of probands with epilepsy was a twin while a twin was born in these families every 1 in 71 live births. The frequency of epilepsy in non-proband twin relatives was 1.5% compared with 2% among non-proband, non-twin relatives. This data suggests that twin birth is not a major risk factor for seizures even in families of Indian probands with epilepsy. Family data such as ours can be used to study the contribution by genetic factors in the pathogenesis of complex genetic diseases such as human epilepsies.

Adult↗
PubMed1998

Juvenile myoclonic epilepsy: disease expression among Indian families.

OBJECTIVES: Juvenile myoclonic epilepsy (JME) is a common, age related, idiopathic generalized epileptic syndrome. We aimed to define the expression of JME in Indian probands and study the occurrence of seizures/epileptic syndromes in their family members. METHODS: We studied 225 JME probands with a uniform protocol. recording the type and frequency of seizures, precipitating factors, EEG data, and family history. Detailed family pedigrees were drawn to include all the 1st- and 2nd-degree relatives of probands. The seizures/epileptic syndromes in relatives examined were classified in a uniform way. RESULTS: The clinical and EEG characteristics of 225 JME probands from India were similar to those reported in probands from different ethnic backgrounds. The incidence of febrile convulsions in probands with JME was similar to that of the general population but was much lower (0.2%) among their relatives. A positive family history of seizures among 1st- or 2nd-degree relatives was noted in 79 of 225 (35%) probands. The risk of relatives being affected as well as their risk of expressing a type of idiopathic generalized epilepsy (IGE) varied as a function of the degree of relation with the probands. CONCLUSIONS: The clinical expression of JME among probands from India is fairly similar to that reported in probands of different ethnic backgrounds. The risk of relatives being affected as well as their risk of expressing a type of IGE (including JME) varies as a function of the degree of relation with the probands. The reduced occurrence of febrile convulsions among the relatives of JME probands probably represents an ascertainment bias. A much larger database of this type should be helpful in understanding the interactions of different genes that are believed to be responsible for some of the inherited human epileptic syndromes like JME and other IGEs.

Adolescent↗
PubMed1998

Knowledge, attitudes and practice of epilepsy: experience at a comprehensive rural health services project.

Beliefs regarding cause and preference of the treatment modality are important factors influencing any epilepsy programme. Patients own attitudes towards the on-going treatment are equally important in ensuring success of any such programme. The study involved interviews of 80 patients with epilepsy attending a comprehensive rural health services project, and was conducted according to a structured questionnaire. The majority of the patients were well informed regarding the cause of epilepsy, but more than half had tried alternative treatment methods. Many patients had misconceptions regarding the goal of the treatment and the consequences of missing a prescribed drug dose. Surprisingly few patients avoided taking medicines on days of religious fast. It was also noted that most patients depended on free medical supplies from the clinic dispensary, and a small number of patients would stop the medicines if these were not given free of cost. We stress the need to understand patients' concepts about the cause and the treatment of epilepsy, the need to educate them and their families regarding principles of modern medical treatment of epilepsy and most importantly, the need to maintain a regular, uninterrupted supply of free medicines, to improve the effectiveness of similar epilepsy management programmes in the setting of rural India and other developing countries.

Adaptation, Psychological↗
PubMed1997

Occurrence of epilepsies in family members of Indian probands with different epileptic syndromes.

PURPOSE: Large numbers of families with many members having seizures have been used to understand the role of hereditary factors in the pathogenesis of human epileptic syndromes. We aimed to establish a genetic database to form a hypothesis on the possible genetic contributions in different epileptic syndromes. METHODS: The occurrence and patterns of different epilepsies and epileptic syndromes in 1,219 Indian probands and their relatives were studied. The concordance of epilepsies between probands and relatives was also analyzed. RESULTS: Of probands, 231 (19% of 1219) had first- or second-degree relatives affected with seizures. Incidence of family history in probands with generalized epilepsies (GES) and syndrome of single, small, enhancing lesions (SSEL) was comparable and significantly higher than that in probands with localization-related epilepsies (LRES). The ratio of affected first- to second-degree relatives was close to 4:1. Generalized epilepsies were the commonest type of epileptic syndromes seen among all relatives. The proportion of sibs and second-degree relatives with epileptic syndromes similar to probands was significantly greater in the GES group as compared with the concordant relatives of probands with LRES and SSEL. CONCLUSIONS: A significant percentage of first- and second-degree relatives of probands with all types of epileptic syndromes have seizures. The risk of relatives being affected varied as a function of the relation with the proband. Concordance of epileptic syndromes between probands and relatives was related to the epileptic syndromes in probands. The syndrome of SSEL is probably a benign epileptic syndrome seen in Indians genetically predisposed to seizures. Hereditary factors may play an almost equal role in the predisposition of relatives to epilepsy in families of probands with different epileptic syndromes.

Brain↗
PubMed1997

Occurrence of only myoclonic jerks in juvenile myoclonic epilepsy.

OBJECTIVES: The clinical data on individuals who were diagnosed to have juvenile myoclonic epilepsy (JME) on the basis of myoclonic jerks alone has been analysed. The points in favour and against individuals with only myoclonic jerks being classified as "affected" for research on JME are discussed. MATERIALS AND METHODS: We studied 15 persons diagnosed with JME on the basis of only myoclonic jerks in a series of 161 patients with JME and their relatives. Detailed information on the seizure types in JME patients and their family members was collected. All affected individuals were examined by one person and had at least one conventional scalp EEG. CT/MRI of the brain was done as and when indicated. RESULTS: Nine of these were probands while 6 were the relatives of JME patients. The EEG was abnormal in 8 of 9 probands and 1 of 6 relatives with only myoclonic jerks. All the 9 probands and 2 relatives with only myoclonic jerks were treated with anti-epileptic drugs. Three of the 4 relatives had spontaneous remission of jerks after variable intervals. Four of 15 persons with only myoclonic jerks had a first degree relative with definite JME. CONCLUSIONS: It appears that persons with myoclonic jerks alone may represent a benign subgroup of JME that may be genetically distinct from classic JME and the jerks may even spontaneously remit in a few cases. It is suggested that those persons with only myoclonic jerks and a first degree relationship with a definite diagnosis of JME can be classified as "affected" for inclusion into molecular studies, till molecular tools are available to settle the issue of phenotypic variations in hereditary neurological disorders like JME.

Adolescent↗
PubMed1997

Usefulness of short-term video EEG recording with saline induction in pseudoseizures.

OBJECTIVES: To study the usefulness of short-term recording of video electroencephalography (VEEG) as an outpatient procedure with placebo induction (PLIN) and intravenous saline in cases of pseudoseizures (Psz). MATERIAL AND METHODS: Fifty cases of suspected Psz were enrolled. They were divided into 2 groups: Group 1 consisted of patients with frank Psz, Group 2 those where diagnosis was uncertain. VEEG recording was done and 10 ml of saline used for placebo-induction. RESULTS: Of 50 patients, 24 (48%) were in Group 1 and 26 (52%) in Group 2. Fifteen (30%) had a spontaneous event during VEEG and 33% had an event only on PLIN. The diagnosis was confirmed in 60 %. In 24% of patients anti-epileptic drugs were discontinued. CONCLUSION: Short-term monitoring with VEEG using PLIN is a useful initial screening procedure and in patients where it is inconclusive, long term recordings may be done.

Adolescent↗
PubMed1997

Cognitive function in younger type II diabetes.

OBJECTIVE: To examine central nervous system involvement as a possible complication of diabetes by performing a comprehensive neuropsychological evaluation of relatively young (age < 55 years) NIDDM patients and a group of control subjects. RESEARCH DESIGN AND METHODS: A cross-sectional comparative study of 28 patients, with duration of diabetes 5-18 years (mean +/- SD +/- 3.2 years), screened for acceptable glycemic control and absence of hypoglycemia on the day of examination, compared with 28 demographically similar, nondiabetic control subjects. Neuropsychometric tests performed were Mini-Mental Status Examination (MMSE), Neurobehavioral Cognitive Status Examination (NCSE), and P300 latencies (endogenous evoked potentials). RESULTS: Seven (25.0%) patients reported history suggestive of cognitive impairment during day-to-day activities, and 17 (60.7%) had distal symmetrical polyneuropathy. Average P300 latencies were significantly delayed among the diabetic patients compared with the control subjects (349.5 +/- 28.2 vs. 312.9 +/- 19.3 ms; t = 5.68, P < 0.001). Although there was no significant difference in MMSE scores, compared with control subjects significantly more patients had impairment in NCSE tests of attention (chi 2 = 7.38, P < 0.01), repetition (chi 2 = 4.073, P < 0.05), and memory (chi 2 = 5.83, P < 0.05), while there was no significant difference in tests of comprehension, naming, construction, and calculation. Duration of diabetes, HbA1c levels, and the presence of distal symmetrical polyneuropathy among patients each did not correlate with any of the parameters of cognitive function evaluated. Higher blood glucose levels during the electrophysiological testing were associated with less delay in P300 latencies among the patients. CONCLUSIONS: Central nervous system impairment, manifesting as mild impairments in certain cognitive skills, should be recognized as a possible complication of long-standing NIDDM, even in relatively younger individuals.

Adult↗
PubMed1994

Albendazole in single CT ring lesions in epilepsy.

Single, small, enhancing lesions that often resolve spontaneously are frequent findings on CTs of Indian patients with seizures. Based on ELISA and biopsy data, the majority of these lesions are probably cysticercosis. To determine if these patients should be treated with albendazole, we performed a double-blind, randomized, placebo-controlled study involving 75 patients with seizures and the appropriate CT abnormality without neurologic abnormality on examination. Patients were randomized to albendazole (15 mg/kg/d) and placebo for 1 week, and we obtained serial CTs at the end of 1 week, 1 month, and 3 months. All patients completed a 3-month follow-up and none had systemic evidence of tuberculosis or cysticercosis. The lesions varied in size from 3 mm to 2.1 cm, with an average size of 1.18 cm. Serum ELISA for cysticercosis was positive in 30 and CSF ELISA was positive in 20 of 45 patients. Forty patients received albendazole and 35 received placebo. At the end of 3 months, a total of 68 patients showed resolution. Thirty-five of 40 patients who received albendazole showed resolution, as opposed to 33 of 35 patients on placebo. We conclude that albendazole therapy was not beneficial.

Adolescent↗
PubMed1992

Dystrophin test in differential diagnosis of childhood muscular dystrophies.

Two cases of childhood muscular dystrophy are described. One of them had clinical features suggestive of Emery-Dreifuss muscular dystrophy and the other with some features of Prader-Willi syndrome, besides proximal muscle weakness. Muscle biopsy from both cases revealed a clear abnormality of dystrophin, and were diagnosed as having Duchenne muscular dystrophy (DMD) by immunofluorescence examination; that is, absent dystrophin at the membrane of the muscle fibers. The clinical spectrum of DMD-related myopathies and the importance of dystrophin testing in childhood muscular dystrophies is discussed.

Biopsy↗
PubMedDate not supplied

Gabapentin in refractory partial epilepsy--a trial in India.

Gabapentin (GBP) has been shown to be effective an add-on drug for the treatment of refractory partial epilepsy. We undertook an open clinical trial to test its efficacy for the first time in India. Twenty-six patients with refractory partial seizures (> 4 per month) were given GBP in a titrated dose and the seizure frequency was noted for 3 months. The mean reduction in seizures was significant: 15.87 (SD = 4.5) vs 5.80 (SD = 10.25). The mean percentage change (PCH) from the baseline was -36. Twenty-one of 26 (80%) patients had a reduction in the number of seizures, and 13/26 (50%) were identified as responders (> 50% reduction in seizures). The responders were significantly younger than the nonresponders. Adverse events were mild and noted in 46% patients. Although the trial has its limitations, this is probably the first trial of GBP in a developing country.

Acetates↗
PubMedDate not supplied

Epilepsy.

Explore the source record for details and available documents.

Epilepsy↗
PubMedDate not supplied

Albendazole in neurocysticercosis.

BACKGROUND: In India, parenchymatous cysticercus cysts are more common than the meningeal racemose variety which are seen frequently in Latin America. Reports from Mexico suggest that albendazole is effective in the treatment of neurocysticercosis. We, therefore, studied whether this drug changed the natural course of neurocysticercosis in India. METHODS: In a randomized, double-blind, placebo controlled study, we allocated 29 consecutive patients (22 men and 7 women) with multiple cystic lesions on computed tomography (CT) of the head suggestive of cysticercosis to 7 days treatment with albendazole (15 mg/kg/day) or placebo. CT scans were repeated at the end of treatment and 1 and 3 months later to assess the number of cysts and extent of oedema. RESULTS: Sixteen patients received albendazole and 13 placebo. No change was seen at the end of one week. At 3 months, 14 patients in the albendazole group and 10 in the placebo group showed more than 25% reduction in the number of lesions. The difference between the two groups was not significant. CONCLUSION: Albendazole given in a dose of 15 mg/kg/day for 1 week does not change the natural course of neurocysticercosis.

Adolescent↗
PubMedDate not supplied

Distribution of vascular lesions in ischaemic stroke: a magnetic resonance angiographic study.

BACKGROUND: Carotid endarterectomy is now an accepted modality for reducing the threat of recurrence of ischaemic strokes in patients with severe carotid artery stenosis. However, the incidence of carotid artery stenosis, and hence the applicability of carotid endarterectomy in the Indian population is not known. We conducted a prospective study to detect and quantify extracranial and intracranial arterial lesions using magnetic resonance angiography in consecutive patients with ischaemic strokes. METHODS: All patients with recent onset of ischaemic stroke (< 4 months) had a magnetic resonance angiography done to evaluate the neck vessels as well as the circle of Willis and its branches. The degree of stenosis of the internal carotid or common carotid artery was measured according to the criteria described by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) collaborators. The site and extent of the extracranial and intracranial arterial lesions were correlated with the clinical features and the pattern of infarcts on magnetic resonance imaging or computerized tomographic scan of the brain. RESULTS: The magnetic resonance angiography was abnormal in 56 out of 100 patients included in the study. Severe stenosis (> 70%) of the extracranial carotid arteries was seen in 26 patients. Lesions suitable for carotid endarterectomy were present in only 11 patients (42.3% of those with severe stenosis). CONCLUSION: Our results are in contrast to those reported from western countries where the likelihood of a surgically correctable lesion being present is 60%-70%. We found operable lesions in only 11%. Intracranial atherosclerotic disease causing strokes is probably more common in India. Therefore, although carotid endarterectomy is the only accepted surgical procedure for secondary prophylaxis of stroke, there is a need to find an alternative surgical intervention for the predominantly intracranial pathology found in the Indian population.

Adolescent↗