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Praful Kelkar

Publications and source records attributed to Praful Kelkar.

9 recordsLinked to original sources
PubMed2006

Isolated high-frequency jaw tremor relieved by botulinum toxin injections.

Jaw tremor can be seen as a component of various neurological disorders such as essential tremor, Parkinson's disease, dystonia, branchial myoclonus, hereditary geniospasm, task-specific tremor, and Whipple's disease, as well as in normal situations such as shivering, and subclinical physiological jaw tremor. In most of these conditions, the jaw tremor is usually associated with tremor or other abnormal involuntary movements affecting additional body parts, and its frequency is lower than 12 Hz. Schrag and colleagues reported a patient with a high-frequency idiopathic jaw tremor, and they speculated it could be related to orthostatic tremor affecting the masseter muscles. We encountered a similar patient with intermittent rapid focal jaw tremor that was successfully treated with botulinum toxin injections to the masseters.

Adult↗
PubMed2005

Diabetic neuropathy.

Diabetic neuropathy is not a single entity but manifests as several different clinical syndromes. It is likely that different pathophysiological mechanisms contribute to the development of the neuropathy, including metabolic alterations, microvascular changes, and inflammatory changes. A summary of the underlying pathophysiological mechanisms and clinical aspects of different diabetic neuropathies are outlined in this article.

Diabetic Neuropathies↗
PubMed2004

Posterior reversible encephalopathy syndrome as the initial manifestation of Guillain-Barré Syndrome.

BACKGROUND: Guillain-Barré Syndrome (GBS) frequently affects autonomic nerves with subsequent fluctuations in blood pressure. Posterior reversible encephalopathy syndrome (PRES) is a descriptive radiological term for hypertensive encephalopathy. This article describes a unique case in which autonomic neuropathy led to marked elevations in blood pressure with subsequent PRES prior to the significant motor weakness and diagnosis of GBS. METHODS: To describe a patient who presented with PRES and GBS. RESULTS: A 58-year-old female presented to the local emergency room with complaints of acute sharp thoracolumbar back pain. Within the following 2 days, her blood pressure showed marked elevation with sudden episodic falls. She subsequently became encephalopathic and had a tonic-clonic seizure. Brain MRI was consistent with PRES. By day 5 of her initial presentation, she had developed weakness and areflexia with the electrophysiological findings of GBS. Her sensorium recovered, and MRI changes reversed with control of blood pressure. She was treated with intravenous immunoglobulin with full recovery back to baseline over the next 4 to 5 months. CONCLUSION: The autonomic effects of GBS may cause hypertensive encephalopathy or PRES prior to the motor manifestations.

Brain↗
PubMed2002

Sensory-predominant, painful, idiopathic neuropathy: inflammatory changes in sural nerves.

Sensory-predominant, painful, idiopathic neuropathies are a common clinical problem. In this retrospective study of 11 patients with such a neuropathy, we found axonal loss in 9, with multifocal axonal loss in 4 patients; there were large perivascular mononuclear inflammatory infiltrates (>50 cells) in 4 and smaller infiltrates (10-20 cells) in 4. These findings suggest that some cases of this neuropathy may be due to autoimmune vasculopathy and therefore may respond to immunotherapy.

Adult↗
PubMed2002

Childhood-onset chronic inflammatory demyelinating polyradiculoneuropathy with cranial nerve involvement.

A 17-year-old male presented with chronic diplopia and generalized motor weakness. He was previously diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy and acute disseminated encephalomyelitis in childhood. Cranial magnetic resonance imaging (MRI) revealed a rarely reported finding of thickening and enhancement of multiple cranial nerves. Nerve conduction studies and electromyography showed peripheral nerve demyelination with axonal involvement. There was improvement in the clinical examination, MRI, and electrophysiologic studies after combined corticosteroid and plasma exchange therapy. We review the clinical presentation, course, and response to therapy among children with chronic inflammatory demyelinating polyradiculoneuropathy, with specific emphasis on the frequency and pattern of cranial nerve involvement.

Adolescent↗
PubMed2002

Idiopathic brachial neuritis.

Idiopathic brachial neuritis is a well defined clinical condition that most commonly affects young adults, seen usually by primary care physicians, neurologists or orthopaedic surgeons. Its onset is characterized by acute, aching shoulder pain lasting a few days to weeks, followed by progressive shoulder girdle and upper extremity weakness and atrophy, with a slow but progressive recovery of motor function over 6 to 18 months. Its early recognition can help avoid unnecessary and potentially harmful diagnostic and therapeutic interventions, and avoid delays in prescribing appropriate therapies that may be helpful only early in the course of the disease. We present a case of idiopathic brachial neuritis and discuss important aspects of the disease and difficulties in reaching the correct diagnosis.

Brachial Plexus Neuritis↗