Publications by authors named "K V Vysakha"

4 Publications

  • Page 1 of 1

Adult-onset subacute sclerosing panencephalitis.

Pract Neurol 2021 Apr 13. Epub 2021 Apr 13.

Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India

Subacute sclerosing panencephalitis (SSPE) is a lethal slow viral disease of the central nervous system caused by a defective measles virus. The onset is mostly in childhood, manifesting clinically as decline in academic performance, behavioural changes, motor dysfunction and myoclonus. Adult-onset SSPE is rare and can present as rapidly progressive dementia. We present a young man of Indian origin with adult-onset SSPE with rapidly progressive dementia but no localising neurological signs. The diagnostic clues were parieto-occipital white matter changes on MR brain scan and history of childhood fever with rash. High titres of antimeasles antibody in cerebrospinal fluid confirmed the diagnosis. The long latency from primary measles virus infection to symptom onset can be misleading in adults. SSPE should be considered in adults with dementia, especially in tropical countries where vaccination coverage is suboptimal.
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http://dx.doi.org/10.1136/practneurol-2020-002880DOI Listing
April 2021

Differential Distribution of Cerebral Microbleeds in Subtypes of Acute Ischemic Minor Stroke and TIA as well as its Association with Vascular Risk Factors.

Neurol India 2020 Sep-Oct;68(5):1139-1143

Comprehensive Stroke Care Program, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

Background: Cerebral microbleed (CMB) is a novel neuroimaging marker of cerebral small vessel disease.

Objective: To determine the prevalence of CMB in the subtypes of acute ischemic minor stroke (AIS) and transient ischemic attack (TIA) and to identify the risk factors associated with location and number of CMB.

Materials And Methods: Patients with AIS (National Institute of Health Stroke Scale of 5 or less) or TIA were included. CMB was characterized using the Microbleed Anatomical Rating Scale (MARS).

Results: Of the 488 subjects [mean age (standard deviation): 57.5 years (14.4 years), males (77.7%)] recruited, CMB was noted in 140 (28.7%). About 35% with CMB had a lacunar stroke etiology, whereas LAA and CE subtype constituted 33.6 and 10.7%, respectively (P = 0.000). Lacunar subtype was more likely to harbor multiple CMB (four or more) and CMB in all locations (lobar, deep or infratentorial). On multivariate analysis, systemic hypertension [P = 0.025; odds ratio (OR) 0.33 (95% confidence interval (CI) 0.129-0.874)], serum triglyceride (TG) levels below 150 mg/dL [P = 0.001; OR 3.70 (95% CI 1.698-8.072)], and presence of white matter hyperintensities on magnetic resonance imaging brain [P = 0.026; OR 2.18 (95% CI 1.096-4.337)] were associated with the presence of CMB. Those with serum TG levels of less than 150 mg/dL were more likely to harbor lobar (P = 0.002) or infratentorial CMB (P = 0.022), whereas those with serum creatinine levels of more than1.5 mg/dL have lobar CMB (P = 0.033).

Conclusion: Our study showed a differential distribution of CMB in ischemic stroke subtypes and association of risk factors with the presence, number and location of CMB.
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http://dx.doi.org/10.4103/0028-3886.299147DOI Listing
October 2020

An unusual presentation of scleromyxedema as inflammatory myopathy.

Acta Myol 2019 03 1;38(1):13-16. Epub 2019 Mar 1.

Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.

Scleromyxedema is a rare cutaneous mucinosis with frequent extracutaneous manifestations. Myopathy in scleromyxedema is a poorly recognized syndrome among neurologists and can mimic idiopathic and connective tissue disease-associated inflammatory myopathy. Diagnosis is suspected by the characterization of the skin lesions and clinched by skin and muscle biopsies. Here, we report a patient with scleromyxedema and myopathy with the characteristic histopathological feature of mucin deposition in skin biopsy. Her muscle biopsy showed a picture consistent with scleromyxedema myopathy with vacuolar and inflammatory changes. The association with paraproteinemia, propensity to life-threatening central nervous system disease and good response to intravenous immunoglobulin necessitate the accurate diagnosis of this condition.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598408PMC
March 2019

T-wave alternans: a harbinger for malignant ventricular arrhythmias.

BMJ Case Rep 2018 Jul 12;2018. Epub 2018 Jul 12.

Department of Internal Medicine, Medical College Hospital, Thiruvananthapuram, Kerala, India.

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http://dx.doi.org/10.1136/bcr-2018-225515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069934PMC
July 2018