Publications by authors named "Neeraj Balaini"

12 Publications

  • Page 1 of 1

"Mercedes Benz Sign: Osmotic Demyelination Syndrome".

Neurol India 2021 May-Jun;69(3):777-778

Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.4103/0028-3886.319223DOI Listing
June 2021

nCoV-2019 infection induced neurological outcome and manifestation, linking its historical ancestor SARS-CoV and MERS-CoV: a systematic review and meta-analysis.

Sci Rep 2021 06 18;11(1):12888. Epub 2021 Jun 18.

Department of Pharmacology, Research Block: B, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

The first systematic review and meta-analysis to help clinician to identify early signs and symptoms of neurological manifestation in COVID-19 positive patients which will further help in early management of patients. Present systematic review and meta-analysis aimed to discuss the prevalence of neurological involvement of the 2019-nCoV patients and assess the symptomatic trend of events as compared to the 2002 "SARS" and 2012 "MERS" pandemics. The articles were systematically screened through several search engine and databases. The articles published or in preprint were included in the study till 15th May 2020. The systematic review done as per the published literatures which included 31 cross sectional, observational studies and case reports which revealed neurological signs and symptoms in SARS-COV-2 disease. For meta-analysis, we included 09 observational and cross-sectional studies which included COVID-19 positive patients and assessed the predominance of various neurological signs and symptoms in COVID-19 patients with relation to SARS-2002 and MERS-2012. Data was analyzed by using the "MedCalc" Statistical Software version 19.2.6 and reported as pooled prevalence. Standard I test was used to analyze the heterogeneity. We have collected and screened about a total 2615articles, finally we have included 31articles for the systematic review and 09 for meta-analysis as per the inclusion/exclusion criteria. The analysis was made as per the prevalence rate of neurological symptoms in COVID-19 positive patients. The cumulative neurological outcome of SARS-2002 and MERS-2012 was assessed to get the trends which was further tried to correlate the events with the current pandemic. During the analysis severity and outcome of neurological manifestations range from simple headache to vague non-focal complaints to severe neurologic impairment associated with seizure or meningitis. Central and peripheral nervous system (CNS/PNS) manifestations were seen during the SARS-2002, MERS-2012 and COVID-19. However, none of the publication had primary or secondary objectives of searching neurological manifestations in the COVID-19 patients and the pathogenic mechanism which will subsequently strengthen the importance to start more prospective clinical trials. The prevalence of neurological signs and symptoms were taken as primary objective. Thereafter, the prevalence of each CNS/PNS symptoms was categorized and their prevalence studied. The selection of Bagheri et al., 2020 may be discussed because they have done the cross-sectional study with the neurological finding and correlated the data with prevalence of the COVID-19 positive patients. The proportion of patients presenting with neurological outcome and clinical/PCR positivity were done. We had searched and followed all the possible online/web source, still the data collection process may remain a limitation of work due to addition of several publications on COVID-19 every day. Due to lack of data of SARS-CoV and MERS-CoV, we have included the case reports, MERS and COVID-19 in CNS/PNS manifestations.
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http://dx.doi.org/10.1038/s41598-021-92188-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213856PMC
June 2021

Carpal tunnel syndrome or C8/T1 radiculoneuropathy due to perinural cyst: A diagnostic conundrum.

Indian J Radiol Imaging 2020 Oct-Dec;30(4):510-512. Epub 2021 Jan 13.

Department of Radio-Diagnosis and Imaging, PGIMER, Chandigarh, India.

Perineural cysts are usually described in Lumbosacral region and are uncommonly seen in cervical spine. These are mostly asymptomatic, with only a few cases of symptomatic cervical perineural cysts. No previous case report of perineural cyst causing C8/T1 radiculoneuropathy mimicking clinically as Carpal tunnel syndrome is reported in the literature. We report a case of elderly female who was operated for presumed Carpal tunnel syndrome. However, her symptoms did not improve. The MRI of the patient revealed presence of perineural cysts at the level of C8/T1 exiting nerve root, compressing it and causing the symptoms. We present the clinical, nerve conduction study and radiological presentation of cervical perineural cyst mimicking Carpal tunnel syndrome in this patient.
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http://dx.doi.org/10.4103/ijri.IJRI_414_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954159PMC
January 2021

Biceps Activity Synchronous with Inspiration After Phrenic Nerve Transfer.

Ann Neurol 2021 05 4;89(5):1053-1054. Epub 2021 Feb 4.

Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

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http://dx.doi.org/10.1002/ana.26025DOI Listing
May 2021

Lafora body disease: a case of progressive myoclonic epilepsy.

BMJ Case Rep 2020 Dec 22;13(12). Epub 2020 Dec 22.

Pathology, Indira Gandhi Medical College, Shimla, India.

Progressive myoclonic epilepsy (PME) is a progressive neurological disorder. Unfortunately, until now, no definitive curative treatment exists; however, it is of utmost importance to identify patients with PME. The underlying aetiology can be pinpointed if methodological clinical evaluation is performed, followed by subsequent genetic testing. We report a case of PME that was diagnosed as Lafora body disease. This case emphasises that, suspecting and identifying PME is important so as to start appropriate treatment and reduce the probability of morbidity and prognosticate the family.
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http://dx.doi.org/10.1136/bcr-2020-236971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757443PMC
December 2020

Magnetic resonance imaging (MRI) versus computed tomographic scan (CT scan) of brain in evaluation of suspected cavernous sinus syndrome.

Neuroradiol J 2020 Dec;33(6):501-507

Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background And Purpose: The cavernous sinus is a unique region owing to anatomical factors and the pathologies affecting it. The diagnosis of cavernous sinus syndrome (CSS) predominantly relies on clinicoradiological correlation. We studied the utility of computed tomographic (CT) scan versus magnetic resonance imaging (MRI) in the diagnosis of CSS.

Methods: A prospective observational study was conducted in a tertiary care center in north India. All patients presenting with a clinical syndrome of cavernous sinus involvement with radiologically confirmed lesions were enrolled in the study. MRI and CT scan with cavernous sinus cuts were done and reviewed by experienced neuroradiologists for cavernous sinus lesions and compared with the final diagnosis. Sensitivity and specificity were calculated.

Results: We included 48 patients in our study. A final diagnosis was achieved in 41 out of 48 (85.6%) patients. Fungal infections (16 (33.3%)) constituted the commonest cause of CSS, followed by neoplastic involvement (13 (27.1%)) and Tolosa-Hunt syndrome (12 (25%)). Vascular involvement was seen in three (6.3%) patients. Other rare causes were seen in four (8.3%) patients. CT scan had an overall sensitivity of 14.6% in achieving a final diagnosis, whereas MRI had an overall sensitivity of 70.7%, with a statistically significant difference ( < 0.001).

Conclusions: Although CT scan is a relatively cheap and accessible resource, its role in CSS diagnosis and management is limited because of poor yield. Hence, it is prudent to do an MRI as an initial investigation in cases of CSS.
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http://dx.doi.org/10.1177/1971400920970921DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788673PMC
December 2020

Primary Central Nervous System Lymphoma With Diffuse Neurolymphomatosis Involving Multiple Cranial and Spinal Nerve Roots.

Clin Nucl Med 2020 Jun;45(6):e285-e287

Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Primary central nervous system lymphoma is an extranodal lymphoma originating in the brain, spinal cord, and leptomeninges, which rarely spreads outside the nervous system. Neurolymphomatosis is the term used to describe lymphomatous involvement of the cranial nerves (except optic nerve) and peripheral nerve roots or plexus. We report a case of a 23-year-old man presented with progressive weakness of all 4 limbs. F-FDG PET/CT revealed FDG-avid thickening along the multiple cranial nerve roots, spinal nerve roots, and brain parenchymal lesion. Core biopsy from the peripheral nerve root demonstrated the lymphomatous involvement.
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http://dx.doi.org/10.1097/RLU.0000000000003018DOI Listing
June 2020

Extreme Delta Brush in Anti N-Methyl-D-Aspartate Encephalitis.

Ann Indian Acad Neurol 2019 Jul-Sep;22(3):335

Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.4103/aian.AIAN_439_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613419PMC
July 2019

Special scenarios in the management of central nervous system aspergillosis: a case series and review of literature.

Postgrad Med J 2019 Jul 20;95(1125):382-389. Epub 2019 Jun 20.

Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

is a rare but important opportunistic pathogen to invade the central nervous system (CNS). It is a significant pathogen of not only immunocompromised but also immunocompetent patients. Its manifestations are pleiotropic, reflecting multiple mechanisms of pathogenesis and host interactions. Despite significant advances in diagnostic methods and therapeutic options, the mortality remains high. Several advances have been made in medications and surgical management, yet, current treatment practices lack uniformity. Patient woes are further heightened by the high costs of treatment and prolonged duration of therapy. In view of the challenging aspects of this disease, we present a short review of four challenging cases touching on the varied aspects of management of CNS aspergillosis covering pathogenesis, diagnostic pitfalls, surgical and medical options and evidence-based guidelines for the management of the same.
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http://dx.doi.org/10.1136/postgradmedj-2018-136095DOI Listing
July 2019

Zika virus: A wake up call.

Neurol India 2018 Sep-Oct;66(5):1286-1287

Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.4103/0028-3886.241374DOI Listing
September 2019

An interesting and rare association of paraneoplastic myelopathy with Hurthle cell neoplasm.

Neurol India 2018 Jul-Aug;66(4):1191-1193

Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

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http://dx.doi.org/10.4103/0028-3886.237028DOI Listing
September 2019

Large serpentine aneurysm of the anterior cerebral artery.

Neurol India 2018 May-Jun;66(3):884-886

Department of Neuroradiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.4103/0028-3886.232329DOI Listing
September 2019
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