Department of Neurology: Research
Major research interests of the department include:

Neurophysiology
Organisation of motor pathways in central nervous system has been studied using stroke as a model and employing central motor conduction studies. A homonculous organisation was more truly represented in internal capsule compared to corona radiata (J Neurol Sci 1995, 134: 67; J Neurol 1997).

Significance of ipsilateral motor pathways was questioned in the possible recovery of stroke (EEG Clin Neurophysiol 1995, 97: 251).

Cortical sensory loss may be produced even following subcortical infarction and the SPECT revealed cortical hypoperfusion (Neurol India 1997, 45: 101).

Intercostal nerve conduction studies in man have been reported (J Neurol Neurosurg Psychiat 1989).

R1 response and its utility in L5-S1 radiculopathy have been reported (Electroencephalogr Clin Neurophysiol 1993).

F responses in lower motor neuron lesions have been reported (Electroencephalogr Clin Neurophysiol 1999, in press).
 

Neurotoxicology
Subtle cognitive changes were reported 1 year after in Bhopal gas disaster (Neurotoxicology 1997, 18: 381).

Studies on Neurolathyrism revealed diverse pattern of central motor conduction (CMCT) abnormalities; normal CMCT in presence of severe spasticity suggests the important role of small diameter pyramidal fibres (J Neurol Neurosurg Psychiat 1994; 57; 572).

Why fluorosis is more severe in India even at relatively low fluoride level? Coexisting dietary vitamin D deficiency has been postulated to play a role (Fluoride 1992; 25: 65).

Role of exitotoxins in ALS has been reported (Clin Chem Acta 1998).

Role of exitotoxins in experimental studies also conducted (Neurotoxicology 1994, Experientia 1993, Neuro report 1995, Amino acids 1995).
 

Stroke
Importance of location of stroke rather than its size in the recovery of stroke patient has been highlighted (Europ J Neurol 1995, 2: 407; J Neurol Sci 1995; 134: 67; Clin Neurol Neurosurg 1996; 98: 291).

A new classification of thalamic haemorrhage based on CT findings has been suggested (type A with posteriolateral extension and type B without posteriolateral extension). Type A has poor outcome (Clin Neurol Neurosurg 1996; 98: 291).

Pure motor hemiplegia (PMH) is attributed to capsular and basis pontis infarction. PMH has been reported following  medium size lateral putaminal haemorrhage (Acta Neurol Scand 1995, 91: 283).

Hypertensive intracerebral haemorrhage has been regarded as one time event; our studies have revealed recurrence of hypertensive bleed up to 3 times. This may be due to vasculopathy following poor BP control (Am J Med Sci 1995, 1: 156).

Transient renal dysfunction in patient with intracerebral haemorrhage occurs in the acute stage and is attributed to excessive catecholamine release due to rise in intracranial tension (J Neurol 1996, 243: 417).

In a multivariate analysis of prognostic predictors  of putaminal haemorrhage coma, pupillary changes and location of hematoma were best predictors of 3 month outcome (Indian J Med Res 1999, 109: 23).
 

Japanese encephalitis
Diagnostic importance of thalamic lesion on CT or MRI has been reported (J Neurol Neurosurg Psychiat 1994, 57: 1484; Neuroradiol 1997, 39: 180).

Importance of thalamus has been postulated in the genesis of movement disorders; this was studied on Japanese encephalitis (J Neurol 1997; 244; 299).

Anterior horn cells are also involved in JE which is based on clinical and neurophysiological observations (Act Neurol Scand 1997).

Pattern of movement disorders and their evolution in JE has been reported (J Neurol 1997, 244: 299).

Alpha coma may be a common entity and may not always suggest a poor prognosis in JE (EEG Clin Neurophysiol 1998).

In a multivariate analysis age, Glasgow coma scale and reflex changes were found to be the best predictors of 6 month outcome of Japanese encephalitis. SPECT studies have confirmed thalamic hypoperfusion in JE. In addition frontal and lentiform hyperperfusion was found (Acta Neurol Scand 1999).

EEG changes in Japanese encephalitis have been described (EEG Clin Neurophysiol 1998, 106: 238).

JE results in nonspecific changes in auditory evoked potential, mainly in form of V amplitude reduction (J Neurol Sci 1999).
 

Tuberculosis
Prognostic predictors of  TB meningitis - mathematical model suggesting age, coma and hydrocephalous reported (J Neurol Sci 1996; 137: 57).

Stage of meningitis and level of coma and infarction are the most important predictors of TB meningitis outcome at 6 and 12 months (Int J Tuberc Lung Dis 1999).

The importance of motor  and somatosensory evoked potentials in objective documentation of TB meningitis has been highlighted (Acta Neurol Scand 1999).

EEG changes and their relationing with radiological findings has been reported (EEG Clin Neurophysiol 1998, 107: 39).

In Potts paraplegia  somatosensory and motor evoked potential changes have been reported (Spinal cord 1996, 34: 272).
 

Acute transverse myelitis
Transverse myelitis although is regarded to affect mainly the dorsal spinal cord but using clinical, MRI and neurophysiological parameters; cervical spinal cord was found to be involved in 70% patients (J Neurol Sci 1996, 138: 57).

The role of EMG in the prognosis of ATM has been reported (J Neurol 1998).

Prognostic  predictors of ATM has been employed using multivariate analysis. The role of degree of weakness, EMG and EPs has been highlighted (Acta Neurol Scand 1998).

Clinical and Prognostic features of  parainfectious conus myelitis have been reported (J Neurol Sci 1998; Acta Neurol Scand 1997).
 

Cervical spondylotic myelopathy
The role of surgery is established in cervical spondylotic myelopathy. A protocol of 6-12 weeks of collar therapy  and monitoring the progress of patients by central motor conduction studies may allow more rational management and prevent otherwise unnecessary surgery (J Neurol Sci 1997).
 

Neuromuscular disorders
The role of infra spinatus  hypertrophy and its importance in the diagnosis of Duchenne muscular dystrophy has been reported  (Clinical Neurology and Neurosurgery 1995).
 

Book
Clinical Neurophysiology - Nerve Conduction, electromyography  and evoked potentials by U K Misra and J Kalita. BI Churchill Livingstone, 1999.


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