Abstract:
BACKGROUND:Acute encephalitis syndrome (AES) is a constellation of symptoms that includes fever and altered mental status. Most cases are attributed to viral encephalitis (VE), occurring either in outbreaks or sporadically. We conducted hospital-based surveillance for sporadic adult-AES in rural Central India in order to describe its incidence, spatial and temporal distribution, clinical profile, etiology and predictors of mortality. METHODS:All consecutive hospital admissions during the study period were screened to identify adult-AES cases and were followed until 30-days of hospitalization. We estimated incidence by administrative sub-division of residence and described the temporal distribution of cases. We performed viral diagnostic studies on cerebrospinal fluid (CSF) samples to determine the etiology of AES. The diagnostic tests included RT-PCR (for enteroviruses, HSV 1 and 2), conventional PCR (for flaviviruses), CSF IgM capture ELISA (for Japanese encephalitis virus, dengue, West Nile virus, Varicella zoster virus, measles, and mumps). We compared demographic and clinical variables across etiologic subtypes and estimated predictors of 30-day mortality. RESULTS:A total of 183 AES cases were identified between January and October 2007, representing 2.38% of all admissions. The incidence of adult AES in the administrative subdivisions closest to the hospital was 16 per 100,000. Of the 183 cases, a non-viral etiology was confirmed in 31 (16.9%) and the remaining 152 were considered as VE suspects. Of the VE suspects, we could confirm a viral etiology in 31 cases: 17 (11.2%) enterovirus; 8 (5.2%) flavivirus; 3 (1.9%) Varicella zoster; 1 (0.6%) herpesvirus; and 2 (1.3%) mixed etiology); the etiology remained unknown in remaining 121 (79.6%) cases. 53 (36%) of the AES patients died; the case fatality proportion was similar in patients with a confirmed and unknown viral etiology (45.1 and 33.6% respectively). A requirement for assisted ventilation significantly increased mortality (HR 2.14 (95% CI 1.0-4.77)), while a high Glasgow coma score (HR 0.76 (95% CI 0.69-0.83)), and longer duration of hospitalization (HR 0.88 (95% CI 0.83-0.94)) were protective. CONCLUSION:This study is the first description of the etiology of adult-AES in India, and provides a framework for future surveillance programs in India.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Joshi R,Mishra PK,Joshi D,Santhosh SR,Parida MM,Desikan P,Gangane N,Kalantri SP,Reingold A,Colford JM Jrdoi
10.1016/j.clineuro.2013.04.008subject
Has Abstractpub_date
2013-09-01 00:00:00pages
1753-61issue
9eissn
0303-8467issn
1872-6968pii
S0303-8467(13)00132-7journal_volume
115pub_type
杂志文章abstract:BACKGROUND:Motor imagery (MI) impairment has been reported in individuals with multiple sclerosis (MS). The present study was designed to investigate neural evidence for MI impairment and its relationship to working memory in MS patients. METHODS:The study participants included 24 early stage MS patients (age: 22-40/m...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.04.002
更新日期:2013-09-01 00:00:00
abstract::A patient is presented with paroxysmal choreoathetosis precipitated by movement, sound and photic stimulation associated with an arterio-venous malformation (AVM) who responded to carbamazepine treatment. Hemodynamic circulatory disorder of the sensory-motor cortices having AVM may alter striatal function and produce ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(05)80011-3
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abstract::Polymethyl-methacrylate (PMMA) as part of bone cement is a widely used material in the context of orthopaedic implants and also in cranioplasty. Although PMMA is characterised by excellent biocompatibility with low intrinsic toxicity and inflammatory activation, a minor portion of patients develop allergic reactions. ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2010.07.013
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abstract:BACKGROUND:During recent years, sialorrhea in Parkinson's disease (PD) has been treated with botulinum toxin type A (BT-A); however, there are no data describing its effects on swallowing dynamics in this group of patients. OBJECTIVE:To investigate whether injection of BT-A into the parotid glands interferes with the ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.12.007
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abstract::Multiple sclerosis (MS) has several clinically different forms. Whereas the illness progresses slowly in most of the patients, 10% have an aggressively progressive course with fatal outcome without signs of remyelination capability. The process of remyelination depends on numerous interactive factors, including the pr...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2005.11.014
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To review the direct and indirect effects on the central nervous system (CNS) of systemically administered immuno-modulatory therapies in use or under evaluation for the relapsing forms of multiple sclerosis (MS). METHODS:We summarize data published by our own lab and by others that delineate the effects of ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2008.03.021
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abstract::Non-pituitary lesions account for a minority of sellar region abnormalities. We report the unusual occurrence of non-pituitary sellar/suprasellar lesions in a mother and her two daughters. Each of these cases was diagnosed and managed differently, illustrating the relative importance of radiographic imaging, tumor mar...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.09.021
更新日期:2008-02-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(89)90119-4
更新日期:1989-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.04.017
更新日期:2018-07-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2015.06.009
更新日期:2015-10-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2016.05.005
更新日期:2016-07-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(90)90035-4
更新日期:1990-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.105572
更新日期:2020-02-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(84)90278-6
更新日期:1984-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105889
更新日期:2020-08-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2020.105942
更新日期:2020-08-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.clineuro.2019.05.011
更新日期:2019-07-01 00:00:00
abstract::Controversy exists about whether depression following stroke represents a biologically mediated change or a psychological reaction to the deficits. We present a patient with an acute isolated personality change and depression following a lacunar infarct of the left internal capsule, who was unaware of his affective ch...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(02)00113-0
更新日期:2003-04-01 00:00:00
abstract::A case of pseudohypoxic brain swelling, a newly defined entity, is described. The patient experienced generalized seizures and did not awake initially after a seemingly uneventful elective craniotomy for clipping of an unruptured anterior communicating artery aneurysm. Neuroimaging findings demonstrated diffuse brain ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.08.007
更新日期:2009-12-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2016.02.010
更新日期:2016-04-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(94)90027-2
更新日期:1994-02-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105833
更新日期:2020-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106302
更新日期:2021-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105899
更新日期:2020-08-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2004.05.003
更新日期:2005-04-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.12.001
更新日期:2009-06-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2020.106208
更新日期:2020-12-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.02.006
更新日期:2014-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.05.013
更新日期:2018-07-01 00:00:00
abstract::A now 58-year-old female patient, carrier of the point-mutation in the beta-amyloid gene on chromosome 21 which causes hereditary cerebral hemorrhage with amyloidosis - Dutch type, developed progressive dementia after the age of 55 years. She never suffered from a cerebral hemorrhage. Dementia has been described as a ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(92)90181-2
更新日期:1992-01-01 00:00:00