Manjari Tripathi

All India Institute of Medical Sciences | AIIMS · Department of Neurology

Purpose: To test the applicability of the new International League Against Epilepsy (ILAE) 2010 classification for epilepsies and to compare it with the ILAE 1989 classification and the ILAE 2001 diagnostic scheme in developing countries with limited resources such as India. Methods: Prospective data of 500 consecutive patients with epilepsy, pr...

BACKGROUND Neurosurgical treatment may improve seizures in children and adolescents with drug-resistant epilepsy, but additional data are needed from randomized trials. METHODS In this single-center trial, we randomly assigned 116 patients who were 18 years of age or younger with drug-resistant epilepsy to undergo brain surgery appropriate to the u...

Witteveen-Kolk syndrome (WITKOS) is an autosomal dominant disorder characterized by distinct facial features, microcephaly, short stature, intellectual disability, and subtle neuroimaging abnormalities. The syndrome is attributed to a loss of function mutation in the SIN3A gene, a member of the switch-insensitive 3 transcription regulator family. H...

This chapter provides a comprehensive overview of the management of surgically remediable epilepsy, focusing on drug-resistant epilepsy (DRE). It details the presurgical evaluation process, including patient history, video electroencephalography (EEG) monitoring, neuroimaging, and neuropsychological testing. The chapter also discusses the importanc...

Background and Objectives Functional dissociative seizures (FDS) are very common in neurology clinics, they straddle both neurology and psychiatry. In India, scarce resources and guidelines are available for effectively conveying their diagnosis and management, which leads to a substantial gap in care. We aimed to provide an instructional module fo...

Progressive myoclonic epilepsy (PME) include phenotype leading to: Ø Myoclonic jerks Ø Seizures Ø Progressive neurologic impairment Ø KCNC1 is an extremely rare potassium channel mutation Ø Presentation: PME with ataxia History Ø 24 year old male born of a non-consanguineous marriage with low birth weight and near normal developmental milestones Ø...

ADSHEwith a rare pathogenic mutation in the CHRNB2 gene, Whole exome sequencing identified a pathogenic heterozygous variant in exon 5 of the CHRNB2 gene (c.859G>T, p.Val287Leu) with autosomal dominant inheritance in both siblings. We report the first Indian family diagnosed with ADNFLE harbouring a rare pathogenic mutation in the CHRNB2 gene cont...

A good night's sleep is essential for maintaining a healthy body and mind, as our body cells repair themselves during sleep. However, various factors can disturb our sleep, and Geopathic Stress is considered one of the contributing reasons. Geopathic Stress refers to the disturbance of natural energy flows, primarily caused by geological features s...

Introduction: Circadian oscillations is reported to be affected by molecular pathways of innate immunity, which is reflected by the stress induced inflammatory upscale, on sleep deprivation. Suprachiasmatic nucleus of hypothalamus is a master pacemaker for entrainment of genes for circadian oscillations, making it a demanding site for plasticity re...

Purpose This study evaluates the efficacy of SISCOS (Subtraction ictal-interictal SPECT coregistered to SPECT) in localizing the epileptogenic zone (EZ) in focal cortical dysplasia (FCD), comparing its predictive performance with MRI and post-surgical outcomes based on ILAE classification. Methods 84 patients with drug refractory epilepsy (DRE) wh...

Hypothalamic hamartomas (HHs) are benign masses, often associated with drug-refractory epilepsy (DRE). Open surgery as well as the endoscopic disconnection techniques are fraught with a high risk of morbidity and failure rates. The authors have been performing robotic-guided radiofrequency (RF) ablation for all types of HH presenting with DRE as a...

Epilepsy is one of the common neurological diseases which affects 65-70 million people worldwide. Modified Atkins diet (MAD) as a therapy is used as one of the treatments to reduce the seizures occurrence in epileptic patients. The purpose of this purpose is to review all evidence regarding the efficacy of the MAD from randomized controlled trials...

Niemann–Pick disease type C (NPC) is a lipid storage disorder having varied neurological, psychiatric, and visceral manifestations. Twenty‐seven‐year‐old female presented to the hospital with recurrent episodes of seizures for the last one and half year. She had delayed motor and language milestones and was scholastically poor in school. On examina...

Over 50 million people worldwide are affected by epilepsy, a common neurological disorder that has a high rate of drug resistance and diverse comorbidities such as progressive cognitive and behavioural disorders, and increased mortality from direct or indirect effects of seizures and therapies. Despite extensive research with animal models and huma...

Introduction: Epilepsy is a chronic neurological condition characterized by a persistent propensity for seizure generation. About one-third of patients do not achieve seizure control with the first-line treatment options, which include >20 antiseizure medications. It is therefore imperative that new medications with novel targets and mechanisms of...

The study aimed to determine the concordance and discordance of epileptiform discharges on scalp video EEG and magnetic resonance imaging (MRI) of brain in drug resistant epilepsy (DRE)

TITLE: Concordance of epileptiform discharges on video-Electroencephalogram (EEG) with the Brain Imaging of focal lesions in drug resistant epilepsy: Experience from a tertiary Centre in India OBJECTIVE: To determine the concordance and discordance of epileptiform discharges on scalp video EEG and magnetic resonance imaging (MRI) of brain in drug...

This study explored the impact of peroxisome proliferator-activated receptor modulators (PPAR-m) on seizure control and epileptogenesis in a lithium-pilocarpine-induced status epilepticus (SE) model in Wistar rats. Following optimal dose determination, the effects of fenofibrate, pemafibrate, and saroglitazar alone and with antiseizure medications...

Background: Neuropsychological Rehabilitation (NR) helps manage cognitive deficits in epilepsy. As interna- tionally developed programs have limited applicability to resource-limited countries, we developed a program to bridge this gap. This 6-week caregiver-assisted, culturally suitable program has components of (1) psycho- education, (2) compensa...

Cytokines have the potential to be the ideal biomarkers to track the onset and progression of immune-mediated diseases, study the development of novel therapeutic strategies, and they can serve as outcome parameters due to their crucial role in the regulation of immune and inflammatory responses. It is vital to keep track of the entire cytokine spe...

The objective of this chapter is to provide an overview of the methods used to investigate the connectivity and structure of the nervous system. These methods allow neuronal cells to be categorized according to their location, shape, and connections to other cells. The Golgi-Cox staining gives a thorough picture of all significant neuronal structur...

Background Hemispherotomy (HS) is an effective treatment for unilateral hemispheric onset epilepsy. There are few publications for HS in adults, and there is no series comparing adults and pediatric patients of HS. Objective To compare the hemispherotomies done in adult patients with pediatric ones in terms of efficacy and safety. Methods Data wa...

Primary CNS Vasculitis (PCNSV) is a rare, diverse, and polymorphic CNS blood vessel inflammatory condition. Due to its rarity, clinical variability, heterogeneous imaging results, and lack of definitive laboratory markers, PCNSV diagnosis is challenging. This retrospective cohort analysis identified patients with histological diagnosis of PCNSV. De...

Objective Benchmarking has been proposed to reflect surgical quality and represents the highest standard reference values for desirable results. We sought to determine benchmark outcomes in patients after surgery for drug‐resistant mesial temporal lobe epilepsy (MTLE). Methods This retrospective multicenter study included patients who underwent MT...

Objective Cognitive assessment is a crucial element of the mental health screening process. However, there is a lack of culturally appropriate cognitive screening tools for the Hindi-speaking aging population in India. We aimed to translate and culturally tailor the English version of the computerized Cognistat test for the Hindi-speaking aging pop...

Low-grade gliomas (LGGs) are a heterogeneous group of tumors with an average 10-year survival rate of 40-55%. Current treatment options include chemotherapy, radiotherapy, and gross total resection (GTR) of the tumor. The extent of resection (EOR) plays an important role in improving surgical outcomes. However, the major obstacle in treating low-gr...

Background Literacy is an important factor that predicts cognitive performance. Existing cognitive screening tools are validated only in educated populations and are not appropriate for older adults with little or no education leading to poor performance on these tests and eventually leading to misdiagnosis. This challenge for clinicians necessitat...

There is a pressing clinical need for thrombolytic agents that can effectively disaggregate arterial thrombi in acute ischemic stroke without significantly increasing the risk of bleeding. This pilot study aimed to investigate the safety and efficacy of N-acetylcysteine (NAC) as an adjunctive therapy to intravenous recombinant tissue plasminogen ac...

Introduction: Corticosteroids are used as adjunctive treatment in tuberculous meningitis (TBM). However, there is no universally accepted regimen, type, duration, or route of steroid administration. Methodology: In a randomized open labelled pilot study, TBM patients were divided into overlap oral dexamethasone (OOD) and direct oral dexamethasone (...

Background With a rising burden of dementia globally, there is a need to harmonize dementia diagnosis and research across diverse populations. Majority of dementia patients reside in low‐middle income countries (LMICs) such as India. Major challenges in the diagnosis of dementia in LMICs include the lack of a proper diagnostic tool for low literate...

Introduction Symptoms of obstructive sleep apnea (OSA) and poor sleep quality affect around one in ten people in India. We aimed to determine if OSA symptoms and poor sleep quality are independently associated with cognition in middle-aged and elderly urban Indian populations. Methods We studied the cross-sectional association between OSA symptoms...

Background and aims Complications of Tuberculous Meningitis (TBM) include hydrocephalus, vasculitis infarcts, arachnoiditis (optico-chiasmatic and spinal), and increase in size/number of tuberculomas. We aimed to study the association of these complications with morbidity and mortality trend over their follow up period of nine months. Methods The...

Background and aims Despite advances in anti-tubercular treatment (ATT), the mortality of central nervous system tuberculosis (CNSTB) is upto 20%. The determinants of poor outcome and mortality have been studied in small single center studies. We aimed to study a multicentric cohort of CNS tubercular mass lesions in an ambispective cohort design to...

Purpose: The advent of COVID- 19 gave the opportunity to examine the feasibility and efficacy of tele- administration of a paper- pencil Neuropsychological Rehabilitation (NR) program standardized for adult patients with Drug Refractory Epilepsy (DRE). Method: 10 patients were recruited in a single arm pilot feasibility study. They were aged 18- 45...

Objective F-18 Fluorodeoxyglucose PET/CT (FDG-PET) is emerging as a useful imaging adjunct to MRI in the initial diagnostic evaluation of autoimmune encephalitis (AIE)-though presently it is not included in the diagnostic criteria. Materials and methods In this prospective study we enrolled a total of 52 patients with clinically diagnosed and trea...

Objectives Although hemispheric surgeries are among the most effective procedures for drug‐resistant epilepsy (DRE) in the pediatric population, there is a large variability in seizure outcomes at the group level. A recently developed HOPS score provides individualized estimation of likelihood of seizure freedom to complement clinical judgement. Th...

Mycobacterium tuberculosis (Mtb) is a life-threatening infectious pathogen that causes tuberculosis (TB). The MTBC complex comprises eight species, including Mtb, M. cannettii, M. bovis, M. africanum, Bacillus Calmette-Guerin (BCG), M. caprae, M. microti, and M. pinnipedi. The methods used for TB laboratory diagnosis are constantly changing to prod...

Background and objectives Persons with epilepsy are afflicted with co-morbidities such as stigma, anxiety and depression which have a significant impact on their quality of life. These co-morbidities remain largely unaddressed in resource limited countries. This randomized controlled trial (RCT) aimed to investigate if yoga and psychoeducation were...

Objective Lennox–Gastaut syndrome (LGS) is a severe form of epileptic encephalopathy, presenting during the first years of life, and is very resistant to treatment. Once medical therapy has failed, palliative surgeries such as vagus nerve stimulation (VNS) or corpus callosotomy (CC) are considered. Although CC is more effective than VNS as the prim...

Multimodal neuroimaging data of various brain disorders provides valuable information to understand brain function in health and disease. Various neuroimaging-based databases have been developed that mainly consist of volumetric magnetic resonance imaging (MRI) data. We present the comprehensive web-based neuroimaging platform “SWADESH” for hosting...

Primary angiitis of the central nervous system (PACNS) is an autoimmune disease with myriad presentations in the form of headache, focal neurological deficits, seizures and rapid cognitive decline. Predilection or isolated and recurrent involvement of one hemisphere is rarely described in literature. This leads to low clinical suspicion and often d...

Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel di...

Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel d...

NUMBER: 1164 Objective: To describe the clinical heterogeneity and expand the phenotypic spectrum of Witteveen-Kolk syndrome Background: Witteveen-Kolk syndrome (WITKOS) is a neurodevelopmental condition, rst described in 2016, and is characterized by distinctive facial features, microcephaly, short stature, modest intellectual delay, development d...