Neoplastic Parkinsonism: An illustrative case report

Non-Hodgkin′s lymphoma of T-cell types are rare neoplasms. Central nervous system metastasis is unusual. We are reporting a patient with peripheral T-cell lymphoma unspecified who had extra nodal metastasis into the brain that manifested with extrapyramidal dysfunction. The clinical presentation was exceptional in that the course was indolent and patient had no overt extra neural manifestations of malignancy for nearly 3 years after the onset of Parkinsonism. Striking brain imaging late in the disease supported by pathological findings enabled the diagnosis of this rare condition

Early stages of Alzheimer's disease are alarming signs in injury deaths caused by traffic accidents in elderly people (≥60 years of age): A neuropathological study

© 2018 Indian Journal of Psychiatry. Background: There is little information available in the literature concerning the contribution of dementia in injury deaths in elderly people (≥60 years). Aim: This study was intended to investigate the extent of dementia-related pathologies in the brains of elderly people who died in traffic accidents or by suicide and to compare our findings with age-And sex-matched natural deaths in an elderly population. Materials and Methods: Autopsy-derived human brain samples from nine injury death victims (5 suicide and 4 traffic accidents) and nine age-And sex-matched natural death victims were screened for neurodegenerative and cerebrovascular pathologies using histopathological and immunohistochemical techniques. For the analysis, Statistical Package for the Social Sciences (SPSS) version 16.0 was used. Results: There was a greater likelihood for Alzheimer's disease (AD)-related changes in the elders who succumbed to traffic accidents (1 out of 4) compared to age-And sex-matched suicides (0 out of 5) or natural deaths (0 out of 9) as assessed by the National Institute on Aging - Alzheimer's Association guidelines. Actual burden of both neurofibrillary tangles (NFTs) and (SPs) was comparatively higher in the brains of traffic accidents, and the mean NFT counts were significantly higher in the region of entorhinal cortex (P < 0.05). However, associations obtained for other dementia-related pathologies were not statistically important

Spectrum of primary intracranial tumors at a tertiary care neurological institute: A hospital?based brain tumor registry

ABSTRACTBackground: Hospital?based cancer registries (HBCRs) provide information on the magnitude and distribution of cancersin a given hospital. Hospital?based brain tumor registry (HBBTR) data on primary intracranial tumors from a tertiary careneurological center is presented. This is compared with related national and international data.Materials and Methods: Data of patients operated for brain tumors at the National Institute of Mental Health andNeurosciences, Bangalore, India, between January 2010 and December 2014 was collected. Patients' clinical details andhistopathological diagnosis were recorded. Data was analyzed and compared with that of Tata Memorial Hospital (TMH),Mumbai, and the Central Brain Tumor Registry of the United States (CBTRUS).Results: A total of 4295 primary intracranial tumors in 1847 (43%) females and 2448 (57%) male patients were recorded.Pediatric and adult patients accounted for 16.2% and 83.8% of the cases, respectively. The maximum proportion of tumorswas noted in the fourth decade. Among children, astrocytomas (25.1%), embryonal (20.6%), and ependymal tumors (14.8%)were the most frequently reported histology. In adults, meningiomas (23.2%), glioblastomas (15.5%), and nerve sheathtumors (12.7%) were common. Glioblastomas and all other tumors showed a male predilection whereas meningiomaspresented more commonly in females. While our HBBTR followed similar trends as TMH data, marked difference was seenin the median age of some tumor subtypes when compared to CBTRUS.Conclusion: This HBBTR data gives a glimpse of the prevalence of varied primary intracranial tumors. Such data can belinked to other HBCRs and population?based cancer registries in India for improved research and policy?making decisions

An uncommon cause of bifacial weakness and non-length-dependent demyelinating neuropathy

Tangier disease is a rare metabolic disorder that causes neuropathy in half of the affected individuals. We present the clinical, electrophysiological, and histopathological findings in a middle-aged gentleman of Tangier disease who was initially diagnosed as leprosy and treated with antileprosy drugs. The presence of a demyelinating electrophysiology in a patient with predominant upper limb involvement and facial diplegia should raise the suspicion of Tangier disease. Estimation of serum lipids should form a part of routine evaluation in order to avoid misdiagnosis

Cytoskeletal pathologies of age-related diseases between elderly Sri Lankan (Colombo) and Indian (Bangalore) brain samples

© 2016 Bentham Science Publishers. Within South Asia, Sri Lanka represents fastest aging with 13% of the population was aged over 60’s in 2011, whereas in India it was 8%. Majority of the Sri Lankan population based genetic studies have confirmed their origin on Indian mainland. As there were inadequate data on aging cytoskeletal pathologies of these two nations with their close genetic affiliations, we performed a comparison on their elderly. Autopsy brain samples of 50 individuals from Colombo, Sri Lanka (mean age 72.1yrs ± 7.8, mean ± S.D.) and 42 individuals from Bangalore, India (mean age 65.9yrs ± 9.3) were screened for neurodegenerative pathologies using immunohistochemical techniques. A total of 79 cases with incomplete clinical history (Colombo- 47 and Bangalore- 32) were subjected to statistical analysis and 13 cases, clinically diagnosed with dementia and/or Parkinsonism disorders were excluded. As per National Institute on Aging Alzheimer’s Association guidelines, between Colombo and Bangalore samples, Alzheimer’s disease neuropathologic change for intermediate/ high level was 4.25% vs. 3.12% and low level was 19.15% vs. 15.62% respectively. Pathologies associated with Parkinsonism including brainstem predominant Lewy bodies-6.4% and probable progressive supra nuclear palsy2.13% were found solely in Colombo samples. Alzheimer related pathologies were not different among elders, however, in Colombo males, neurofibrillary tangle grade was significantly higher in the region of hippocampus (odds ratio = 1.46, 95% confidence interval = 0.07-0.7) and at risk in midbrain substantia nigra (p = 0.075). Other age-related pathologies including spongiform changes (p < 0.05) and hippocampus cell loss in dentate gyrus region (p < 0.05) were also identified prominently in Colombo samples. Taken together, aging cytoskeletal pathologies are comparatively higher in elderly Sri Lankans and this might be due to their genetic, dietary and/ or environmental variations