Browsing by Author "Monika Shailesh"

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Clinical Spectrum of Non-motor Symptoms in Correlation with Quality of Life in Parkinson’s Disease and Atypical Parkinsonism: Evidence in Reaching Consensus
(SAGE Publications Inc., 2025) Madhusudan Rajendrakumar Tapdia; Anand Kumar; Ajay Kumar Yadav; Varun Kumar Singh; Abhishek Pathak; Rameshwar Nath Chaurasia; Vijay Nath Mishra; Navneet Kumar Dubey; Neetu Rani Dhiman; Monika Shailesh; Deepika Srivastava Joshi
Background: Non-motor symptoms (NMS) are frequently overlooked, yet they significantly contribute to the progression of Parkinson’s disease (PD) or atypical parkinsonism (AP), which include multiple system atrophy (MSA), progressive supranuclear palsy (PSP). Moreover, discrepancies exist in non-motor symptom scale (NMSS) scores for AP and PD, and no consensus has yet been reached. Purpose: We evaluated and compared the NMS and their association with life quality in patients with AP and PD. Methods: This cross-sectional observational report at a single-centre enrolling 204 patients (155 PD, 49 AP (27 MSA), and 22 PSP) from a tertiary care hospital’s movement disorder clinic. We used Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS UPDRS)-III and modified Hoehn and Yahr (H&Y) to compute a motor score and disease severity, respectively. We assessed patients’ mental capabilities, such as cognitive impairment, through a Mini-Mental State Examination (MMSE). Meanwhile, the NMSS determined the NMSs. Quality of life (QoL) was estimated by PD Questionnaire-39 (PDQ-39). Results: We observed insignificant differences between the PD and atypical parkinsonian syndrome (APS) groups based on disease duration and gender. Worsened motor disability and disease severity were observed in AP (PSP>MSA) (P <.001). The mean NMSS scores for PD, PSP and MSA were 23.7 ± 27.9, 47.6 ± 41.3 and 65.6 ± 35.5, respectively (P <.05). MSA had a comparatively high score for sexual, cardiovascular and urinary domains, while PSP scored higher for memory/attention domains. In contrast, PD group revealed significantly lower scores for perceptual and sexual domains. Conclusion: Compared to PD, NMS was severe and highly prevalent among AP (MSA > PSP), which could be confirmed through the prevalence of sexual cardiovascular and urinary domains in MSA, while attention and mood/cognition, and sleep in PSP. © The Author(s) 2025.
Restless Legs Syndrome: An Unusual Initial Non-motor Manifestation of Huntington's Disease
(Wolters Kluwer Medknow Publications, 2025) Monika Shailesh; Nayana Bhuyan; Niraj Kumar Srivastava; Anand Kumar; Varun Kumar Singh; N. Suresh Kumar; Deepika Srivastava Joshi
[No abstract available]
Unravelling limb-girdle muscular dystrophy in an HIV patient: a diagnostic odyssey
(Springer Science and Business Media Deutschland GmbH, 2025) Sanchit Shailendra Chouksey; Neetu Rani Dhiman; Anand Kumar; Varun Kumar Singh; Monika Shailesh; Deepika Srivastava Joshi
Background: Neuromuscular complications are common in patients with HIV/AIDS at any stage of the disease process. Myopathies can be secondary to antiretroviral therapy, HIV myositis itself or other aetiologies. Progressive muscle weakness in an HIV patient often poses a diagnostic challenge. Case presentation: A 35-year-old lady with a 4-year history of progressive proximal weakness of both lower limbs, followed upper limbs for about 2 years duration associated with muscle pain, was referred to us with a tentative diagnosis of polymyositis. There was no history of diplopia, dysphagia, dysarthria, neck muscle, facial muscles or respiratory muscle weakness. Her medical history was also notable for HIV (prior CD4 nadir was 419 cells/mm3), diagnosed 10 years ago. She was on antiretroviral therapy (ART) regimen of tenofovir, lamivudine and efavirenz. There was no muscle atrophy/fasciculations; sensory system was normal, with preserved deep tendon reflexes. After extensive workup including clinical history, physical examination, laboratory markers and electromyography, a possibility of a genetic aetiology was considered. Whole exome sequencing showed compound heterozygous pathogenic variants in DYSF gene. Finally, the patient was diagnosed as LGMDR2 clinically and genetically. Conclusion: This case illustrates the importance of a good clinical history coupled with appropriate diagnostic workup, in clinching the diagnosis of muscular dystrophy in an HIV patient. © The Author(s) 2025.