Browsing by Author "Prakash Chandra Pandey"

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Corticosteroid-responsive epilepsia partialis continua; [Kortikosteroide yanıtlı epilepsiya parsiyalis kontinua]
(Turkish Neurosurgical Society, 2021) Jayantee Kalita; Prakash Chandra Pandey; Sarvesh Kumar Chaudhary; Varun Kumar Singh; Usha Kant Misra
Epilepsia partialis continua (EPC) is a rare form of status epilepticus and often refractory to antiepileptic drugs (AEDs). Persistent seizure activity may increase pro-inflammatory biomarkers locally, which may respond to adjunctive corticosteroid treatment, especially in central nervous system (CNS) infections. We report four children with refractory EPC and the effect of adjunctive corticosteroid in controlling EPC. The duration of EPC ranged between 3 days and 7 months. One patient had secondary generalized convulsive status epilepticus. Cranial computed tomography/magnetic resonance imaging was abnormal in three out of four patients; revealing old infarction in one, tuberculoma in one, and neurocysticercosis in one. Electroencephalography revealed spike and sharp wave discharges on the corresponding cerebral hemisphere. The EPC was refractory to 2-6 AEDs. Following corticosteroid treatment, EPC remitted in two patients with CNS infection, and those with infarction and cryptogenic EPC converted to discrete seizures. In AED-resistant EPC, a short course of corticosteroid may be helpful. © 2021 by Turkish Neurological Society Turkish Journal of Neurology published by Galenos Publishing House.
Outcome of Cerebral Venous Thrombosis Requiring Mechanical Ventilation
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Jayantee Kalita; Prakash Chandra Pandey; Nagendra Babu Gutti; Kuntal Kanti Das; S. P.V. Kumar; Varun Kumar Singh
Background: Patients with cerebral venous thrombosis (CVT) requiring mechanical ventilation (MV) may have a severe procoagulant state, extensive venous sinus thrombosis, and a worse outcome, but there is a paucity of studies on this topic. We compare the clinical risk factors, radiological findings, and outcomes between CVT patients requiring MV and the non-MV group. Methods: Consecutive CVT patients admitted to our service were included. Their clinical details, prothrombotic states and MRI and MRV findings were noted. The patients were admitted to the intensive care unit (ICU) if the Glasgow Coma Scale (GCS) score was below 14 and intubated if arterial blood gas analysis was abnormal. All the patients received heparin followed by an oral anticoagulant. In-hospital death was noted, and functional outcomes at 3 months were assessed using the modified Rankin Scale (mRS). Results: Ninety-eight patients with CVT were admitted during the study period; 45 (45.9%) required ICU care, and 18 of them required MV for a median of 6.5 (1–15) days. The MV patients had a shorter duration of illness, a lower GCS score, and protein C deficiency. Twelve (12.2%) patients died: five (27.8%) in the MV, four (14.8%) in the non-MV ICU, and three (5.7%) in the non-MV non-ICU groups. Poor outcomes were 5.5%, 14.8%, and 5.7%, respectively. On Cox regression analysis, the MV had an association with death [adjusted hazard ratio (AHR) 0.40, 95% confidence interval 0.21–0.77; p = 0.007] and poor outcome at 3 months (AHR 0.45, 95% CI 0.27–0.76; p = 0.003). Conclusions: About 18.4% of CVT patients require MV with a mortality of 27.8%. Amongst the survivors, 90.7% of patients have a good outcome at 3 months. © 2025 by the authors.