The coexistence of neuronal degeneration, psychiatric manifestation, immune activation and malignant transformation has been documented in literature, suggesting a central dysfunction in the pathophysiology of these disorders. The isoprenoid pathway may be candidate in this respect, in view of the changes in the concentration of some products of this pathway in many of these disorders, however, no detailed study has been carried out in this respect. In view of this, a study was undertaken on the isoprenoid pathway in some of these disorders - primary generalized epilepsy, Parkinson’s disease (PD), schizophrenia, manic depressive psychosis (MDP), CNS glioma, multiple sclerosis, subacute sclerosing panencephalitis (SSPE)and a familial group with familial coexistence of schizophrenia, PD, primary generalized epilepsy, malignant neoplasia, rheumatoid arthritis and syndrome-X over three generations. The following parameters were studied in the patients of these disorders as compared to age and sex matched control subjects - ubiquinone dolichol, digoxin, activity of HMG CoA reductase in the plasma and erthyorcyte membrane Na -K--ATpase. Increase in the activity of HMG CoA reductase and in the concentration of plasma digoxin and dolichol was observed in most of these cases. On the other hand, there was decrease in the concentration of plasma ubiquinone. Decrease in the activity of erythrocyte membrane Na-K- ATpase activity for which digoxin is an inhibitor was also observed in all the cases studied. These results indicate an upregulation of the isoprenoid pathway in the neurological and psychiatric disorders studied. The implications of this change is discussed in details.

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Problems related to pregnancy and birth defects in the baby are major concerns for women with epilepsy. Hardly any data from this country is available in this regards to provide factual information to people with epilepsy. This study was undertaken to survey the outcome of pregnancies in women with epilepsy in this part of the country. Women with epilepsy (20to55 year of age) who had attended this institute between March 1997 and march 1997 were sent a questionnaire by post regarding their martial status, reproductive history and outcome of pregnancies including any birth defects in their children. The data on clinical aspects and treatment were extracted from their medical records. 184 women (mean age 28.5 + 8 years) were included in this study. 108 (58.7%) of them were married. Women with epilepsy had three times higher rate of abortions (24.1%) than general population(8%). Their mean family size (1.6) was lower than that is Kerala State (2.3). The proportion of women without children (13.9%) was also higher than that for the state (9.8%). The frequency of birth defects among their children was twice (4%) that in the community (2%). Women taking sodium valproate had higher frequency of birth defects in their children (15%) as compared to other drugs but this was not statistically significant. There is a tendency for lower fertility among women with epilepsy. There is a slight increase in the frequency of birth defects among children born to mothers with epilepsy.

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The efforts made in the last three decades to establish Brain Research Centre have fructified and in1997, National Brain Research Centre (NBRC), funded by Department of Biotechnology, has been created. The aim of this centre is to pormote neurosciences, function as a national apex centre and establish linkages with national and international agencies to co-ordinate nationally relevant and carry ut research in frontier areas. An unique role of NBRC is that it will act as a node with linkages to other centres in the country and will be the " hub of the wheel" rather than the wheel.

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We report a case of essential segmental myoclonus a 10 year old girl who presented with continuing movement of both the shoulder girdle muscles for 6 months. The movements were exacerbated with the hands raised above the head or in the outstretched posture and were persisting during sleep. There was no abnormal palatal movement. Additionally there was a rhythmical clicking sound arising from the shoulders that could be felt and ausculated with the stethoscope. CT scan of brain and MRI of cervical spine were non-contributory, EMG showed muscle activates at about 50 per second in the shoulder girdle muscles. Cine-radiography of shoulder joints showed the head of humerus hitting against the spine of the scapula rhythmically. Spinal tap was non-contributory. The diagnosis or essential segmental myoclonus was entertained and the subject with fluoxetine, a selective serotonin reuptake inhibitor with remarkable response. The possible mechanism of action of agents modulating the serotonergic system in the brain for the management of myoclonus has been reviewed and their role suggested.

[ABSTRACT]   Full text not available  [PDF]

Full text not available  [PDF]

Full text not available  [PDF]

Full text not available  [PDF]