37^th European Neurology Congress May 02-03, 2023 London, UK

Biography:

Urmita Chakraborty is currently serving as an Associate Professor in a Private University in India (TIU). She is a licensed practitioner as well. She practices as a Consultant Psychologist in India. She is associated with hybrid consultation brands, general private hospitals and runs own clinic (Alo psychological counselling and psychotherapy clinic (Regd.) Kolkata). Currently she is preparing for her Postdoctoral degree education to be pursued soon. She has a good number of publications as well. She follows Neo Freudian thoughts and loves to teach Clinical Psychology, Social Psychology and Developmental Psychology.

Abstract:

Neurodevelopmental disorders are significant in restricting freedom in children. The objective is here to understand the relation between neurological and neurodevelopmental conditions in children. The current DSM 5 TR shows various classifications under neurodevelopmental conditions namely autism spectrum disorder, motor disorders, social communication disorders, global developmental delay and so on. Many of these maladaptive conditions are associated with neurological symptoms at its core and as comorbid states. These children show symptoms of epilepsy, encephalopathy, microcephaly, muscular dystrophy, cerebral palsy, macrocephaly and other mild neurological disturbances. In this paper a rapid systematic review has been made to focus upon current studies which see this coexistence. Probable non-medical intervention plan will be considered based on prior researches and researcher’s assumptions. Neuropsychological intervention along psychosocial intervention plans will be discussed by evaluating evidence based researches. A community based rehabilitation plan will be focused. A module on daily tasks for these children will be outlined. A conclusion will be derived by extending a theoretical model for such overlapping condition.

Keywords: Neurodevelopmental disorders, Neurological symptoms, Neuropsychological intervention, Community based intervention, Evidence based researches.

Biography:

Raneem Alghamdi is a Pediatric Neurology Resident currently working at King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. He is the current Deputy Chief Resident and the Quality Chief of Pediatric Neurology Trainees. He has a strong interest in epilepsy and neurogenetics and has ongoing research publications in both fields.

Abstract:

Biallelic mutations of CYP2U1 are known to cause a complicated form of hereditary Spastic Paraplegia (SPG56). Only 26 families with SPG56 have been reported to date with 29 variants in CYP2U1. Here, we report 18 additional families (25 patients) all but two are homozygous for a founder Arab variant c.947A>T:p.Asp316Val. This largest cohort to date on SPG56 demonstrates a remarkably consistent phenotypic expression of the founder variant with predictable and universal loss of ambulation but variable degree of loss of speech, intellectual disability and white matter changes. Two families had novel variants in CYP2U1 (c.890T>C:p.Phe297Ser and c.967 997del) and the phenotype was compatible with that seen in the rest of the cohort. Haplotype analysis allowed us to estimate the age of the founder mutation at 1040 years, which makes this as one of the most ancient intellectual disability mutations in Arabia and explains its high carrier frequency and wide geographic distribution.

Biography:

Elina Melikyan, Neurology Consultant, MD, PhD, Doctor of Medical Science, MBA. In 1985, she is graduated from Yerevan Medical University, Armenia, with honour. She was engaged in an array of medical education projects since 1999. In 2004, she earned PhD in Neurology & Clinical Pharmacology and later became Associate Professor of Neurology, Pirogov’s National Medical & Surgical Center, Neurology & Neurosurgery Department, Moscow and then Professor of Rehabilitation Medicine at Russian National Medical University (RNMU) named after N. I. Pirogov, Moscow. In 2011, she completed dissertation on Health-related Quality of Life in Epilepsy Patients at RNMU, Neurology & Neurosurgery Department and St Luka’s Institute of Child Neurology and Epilepsy, Moscow. She is an author of more than 60 publications in peer-reviewed medical journals and textbook chapters, her research spans pain, cognitive impairment, epilepsy and medical rehabilitation. She had been working in the UK since 2016. She moved to Basildon University Hospital in 2021.

Abstract:

Statement of the problem: The implications of ‘neurophobia’ are still under recognized in medical education. At the same time, the magnitude of neurologic disorders, as the second leading cause of death after heart disease and the leading cause of disability, mandates a substantial need for trained health workforce to develop competence and confidence in the care of patients with neurologic disease. The global burden of neurologic disease is expected further to increase as a result of population growth and ageing.

Methodology & theoretical orientation: We performed a search for peer-reviewed articles published between January 1995 and February 2023 using PubMed, EMBASE, Medline, Google Scholar and Cochrane Library. ‘Neurophobia’ was described during postgraduate training and later in the professional career, causing avoidance of examination of the nervous system. Undergraduates ranked neurology to be more difficult than any other discipline to learn because of large number of complex and rare neurological diagnoses, limited exposure to neurological patients and opportunity to work with a neurologist, overreliance on passive lectures, instead of bedside teaching, lack of clinical reasoning exercises and innovative methods to bridge the educational gap. The trainees’ knowledge and confidence in the management of neurologic cases increased mostly during bedside tutorials, followed by textbooks, studying with a small group of classmates, case discussions, electronic resources. Numerous innovative approaches were implemented to improve education and increase learner confidence, including simulation, eLearning, 3D modeling/printing, virtual reality, podcasts/smartphone/social media.

Conclusion: Applications of basic neuroscience to clinical scenarios, frequent and effective exposure to neurology teaching are quintessential. This can reduce ‘neurophobia’, improve neurological knowledge and augment in medical profession comfort levels with neurological examination and clerkship. However, lack of time within the curriculum might be a barrier to implementation. More research is needed to apply interventions to develop a fascination with neurology.

Biography:

Avathvadi Venkatesan Srinivasan has driven by his quest for excellence joined Madras Medical College (MMC) and received MD (General Medicine) in 1978. Later he pursued and received DM in Neurology from his alma mater. His thirst for research, skills and the latest development in Neurology made him find his way to the National Institute of Neurology and Neurosurgery, his pioneering research work on Neuroleptic Malignant Syndrome got him bestowed with the PhD degree in 2002. It made him the first ever recipient in Neurology from the Tamil Nadu Dr. M.G.R. Medical University, since its inception in 1988. His path breaking research (6 papers) in Phantom limbs, Stroke etc., with Padma Bhusan Dr. VS Ramachandran, Director, Center of Brain and Cognition, University of San Diego remain acclamatory to his undisputed authority in Behavioral Neurology and Movement disorders. He authored more than 100 scientific papers; dozens of his other work have found places in reputed medical journals and has published 12 chapters. His research papers presented, won acclaims in 60 National conferences and in 25 International conferences held in UK, USA, Japan, Australia, China, Europe and other countries. He is the only one from India to collaborate with Dr. VS Ramachandran, who is the first recipient of Padma Bhusan for his contribution to Neurosciences.

Abstract:

Introduction:

Professor C. Miller Fisher defined dizziness as false and conflicting sensation of motion and posture. It is a feeling of uncertainty of one’s own physical and spatial orientation as well as motion in space. In health the function of vestibular system is subconscious and not apparent.

Central vestibular system integrates vestibule, visual and proprioception input for the conscious awareness of body position with environment, gaze stabilization, posture and locomotion. Dizziness and disorientation symptoms occurs only when the disease or excessive stimulation of Central vestibular system occur. It can be due to medical and cardiac illness, Otological illness as well as neurological conditions. Most syndrome of dizziness can be correctly diagnosed only by means of careful history taking and physical examination of patients.

Pathophysiology:

Any alteration in the continuous sensory input from visual, vestibular and proprioceptive end organs that enables a person to maintain spatial orientation leads to dizziness. There are many sensations that are perceived as dizziness by patients, which are not synonymous to true vertigo. Hence careful history taking is important.

Clinical features:

There are 6 types of dizziness generally complained, they are true vertigo, syncopal sensation or presyncope, Disequilibrium, Psycho physiologic dizziness and visual induced dizziness, light headedness and giddiness.

Examination:

Standard physical and neurological examination must emphasis on cerebellar testing, test of vestibular function and brain stem signs. The core examination findings required are eye movement assessment, funduscopy, otoscopy, assessment of hearing, Romberg test, Gait and Tandem walking, Dix- Hallpike maneuver.

Etiology:

Vertigo based on specific etiologies is classified as otologic vertigo, central vertigo, Medical vertigo and unlocalized vertigo syndromes.

Ten step approach guidelines:

Step 1- To establish the nature of dizziness, is it vertigo or not?

Step 2- To rule out if it was the first attack or one of the recurrent episode or chronic problems?

Step 3- Duration of attack and trigger factor if any should be obtained

Step 4- Neurological examination

Step 5- status praesens

Step 6- To rule out vestibular causes

Step 7- clinical test to diagnose vestibular involvement

Step 8- Investigation in evaluation of dizziness

Step 9- Medical causes

Step 10- Psychiatric causes

Treatment:

• Treating the underlying cause for non- vertiginous dizziness
• For vertiginous dizziness requires pharmacological therapy, physical therapy, surgery and psychotherapeutic measures

Conclusion:

I have covered the field in a concise and clinically oriented fashion. The team approach, given the complexity for evaluation, Diagnosis and treatment, is the central theme of this communication

Biography:

Isha Akulwar-Tajane (PT) holds a master’s degree in Neurosciences Physiotherapy and is currently pursuing PhD. She is working as an Associate Professor at an academic institute and a tertiary care hospital in India; and has more than 13 years of clinical and teaching experience. She is in-charge of the adult neurological unit and has a vast experience in rehabilitation of a wide range of pediatric as well as adult neurological conditions. She is passionate about research; her areas of interest being clinical research, literature based reviews, advanced technology and medical education. She strives to implement recent advances and evidence based practice to deliver quality patient care and also in teaching-learning methods for students. Her expertise is advanced balance training using computerized equipment such as the balance manager system. She has served as an international faculty for balance and mobility academy, USA. She has presented posters and papers at various national and international research conferences and has won many awards. She has more than 30 publications in various international journals to her credit and has been serving as an editorial board member and/or reviewer for more than 50 international journals of repute. Her excellent contribution to research has been well appreciated by the scientific community all across the globe. She continues to inspire students and fellow colleagues with her significant achievements in the field of physiotherapy.

Abstract:

Strength Duration Curve (SDC) is a plot of the threshold current versus pulse duration required to stimulate excitable tissue such as a nerve or muscle. This geometrical relationship makes it a quantitative and qualitative tool to assess electrophysiologic excitability. It is a routinely performed procedure for clinical identification of many neuromuscular conditions.

Radiculopathy is a clinical condition defined as pain and/or neurologic deficit in a specific nerve root distribution, including motor loss, sensory changes and sometimes depression of reflexes. It is caused by mechanical compression of a nerve root usually at the exit foramen or lateral recess. The intervertebral disc is the most important factor in Low Back Pain (LBP) and testing these subjects for nerve root lesions might be rewarding. In LBP patients, it is important to establish whether or not radiculopathy is present. This can be difficult when clinical, radiological & electromyographic abnormalities are not consistent with focal nerve root involvement. For many years, traditional electro diagnosis has been the main means of testing for radiculopathies caused by lumbar disc herniation. Determination of chronaxie values has been suggested as a method of studying intervertebral disc lesions. The assumption or basis is that the electrical excitability would be altered in muscles supplied by a nerve with a compressed root as a result of a disc herniation. This scoping review focuses on the role of SDC in radiculopathy and discusses its importance; procedural approach; parameters of significance; limitations; and implications for clinical practice and research. Literature search for the present study identified four clinical experimental studies using chronaxie alone and/or with SDC in patients with suspected disc pathology published between the years 1952 to 2015. Results of the study suggest that SDC and chronaxiemetry can serve as an electrical equivalent to myotomes testing & can help in localizing the level of disc lesion after causes of nerve affection have been ruled out by clinical evaluation. Chronaxie tests are practical and objective tests that can be very helpful to the clinician in correlation with other clinical and laboratory data. SDC plotting along with chronaxiemetry improves the accuracy and reliability. Together they offer a reliable, reproducible method for the detection of nerve root lesions resulting from disc pathology and assist in localization of the disorder to within two disc spaces and also can help in determining whether the disc bulge is unilateral or bilateral. This approach can complement assessment in the diagnostic phase prior to rehabilitation & in the monitoring of treatment effectiveness. In terms of clinical applications, the results of this study reinforce the need for quantitative evaluation & to reinstate electro-diagnostic procedures in clinical practice.