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Article ; Online: Electrodiagnosis of Common Mononeuropathies: Median, Ulnar, and Fibular (Peroneal) Neuropathies.

Patel, Kamakshi / Horak, Holli A

2021 Volume 39, Issue 4, Page(s) 939–955

Abstract: This article addresses common mononeuropathies seen in the electrodiagnostic laboratory. The most common mononeuropathies-median neuropathy at the wrist (carpal tunnel syndrome), ulnar neuropathy at the elbow, and fibular (peroneal) neuropathy at the ... ...

Abstract	This article addresses common mononeuropathies seen in the electrodiagnostic laboratory. The most common mononeuropathies-median neuropathy at the wrist (carpal tunnel syndrome), ulnar neuropathy at the elbow, and fibular (peroneal) neuropathy at the fibular head-are reviewed. The causes, clinical presentations, approached to the electrodiagnostic studies (including nerve conduction studies and needle electromyography), and the typical findings are discussed.
MeSH term(s)	Electrodiagnosis ; Electromyography ; Humans ; Mononeuropathies ; Neural Conduction ; Peripheral Nervous System Diseases
Language	English
Publishing date	2021-08-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1013148-6
ISSN	1557-9875 ; 0733-8619
ISSN (online)	1557-9875
ISSN	0733-8619
DOI	10.1016/j.ncl.2021.06.004
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Article ; Online: Epilepsy surgery perceptions among general neurologists and epilepsy specialists: A survey.

Haneef, Zulfi / Patel, Kamakshi / Nguyen, Angela / Kayal, Gina / Martini, Sharyl R / Sullivan-Baca, Erin

Clinical neurology and neurosurgery

2024 Volume 237, Page(s) 108151

Abstract: Objective: Surgical intervention for drug-resistant epilepsy (DRE) is a safe and efficacious evidence-based treatment. Yet, neurologists have historically revealed hesitance in referring patients for surgical evaluations. The present study surveyed ... ...

Abstract	Objective: Surgical intervention for drug-resistant epilepsy (DRE) is a safe and efficacious evidence-based treatment. Yet, neurologists have historically revealed hesitance in referring patients for surgical evaluations. The present study surveyed general neurologists and epilepsy specialists to assess their views and process in referring patients for specialized epilepsy care and epilepsy surgery. Methods: A 14-item survey assessing epilepsy referrals and views of epilepsy surgery was distributed to all neurologists currently practicing in a large national integrated health system using REDCap. Responses were qualitatively analyzed and differences between general neurologists and epileptologists were assessed using chi-squared tests. Results: In total, 100 responses were received from 67 general neurologists and 33 epileptologists with several similarities and differences emerging between the two groups. Both groups endorsed surgery and neuromodulation as treatment options in DRE, felt that seizure frequency rather than duration was relevant in considering epilepsy surgery, and indicated patient preference as the largest barrier limiting epilepsy surgery. General neurologists were more likely to require ≥ 3 ASMs to fail to diagnose DRE compared to epileptologists (45% vs. 15%, p < 0.01) who more often required ≥ 2 ASMs to fail. Epileptologists were also more likely than neurologists to try a new ASM (75.8% vs. 53.7%, p < 0.05) or optimize the current ASM (75.8% vs. 49.3%, p < 0.05) in DRE. General neurologists were more likely to consider epilepsy surgery to be less efficacious (p = 0.001) or less safe (p < 0.05). Significance: Overall, neurologists appear to have generally positive opinions of epilepsy surgery, which is a change from prior literature and represents a changing landscape of views toward this intervention. Furthermore, epileptologists and general neurologists endorsed more similarities than differences in their opinions of surgery and steps to referral, which is another encouraging finding. Those gaps that remain between epileptologists and general neurologists, particularly in standards of ASM prescription, may be addressed by more consistent education about DRE and streamlining of surgical referral procedures.
MeSH term(s)	Humans ; Neurologists ; Epilepsy/diagnosis ; Epilepsy/surgery ; Drug Resistant Epilepsy ; Educational Status ; Emotions
Language	English
Publishing date	2024-02-05
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2024.108151
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Article ; Online: Diabetic neuropathies.

Patel, Kamakshi / Horak, Holli / Tiryaki, Ezgi

Muscle & nerve

2020 Volume 63, Issue 1, Page(s) 22–30

Abstract: Diabetic neuropathies are the most common type of neuropathies seen in clinical practice. These neuropathies can range clinically from asymptomatic to manifesting symptoms caused by motor, sensory, and autonomic nerve dysfunction. These neuropathies can ... ...

Abstract	Diabetic neuropathies are the most common type of neuropathies seen in clinical practice. These neuropathies can range clinically from asymptomatic to manifesting symptoms caused by motor, sensory, and autonomic nerve dysfunction. These neuropathies can affect the peripheral nervous system, pain receptors, cardiovascular, urogenital, and gastrointestinal systems. This monograph presents an overview of the different types of diabetic neuropathies, their presentations, diagnostic tools, and strategies for management.
MeSH term(s)	Autonomic Nervous System/physiopathology ; Autonomic Nervous System Diseases/diagnosis ; Cardiovascular System/physiopathology ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/physiopathology ; Diabetic Neuropathies/diagnosis ; Humans
Language	English
Publishing date	2020-07-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	438353-9
ISSN	1097-4598 ; 0148-639X
ISSN (online)	1097-4598
ISSN	0148-639X
DOI	10.1002/mus.27014
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Zs.A 1449: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Are preterm birth and very low birth weight rates altered in the early COVID (2020) SARS-CoV-2 era?

Rodriguez, Kayla / Nudelman, Matthew J / Jegatheesan, Priya / Huang, Angela / Devarajan, Kamakshi / Haas, Jessica E / Cervantes, Rosemarie / Falbo, Kelle / Narasimhan, Sudha Rani / Cormier, Machelnil / Stewart, Mary Beth / Patel, Rupalee / Govindaswami, Balaji

Frontiers in pediatrics

2023 Volume 10, Page(s) 1093371

Abstract: Objective: We evaluated the prevalence of preterm birth (PTB) and very low birth weight (VLBW) during Jan-Dec 2,020 (early COVID era) at 5 hospitals (2 in West Virginia, 3 in California) compared to Jan 2017-Dec 2019 (pre-COVID) inclusive of 2 regional ... ...

Abstract	Objective: We evaluated the prevalence of preterm birth (PTB) and very low birth weight (VLBW) during Jan-Dec 2,020 (early COVID era) at 5 hospitals (2 in West Virginia, 3 in California) compared to Jan 2017-Dec 2019 (pre-COVID) inclusive of 2 regional perinatal centers (1 in Huntington, WV and 1 in San Jose, CA) and 3 community hospitals (1 each in Cabell, Los Angeles and Santa Clara counties). Design/methods: We examined PTB and VLBW rates of live births at 5 US hospitals from Jan 2017-Dec 2020. We compared PTB and VLBW rates in 2020 to 2017-2019 using Poisson regression and rate ratio with a 95% confidence interval. We stratified live births by gestational age (GA) (<37, 33-36, and <33 weeks) and birth weight (≤1,500 g, >1,001 g to ≤1,500 g, ≤1,000 g). We examined PTB rates at 4 of the hospitals during Jan-Dec 2020 and compared them to the prior period of Jan 2017-Dec 2019 using Statistical Process Control (SPC) for quarterly data. Results: We examined PTB and VLBW rates in 34,599 consecutive live births born Jan 2017-Dec 2019 to rates of 9,691 consecutive live births in 2020. There was no significant change in PTB (<37 weeks GA) rate, 10.6% in 2017-2019 vs. 11.0% in 2020 ( Conclusion: We found no significant change in the rates of PTB or VLBW when combining the live birth data of 5 US hospitals in 3 different counties.
Language	English
Publishing date	2023-01-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.1093371
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Article: Unplanned 30-Day Hospital Readmissions of Symptomatic Carotid and Vertebral Artery Dissection.

Mehta, Tapan / Patel, Smit / Male, Shailesh / Parikh, Romil / Mehta, Kathan / Lakshminarayan, Kamakshi / Tummala, Ramachandra / Ezzeddine, Mustapha

Journal of stroke

2018 Volume 20, Issue 3, Page(s) 407–410

Language	English
Publishing date	2018-09-30
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2814366-8
ISSN	2287-6405 ; 2287-6391
ISSN (online)	2287-6405
ISSN	2287-6391
DOI	10.5853/jos.2018.02236
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Article ; Online: Use of noninvasive induction techniques in the diagnosis of PNES.

Gogia, Bhanu / Rai, Prashant K / Matthys, Samuel A / Mong, Eric R / Rodriguez, Rafael / Yassin, Ahmed / Patel, Kamakshi / Patel, Chilvana / Todd, Masel

Epilepsy & behavior : E&B

2019 Volume 99, Page(s) 106491

Abstract: The diagnosis of psychogenic nonepileptic seizures (PNES) remains challenging. In the correct clinical setting with prolonged electroencephalography (EEG) monitoring, the specificity of provocative techniques to distinguish induced epileptic event from a ...

Abstract	The diagnosis of psychogenic nonepileptic seizures (PNES) remains challenging. In the correct clinical setting with prolonged electroencephalography (EEG) monitoring, the specificity of provocative techniques to distinguish induced epileptic event from a nonepileptic event approaches 90%. We report our epilepsy monitoring unit (EMU) experience with the use of noninvasive verbal suggestion (VS) during hyperventilation (HV), photic stimulation (PS) as induction technique in making the diagnosis of PNES. In total, 189/423 patients were diagnosed with PNES during the EMU evaluation. Of the 189, 20 had mixed disorder and 169 patients had only PNES, 80 patients (47.3%) had a PNES with induction, and the remaining 89 of 169 patients (52.7%) had a spontaneous PNES episode that did not require induction. Verbal suggestion during HV and PS confirmed the diagnosis of PNES in 47% of the patients who otherwise did not have spontaneous events. Within the group who was diagnosed with PNES following induction, antiepileptic drugs (AEDs) were stopped in 53% of the patients. We believe that this is a large proportion of patients that would possibly remain undiagnosed if no induction were performed.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diagnostic Techniques, Neurological ; Electroencephalography/methods ; Female ; Humans ; Male ; Middle Aged ; Placebo Effect ; Psychophysiologic Disorders/diagnosis ; Psychophysiologic Disorders/psychology ; Seizures/diagnosis ; Suggestion ; Young Adult
Language	English
Publishing date	2019-10-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2019.106491
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Article ; Online: Joint effects of OSA and self-reported sleepiness on incident CHD and stroke.

Ogilvie, Rachel P / Lakshminarayan, Kamakshi / Iber, Conrad / Patel, Sanjay R / Lutsey, Pamela L

Sleep medicine

2018 Volume 44, Page(s) 32–37

Abstract: Background: Although excessive daytime sleepiness (EDS) is a common symptom of obstructive sleep apnea (OSA), and both EDS and OSA have separately been associated with increased risk of cardiovascular disease (CVD), their joint association with CVD risk ...

Abstract	Background: Although excessive daytime sleepiness (EDS) is a common symptom of obstructive sleep apnea (OSA), and both EDS and OSA have separately been associated with increased risk of cardiovascular disease (CVD), their joint association with CVD risk is unknown. Methods: Among 3874 Sleep Heart Health Study (SHHS) participants without prevalent CVD, moderate to severe OSA was defined by an apnea hypopnea index (AHI) ≥ 15 on an in-home polysomnography. EDS was defined as an Epworth Sleepiness Scale score ≥11. Incident CVD events included total CVD events (coronary heart disease (CHD) and stroke), as well as CHD and stroke separately. Cox proportional hazards models adjusted for age, sex, alcohol, smoking, and body mass index. Results: Compared to those with AHI <15, the hazard ratios (95% CI) for the association of moderate-severe OSA (AHI ≥15) were as follows: CVD 1.06 (0.85-1.33); CHD 1.08 (0.85-1.33); and stroke 1.18 (0.75-1.84). Weak associations between EDS and CVD risk = [1.22 (1.01-1.47)] and CHD risk [1.25 (1.02-1.53)] were present, however there were none for stroke risk [1.10 (0.75-1.63)]. When jointly modeled, both AHI ≥15 and EDS (compared with having AHI <15 and no EDS) was associated with HRs of 1.26 (0.91-1.73) for CVD, 1.24 (0.87-1.75) for CHD and 1.49 (0.78-2.86) for stroke. There were no statistically significant interactions between daytime sleepiness and OSA on the multiplicative or additive scales. Conclusions: Having both EDS and moderate-severe OSA was not associated with an increased risk of CVD in the SHHS data.
MeSH term(s)	Aged ; Body Mass Index ; Coronary Disease/epidemiology ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Polysomnography ; Prevalence ; Risk Factors ; Self Report ; Sex Factors ; Sleep Apnea, Obstructive/physiopathology ; Sleepiness ; Stroke/epidemiology
Language	English
Publishing date	2018-01-31
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2012041-2
ISSN	1878-5506 ; 1389-9457
ISSN (online)	1878-5506
ISSN	1389-9457
DOI	10.1016/j.sleep.2018.01.004
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Article ; Online: A 1.02 μW Battery-Less, Continuous Sensing and Post-Processing SiP for Wearable Applications.

Lukas, Christopher J / Yahya, Farah B / Breiholz, Jacob / Roy, Abhishek / Chen, Xing / Patel, Harsh N / Liu, NingXi / Kosari, Avish / Li, Shuo / Akella Kamakshi, Divya / Ayorinde, Oluseyi / Wentzloff, David D / Calhoun, Benton H

IEEE transactions on biomedical circuits and systems

2019 Volume 13, Issue 2, Page(s) 271–281

Abstract: Improving system lifetime and robustness is a key to advancing self-powered platforms for real world applications. A complete self-powered, battery-less, wearable platform requires a microwatt-power system-on-chip (SoC), operating reliably within this ... ...

Abstract	Improving system lifetime and robustness is a key to advancing self-powered platforms for real world applications. A complete self-powered, battery-less, wearable platform requires a microwatt-power system-on-chip (SoC), operating reliably within this budget, capable of surviving long periods without charging, and recovering from power loss to its previous state. To meet these requirements, we designed a wireless sensing heterogeneous system-in-package (SiP) containing an ultra-low power (ULP) SoC, a non-volatile boot memory (NVM), and a 2.4 GHz frequency shift key (FSK) radio, all integrated with custom ULP interfaces. The SoC includes a fully integrated energy harvesting platform power manager (EH-PPM) to power the SiP and other commercial sensors. The EH-PPM is designed for small loads and powers the SoC and peripherals while drawing very low operating current. The SoC also includes a digital system data-flow for sensing applications, an analog front end for ECG signal acquisition, and a cold-boot management system (CBMS) for boot and recovery from the NVM. The CBMS enables integration of the SoC with the ULP NVM to create a wearable formfactor, self-powered system capable of recovery from power loss. The SoC also includes a radio interface tightly integrated with a compression accelerator to efficiently communicate with the FSK transmitter and reduce the FSK's transmission time. This tight integration between accelerators on the SoC and peripherals is another feature that reduces the system's power consumption by reducing the code size and number of memory accesses required to perform an operation. The SoC consumes 507 nW average power while running free-fall detection, 519 nW average power while measuring ambient temperature, and 1.02 μW during continuous ECG monitoring and post-processing.
MeSH term(s)	Analog-Digital Conversion ; Electric Power Supplies ; Electrocardiography ; Signal Processing, Computer-Assisted ; Temperature ; Wavelet Analysis ; Wearable Electronic Devices ; Wireless Technology
Language	English
Publishing date	2019-01-24
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	1940-9990
ISSN (online)	1940-9990
DOI	10.1109/TBCAS.2019.2894775
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Article: Impact of Acute Confusional State in Patients With COVID-19 and a Predictive Score.

Gogia, Bhanu / Pujara, Deep / Thottempudi, Neeharika / Ghanayem, Tamer / Ajam, Yousaf / Singh, Ayush / Dabi, Alok / Patil, Shekhar / Curtis, Kyra / Fang, Xiang / Patel, Kamakshi / Bhardwaj, Anish / Rai, Prashant

Cureus

2021 Volume 13, Issue 9, Page(s) e18360

Abstract: Background: Acute confusional state (ACS) in COVID-19 is shown to be associated with poor clinical outcomes.: Methods: We assessed the impact of ACS - defined as a documented deterioration of mental status from baseline on the alertness and ... ...

Abstract	Background: Acute confusional state (ACS) in COVID-19 is shown to be associated with poor clinical outcomes. Methods: We assessed the impact of ACS - defined as a documented deterioration of mental status from baseline on the alertness and orientation to time, place, and person - on inpatient mortality and the need for intensive care unit (ICU) transfer in inpatient admissions with active COVID-19 infection in a single-center retrospective cohort of inpatient admissions from a designated COVID-19 tertiary care center using an electronic health record system. Furthermore, we developed and validated a neurological history and symptom-based predictive score of developing ACS. Results: Thirty seven out of 245 (15%) patients demonstrated ACS. Nineteen (51%) patients had multifactorial ACS, followed by 11 (30%) patients because of hypoxemia. ACS patients were significantly older (80 [70-85] years vs 50.5 [38-69] years, p < 0.001) and demonstrated more frequent history of dementia (43% vs 9%, p < 0.001) and epilepsy (16% vs 2%, p = 0.001). ACS patients observed significantly higher in-hospital mortality (45.9% vs 1.9%, aOR [adjusted odds ratio]: 15.7, 95% CI = 3.6-68.0, p < 0.001) and need for ICU transfer (64.9% vs 35.1%, aOR: 2.7, 95% CI = 1.2-6.1, p = 0.015). In patients who survived hospitalization, ACS was associated with longer hospital stay (6 [3.5-10.5] days vs 3 [2-7] day, p = 0.012) and numerically longer ICU stay (6 [4-10] days vs 3 [2-6] days, p = 0.078). A score to predict ACS demonstrated 75.68% sensitivity and 81.73% specificity at a cutoff of ≥3. Conclusion: A high prevalence of ACS was found in patients with COVID-19 in our study cohort. Patients with ACS demonstrated increased mortality and need for ICU care. An internally validated score to predict ACS demonstrated high sensitivity and specificity in our cohort.
Language	English
Publishing date	2021-09-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.18360
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Article ; Online: Co-VAN study: COVID-19 vaccine associated neurological diseases- an experience from an apex neurosciences centre and review of the literature.

Samim, M M / Dhar, Debjyoti / Arshad, Faheem / Anudeep, D D S / Patel, Vishal G / Neeharika, Sriram Ramalakshmi / Dhamija, Kamakshi / Ravindranath, Chowdary Mundlamuri / Yadav, Ravi / Raja, Pritam / Netravathi, M / Menon, Deepak / Holla, Vikram V / Kamble, Nitish L / Pal, Pramod K / Nalini, Atchayaram / Vengalil, Seena

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2022 Volume 108, Page(s) 37–75

Abstract: Background: Recent studies have shown various neurological adverse events associated with COVID-19 vaccine.: Objective: We aimed to retrospectively review and report the neurological diseases temporally associated with COVID-19 vaccine.: Methods: ... ...

Abstract	Background: Recent studies have shown various neurological adverse events associated with COVID-19 vaccine. Objective: We aimed to retrospectively review and report the neurological diseases temporally associated with COVID-19 vaccine. Methods: We performed a retrospective chart review of admitted patients from 1st February 2021 to 30th June 2022. A total of 4672 medical records were reviewed of which 51 cases were identified to have neurological illness temporally associated with COVID-19 vaccination. Results: Out of 51 cases, 48 had probable association with COVID-19 vaccination while three had possible association. Neurological spectrum included CNS demyelination (n = 39, 76.5 %), Guillain-Barré-syndrome (n = 3, 5.9 %), stroke (n = 6, 11.8 %), encephalitis (n = 2, 3.9 %) and myositis (n = 1, 2.0 %). Female gender had a greater predisposition (F:M, 1.13:1). Neurological events were more commonly encountered after the first-dose (n = 37, 72.5%). The mean latency to onset of symptoms was 13.2 ± 10.7 days after the last dose of vaccination. COVIShield (ChAdOx1) was the most commonly administered vaccine (n = 43, 84.3 %). Majority of the cases with demyelination were seronegative (n = 23, 59.0 %) which was followed by anti-Myelin oligodendrocyte-glycoprotein associated demyelination (MOGAD) (n = 11, 28.2 %) and Neuromyelitis optica (NMOSD) (n = 5, 12.8 %). Out of 6 Stroke cases, 2 cases (33.3 %) had thrombocytopenia and coagulopathy. At discharge, 25/51 (49.0 %) of the cases had favourable outcome (mRS 0 to 1). Among six patients of stroke, only one of them had favourable outcome. Conclusion: In this series, we describe the wide variety of neurological syndromes temporally associated with COVID-19 vaccination. Further studies with larger sample size and longer duration of follow-up are needed to prove or disprove causality association of these syndromes with COVID-19 vaccination.
MeSH term(s)	Humans ; ChAdOx1 nCoV-19 ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Nervous System Diseases/etiology ; Neuromyelitis Optica ; Retrospective Studies ; Stroke
Chemical Substances	ChAdOx1 nCoV-19 (B5S3K2V0G8) ; COVID-19 Vaccines
Language	English
Publishing date	2022-12-23
Publishing country	Scotland
Document type	Review ; Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2022.12.015
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