BACKGROUND Pregnancy is associated with major hormonal changes and other physiological changes. Several neurological conditions may appear during pregnancy that are either unique to or occur with increased frequency during pregnancy and puerperium. Preexisting disorders such as epilepsy may worsen in one-third of pregnant patients and seizures are common during peripartum period. Changes in haemodynamics, blood volume and hormonal effects on the vessel wall increase risk of cerebrovascular disorders during pregnancy and the postpartum period. Cerebral venous sinus thrombosis is common in the postpartum period. Brain tumours may enlarge during pregnancy because of fluid retention and the presence of oestrogen and progesterone receptors on the tumour cells. Neurological disorders may influence the management of obstetric outcomes. In this study, the common neurological problems during pregnancy and six weeks of postpartum period are discussed. Aim-To study the neurological disorders and clinical features occurring during pregnancy and 6 weeks of postpartum. MATERIALS AND METHODS This was a descriptive study carried out in Osmania, Hyderabad (December 2015-January 2018). Source of Data: All the pregnant women attending OP and admitted as inpatients in Osmania General Hospital. Total 67 patients attending Outpatient Department of Neurology and admitted in the hospital with neurological disorders were included. Patients with neurological disorders due to trauma, infections and obstetrical procedures were excluded from the study. A total of 67 patients were included in the study and consent was taken from them. Demographic data and data of history and detailed examination were collected. Basic and relevant investigations were done including Brain Imaging, CSF analysis, EEG, NCS, 2D Echocardiography and ANA profile whenever necessary. RESULTS Most patients were in the age group of 21-25 years (61%). Age of patients ranged between 19-35. Most patients presented in postpartum period (41%). Seizures (46%) was the most common presentation followed by stroke (36%). Most of the patients (45%) with seizures were in 2 nd trimester. 87.5% patients with stroke presented in postpartum period. 3 patients had facial palsy. 2 patients presented with astrocytomas and 3 patients had chorea. CONCLUSION Many neurological disorders are encountered in pregnancy. In our study, we have identified 7 different conditions, of which seizures was the most common presentation. Effect of the condition and its treatment on pregnancy and vice versa should always be kept in mind. Appropriate management with collaborative effort of obstetricians, neurologists, neurosurgeons and paediatricians at specialised centres should be undertaken for successful maternal and foetal outcomes.

BACKGROUND The posterior circulation strokes account for 10 to 15% of all strokes. The posterior circulation ischaemia ranges from fluctuating brainstem symptoms caused by intermittent insufficiency (so called VBI) to many syndromes like lateral, medial medullary, total medullary, locked in and top of basilar artery syndrome. Population based studies have shown that in India the annual incidence rates of stroke are 119-145 and 84-262 in rural and 334-424 in urban areas per 100,000 population respectively. The incidence in Indian studies was approximately 12.3%. Basilar Artery Occlusion (BAO) represents 8 to 14% of all posterior circulation strokes and carries mortality of over 90%. The aim of this study was to evaluate the clinical and aetiological profile of ischaemic posterior circulatory stroke and to assess the outcome of ischaemic posterior circulatory stroke. MATERIALS AND METHODS The present descriptive study was conducted in patients attending neurology outpatient department, emergency department of Narayana Medical College, Nellore with acute ischaemic posterior circulation stroke from January 2014 to June 2015. This study included 130 patients of posterior circulation ischaemic stroke. Patients with age > 18 years who presented with signs and symptoms of posterior circulation ischaemic stroke were evaluated by clinical examination and confirmed by imaging, either by CT/ MRI brain were included. Patients with head injury, ICSOL (Intracranial Space Occupying Lesion), haemorrhagic stroke, CVT (Cerebral Venous Thrombosis), SAH (Subarachnoid Haemorrhage), Recurrent Strokes and Anterior Circulation Ischaemic Stroke were excluded. The patients were subjected to routine biochemical investigations including complete haemogram, renal function tests and serum electrolytes, fasting lipid profile, coagulation profile, serum homocysteine, serum APLA (Antiphospholipid Antibody) IgG, IgM, 2D Echocardiography, neck vessel Doppler, imaging of the brain with CT (Computerised Tomography) and MRI (Magnetic Resonance Imaging). MRA (Magnetic Resonance Angiography) study could be done only for few patients, because of financial constraints. The patients were evaluated clinically and monitored during the course of disease. The Stroke Severity (at admission, discharge, 3 months) and outcome at 3 months were assessed with NIHSS (National Institute of Health Stroke Scale). The data values were entered into MS-Excel and statistical analysis was done by using IBM SPSS Version 20.0. For categorical variables, the data values were represented as number and percentages. RESULTS Posterior Circulation Ischaemic Stroke was predominantly noted in males (61%) when compared to females. Mean age of patients was 59.81 +/-11.55 years. Hypertension (84.6%) was the leading modifiable risk factor followed by diabetes mellitus (33.1%). The most common clinical feature is vertigo/giddiness (48.5%). Large vessel atherosclerosis (84.6%) was the most common aetiology observed followed by cardioembolic stroke of other determined aetiology and small vess...

Background: Insulin resistance (IR) is one of the inflammatory markers that is receiving increasing attention as a possible early marker of increased risk of cerebrovascular disease. The purpose of the study was to determine the prevalence of IR in non-diabetic ischemic stroke patients and its correlation with the stroke severity.