doi:10.4103/0972-2327.104320
PMCID: PMC3548358
doi:10.4103/0972-2327.99692
PMCID: PMC3424790
doi:10.4103/0972-2327.93265
PMCID: PMC3299061
PMID: 22412262
doi:10.4103/0972-2327.93269
PMCID: PMC3299063
PMID: 22412266
The spectrum of chronic dysimmune neuropathies has widened well beyond chronic demyelinating polyradiculoneuropathy (CIDP). Pure motor (multifocal motor neuropathy), sensorimotor with asymmetrical involvement (multifocal acquired demylinating sensory and motor neuropathy), exclusively distal sensory (distal acquired demyelinating sensory neuropathy) and very proximal sensory (chronic immune sensory polyradiculopathy) constitute the variants of CIDP. Correct diagnosis of these entities is of importance in terms of initiation of appropriate therapy as well as prognostication of these patients. The rates of detection of immune-mediated neuropathies with monoclonal cell proliferation (monoclonal gammopathy of unknown significance, multiple myeloma, etc.) have been facilitated as better diagnostic tools such as serum immunofixation electrophoresis are being used more often. Immune neuropathies associated with malignancies and systemic vasculitic disorders are being defined further and treated early with better understanding of the disease processes. As this field of dysimmune neuropathies will evolve in the future, some of the curious aspects of the clinical presentations and response patterns to different immunosuppressants or immunomodulators will be further elucidated. This review also discusses representative case studies.
doi:10.4103/0972-2327.82789
PMCID: PMC3141494
PMID: 21808468
Multifocal motor neuropathy; multifocal acquired demyelinating sensory and motor; chronic inflammatory demyelinating neuropathy; distal acquired demyelinating predominately sensory
India is silently witnessing a stroke epidemic. There is an urgent need to develop a national program towards “Fighting Stroke”. This program should be specific to our national needs. In order to recommend on who should lead an Indian fight-stroke program, we examined the published opinions of stroke clinicians and the official documents on stroke care training abroad. We identified the resources that already exist in India and can be utilized to develop a national fight-stroke program. Through a review of published literature, we noted different opinions that exist on who would best manage stroke. We found that because stroke is a cardiovascular disorder of the central nervous system, its management requires a multi-disciplinary approach involving clinicians with background not limited to neurology. India has very few neurologists trained in stroke medicine and they cannot care for all stroke patients of the country. We propose a mechanism that would quickly put in place a stroke care model relevant in Indian context. We recommend for tapping the clinical expertise available from existing pool of non-neurologist physicians who can be trained and certified in stroke medicine (Strokology). We have discussed an approach towards developing a national network for training and research in Strokology hoping that our recommendations would initiate discussion amongst stroke academicians and motivate the national policy makers to quickly develop an “Indian Fight Stroke Program.”
doi:10.4103/0972-2327.61273
PMCID: PMC2859584
PMID: 20436743
Stroke; epidemic; India; national program; strokology