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"We present a rare case of striatal encephalitis associated with small cell lung cancer (SCLC), manifesting as a choreiform movement disorder. A 57-year-old woman presented with a subacute onset of involuntary movements. Despite extensive investigations, the etiology of this choreiform movement disorder remained elusive until a detailed evaluation of clinical signs and radiological findings revealed SCLC. In addition, she had an asymptomatic metastatic brain parenchymal lesion. This case highlights the importance of considering paraneoplastic striatal encephalitis (PSE), a rare presenting neurological syndrome."

"Spinocerebellar ataxia (SCA)-50 is a recently reported rare subtype. We describe the first case of SCA-50 from the Indian subcontinent. A 22-year-old man presented with progressive cerebellar ataxia over 2 years, along with oculomotor abnormalities and imaging findings indicating mild cerebellar atrophy. Genetic testing revealed an NPTX1 gene mutation, which correlates with SCA-50. Its unique pathogenesis distinguishes it from other SCA subtypes."

"Six randomized trials have demonstrated the benefit of endovascular thrombectomy (EVT) for patients with large ischemic core stroke, but the extent to which treatment effect diminishes with increasing onset-to-treatment time remains unclear. We evaluated whether trial-level median time from symptom onset to randomization modifies the absolute EVT effect compared with medical management (MM). Using study-level data from six trials (n=1,881), we modeled differences in 90-day utility-weighted modified Rankin Scale (uw-mRS) outcomes between EVT and MM as a function of median onset-to-randomization time via Bayesian regression, selecting models based on deviance information criteria. Increasing time was strongly associated with declining EVT benefit (posterior probability =0.9925). The absolute treatment effect fell below 0.10 at 10 hours (95% CrI, 7–15) and below 0.03 at 18 hours (95% CrI, 12–33). These findings suggest that treatment delays attenuate EVT benefit and may inform hypothesis generation and future trial design in acute stroke."

"Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective intervention for managing Parkinson’s disease (PD) refractory to optimal medical therapy. However, conventional clinical scales often overlook subjective outcomes perceived by patients and caregivers. This study aimed to assess these perceptions using a structured questionnaire featuring 18 items evaluating motor and non-motor outcomes, rated on a visual analog scale (VAS, 0–100), where 0 = no perceived change and 100 = maximum perceived magnitude of change compared to the pre-DBS state. Participants were asked to indicate separately whether the reported change represented improvement or deterioration for directional clarity of the VAS score. This retrospective, cross-sectional pilot study evaluated long-term outcomes following DBS at variable postoperative intervals, with an inherent risk of recall bias. Thirty-one patients with idiopathic PD who had undergone STN-DBS at least one year earlier were interviewed along with their primary caregivers. Treating neurologists also provided independent assessments. While 67.7% of patients reported initial motor improvement, 45.2% retained an overall improvement in clinical course over time. Significant improvements were observed in OFF-phase duration and daily functioning in 77.4% and 61.3% of patients, respectively. Caregivers reported perceived declines in cognition, psychiatric symptoms, and speech clarity in 58.1%, 54.8%, and 71% of participants, respectively. A significant observable difference was noted between neurologist-rated global improvement (90.3%) and caregiver-reported outcomes (67.7%). These findings highlight that integrating patient and caregiver perspectives may enhance comprehensive post-DBS care."

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