Informatics Publishing Limited

T. Asha , S. K. Shankar , Sarala Das , T. Vasudev Rao , Y. Ramamohan , K. R. Vani , D. Nagaraja , S. R. Aroor , V. Ravi , K. Taranatha Shetty , B. A. Chandramouli

Abstract

Brain biopsy is one of the important investigative procedures for establishing a diagnosis in various progressive diseases of the nervous system. At present with the availability of more modern and sophisticated techniques, the need for sampling brain is becoming limited. However, in a few conditions it remains the only method for establishing the diagnosis. We have reevaluated 71 brain biopsies performed during the past 15 years regarding the diagnostic usefulness. In 48 cases a definite diagnosis could be made, 16 biopsies were abnormal but no definite diagnosis could be offered, while 5 biopsies were within normal limits. In two cases, the biopsy material was inadequate for study. Majority of the biopsies with definite diagnostic pathology were from cases of SSPE. The other conditions diagnosed histopathologically include dysmyelinating and demyelinating conditions like, Schilder's disease, Krabbe's disease, Canavan's disease, sundanophillicleukodystrophy, degenerate conditions like Lafora body disease, Creutzfeldt Jakob disease and Viral encephalitis of herpes simplex type. A multi disciplinary approach in study has helped in improving the diagnostic efficiency and evolving other modalities of investigations to limit the procedure of brain biopsy to only conditions, with no other alternative diagnostic procedure.

Keywords

Brain Biopsy, Neurodegenerative Conditions, SSPE, Canavan's Disease, Schilder's Disease, Leukodystrophy, CJD

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K. R. Vani , S. K. Shankar , V. Ravi , P. K. Shenoy , P. Satishchandra , T. Vasudev Rao , T. Asha , Sarala Das

Abstract

Role of immunocytochemical localization of Herpes Simplex Viral antigen in cytological preparations viz., brain biopsy smears and CSF cytospin, for a rapid and specific diagnosis of the encephalitis was evaluated. The antigen could be localised in the neurons of the brain biopsy and mononuclear cells in CSF, in three cases, thus helping in a rapid diagnosis and timely antiviral treatment. Failure to localise the antigen in another brain biopsy alerted to seek alternative diagnosis and avoid the expensive Acyclovir therapy. Immunocytochemical detection of HSV antigen in cytological preparations appears to be a very useful technique for diagnosis in neurological practice.

Keywords

Herpes Simplex Encephalitis, Rapid Diagnosis, Cytological Preparations, Immunohistochemistry

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