Neuromyelitis Optica Spectrum Disorder Presenting Radiologically like Spinal Astrocytoma

Neuromyelitis optica spectrum disorder (NMOSD) is an infrequent antibody-mediated disorder of the central nervous system. The diagnosis is made in the setting of specific clinical syndromes and a positive aquaporin‑4 antibody titer. Intramedullary spinal cord tumors may clinically and radiologically mimic NMOSD, necessitating careful differentiation, especially in individuals who meet the epidemiological profile of NMOSD. We report two cases of NMOSD in young female patients who had a neuroradiological diagnosis of spinal cord astrocytoma and were initially planned for spinal cord surgery. We aim to highlight the similarities between NMOSD and spinal cord tumors using these two clinical cases

Pattern, Risk Factors, and Outcome of Acute Stroke in a Nigerian University Teaching Hospital: A 1‑Year Review

Background: This study aimed to document the pattern, risk factors, in‑hospital outcomes, and stroke mortality in a hospital over oneyear. Materials and Methods: Acute stroke patients admitted at the Lagos State University Teaching Hospital between October 2019 andSeptember 2020 had their records reviewed. Information including age, sex, risk factors, stroke type, access to neuroimaging, and the in‑hospital outcome was extracted and analyzed. Results: A total of 230 patient records were included in this study. The proportion of intracerebral hemorrhage (ICH) was 44.8%, while  ischemic stroke was 52.2%. Only 9.1% of ischemic stroke cases had an onset‑to‑arrival time of fewer than nine hours, with just three thrombolytic therapy given. The 30‑day mortality was 28.7%, lesser among younger patients and patients managed in the stroke unit. Conclusion: The hospital incidence of ICH was close to that of ischemic stroke. Mortality data confirms the importance of management in a stroke unit. Keywords: Nigeria, outcome, pattern, risk factors, strok

APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

Histopathological Analysis of Psoriasis

Background: Treatment of psoriasis results in alteration in clinical and histopathology findings with resultant inconclusive histopathology findings and a diagnostic dilemma in resource poor settings. Objective: To document the histopathology of clinically correlated psoriasis, compare with other studies and observe any differences in features.Methodology: A retrospective cross-sectional evaluation of 60 cases histopathologically diagnosed as psoriasis was conducted at the ClinaLancet laboratory in Lagos, Nigeria over a 2-week period. Slides of 60 dermatology clinic treatment naive cases diagnosed by dermatologists with histopathological correlation as psoriasis were retrieved, observed under the microscope and the features of psoriasis were documented in a pre-designed proforma. Data was entered into a Microsoft Excel Spreadsheet. Simple means and frequencies were presented.Results: There were 35 females (58.3%) and 25 males (41.7%). The mean age of the patients was 41.55 ± 19.03 years; age range was 1-83 years. The commonly observed features of psoriasis were hyperkeratosis (100%), acanthosis (100%), perivascular infiltrates (100%), parakeratosis (95%), absent granular layer (83.3%), suprapapillary plate thinning (86.7%) and Munro microabscess (45%). The findings were comparable to other studies.Conclusion: The findings from this study are similar to the findings from other histopathology study of psoriasis. Iatrogenic intervention does not significantly change the histopathology features of psoriasis to the extent that a conclusive diagnosis cannot be made