Short-latency somatosensory-evoked potential in patients with central nervous system space-occupying lesions: a study of 261 cases

INTRODUCTION: Short-latency somatosensory-evoked potential (SSEP) is an electrophysiological technique to study the dorsal column–medial lemniscal sensory system. Its application in central nervous system spaceoccupying lesions (CNS SOLs) has sparsely been published. METHODS: A total of 261 patients with CNS SOLs underwent SSEP before neurosurgeries. Anatomical locations of the lesions, histopathological diagnoses and prognosis were tried to correlate with the SSEP variables. RESULTS: The spinal SOLs, especially nerve sheath tumours, was associated with significant abnormalities in various variables including the central conduction time. Other anatomical sites and histopathologies did not correlate with the SSEP findings. Also SSEP did not reflect clinical prognosis. CONCLUSION: Short-latency somatosensory-evoked potential is probably not a sensitive test for CNS SOLs except spinal cord lesions. This is probably due to anatomy of the somatosensory pathway. The fact that SSEP has different sensitivities to various tumours may reflect that sensory neurons have heterogenous susceptibilities to different pathologies.published_or_final_versionThe 15th Medical Research Conference; Department of Medicine, The University of Hong Kong, Hong Kong, 16 January 2010. In Hong Kong Medical Journal, 2010, v. 16 suppl 1, p. 13, abstract no. 1

Feasibility of T1rho MR imaging in identification of the epileptogenic zone in patients with mesial temporal lobe epilepsy

Poster PresentationPURPOSE: T1rho is sensitive to physiochemical exchange and early molecular changes. We aim to investigate the feasibility and utility of T1rho MR imaging in identification of epileptogenic zone in patient with mesial temporal lobe epilepsy (MTLE). METHODS: 7 patients (male 28.6%, female 71.4%; mean age of 36.29±8.77 yrs) with estab…published_or_final_versio

First year of 24/7 Acute Stroke Unit. Part 1: eligibility and utilisation of intravenous thrombolysis

INTRODUCTION: Intravenous recombinant tissue plasminogen activator (IV-rtPA) is the standard therapy for acute ischaemic stroke. Because of its narrow therapeutic time window, eligibility and utilisation rates of this treatment remained low. Our IV-rtPA programme was enhanced to a 24/7 protocol since September 20…published_or_final_versio

First year of 24/7 Acute Stroke Unit. Part 2: outcome of stroke thrombolysis using telemedicine

OBJECTIVE: To evaluate the safety and efficacy of intravenous recombinant tissue plasminogen activator (IV-rtPA) for acute ischaemic stroke through telemedicine consultation …published_or_final_versio

Risk factors, clinical features and prognosis of perioperative stroke in adults

INTRODUCTION: Perioperative stroke (POS) is an uncommon but severe surgical complication. No widely accepted guidelines for risk prediction or management have been established. Its prevention depends on knowledge about the nature of this disease. METHODS: A total of 36 cases and equal number of controls in Hong Kong West Cluster hospitals were recruited over 43 months. Peri- and intra-operative features were compared and characteristics of POS were described. RESULTS: Atrial fibrillation, diabetes mellitus (DM), and history of stroke were identified as risk factors (P=0.017, 0.002, and 0.003, respectively). Prolonged aortic occlusion (P=0.018) and bypass (P=0.002) contributed in cardiac surgery. Only few BP parameters, but not consistently all, were significant; 78% POS were infarcts. Watershed infarction related to hypotension was uncommon. Beta-blocker use seemed to bare protective effect. Blood loss and haemoglobin levels did not correlate to POS. Three-month mortality rate was 36%. CONCLUSION: Optimal DM control and cardioversion before elective OT, perioperative anticoagulation in AF and old stroke patients, and beta-blockers may be preventive measures for POS. Role of hypotension in POS aetiology is debatable.published_or_final_versionThe 15th Medical Research Conference; Department of Medicine, The University of Hong Kong, Hong Kong, 16 January 2010. In Hong Kong Medical Journal, 2010, v. 16 suppl. 1, p. 13, abstract no.

Central nervous system inflammatory demyelinating disorders in Hong Kong Chinese

Poster PresentationBACKGROUND: Classical multiple sclerosis (CMS) must be differentiated from neuromyelitis optica (NMO) as treatments are different. Serum aquaporin-4 autoantibodies (AQP4 Ab) are specific for NMO spectrum disorders (NMOSD). We aimed to study the diagnoses of CNS inflammatory demyelinating disorder (IDD) patients presenting to a hospital over 29 years. METHODS: Chinese patients presenting with CNS IDD to our hospital from 1981 to 2009 were studied. Patients referred from other centres were excluded. Since 2008, patients had yearly magnetic resonance imaging (MRI) brain and cord for 3 years even without relap…published_or_final_versio

Directed differentiation of human bone marrow stromal cells to fate-committed Schwann cells

Transplantation of oligodendrocyte precursors represents a potential therapy for myelin disorders but requires a safe and accessible cell source. Here we report the directed differentiation of neural progenitors derived from adult bone marrow stromal cells (BMSCs) into oligodendrocyte precursors for cell therapy purpose. Neural progenitors among BMSCs could be culture expanded in non-adherent sphere-forming conditions and directed to differentiate along the oligodendrocyte lineage. BMSC-derived oligodendrocyte precursors (BM-OPs) differentiated into myelin basic protein (MBP)-positive oligodendrocyte when co-cultured with purified dorsal root ganglion (DRG) neurons. Injection of BM-OPs into the brain of myelin deficient Shiverer mice resulted in the generation of MBP-positive oligodendrocyte and compact myelin. Our results provided pointers to adult BMSCs as a readily accessible source of OPs towards cell therapy for myelin disorders.published_or_final_versio

Clinical features, management, and prognostic factors of status epilepticus in Chinese

Poster PresentationINTRODUCTION: Status epilepticus (SE) is a neurological emergency with significant mortality and morbidity. There are currently limited data regarding the causes and outcomes of SE in our locality, and identification of prognostic factors, especially those available at presentation, could lower risk of under- or over-treatment in SE. METHODS: We retrospectively studied the clinical characteristics, management, and clinical outcome of adults diagnosed with incident SE, excluding episodes due to cerebral anoxia, at a regional hospi…published_or_final_versio

Stroke Patients with a Past History of Cancer Are at Increased Risk of Recurrent Stroke and Cardiovascular Mortality

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Variants, clinical characteristics and prognostic factors of Guillain-Barre syndrome in Chinese

INTRODUCTION: The variants, clinical characteristics, and prognostic factors of Guillain-Barre syndrome (GBS) in Hong Kong Chinese has not been widely studied previously. METHODS: We performed a retrospective review of adults with GBS admitted to Queen Mary Hospital, Hong Kong during the peri…published_or_final_versio