Cardiogenic Embolisation And Ischaemic Stroke: A Review Of Cases Seen At The University Of Nigeria Teaching Hospital Enugu

A review of hospital admissions for stroke between January 1980 – December 1999 at the Medical wards of the the University of Nigeria Teaching Hospital (UNTH) Enugu was undertaken to ascertain the frequency, patterns and risk factors associated with ischaemic strokes attributable to cardiogenic brain emolisation. The results showed that of the 450 medical admissions for ischemic stroke, 5.1% (23 cases) were cerebral infarction related to cardiogenic embolism. There was a male preponderance (M:F=5.7:2). The highest rate of cerebral embolism was seen in the age group 50 -59 years. The commonest observed risk factors included hypertension in association with atrial fibrillation (21.7%) and hypertensive left ventricular hypertrophy (17.4%). The right cerebral hemispheres were more frequently affected (43.5%). The relative risk (R,R) risk of cerebral Cardioembolism attributable to AF Cardiomyopathy, hypertension were 13.34 (C.I. 11.5, 15.5); 9.8, (C.I. 6.3, 1.6); 0.27 (C.I. 6.1, 2.2) respectively. There is need for physicians to properly identify patients at risk for cardiogenic cerebral arterial emobolisation in whom anticoagulation may be beneficial. Journal of Medical Investigation and Practice Vol. 4: 2003: 4-

A community-based case–control study of prevalence and pattern of cognitive impairments in patients with epilepsy residing in South-Eastern Nigeria

Background: Epilepsy is the commonest neurological disorder encountered in Sub-Saharan Africa. The quality of life of patients with epilepsy (PWEs) is adversely affected by cognitive impairments. Aim: This study investigated the prevalence and pattern of cognitive impairments in PWE in Ukpo community located in a South-Eastern state in Nigeria using Community Screening Interview for Dementia (CSID) and a computer-assisted cognitive test battery (FePsy). Methods and Patients: Fifty-one PWEs were studied and compared with 51 age-, sex-and level of education-matched healthy controls. Diagnosis of epilepsy was confirmed clinically with eye-witness corroboration. Sociodemographic data and information on epilepsy variables were obtained with the aid of a questionnaire. Cognitive domains assessed include language, memory, orientation, attention, psychomotor speed and constructional praxis. Results: The prevalence rate of cognitive impairment using total CSID score was 19.6%. Analysis of CSID scores revealed significant impairment in language (17.6%), memory (29.4%), orientation (15.7%), attention (7.8%) and constructional praxis (15.7%) compared to healthy controls. A similar pattern was observed with FePsy but with better sensitivity indices for detecting cognitive impairment. Conclusion: This study indicated significant prevalence rate of cognitive impairment among treatment-naïve PWE with profound affectation of memory, mental speed and language. In addition, the FePsy was found to be more sensitive and specific in assessment of cognitive function in PWE