Neurocutanoussarcoidosis: a rare entity

Neurosarcoidosis is a granulomatous disorder considered to be a great imitator. We report a case of young lady who presented with gradual onset flexed posturing of fingers of left hand for four years, followed by similar pattern of weakness involving the right hand for three years along with slipping of slippers for one year. Neurologic examination showed distal wasting & weakness in upper limbs with normal jerks and sensory impairment in gloves and stocking distribution. On skin examination there were hypopigmented macules over face, neck and back. Electro diagnostic studies showed sensory motor axonal polyneuropathy, while skin biopsy reported as naked noncaseating granulomas suggestive of sarcoidosis. No such case reported yet in Pakistan with sarcoidperipheral polyneuropathy and rare hypopigmented form of Sarcoidosis without pulmonary involvement

Eight – and - half syndrome: a rare neuro-ophthalmic syndrome “Possible Nine Syndrome”

“Eight-and-half” syndrome is “one-and-a-half” syndrome characterized by conjugated horizontal gaze palsy and internuclearopthalmoplegia plus ipsilateral fascicular seventh nerve palsy. We report a case of 50 year old woman who presented with right eight and half syndrome together with contralateral hemiparesis and hemihypesthesia. Non contrast CT scan brain showed hyperdensesignal on right pontine region. MRI brain plain revealed hemorrhagicpontinetegmentuminfarction as well as corticospinal tract and medial meniscus. This spectrum of presentation suggests a possible “Nine syndrome” as a novel neuropthalmicpontine syndrome. The first of its kind ever reported from Pakista

Frequency of peripheral neuropathy in newly diagnosed patients of diabetes mellitus iion clinical and electrophysiological basis

To determine the frequency of peripheral neuropathy in newly diagnosed patients of Diabetes Mellitus type II on clinical and electrophysiological basis. Methods: This is Hospital based descriptive cross sectional study conducted at department of Neurology Civil Hospital Karachi/ Dow University of Health Sciences from 20th December 2011 to 20th June 2012. Data was collected from Neurology OPD, Medicine OPD and Diabetic Clinic Civil Hospital Karachi. Results: Total no of patients were 107 who were already diagnosed as type 2 Diabetes Mellitus. Out of these, there were 57 (53.3%) male patients and 50 (46.7%) female patients, with ratio of males to female was . 1.14The age group distribution of study population ranged from 30-60 years and mean age was 45.19 with standard deviation of 7.38. It was observed that 35 (32.7%) patients had symptoms of peripheral neuropathy as compared to this 72 (67.3.2%) patients did not have symptoms of peripheral neuropathy while mean ± standard deviation of duration of symptoms was 2.42±1.95 months and 18 (16.8%) patients had peripheral neuropathy as compared to these 89 (83.2%) patients did not have peripheral neuropathy, clinical or electrophysiological. Conclusion: Diabetic Peripheral Neuropathy is a fairly common entity in our patients with type 2 Diabetes Mellitus and was seen as early as within four weeks of diagnosis in 16.8% of patients

Etiological Factors of Non-Traumatic Compressive Myelopathy

Objective: To determine the frequency of etiological factors of non-traumatic compressive myelopathies. Methods: This is tertiary care Hospital based descriptive cross sectional study conducted at Neurology department of Liaquat University of medical and health Sciences, Jamshoro / Hyderabad after approval of departmental ethical committee from 22th October 2020 to 21st April 2021. Study data was collected after informed consent from all cases. All cases fulfilled inclusion criteria were selected and included in study and data was recorded on preformed proforma. Data was analyzed on SPSS 21 and results were formulated accordingly. Results: In this study 163 patients were included to assess the etiological factors of non-traumatic compressive myelopathy and the results were analyzed. Out of theses 163 subjects who had nontraumatic compressive myelopathies, the etiological and demographic features revealed that, 106 (65%) were male & 57 (35%) were female patients, having a 1.85:1 male to female ratio. The study population’s age ranged from 20 to 60 years, and the mean age SD was 47.6 ± 11.2 years. One hundred and eleven 111 (68.1%) patients had paraparesis while fifty two 52 (31.9%) had Quadriparesis. Most common cause of non-traumatic compressive myelopathy was Tuberculosis spine 35(21.5%) followed by demyelinating Myelitis 30 (18.4%) spinal secondaries 24 (14.8%), disc prolapse was noted in 22(13.5%), multiple myeloma 12 (7.3%) cervical spondylosis 10(6.1%), spinal epidural abscess 8(4.9%), transverse myelitis 4(2.5%) while ossification of the posterior longitudinal ligament as 3(1.8%) patients. Conclusion: Tuberculosis of spine followed by demyelinating Myelitis were most common causes of non-traumatic compressive myelopathies. It is of prime importance to identify those risk factors and contributing states that prone the population for the development of such disabling ailments to address the burden of diseases and to optimize the management’s strategies for this already compromised patients