Anterior spinal artery syndrome complicating aortic dissecting aneurysm: Case report

Spinal Cord ischaemia is rare in the absence of trauma. We report a case of a 45 year old known hypertensive for six years, who presented with features of anterior spinal artery syndrome (ASAS) complicating acute dissection of the descending aorta. He developed sudden onset non-traumatic paraparesis, sphincteric dysfunction and dissociated anaesthesia with a sensory level at T6. This was preceded by a two weeks' history of severe, sharp, lancinating, tearing left parasternal chest pain radiating to the back. He was managed conservatively on pentazocine lactate (fortwin), calcium- and beta-blockers, steroids, anti-platelet and free-radical scavengers. On the 8th day of hospitalisation, he had a sudden abdominal distension, bled from the nose and mouth, went into hypovolaemic shock and died within a time frame of two minutes. He was presumed to have had a progression of the aortic dissection with subsequent rupture. Dissecting aortic aneurysm could run a benign asymptomatic or a lethal course and a high index of suspicion is necessary. The lack of exhaustive diagnostic investigative tools as well as surgical intervention in the management of this patient in a developing country was highlighted as was possible that the patient could have been mismanaged. East African Medical Journal Vol.81(10) 2004: 549-55

Repeat Stroke Associated with ‘Migraine with Aura’ and Middle Cerebral Artery Stenosis

We present a 21 year-old female, known migraineur, who presented with visual aura followed by throbbing left hemicranial headache, associated with sudden onset of weakness of the right side of the body and moderate to severe pains on the paretic limb (mixed lacuna stroke), three days after the onset of headache. She had a similar episode about 12 months prior to the present ictus. Findings on examination revealed essentially, right spastic hemiparesis with dysaesthesia and subtle right facial paresis. Brain MRI (magnetic resonance imaging) was normal, while MRA (magnetic resonance angiography) revealed middle cerebral artery (M2) stenosis. She was managed with aspirin, propranolol, amitriptyline and physiotherapy on which she made steady progress

A Case-Control Study of Neutrophil-Lymphocyte Ratio as a Biomarker of Inflammation in Adults with Epilepsy

Background: There is growing evidence that inflammation plays a specific role in the pathogenesis of epilepsy and seizures also induce inflammation. The Neutrophil/Lymphocyte ratio (NLR) is an emerging inflammatory biomarker of epilepsy. Objectives: To determine the association between epilepsy and Neutrophil /Lymphocyte Ratio among adults. Methods: Adults with epilepsies the attending outpatient neurology clinics at two Nigerian tertiary health facilities, were recruited. One hundred cases and one hundred age-matched, healthy controls were recruited. The total white blood cell (WBC) and its differential counts were extracted from Full Blood Count (FBC) results and NLR was calculated. The predictors of the association between WBC parameters and epilepsy were established using a linear regression model derived from WBC parameters associated with epilepsy. Results: Out of 100 cases and controls, there was no gender-related statistical difference between the cases and controls (p = 0.777). There was no difference between the mean ages of cases and control (p = 0.058). The total mean white blood cell count among the cases was 8.80±9.84×109 cells/L compared to was 6.30±1.90 ×109 cells/L in the controls, (p = 0.013). The mean neutrophil count in the cases was 59.00±17.89 ×109 cells/L compared to 49.50±15.44 ×109 cells/L among the controls (p < 0.001). The mean NLR for the cases was 4.24±10.44 compared to 1.84±2.26 in the controls (p = 0.026). The Neutrophil/Lymphocyte Ratio (p = 0.013) and Basophil (p < 0.001) predicted epilepsy on linear regression analysis. Conclusion: This study shows a clear difference in the TWBC and NLR with between adults with epilepsies and health controls

Electroencephalographic Correlates of Cognition among Nigerian Women with Epilepsy on Anti-epileptic Monotherapy

Background:&nbsp;The prospect of EEG as a potential biomarker for detecting a cognitive decline in those living with epilepsy has not been extensively studied. Objective:&nbsp;To determine the relationship between electroencephalographic (EEG) changes and cognitive functions in Women with Epilepsy (WWE). Methods:&nbsp;The study involved 100 adult WWE aged between 16 and 40 years on Levetiracetam (LEV) or Carbamazepine (CAB) monotherapy. Zung Self-Reporting Depression Scale (ZSRDS) was used to assess the mood of participants while the Community Screening Interview for Dementia (CSID) was used to assess various cognition domains. Results:&nbsp; The frequency of Periodic Epileptiform Discharges (PED) (p = 0.008), delta waves and theta waves (p = 0.004) were higher in WWE with Cognitive Impairment (CI) compared to those without CI. Lower cognitive scores were seen among those with delta wave across the domains of cognition with statistical significance for language fluency (p = 0.039), language comprehension (p = 0.000), and total CSID (p = 0.000). WWE with PED had a lower mean total CSID score compared to those without PED (p = 0.019). The absence of alpha wave (p = 0.027), presence of delta wave (p = 0.013), slow frequency (p = 0.015) and PED (p = 0.031) were EEG predictors of cognitive impairment. Medication type (p = 0.016) and depression (p = 0.001) were the clinical predictors of cognitive impairment in WWE. Conclusion:&nbsp;The frequencies of PED and slow waves were higher in WWE with CI while the absence of alpha wave, presence of delta wave and PED were EEG predictors of CI

Quality of Sleep among Adults in Sagamu, Southwest Nigeria

Sleep plays an essential restorative function and is essential for good health, good quality of life and well-being. This study aimed to assess quality of sleep in a southwestern community within Nigeria.Participants were recruited using a multi-stage random sampling technique from Sagamu community. Four hundred and sixteen participants were interviewed using a socio-demographic questionnaire, Pittsburgh Sleep Quality Index and the 12-item General Health Questionnaire. Poor sleep quality was reported by 25.7% (n=107) of the respondents. There was a significant difference in the average hours of sleep across gender (male = 7.166 ± 1.385; female = 7.640 ± 1.201, t = 3.710, p = 0.000). Respondents that were 65 years and above were likely to be poorer sleepers compared to other age groups (X2 = 5.416, p = 0.067). Respondents who were separated or divorced (52.4%), widowed (46.7%) and married (31.2%) were significantly poorer sleepers compared with those that were single or never married (14.6%) (X2 = 25.926, p = 0.000) The overall sleep quality correlated positively with age (r = 0.220, p = 0.000) and psychological morbidity (r = 0.211, p = 0.000).A good proportion of the community dwellers were poor sleepers. Sleep disturbance might represent a significant and unrecognized public health issue within the community. Keywords: Quality of Sleep, Sleep Duration, Psychiatric Morbidity and Pittsburgh Sleep Quality inde

Pattern of malignancies in OOUTH Sagamu

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