Open Access Case Study

Mortal Aneurysm Rupture in a Rare Case of Steroid-resistant Tolosa-Hunt Syndrome

Anthoula C. Tsolaki, Galaktion Konstantinidis, Stavroula Koukou, Fotini Michali, Christina Manika, Nikolaos D. Michalis

Asian Journal of Research and Reports in Neurology, Page 1-6

Tolosa-Hunt Syndrome is a rare condition characterized by painful ophthalmoparesis and idiopathic granulomatous inflammation of the cavernous sinus, classically extremely responsive to corticosteroid administration. We present a rare case of a 27-year-old man with Tolosa-Hunt Syndrome who did not respond to corticosteroids and the rupture of the co-existing internal carotid artery aneurysm caused his death.

Open Access Case Study

Landau–Kleffner Syndrome (Acquired Epileptic Aphasia) about a 13 Year Old Child: A Case Report

Ouajid El. Bakkali, Sanae El. Moussaoui, Yamna Kriouile

Asian Journal of Research and Reports in Neurology, Page 1-4

Landau-Kleffner syndrome or acquired epileptic aphasia is an acquired infantile epileptic syndrome. It was identified by Landau and Kleffner in 1957, where six affected children were listed. It is characterized by an acute loss of speech and language and an overall regression of behavior in a child who had good psychomotor development with language normal. The rarity of this syndrome makes it demanding to diagnose. Multidisciplinary treatment will be required by pediatricians, neuropediatricians, child psychiatrists, psychologists, speech-language pathologists, otolaryngologists and radiologists. The final diagnosis is based on an altered EEG during sleep with a normal brain MRI, as well as clinical manifestations syndrome. we report the case of a 13-year-old child, with good psychomotor and cognitive development, from 1st degree inbred parents, there was no family history of childhood epileptic disorder, having presented six months ago 15 minute tonic-clonic straight hemicrises and a dysgraphia was installed gradually, against a background of apyrexia. These symptoms progressed six months later, towards a very significant regression of the oral language with difficulties of articulation and a total regression written. The sensory and motor examination was normal. The cranial nerves were intact. The walk was normal. The systemic examination was without abnormality. The studies on cerebrospinal fluid (CSF) were normal. Magnetic resonance imaging (MRI) of the brain with contrast is normal. EEG objectified short, predominantly centro-temporal biphasic short bursts and during sleep, the presences of a central theta focus. The patient was put on sodium valproate, Levetiracetam, Clobazam, intravenous immunoglobulin and corticosteroid and speech therapy.

Open Access Original Research Article

Validity of the Filipino Version of the Michigan Neuropathy Screening Instrument as a Measure of Distal Symmetric Peripheral Neuropathy among Diabetic Patients in the Clinic

Ma. Luisa Gwenn Pabellano-Tiongson, Glennis Fiona J. Javelosa, Armand Delo A. Tan

Asian Journal of Research and Reports in Neurology, Page 1-9

Aims: To determine the accuracy of the Filipino version of the Michigan Neuropathy Screening Instrument (MNSI) in detecting distal symmetric peripheral neuropathy (DSPN) among diabetic patients, by comparing it to electromyography-nerve conduction velocity (EMG-NCV) as a gold standard.

Study Design: Cross-sectional study.

Place and Duration of the Study: Out-patient Department, University of the East Ramon Magsaysay Memorial Medical Center Inc., Philippines; From May 2016 to March 2017.

Methodology: Researchers tested 103 patients with Type 2 diabetes mellitus in the out-patient clinic of a single-centre tertiary hospital and determined the sensitivity and specificity of the Filipino version of the MNSI in identifying DSPN by comparing it to the EMG-NCV as a gold standard. Risk factors for neuropathy were also identified.

Results: The sensitivity of the combined Filipino MNSI questionnaire and clinical examination tool was 74.7%, and a specificity of 25%.  The MNSI questionnaire scores had a statistically significant correlation to the degree of neuropathy as measured by the EMG-NCV (P= .01). There was no statistically significant difference between those with and without DSPN in terms of BMI, history of smoking, duration of diabetes, level of glycaemic control or presence of hypertension.

Conclusion: The Filipino MNSI may be used as a screening tool for distal symmetric peripheral neuropathy among diabetic patients due to its high sensitivity (74.7%). A positive Filipino MNSI will signal the need for further investigation using the EMG-NCV. The MNSI can be performed easily by a healthcare worker in the clinic to screen diabetic patients for neuropathy, and to monitor disease severity, preventing its complications.

Open Access Original Research Article

Febrile Convulsions among Children Admitted in University of Port Harcourt Teaching Hospital, Rivers State, Nigeria

N. Gabriel-Job, A. I. Frank-Briggs

Asian Journal of Research and Reports in Neurology, Page 1-7

Introduction: Febrile convulsion is defined as seizures occurring in children with fever in the absence of any brain pathology. It is usually a frightening experience for the caregivers and parents who in the bid to stop the seizure can apply harmful substances on the child before presenting to the hospital. This study seeks to determine the prevalence and pattern of febrile convulsion in the University of Port Harcourt Teaching Hospital.

Patients and Methods: Retrospective study of children admitted to the paediatrics emergency ward from October 2017 to October 2019 was carried out. Patient’s records were used to retrieve relevant information. Descriptive analysis was done, test of significance was by chi square and a p value of ≤ 0.05 was significant.

Results: 2463 children were admitted within the period, 165(6.7%) of them had febrile convulsion. (χ2=1.88, p= 0.17). The ages ranged from 6 months – 60 months with a mean age of 24.08±15.07 months. The median age at onset was 20.06±14.02 months. About 69.0% of the cases occurred within the ages of 12-36 months. A total of 156(94.6%) of the children with febrile convulsions had simple febrile convulsions while 9(5.4%) had complex febrile convulsion. One hundred and twenty two (73.9%) had a family history of febrile convulsion, of which 74(60.7%) were males and 48(39.3%) were females (χ2=7.01, p=0.008). The causes of febrile convulsion were malaria (56.4%) and URTI (30.9%). In 119(72.1%) of the cases harmful substances were administered at home before presenting to the hospital.

Conclusion: Febrile convulsion is common in children. Over half of the cases were due to Malaria; the use of multiple harmful substances during convulsive episodes is common. Malaria control and health education may reduce the prevalence and morbidity in children.

Open Access Review Article

Using Calcitonin Gene-related Peptide Monoclonal Antibodies for Migraine Headache Treatment and Prevention

Nour Al-Kharrat, Gunay Arsoy

Asian Journal of Research and Reports in Neurology, Page 1-8

Novel drugs are available now for treating and preventing migraine attacks. Those new drugs have a special strategy to treat migraine by modifying the signaling of calcitonin gene- related peptide (CGRP) which is a strong neuropeptide released from the nerves. Monoclonal antibodies (mAbs) have been developed for targeting the CGRP pathway by binding the CGRP ligand (eptinezumab, galcanezumab fremanezumab,) or the CGRP receptor (erenumab). Recent studies show that mAbs have several advantages over small molecule antagonists, including high selectivity and reduced potential for drug–drug interactions. In this article we reviewed literature to assess whether mABs can be used for treatment of acute and chronic migraine safely compared to classical antimigraine agents.