Neurosciences最新文献

Objectives: To determine causes of headaches in patients who presented to the emergency department (ED) and underwent neuroimaging, and to determine the clinical features associated with abnormal neuroimaging.

Methods: Patients were retrospectively selected from a database between June, 2015 and May, 2019. Patients were included if they had neuroimaging requested from the ED mainly for headache. Associations between clinical characteristics and abnormal neuroimaging were assessed.

Results: We included 329 patients (33.4% men, 66.6% women). The mean (SD) age was 39.7 (18.4) years. Neurological signs were reported in 43.8% of the patients, head-computed tomography was requested in 79.6%, magnetic resonance imaging in 77.5%, and both in 57.1%. Abnormal neuroimaging was reported in 31.9%. The most common reported diagnoses were secondary headache disorders (48.9%), followed by primary headache disorders (16.4%). The remainder were nonspecific-headaches (35%). Variables associated with abnormal neuroimaging were headache onset ≤1 month (OR 3.37, CI 1.47-7.70, p=0.004), and presence of an abnormal neurological sign (OR 3.60, CI 1.89-6.83, p<0.001).

Conclusion: Secondary headache disorders are common in patients who undergo neuroimaging in the ED. Those who have a neurological sign and recent onset of headache are more likely to have abnormal neuroimaging.

Objective: To evaluate drug resistance epilepsy (DRE) patients with persistent seizures after using of standard antiepileptic drugs. This single center study aimed to investigate the utility of Epilepsy Monitoring Unit (EMU) resulted in a definitive diagnosis.

Methods: This was an observational retrospective study in 323 children who were admitted to the EMU for evaluation between 2012 and 2020.

Results: Of the 323 patients, 168 (52.01%) were males. The most common referral for EMU were better characterization 91 (28.17%) and pre-surgical evaluation 56 (17.3%). Of the participants, 273 (84.5%) had seizures one to 2 times per day. At discharge, 75.5% of admissions received a definitive diagnosis.

Conclusion: The EMU admission for pediatric epilepsy patients is very important for early accurate diagnosis and management with surgery for those consider DRE patients.

A 56-year-old woman experienced persistent excruciating pain with peroneal nerve injury in the anterior aspect of the lower leg after knee surgery. In our pain clinic, we diagnosed the patient with complex regional pain syndrome and performed lumbar sympathetic neurolysis (LSN) with absolute alcohol at the 3rd lumbar vertebra (L3). After the next follow-up, she complained of continuous dull low back pain, anal dysregulation, and fecal incontinence. We performed magnetic resonance imaging (MRI) to rule out other existing pathologies of back pain. On MRI, the nucleus pulposus was moderately extruded to the central zone with inferior sequestration at L2/3, and moderate central canal stenosis was observed at L2/3. She underwent partial laminectomy with discectomy at L2 level. We were not sure of the cause of disc herniation, but we strongly suspected that LSN at the L3 vertebral level was related to the pathology. Therefore, we discuss this unusual case.

Objectives: To determine the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms in patients who have survived COVID-19.

Methods: The study used an observational cross-sectional design between July and October 2021. The target population was adult patients who had confirmed COVID-19 infection prior to joining the study, OCD symptoms were assessed using the Arabic OCD scale created by Abohendy and colleagues, which included 83 questions covering 12 different domains and was administired online.

Results: A total of 356 patients were included in the analysis. Approximately 9.0% and 1.7% of the patients had a history of psychiatric disease and OCD diagnosis (respectively). The total symptom score was 32.8%. The most frequently reported domains were rumination of ideas (55.5%), re-checking compulsions (37.0%), and slowness (34.0%), while the least frequently reported domains included obsessive impulses (26.3%), obsessive images (26.5%), and religious compulsions (26.8%). Unlike other domains, the purity and cleanliness compulsions scores were significantly higher than the scale reference population. A higher total symptom score was observed in psychiatric patients (p=0.004) and, to a lesser extent, in OCD patients (p=0.250).

Conclusion: Overall, OCD symptoms, including cleanliness and fear of disease obsessions, tend to be higher in psychiatric and OCD patients, these findings are valuable for future studies.

A 65-year-old male patient presented with a rare arterio-venous fistula (AFV). The symptoms included congestion, decreased visual acuity, and proptosis. Further investigation revealed a non-traumatic intra orbital AFV with ophthalmic vein thrombosis. The management strategy was craniotomy and the prescription of anticoagulants. The patient recovered 2 months after surgery demonstrating successful resolution of his presenting symptoms and an alternative approach to complicated cases of embolization.