Pub Date : 2024-02-25DOI: 10.56310/pjns.v18i04.323
H. Imtiaz, Ayisha Farooq Khan, Zuha Alvi, Dureshahwar Kanwar
Background and Objective: Electrodiagnostic studies play a crucial role in identifying neurogenic and non-neurogenic causes of bladder and bowel dysfunction. Such data is scarce in Pakistan. The objective of this study was to evaluate utility of pudendal nerve assessment in bladder-bowel dysfunction. Methods: A retrospective observational study was carried out at the neurophysiology lab in Aga Khan University Hospital. Patients referred for electromyography/nerve conduction studies (EMG/NCS) for pudendal nerve assessment from June 2013 to June 2023 were included. Clinical data, EMG/NCS results, and demographic information were analyzed using SPSS. Results: Twenty patients (11 male and nine female) were included. Five patients experienced backache radiating to one or both lower extremities, along with urinary or fecal incontinence. Three patients had urinary incontinence, and additional three presented with both urinary and fecal incontinence. Three patients reported perianal numbness. Four patients had fecal incontinence, while one patient each reported painful defecation and backache along with perianal numbness. Three patients were diagnosed with pudendal neuropathy, out of which one had a coexisting lumbosacral radiculopathy as well. Five patients had isolated lumbosacral radiculopathy. Twelve patients exhibited normal EMG/NCS results. Conclusion: This study highlights the diagnostic utility of EMG/NCS in diagnosing pudendal nerve injuries. Despite its widespread use worldwide, the utilization of these tests in Pakistan is hindered by factors such as limited awareness, inadequate training, and resource constraints.
{"title":"Utility of pudendal nerve electrodiagnostics in cases of bladder-bowel dysfunction- A retrospective study from a tertiary care center in Pakistan","authors":"H. Imtiaz, Ayisha Farooq Khan, Zuha Alvi, Dureshahwar Kanwar","doi":"10.56310/pjns.v18i04.323","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.323","url":null,"abstract":"Background and Objective: \u0000Electrodiagnostic studies play a crucial role in identifying neurogenic and non-neurogenic causes of bladder and bowel dysfunction. Such data is scarce in Pakistan. The objective of this study was to evaluate utility of pudendal nerve assessment in bladder-bowel dysfunction. \u0000Methods: \u0000A retrospective observational study was carried out at the neurophysiology lab in Aga Khan University Hospital. Patients referred for electromyography/nerve conduction studies (EMG/NCS) for pudendal nerve assessment from June 2013 to June 2023 were included. Clinical data, EMG/NCS results, and demographic information were analyzed using SPSS. \u0000Results: \u0000Twenty patients (11 male and nine female) were included. Five patients experienced backache radiating to one or both lower extremities, along with urinary or fecal incontinence. Three patients had urinary incontinence, and additional three presented with both urinary and fecal incontinence. Three patients reported perianal numbness. Four patients had fecal incontinence, while one patient each reported painful defecation and backache along with perianal numbness. Three patients were diagnosed with pudendal neuropathy, out of which one had a coexisting lumbosacral radiculopathy as well. Five patients had isolated lumbosacral radiculopathy. Twelve patients exhibited normal EMG/NCS results. \u0000Conclusion: \u0000This study highlights the diagnostic utility of EMG/NCS in diagnosing pudendal nerve injuries. Despite its widespread use worldwide, the utilization of these tests in Pakistan is hindered by factors such as limited awareness, inadequate training, and resource constraints.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"14 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140432319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.56310/pjns.v18i04.322
Anjum Farooq, Muhammad Essa, Muhammad Saleem, Abdul Aleem, Muhammad Rizwan
Background and Objective: Stroke is the leading cause of death and disability. Improving stroke knowledge among medical students will help to improve stroke care and its prevention. This study aims to evaluate the prevalence of risk factors and stroke awareness among university students. Methods: This cross-sectional study was conducted among students at Sardar Bahadur Khan Women's University in Quetta. An eleven-question multiple-choice survey was administered to assess participants' knowledge of stroke-related concepts. The initial study was conducted using descriptive statistics. Additionally, a supplementary screening for common risk factors linked to stroke was included in the study, which involved blood pressure, blood sugar, and cholesterol measures. Data were coded, entered into SPSS, and screened for missing values and outliers. Descriptive analyses were conducted, including frequency tables and graphical representations using pie charts. Results: In our survey of 255 female students, the vast majority (94.9%) correctly classified stroke as a brain disease, whereas a lesser percentage (1.6%) confused it with heart (0.8%), kidney (0.8%), or lung diseases (0.8%) problems. Notably, 74.1% of participants were aware of the precise cause of stroke, but 58.8% identified arm and leg weakness as a symptom. Other symptoms that were recognized by participants included difficulties speaking (25.5%), headache (9.8%), vertigo (2.4%), and chest pain (3.4%). Moreover, 94.9% of participants recognized that stroke is preventable. The most often diagnosed risk factor was hypertension (58.4%), which was followed by high cholesterol (11.8%), diabetes (9.0%), migraine (8.2%), advanced age (7.8%), and smoking (4.7%). Conclusion Our study shows a very good knowledge about stroke among the students at Sardar Bahadur Khan University but our results are biased due to addressing only an educated group of people.
{"title":"Evaluation of stroke awareness and risk factor prevalence among students at a public sector university in Quetta","authors":"Anjum Farooq, Muhammad Essa, Muhammad Saleem, Abdul Aleem, Muhammad Rizwan","doi":"10.56310/pjns.v18i04.322","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.322","url":null,"abstract":"Background and Objective: \u0000 Stroke is the leading cause of death and disability. Improving stroke knowledge among medical students will help to improve stroke care and its prevention. This study aims to evaluate the prevalence of risk factors and stroke awareness among university students. \u0000Methods: \u0000This cross-sectional study was conducted among students at Sardar Bahadur Khan Women's University in Quetta. An eleven-question multiple-choice survey was administered to assess participants' knowledge of stroke-related concepts. The initial study was conducted using descriptive statistics. Additionally, a supplementary screening for common risk factors linked to stroke was included in the study, which involved blood pressure, blood sugar, and cholesterol measures. Data were coded, entered into SPSS, and screened for missing values and outliers. Descriptive analyses were conducted, including frequency tables and graphical representations using pie charts. \u0000Results: \u0000In our survey of 255 female students, the vast majority (94.9%) correctly classified stroke as a brain disease, whereas a lesser percentage (1.6%) confused it with heart (0.8%), kidney (0.8%), or lung diseases (0.8%) problems. Notably, 74.1% of participants were aware of the precise cause of stroke, but 58.8% identified arm and leg weakness as a symptom. Other symptoms that were recognized by participants included difficulties speaking (25.5%), headache (9.8%), vertigo (2.4%), and chest pain (3.4%). Moreover, 94.9% of participants recognized that stroke is preventable. The most often diagnosed risk factor was hypertension (58.4%), which was followed by high cholesterol (11.8%), diabetes (9.0%), migraine (8.2%), advanced age (7.8%), and smoking (4.7%). \u0000Conclusion \u0000Our study shows a very good knowledge about stroke among the students at Sardar Bahadur Khan University but our results are biased due to addressing only an educated group of people.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.244
Ahtesham Khizar
Artificial Intelligence (AI) is being used in the field of neurosurgery for improving patient outcomes, reducing the risk of complications, and increasing the efficiency of surgical procedures. AI algorithms can analyze patient data, plan surgical procedures, guide surgical instruments, monitor brain activity, and improve post-operative care. The benefits of incorporating AI into neurosurgical practice include pre-operative planning, intraoperative navigation, real-time monitoring, and post-operative care. AI is already being used in neurosurgery for image segmentation, surgical planning, intraoperative navigation, real-time monitoring, and predictive analytics. The potential applications of AI in neurosurgery include personalized medicine, virtual reality, robotic surgery, predictive analytics, and medical imaging. However, the challenges of incorporating AI into neurosurgical practice are data quality, data privacy and security, regulatory frameworks, and training and education. In short, AI has the potential to completely transform the discipline of neurosurgery, but there is a need to address the challenges associated with its incorporation into neurosurgical practice.
{"title":"Artificial intelligence and neurosurgery: a revolution in the field","authors":"Ahtesham Khizar","doi":"10.56310/pjns.v18i04.244","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.244","url":null,"abstract":"Artificial Intelligence (AI) is being used in the field of neurosurgery for improving patient outcomes, reducing the risk of complications, and increasing the efficiency of surgical procedures. AI algorithms can analyze patient data, plan surgical procedures, guide surgical instruments, monitor brain activity, and improve post-operative care. The benefits of incorporating AI into neurosurgical practice include pre-operative planning, intraoperative navigation, real-time monitoring, and post-operative care. AI is already being used in neurosurgery for image segmentation, surgical planning, intraoperative navigation, real-time monitoring, and predictive analytics. The potential applications of AI in neurosurgery include personalized medicine, virtual reality, robotic surgery, predictive analytics, and medical imaging. However, the challenges of incorporating AI into neurosurgical practice are data quality, data privacy and security, regulatory frameworks, and training and education. In short, AI has the potential to completely transform the discipline of neurosurgery, but there is a need to address the challenges associated with its incorporation into neurosurgical practice.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"51 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.312
Man Mohan Mehndiratta, Vasundhara Aggarwal, Nishant Tomar
{"title":"In the symphony of green spaces, brain and its thoughts find the healing melody","authors":"Man Mohan Mehndiratta, Vasundhara Aggarwal, Nishant Tomar","doi":"10.56310/pjns.v18i04.312","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.312","url":null,"abstract":"","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"154 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.257
Soban Khan, Zaid Waqar, Zakir Jan, Muhammad Tariq
Dengue fever is a seasonal epidemic that effects population all across Pakistan every monsoon season and leads to thousands of cases every year. Dengue fever can be associated with neurological complications both during the acute stage and after recovery. These include encephalitis and hemorrhagic complications as well as late immune-related conditions such as Guillain-Barre syndrome and acute disseminated encephalomyelitis. Here we present case of a patient who developed new onset cerebellar symptoms two weeks after recovery from dengue fever, with a middle cerebellar peduncle sign on MRI Brain.
{"title":"Cerebellar symptoms after dengue fever with bright middle cerebellar peduncle sign","authors":"Soban Khan, Zaid Waqar, Zakir Jan, Muhammad Tariq","doi":"10.56310/pjns.v18i04.257","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.257","url":null,"abstract":"Dengue fever is a seasonal epidemic that effects population all across Pakistan every monsoon season and leads to thousands of cases every year. Dengue fever can be associated with neurological complications both during the acute stage and after recovery. These include encephalitis and hemorrhagic complications as well as late immune-related conditions such as Guillain-Barre syndrome and acute disseminated encephalomyelitis. Here we present case of a patient who developed new onset cerebellar symptoms two weeks after recovery from dengue fever, with a middle cerebellar peduncle sign on MRI Brain.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"53 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.258
Soban Khan, Zaid Waqar, Haris Majid, Ahmed Farhan, Shajee Siddique
Wilson Disease results from autosomal recessive mutation in ATP7B gene which leads to reduced formation of ceruloplasmin protein in the body that acts as a copper transporter. Due to its deficiency, there is the build-up of copper in the liver and brain among other organ systems and it leads to the development of various clinical abnormalities but commonly presents either as hepatic dysfunction and/or cirrhosis in young patients with movement disorder. Here we present a case that presented with hypoglycemia and hypothermia in absence of any infection, drug abuse or metabolic abnormality. He was later diagnosed as Wilson disease. Wilson Disease is mostly thought of hepatic /neurological disease. Contrary to this Wilson’s disease is a multisystem disease affecting multiple organ system including, kidneys, endocrine system and musculoskeletal system and can present with manifestations of above-mentioned systems.
{"title":"A rare presentation of Wilson disease: a case report","authors":"Soban Khan, Zaid Waqar, Haris Majid, Ahmed Farhan, Shajee Siddique","doi":"10.56310/pjns.v18i04.258","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.258","url":null,"abstract":"Wilson Disease results from autosomal recessive mutation in ATP7B gene which leads to reduced formation of ceruloplasmin protein in the body that acts as a copper transporter. Due to its deficiency, there is the build-up of copper in the liver and brain among other organ systems and it leads to the development of various clinical abnormalities but commonly presents either as hepatic dysfunction and/or cirrhosis in young patients with movement disorder. Here we present a case that presented with hypoglycemia and hypothermia in absence of any infection, drug abuse or metabolic abnormality. He was later diagnosed as Wilson disease. Wilson Disease is mostly thought of hepatic /neurological disease. Contrary to this Wilson’s disease is a multisystem disease affecting multiple organ system including, kidneys, endocrine system and musculoskeletal system and can present with manifestations of above-mentioned systems.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"721 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140453979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.278
Qurat ul ain Khan
Background and Objective: Pakistan is a low middle-income country (LMIC) in South Asia with a rising aging population. This study aimed to understand care-arrangement and resources of people with dementia (PWD) in Karachi, Pakistan. Methods: This cross-sectional mixed-method (qualitative and quantitative) study was carried out using 10/66 protocol for dementia patients. Data collection for the study was done from September 2016 till August 2017.This assessed characteristics of patients and caregivers, the economic impact of caregiving, and resources available to care for people with dementia (PWD). Results: One-hundred-twenty-eight PWD and their caregivers were included in the study. The average gross national product (GNP) per PWD per capita was $140. Majority of the caregivers were married women, family members, and full-time housewives. Three quarters of the caregivers were patients’ children or spouse residing with the patient, in a 2-to-3-bedroom house. Majority of the time of the caregivers’ day was spent with the PWD. Conclusion: In Pakistan majority of PWD are dependent on female family members for care. Caregiver roles are full-time responsibilities with little to no burden shared by others. There is low monthly GNP per PWD with a high cost of medical needs of PWD.
{"title":"Assessment of care-arrangement of people with dementia in Karachi by 10/66 protocol","authors":"Qurat ul ain Khan","doi":"10.56310/pjns.v18i04.278","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.278","url":null,"abstract":"Background and Objective: \u0000Pakistan is a low middle-income country (LMIC) in South Asia with a rising aging population. This study aimed to understand care-arrangement and resources of people with dementia (PWD) in Karachi, Pakistan. \u0000Methods: \u0000This cross-sectional mixed-method (qualitative and quantitative) study was carried out using 10/66 protocol for dementia patients. Data collection for the study was done from September 2016 till August 2017.This assessed characteristics of patients and caregivers, the economic impact of caregiving, and resources available to care for people with dementia (PWD). \u0000Results: \u0000One-hundred-twenty-eight PWD and their caregivers were included in the study. The average gross national product (GNP) per PWD per capita was $140. Majority of the caregivers were married women, family members, and full-time housewives. Three quarters of the caregivers were patients’ children or spouse residing with the patient, in a 2-to-3-bedroom house. Majority of the time of the caregivers’ day was spent with the PWD. \u0000Conclusion: \u0000 In Pakistan majority of PWD are dependent on female family members for care. Caregiver roles are full-time responsibilities with little to no burden shared by others. There is low monthly GNP per PWD with a high cost of medical needs of PWD.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"60 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.314
A. Sonawalla, Saadia Arshad, Shafaq Saleem
A 32-year-old male, with a history of recurrent throbbing headaches, presented with three episodes of minor trauma to the head followed by throbbing headaches and blurred vision. In two of these episodes, he also had clinical features suggesting the occurrence of transient global amnesia (TGA) at the same time. Although migraines as well as TGAs are reported to occur following minor head trauma, the simultaneous occurrence of both is rather unusual and would support the fact that spreading depression is the main pathophysiological mechanism underlying TGAs as it is for migraines. We report an unusual case of migraine and TGA occurring simultaneously in a footballer after minor head trauma.
{"title":"Co-occurrence of recurrent migrainous headaches and transient global amnesia following minor head trauma: a case report","authors":"A. Sonawalla, Saadia Arshad, Shafaq Saleem","doi":"10.56310/pjns.v18i04.314","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.314","url":null,"abstract":"A 32-year-old male, with a history of recurrent throbbing headaches, presented with three episodes of minor trauma to the head followed by throbbing headaches and blurred vision. In two of these episodes, he also had clinical features suggesting the occurrence of transient global amnesia (TGA) at the same time. Although migraines as well as TGAs are reported to occur following minor head trauma, the simultaneous occurrence of both is rather unusual and would support the fact that spreading depression is the main pathophysiological mechanism underlying TGAs as it is for migraines. We report an unusual case of migraine and TGA occurring simultaneously in a footballer after minor head trauma.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"776 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140453850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.302
Arshad Mehmood, Javeria Raza Alvi, Ahmad Bilal, Sameen Qureshi, Shaila Ali, Tipu Sultan
Poretti–Boltshauser syndrome is rare genetic disorder of brain malformation with ocular findings due to mutation in LAMA1 gene. We report a case of five years old girl who presented with high myopia, delayed language and motor development with otherwise normal neurological examination. Brain imaging findings were consistent of Poretti–Boltshauser syndrome with cerebellar dysplasia and cyst (CDC). However, cerebellar ataxia and retinopathy were not found in our index case.
Poretti-Boltshauser 综合征是一种罕见的遗传性疾病，由于 LAMA1 基因突变导致脑部畸形并伴有眼部症状。我们报告了一例五岁女孩的病例，她患有高度近视，语言和运动发育迟缓，但神经系统检查正常。脑成像结果与波雷蒂-博尔特豪泽综合征（Poretti-Boltshauser Syndrome with cellerebar dysplasia and cyst，CDC）一致。然而，在我们的病例中并未发现小脑共济失调和视网膜病变。
{"title":"Child with developmental delay and pathological myopia: Poretti–Boltshauser syndrome","authors":"Arshad Mehmood, Javeria Raza Alvi, Ahmad Bilal, Sameen Qureshi, Shaila Ali, Tipu Sultan","doi":"10.56310/pjns.v18i04.302","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.302","url":null,"abstract":"Poretti–Boltshauser syndrome is rare genetic disorder of brain malformation with ocular findings due to mutation in LAMA1 gene. We report a case of five years old girl who presented with high myopia, delayed language and motor development with otherwise normal neurological examination. Brain imaging findings were consistent of Poretti–Boltshauser syndrome with cerebellar dysplasia and cyst (CDC). However, cerebellar ataxia and retinopathy were not found in our index case.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"186 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.212
Shahmeer Khan, Muhammad Awais, Muhammad Azeemuddin, A. Shoukat
Background and Objective: A large number of review and research articles exists in literature which describe the radiological appearance of various manifestations of nervous system tuberculosis, however there is paucity of text which describes the application of each and every imaging modality in the workup of the entire spectrum of this pathology. The intent of this article is to review the existing literature on the role of different radiological modalities in the stepwise work up of CNS TB. The article focuses on the role of plain radiograph, fluoroscopy, computed tomography, magnetic resonance imaging along with its advanced sequences and nuclear medicine in imaging of the many faces of tuberculosis in CNS. The article also aims to review the existing literature on the role of MR based textural analysis (Radiomics) as a problem-solving tool in various nervous system pathologies. Methods: We searched PubMed central databases for articles published in English from January 1 2000 to February 28 2021 along with references from the relevant articles. The search terms included “imaging in central nervous system tuberculosis” “Radiomics in tuberculosis “, “Radomics in central nervous system ”. In total 95 articles including case reports, case series, original articles and review articles were included in this review. Results: Conventional imaging modalities including radiograph and fluoroscopy are becoming extinct in work up of tuberculosis in the nervous system itself, however a plain radiograph still holds a key position in screening the chest for presence of subclinical respiratory tract infection in patients presenting with brain tuberculosis. In addition, it is a sensitive tool as baseline investigation in workup of spinal tuberculosis (T.B). Fluoroscopy is a useful tool in image guided procedures for collection of samples for histopathology and CSF analysis. Cross sectional imaging modalities including computed tomography and magnetic resonance imaging have revolutionized imaging of central nervous system pathologies in particular tuberculosis. Computed tomography acts as a screening tool to identify the presence of intracranial tuberculosis and recognize its complications. In addition it is an important tool to determine the extent of spinal T.B. Magnetic Resonance Imaging (MRI) along with its advanced sequences including spectroscopy, Magnetization transfer T1 sequence (MT T1), perfusion imaging, and magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) is an ideal imaging method to work up CNS TB. It can identify numerous manifestations of tuberculosis in the brain, work up its associated complication, and explain the extent of neurological symptoms. Moreover, it has the capability to differentiate TB from other nervous system infections. Furthermore, it can differentiate neoplastic and inflammatory brain disorders from CNS TB. Radiomics, particularly the textural features based on MR imaging is the future of ne
{"title":"Neuroimaging of tuberculosis- modalities, imaging protocols and radiomics: a review","authors":"Shahmeer Khan, Muhammad Awais, Muhammad Azeemuddin, A. Shoukat","doi":"10.56310/pjns.v18i04.212","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.212","url":null,"abstract":"Background and Objective: \u0000A large number of review and research articles exists in literature which describe the radiological appearance of various manifestations of nervous system tuberculosis, however there is paucity of text which describes the application of each and every imaging modality in the workup of the entire spectrum of this pathology. The intent of this article is to review the existing literature on the role of different radiological modalities in the stepwise work up of CNS TB. The article focuses on the role of plain radiograph, fluoroscopy, computed tomography, magnetic resonance imaging along with its advanced sequences and nuclear medicine in imaging of the many faces of tuberculosis in CNS. The article also aims to review the existing literature on the role of MR based textural analysis (Radiomics) as a problem-solving tool in various nervous system pathologies. \u0000Methods: \u0000We searched PubMed central databases for articles published in English from January 1 2000 to February 28 2021 along with references from the relevant articles. The search terms included “imaging in central nervous system tuberculosis” “Radiomics in tuberculosis “, “Radomics in central nervous system ”. In total 95 articles including case reports, case series, original articles and review articles were included in this review. \u0000Results: \u0000Conventional imaging modalities including radiograph and fluoroscopy are becoming extinct in work up of tuberculosis in the nervous system itself, however a plain radiograph still holds a key position in screening the chest for presence of subclinical respiratory tract infection in patients presenting with brain tuberculosis. In addition, it is a sensitive tool as baseline investigation in workup of spinal tuberculosis (T.B). Fluoroscopy is a useful tool in image guided procedures for collection of samples for histopathology and CSF analysis. \u0000Cross sectional imaging modalities including computed tomography and magnetic resonance imaging have revolutionized imaging of central nervous system pathologies in particular tuberculosis. Computed tomography acts as a screening tool to identify the presence of intracranial tuberculosis and recognize its complications. In addition it is an important tool to determine the extent of spinal T.B. Magnetic Resonance Imaging (MRI) along with its advanced sequences including spectroscopy, Magnetization transfer T1 sequence (MT T1), perfusion imaging, and magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) is an ideal imaging method to work up CNS TB. It can identify numerous manifestations of tuberculosis in the brain, work up its associated complication, and explain the extent of neurological symptoms. Moreover, it has the capability to differentiate TB from other nervous system infections. Furthermore, it can differentiate neoplastic and inflammatory brain disorders from CNS TB. Radiomics, particularly the textural features based on MR imaging is the future of ne","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"57 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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