Medicine and Health Sciences Commons^™

Lack Of Stroke Care Centers In Sindh, Adnan Malik, Rahul Agia

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Fibromyalgia: The Misunderstood Victim, Wajid Jawaid

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Mandatory Child Neurology Training For Adult Neurology Residents In Pakistan, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Terson Syndrome In A Patient With Unrepaired Tetralogy Of Fallot, Amina Saddiqa, Zaid Waqar, Maryam Khalil, Muhammad Anas, Zeeshan Munawar, Ifrah Ayaz, Zakir Jan, Haris Majid

Pakistan Journal of Neurological Sciences (PJNS)

Tetralogy of Fallot is the most commonly seen cyanotic congenital heart disease. It includes four cardinal features: right ventricular outflow tract obstruction, misaligned ventricular septal defect, overriding aorta, and concentric right ventricular hypertrophy. Intracranial pathologies such as brain abscesses, cerebrovascular accidents, and intracranial haemorrhage all have been reported with Tetralogy of Fallot. Here we present a case who had subarachnoid haemorrhage with vitreous haemorrhage in Tetralogy of Fallot.

National Guidelines For The Treatment Of Common Headaches Disorders In Pakistan, Abdul Malik, Sabrina Khan, Mohammad Wasay, Aziz Sonawalla, Samaira Younis, Faisal Mohammad Amin

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

World Health Organization Intersectoral Global Action Plan (Who-Igap); Implications And Impact On Neurological Care In Pakistan, Mohammad Wasay Wasay, Safa Younis, Abdul Malik, Akhtar Sherin

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Application Of Multiphase Ct Angiography In Acute Ischemic Stroke, Salman Mansoor

Pakistan Journal of Neurological Sciences (PJNS)

This article explores the use of multiphase CT angiography (CTA) as a valuable tool in acute stroke management. Unlike traditional imaging methods, multiphase CTA provides a more comprehensive view of the neurovascular system and can detect occlusions and aid in treatment decision-making. Recent studies have shown that multiphase CTA has high accuracy in identifying patients who are suitable for endovascular treatment. Furthermore, it has also been used to visualize intracranial aneurysms and track the development of collateral circulation during and after treatment. Despite concerns regarding radiation exposure and image interpretation, multiphase CTA remains an essential imaging modality in the management …

Myositis As A Complication Of Dengue Viral Infection, Amina Sadiqa, Usama Hayyan, Zaid Waqar, Taha Pasha

Pakistan Journal of Neurological Sciences (PJNS)

Dengue fever is a febrile illness caused by an arbovirus transmitted by the Aedes aegypti mosquito. It occurs as a seasonal epidemic every year in Pakistan. Apart from febrile illness and its associated hemorrhagic complication, dengue fever is associated with multi-system involvement and their respective complications, including myriad neurological complications. In this case report we describe two patients who developed acute viral myositis.

Creutzfeldt-Jakob Disease Experience In Patients Presenting To A Tertiary Care Hospital: A Case Series, Zaid Waqar Waqar, Amina Sadiqa, Soban Khan, Muhammad Annas Farooq Farooq, Zeeshan Munawar, Maryam Khalil, Adil Awan

Pakistan Journal of Neurological Sciences (PJNS)

Creutzfeldt-Jakob disease (CJD) is a rare cause of rapidly progressive dementia, it is a neurodegenerative disorder caused by the misfolding of prion proteins in the brain, and misfolded proteins further propagate by causing misfolding of other proteins. It presents with insidious onset of neurobehavioral symptoms that rapidly develop into cognitive and motor decline and uncontrolled seizures. The diagnosis is established with help of clinical signs and symptoms, and using imaging and lab investigations to rule out other treatable causes. Some imaging findings point to the diagnosis of CJD that will be viewed in the cases below. Diagnosis can be augmented …

Mutational Analysis Among Patients With Duchenne Muscular Dystrophy, Shumaila Rafique, Muhammad Asif Ibrahim, Natasha Ghani, Muhammad Athar Khalily, Syed Zubair Shah Shah, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Duchenne Muscular Dystrophy is caused by mutations in dystrophin gene that include deletion, duplication and small mutations. Introduction to newer drug therapies in DMD is based on the type of mutation. The objective of this study was to assess distribution and percentage of different mutations among DMD patients. Methods: This retrospective cross-sectional study was conducted in Pediatric Neurology department of UCHS & Children Hospital Lahore. All the cases of Duchenne Muscular Dystrophy confirmed through genetic analysis from January 2022 to June 2022 through MLPA method were enrolled in the study. Data was recorded on detailed history and …

Clinical Spectrum, Risk Factors & Electrophysiological Evaluation Of Sciatic Nerve Injury In Patients Presenting To A Tertiary Care Hospital, Maryum Khadim Khadim, Safia Bano, Ahsan Numan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Assessment Of Social Media Addiction And Its Link To Psychological Distress: A Comparative Study On Undergraduate Students, Syeda Aqeela Zehra, Javeria Khan, Marium Rafiq, Kinza Ansari, Shabina Iqbal, Faizan Nafees Nafees, Syed Tafazzul Hyder Zaidi Zaidi

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and objective: Addiction to social networking sites (SNSs) is their unhealthy use that interferes with daily functionality and results in unwanted outcomes. This study investigates the prevalence and intensity as well as the impact of SNSs addiction on the daily routine among young undergraduate students. In addition, it evaluates the relationship between psychological suffering and SNSs addiction. Methods: A cross sectional study was conducted among undergraduate students of Karachi, Pakistan from January to June 2022. Data was collected using non-probability convenience sampling technique. A self-administered questionnaire was used, compiled from two validated questionnaires, Young’s internet addiction (YIA) test …

Frequency Of Tension-Type Headache In Patients With Migraine: A Single-Center Cross-Sectional Study, Haris Majid Rajput, Zahid Hussain Mir, Muhammad Fateen Rashed, Fiza Batool Almosvi, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT Background and objective: Migraine is a common headache disorder characterized by recurrent episodes of moderate to severe headaches which are usually unilateral. Migraine is the second most common headache disorder after tension-type headache. The objective of this study was to determine the frequency of tension-type headache in patients with migraine. Methods: This cross-sectional study was carried out at Pakistan Institute of Medical Sciences, Islamabad for a period of six months between 1st July 2018 and 31st December 2018. This study enrolled patients above the age of 12 years that were diagnosed with “Migraine without aura” or “Migraine with aura”. …

Exploring The Relationship Between Egris And The Need For Mechanical Ventilation In Guillain Barré Syndrome, Bushra Khalid, Zaid Waqar, Soban Khan, Sajid Ali, Ijaz Ali, Muhammad Tariq, Anum Irfan, Waleed Malik, Samer Naik, Malik Adil, Hira Abbasi

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Guillain-Barré syndrome (GBS) is an immune system-mediated polyradiculoneuropathy that accounts for approximately 100,000 new patients per year globally. GBS has also been linked to respiratory failure in 20% to 40% of cases. The objective of this study was to find an association between Erasmus GBS respiratory insufficiency score (EGRIS) and the need for mechanical ventilation. Methods: We conducted our cross-sectional study at department of Neurology, Pakistan Institute of Medical Sciences from November 2019 to February 2020. Sixty patients were selected for this study. Data including demographic profile, variant of GBS, and EGRIS was calculated from all the …

Evidence Based Medicine Should Apply Equally To Resource-Limited Settings, Thirugnanam Umapathi

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Impairment-Based Multidisciplinary Rehabilitation Management In Multiple Sclerosis In Pakistan, Sarah Razaq, Fahim Anwar, Wasim Wali

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Psychiatric Manifestations Of Dengue Fever- A Case Report From Pakistan, Ifrah Hambal, Samrah Nasir, Tania Nadeem

Pakistan Journal of Neurological Sciences (PJNS)

A 29-year-old male presented to Aga Khan University Hospital with complaints of fever, body-aches, vomiting and one episode of gum bleeding. A Dengue antigen test done prior to presentation was positive. He was admitted for medical management. During hospital stay, the patient developed manic symptoms including over-talkativeness, expansive mood, disinhibited behavior, excessive planning, paranoia and aggression. He remained oriented to time, place and person and neurological examination was unremarkable. He was managed with anti-psychotics and benzodiazepines, and his psychiatric symptoms improved with improvement in his medical condition. This case highlights the possibility of psychiatric manifestations occurring in context of a …

Sars-Cov-2 Infection With Polymyositis- A Case Report, Muhammad Hassan, Fatima Mustafa, Naveed Ullah Khan, Taimoor Hassan, Mansoor Iqbal Chaudhry, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Among the most prevalent and least addressed symptoms of SARS-CoV-2 infection are myalgia, muscle weakness, and body aches. Only a few studies have reported polymyositis in patients with Covid-19 infection. At least one-third of patients with Covid-19 syndrome had elevated CPK levels. The cause of elevated CPK can be a cytokine storm or viral infection of the muscles. We present a case in which our patient developed features of myositis following the resolution of an acute viral prodrome caused by SARS-CoV-2. Our patient had both radiological and biopsy-proven neuromuscular manifestations of SARS-CoV-2 associated with polymyositis. Proximal muscle weakness began shortly …

The Sub-Standardized Approach To Stroke Management In Low And Middle-Income Countries Including Pakistan: Limitations And Suggested Options To Overcome Some Of The Shortcomings Via Teleneurology/Telestroke Application, Rizwana Shahid

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Ischemic stroke still poses a significant health concern throughout the world. However, low and middle-income countries (LMIC) in Asia have more devastating outcome. The vascular risk factors are prevalent in most parts of Asia, contributing to increasing incidence. The recommended approved treatment for acute stroke is limited to a few areas in these countries. We aimed to identify stroke risk factors, its incidence and prevalence; treatment opportunities offered in various parts of the region and utilizing the alternate pathways to improve the disease recognition and management outcome.

Method: A comprehensive search using PubMed, MEDLINE, Medline Plus, PubMed …

48 Hours Holter Monitoring In Detecting Occult Atrial Fibrillation In Young Patients With Possible Cardioembolic Stroke, Bushra Khalid, Soban Khan, Muhammad Tariq, Sajid Ali, Ijaz Ali, Zaid Waqar

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and objective: Atrial fibrillation (AF) is a common cause of ischemic stroke. AF is usually paroxysmal and could escape detection via single lead electrocardiogram ECG recorder. Holter monitoring is useful in this scenario. The objective of this study was to assess the role of 48 hours Holter monitoring in identifying clinically inapparent AF in young patients with ischemic stroke

Methods: A retrospective cross-sectional study was conducted with patient data from November 2019 to February 2021. It was conducted in Neurology department of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Study contained medical records of 60 patients which were …

Neurological Manifestations Of Cerebral Venous Thrombosis: Experience From A Tertiary Care Center, Anum Irfan, Soban Khan, Zaid Waqar, Sumaira Nabi, Bushra Khalid, Muhammad Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Cerebral venous thrombosis (CVT) is a common cause of cerebrovascular accident (stroke). CVT is caused due to blockage in blood flow either in cerebral veins or in dural sinuses. The objective of this study was to determine prevalence of various clinical and imaging characteristics in patients with cerebral venous thrombosis.

Methods: A descriptive retrospective cross-sectional patient data was collected from November 2019 to February 2021. This study was conducted in Neurology Department in Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. This study contains patient medical histories of 60 patients who were admitted in two and a …

Short, Medium And Long Term Neurological Manifestations And Outcome In Covid-19 Patients, Sajid Hameed, Bashir Soomro, Samar Iltaf, Abdul Malik, Anjum Farooq, Alam Ibrahim Siddiqi, Safia Awan, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: There is a need to improve the understanding of Covid-19 neurological complications in a temporal manner. The objective of our study was to find out temporal relationship of neurological manifestations and outcome in Covid-19 Patients.

Methods: This was a multi-center observational study from six centers in Pakistan. Data of covid patients with six months follow up was retrospectively collected from the hospital records. Time periods were divided into short-term (< 1 month), medium-term (2-3 months) and long-term (>4 months). SPSS version 26.0 (SPSS Inc., Chicago, IL, USA) was used to analyze the data.

Results: Neurological manifestations were reported in 208 out of 905 covid …

Decompressive Hemicraniectomy For Patients With Malignant Cerebral Venous Sinus Thrombosis, Sadaf Majid, Waseem Tariq Malik, Asfandyar Khan Niazi, Ehsan Ul Haq, Hina Yusuf, Raja Farhat Shoaib, Maimoona Siddiqui Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and may lead to the development of raised intracranial pressure due to edema, infarct or bleed. These patients may require decompressive hemicraniectomy to reduce the raised intracranial pressure. However, the evidence for hemicraniectomy in these patients is scanty. Our objective was to perform a retrospective chart review to describe the clinical characteristics of patients who underwent decompressive hemicraniectomy for malignant CVST and their outcomes.

Methods: We retrospectively analyzed the medical records of patients with CVST who underwent decompressive hemicraniectomy between 2013 and 2020 at Shifa International …

Hurdles Of Intravenous Thrombolysis In Acute Ischemic Stroke At Balochistan, Anjum Farooq, Muhammad Essa, Nimra Shafique, Sakina Gull

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Intravenous thrombolysis (IVT) with alteplase tPA (tissue plasminogen Activator) is the FDA approved treatment for acute ischemic stroke. The objective of this study was to determine the hurdles of intravenous thrombolysis in acute ischemic stroke in Balochistan.

Methods: A prospective cross-sectional observational study was carried out from June 2021 to December 2021 at Neurology department of Bolan Medical Complex Hospital Quetta on 272 patients of acute ischemic stroke who fulfilled the criteria. Proforma was filled by relative or patient after informed consent. Proforma included sex, age, diagnosis, time of presentation after stroke and reason of delay. Data …

Multiple Sclerosis And Parkinson’S Disease: Poles Apart Or Cut From The Same Cloth?, Wajid Jawaid

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Pediatric Stroke: A Review, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Background and objectives: Pediatric Stroke is a neurological disorder in which the patient suffers with two or more Pediatric stroke is a focal neurological deficit lasting more than 24 hours because of stenosis, occlusion or rupture of cerebral blood vessels. Variable etiological factors are involved ranging from cardiac, haematological, infectious, immune mediated to arteriopathies which is emerging as most important cause of arterial ischemic stroke in children. In this review article we will discuss paediatric stroke with its epidemiology, etiological factors in particular arteriopathies, diagnostic modalities, management protocols and outcome.

Methods: We searched stroke in Pubmed and found 15315 articles, …

Catatonia In The General Hospital: A Case Series Wading Through Diagnostic & Management Challenges, Shireen Najam, Marium Mansoor, Muhammad Yusuf Hafiz, Alviya Shafique, Ifrah Hambal, Banafsha Gul, Tania Nadeem

Pakistan Journal of Neurological Sciences (PJNS)

Catatonia is a cluster of affective, behavioral, and motor symptoms. Its causes are multifactorial ranging from severe and untreated psychiatric illnesses to neurological diseases and other general medical conditions. It is estimated that 20% of catatonia causes are due to medical conditions out of which two thirds are due to an underlying neurological condition which might include encephalitis, neural injury, developmental disorders, structural brain pathology, or seizures. Symptoms of catatonia can wax and wane, fluctuating between the retarded and the excited type within hours making it more difficult to identify and diagnose. If left untreated, catatonia can lead to multiple …

Anti-Nmda Receptor Encephalitis Presenting With Severe Episodic Hypertension: A Case Report, Tehreem Arshad, Musarrat Hussain, Abdul Wahab Yousafzai, Arsalan Ahmad

Pakistan Journal of Neurological Sciences (PJNS)

Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is one of the most commonly emerging autoimmune encephalitis in children and young adults in recent years. Clinical manifestations range from prodromal symptoms to seizures, movement disorder, psychiatric manifestations, cognitive/speech impairment, and autonomic dysfunction. Our case presented with initial symptoms of severe episodic hypertension, sweating, agitation, and tachycardia. She received early care for pheochromocytoma and panic disorder in Qatar, but there was no relief. Three weeks later, she presented in our emergency room with seizures, cognitive/speech impairment, and orofacial dyskinesia. Electroencephalography (EEG) revealed right hemispheric delta activity and cerebrospinal fluid CSF anti-NMDA Receptor IgG was positive. …

Clinical Spectrum, Risk Factors And Electrophysiologic Aspect Of Radial Nerve Injury, Arfah Kanwal, Safia Bano, Ubaid Ullah, Ahsan Numan

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and objective: Radial nerve is injured due to a variety of reasons. The objective of this study was to determine the clinical spectrum, risk factors and electrophysiologic aspect of radial nerve injury presenting to a tertiary care hospital in Lahore.

Methods: This descriptive prospective cross-sectional study was conducted at department of Neurology, Mayo hospital Lahore from July 2022 to December 2022 and comprised patients with isolated radial nerve injury on the basis of history and clinical examination regardless of their gender, above 15 years of age. NCS/EMG was done on a Japanese machine Nihon Kohden by an expert …

Temporal Lobe Epilepsy With Hippocampus Sclerosis: Prevalence, Etiology, And Treatment Options With Herbal Medicines, Muhammad Wasim, Mehr Musani, Hasan Salman Siddiqi, Saara Muddasir, Bushra Amin, Fazal Manzoor Arain

Pakistan Journal of Neurological Sciences (PJNS)

Background and objectives: Epilepsy is a neurological disorder in which the patient suffers with two or more unprovoked seizures. It is one of the most common neurological disorders worldwide, affecting more than 70 million people. Currently various modes of effective treatments are available, but still there are many cases that remain drug resistant. Hence, there is a need to explore herbal medications for the treatment of drug resistant epilepsy.

Methods: Recent reviews and research articles (2000-2022) from PubMed and Google Scholar have been explored.

Review: Based on etiology, there are six categories of epilepsy: Genetic, Structural, Metabolic, Immune, Infectious, and …