Neurology Commons^™

Improving Clinical Outcomes In A Neurocritical Intensive Care Unit Through Collaboration And Innovation., Shweta Varade Md, Keithan Sivakumar Md, Mba, Maureen T. Smith Msn, Rn, Cnrn, Adam Edwards Md, Preet Varade Md

Department of Medicine

No abstract provided.

Economic Impact Of Pharmacist Participiation In The Neurocritical Care Unit., Keithan Sivakumar Md, Shweta Varade Md, Jason Laskosky Pharmd, Bcps, Adam Edwards Md, Preet Varade Md

Department of Medicine

No abstract provided.

Mini-Craniotomy Under Local Anesthesia For Chronic Subdural Hematoma: An Effective Choice For Elderly Patients And For Patients In A Resource-Strained Environment, Shaikh Danish Mahmood, Muhammad Waqas, Mirza Zain Baig, Aneela Darbar

Medical College Documents

Background: Mini-craniotomy for chronic subdural hematoma (CSDH) is associated with lower rates of recurrence. However, the procedure is performed mostly with the patient under general anesthesia (GA) and therefore frequently requires an intensive care unit (ICU) facility, especially in the elderly population. Because of the unavailability of ICU beds, and to avoid GA, we started to perform this procedure with the patient under local anesthesia (LA).
Materials and methods: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan. The study duration was 1 year. We included patients aged …

Mighty Rapalink-1 Vanquishes Undruggable Mutant Mtor In Glioblastoma, Meena Jhanwar-Uniyal

NYMC Faculty Publications

No abstract provided.

Effects Of Random Oscillations On Balance Control In Healthy Young Adults, Jacob Van Dehy

Master's Theses (2009 -)

In human walking, balance control is managed through proactive changes in spatio-temporal parameters of stepping [1]. It has been suggested that continuous disruptions to healthy young adult balance cause greater changes to overall variability of these parameters than a shift in the mean stepping parameters [2]. This suggests that walking may be occurring in a more reactive manner, modulating to maintain balance without increasing the mean significantly. Work using continuous oscillations to treadmill walking suggest there is an interplay between the predictability of a signal used to disrupt subject balance and the degree to which compensation occurs [3]. To determine …

Acute Stroke Multimodal Imaging: Present And Potential Applications Toward Advancing Care., Ivan Matos Diaz, John W. Liang, L. Velickovic Ostojic, Aaron P. Tansy

Department of Neurology Faculty Papers

In the past few decades, the field of acute ischemic stroke (AIS) has experienced significant advances in clinical practice. A core driver of this success has been the utilization of acute stroke imaging with an increasing focus on advanced methods including multimodal imaging. Such imaging techniques not only provide a richer understanding of AIS in vivo, but also, in doing so, provide better informed clinical assessments in management and treatment toward achieving best outcomes. As a result, advanced stroke imaging methods are now a mainstay of routine AIS practice that reflect best practice delivery of care. Furthermore, these imaging methods …

Diffusion Tensor Imaging For Ruptured Cerebral Arteriovenous Malformation, Muhammad Waqas, Ayesha Siddiqui, Fatima Mubarak, Ather Enam

Section of Neurosurgery

Non-ruptured arteriovenous malformations (AVMs) rarely cause tract disruption. Few studies have described how ruptured AVMs influence white matter (WM) tract morphology. We reviewed consecutive AVM cases treated at a tertiary care hospital where diffusion tensor imaging (DTI) tractography was obtained preoperatively. DTI was performed using the Synaptive Plan (Synaptive Medical Inc., Toronto, Canada). Quality control was performed by clinical application specialist. Perinidal fractional anisotropy (FA) value of corticospinal tracts (CST) was obtained. A reference FA value was obtained from the corresponding area on the contralateral side. Images were evaluated by a consultant neuroradiologist. Radiological findings were correlated with clinical findings. …

Precursor Processes Of Human Self-Initiated Action, Nima Khalighinejad, Aaron Schurger, Andrea Desantis, Leor Zmigrod

Psychology Faculty Articles and Research

A gradual buildup of electrical potential over motor areas precedes self-initiated movements. Recently, such “readiness potentials” (RPs) were attributed to stochastic fluctuations in neural activity. We developed a new experimental paradigm that operationalized self-initiated actions as endogenous ‘skip’ responses while waiting for target stimuli in a perceptual decision task. We compared these to a block of trials where participants could not choose when to skip, but were instead instructed to skip. Frequency and timing of motor action were therefore balanced across blocks, so that conditions differed only in how the timing of skip decisions was generated. We reasoned that across-trial …

Concussion As A Multi-Scale Complex System: An Interdisciplinary Synthesis Of Current Knowledge, Erin S. Kenzie, Elle L. Parks, Erin D. Bigler, Miranda M. Lim, James C. Chesnutt, Wayne Wakeland

Complex Systems Faculty Publications and Presentations

Traumatic brain injury (TBI) has been called “the most complicated disease of the most complex organ of the body” and is an increasingly high-profile public health issue. Many patients report long-term impairments following even “mild” injuries, but reliable criteria for diagnosis and prognosis are lacking. Every clinical trial for TBI treatment to date has failed to demonstrate reliable and safe improvement in outcomes, and the existing body of literature is insufficient to support the creation of a new classification system. Concussion, or mild TBI, is a highly heterogeneous phenomenon, and numerous factors interact dynamically to influence an individual’s recovery trajectory. …

Sex Differences In Rt-Pa Utilization At Hospitals Treating Stroke: The National Inpatient Sample., Amelia K. Boehme, Brendan G. Carr, Scott Eric Kasner, Karen C Albright, Michael J. Kallan, Mitchell S V S.V. Elkind, Charles C. Branas, Michael T. Mullen

Department of Emergency Medicine Faculty Papers

BACKGROUND AND PURPOSE: Sex and race disparities in recombinant tissue plasminogen activator (rt-PA) use have been reported. We sought to explore sex and race differences in the utilization of rt-PA at primary stroke centers (PSCs) compared to non-PSCs across the US.

METHODS: Data from the National (Nationwide) Inpatient Sample (NIS) 2004-2010 was utilized to assess sex differences in treatment for ischemic stroke in PSCs compared to non-PSCs.

RESULTS: There were 304,152 hospitalizations with a primary diagnosis of ischemic stroke between 2004 and 2010 in the analysis: 75,160 (24.7%) patients were evaluated at a PSC. A little over half of the …

Effect Of Levodopa-Carbidopa Intestinal Gel On Non-Motor Symptoms In Patients With Advanced Parkinson's Disease, David G. Standaert, Ramon L. Rodriguez, John T. Slevin, Michael Lobatz, Susan Eaton, Krai Chatamra, Maurizio F. Facheris, Coleen Hall, Kavita Sail, Yash J. Jalundhwala, Janet Benesh

Neurology Faculty Publications

Background: Levodopa-carbidopa intestinal gel (LCIG; carbidopa-levodopa enteral suspension in the United States), delivered via percutaneous gastrojejunostomy (PEG-J) and titrated in the inpatient setting, is an established treatment option for advanced Parkinson's disease (PD) patients with motor fluctuations. However, long-term prospective data on the efficacy of LCIG on non-motor symptoms and the safety of outpatient titration are limited.

Methods: In this 60-week, open-label phase 3b study, LCIG titration was initiated in an outpatient setting following PEG-J placement in PD patients. The efficacy of LCIG on motor and non-motor symptoms, quality of life, and safety was assessed.

Results: Thirty-nine patients were enrolled …

Erenumab (Amg 334) In Episodic Migraine: Interim Analysis Of An Ongoing Open-Label Study., Messoud Ashina, David Dodick, Peter J. Goadsby, Uwe Reuter, Stephen Silberstein, Feng Zhang, Julia R. Gage, Sunfa Cheng, Daniel D. Mikol, Robert A. Lenz

Department of Neurology Faculty Papers

OBJECTIVE: To assess long-term safety and efficacy of anti-calcitonin gene-related peptide receptor erenumab in patients with episodic migraine (EM).

METHODS: Patients enrolled in a 12-week, double-blind, placebo-controlled clinical trial (NCT01952574) who continued in an open-label extension (OLE) study will receive erenumab 70 mg every 4 weeks for up to 5 years. This preplanned interim analysis, conducted after all participants had completed the 1-year open-label follow-up, evaluated changes in monthly migraine days (MMD), achievement of ≥50%, ≥75%, and 100% reductions, Headache Impact Test (HIT-6) score, Migraine-Specific Quality of Life (MSQ), Migraine Disability Assessment (MIDAS), and safety. Data reported as observed without …

Neurosyphilis Increases Human Immunodeficiency Virus (Hiv)-Associated Central Nervous System Inflammation But Does Not Explain Cognitive Impairment In Hiv-Infected Individuals With Syphilis., Emily L Ho, Clare L Maxwell, Shelia B Dunaway, Sharon K Sahi, Lauren C Tantalo, Sheila A Lukehart, Christina M Marra

Articles, Abstracts, and Reports

Background: Individuals infected with human immunodeficiency virus (HIV) who have previously had syphilis may have cognitive impairment. We tested the hypothesis that neurosyphilis causes cognitive impairment in HIV by amplifying HIV-related central nervous system (CNS) inflammation.

Methods: HIV-infected participants enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis underwent the mental alternation test (MAT), venipuncture, and lumbar puncture. CSF concentrations of chemokine (C-X-C motif) ligand 10 (CXCL10), chemokine (C-C motif) ligand 2 (CCL2), and neurofilament light (NFL) were determined by commercial assays. The proportion of peripheral blood mononuclear cells (PBMCs) and of CSF white blood cells (WBCs) that …

Accuracy Of Emergency Medical Services Dispatcher And Crew Diagnosis Of Stroke In Clinical Practice., Judy Jia, Roger Band, Michael E. Abboud, William Pajerowski, Michelle Guo, Guy David, C. Crawford Mechem, Steven R Messé, Brendan G. Carr, Michael T Mullen

Department of Emergency Medicine Faculty Papers

BACKGROUND: Accurate recognition of stroke symptoms by Emergency Medical Services (EMS) is necessary for timely care of acute stroke patients. We assessed the accuracy of stroke diagnosis by EMS in clinical practice in a major US city.

METHODS AND RESULTS: Philadelphia Fire Department data were merged with data from a single comprehensive stroke center to identify patients diagnosed with stroke or TIA from 9/2009 to 10/2012. Sensitivity and positive predictive value (PPV) were calculated. Multivariable logistic regression identified variables associated with correct EMS diagnosis. There were 709 total cases, with 400 having a discharge diagnosis of stroke or TIA. EMS …

Trkb-Enhancer Facilitates Functional Recovery After Traumatic Brain Injury, John Marshall, Joanna Szmydynger-Chodobska, Mengia S. Rioult-Pedotti, Kara Lau, Andrea T. Chin, Siva K. Reddy Kotla, Rakesh Tiwari, Keykavous Parang, Steven W. Threlkeld, Adam Chodobski

Pharmacy Faculty Articles and Research

Brain-derived neurotrophic factor (BDNF), a key player in regulating synaptic strength and learning, is dysregulated following traumatic brain injury (TBI), suggesting that stimulation of BDNF signaling pathways may facilitate functional recovery. This study investigates whether CN2097, a peptidomimetic ligand which targets the synaptic scaffold protein, postsynaptic density protein 95, to enhance downstream signaling of tropomyosin-related kinase B, a receptor for BDNF, can improve neurological function after TBI. Moderate to severe TBI elicits neuroinflammation and c-Jun-N-terminal kinase (JNK) activation, which is associated with memory deficits. Here we demonstrate that CN2097 significantly reduces the post-traumatic synthesis of proinflammatory mediators and inhibits the …

Self‑Resolving Prepontine Cyst, Muhammad Waqas, Inamullah Khan, Reehana Khawaja, Ayesha Quddusi, Ather Enam

Section of Neurosurgery

Background: Intracranial prepontine cysts are rare and include epidermoid cysts, arachnoid cysts, and neurenteric cysts. Symptomatic prepontine cysts may require surgical intervention. Reports of spontaneous resolution of cysts are rare.
Case description: We describe the case of a young gentleman who presented with headache and fever. Magnetic resonance imaging of the brain identified a prepontine lesion with features consistent with epidermoid cyst. During admission, the patient received symptomatic management in addition to empirical antibiotic therapy and dexamethasone. The patient improved symptomatically in the next 48 hours and was discharged. Follow-up imaging at 6 months and 1 year showed significant reduction …

Impacts Of Exercise On Functional Ability Of Recovering Gbs Patients: An Integrative Literature Review, Yasmin Sheriff

Grace Peterson Nursing Research Colloquium

This integrative literature review aimed to investigate the impacts exercise has on functional ability of GBS patients in recovery.

Application Of Rns In Refractory Epilepsy: Targeting Insula., Hai Chen, Patricia Dugan, Derek J Chong, Anli Liu, Werner Doyle, Daniel Friedman

Neurology Faculty Publications

Although responsive neurostimulation (RNS) is approved for treatment of resistant focal epilepsy in adults, little is known about response to treatment of specific cortical targets. We describe the experience of RNS targeting the insular lobe. We identified patients who had RNS implantation with at least one electrode within the insula between April 2014 and October 2015. We performed a retrospective review of preoperative clinical features, imaging, electrocardiogram (EEG), intraoperative electrocorticography (ECoG), and postoperative seizure outcome. Eight patients with at least 6 months of postimplant follow-up were identified. Ictal localization was inconclusive with MRI or scalp EEG findings. Intracranial EEG monitoring …

Do We Really Understand Spine Treatments And Science Around The World?, Karsten Wiechert, Jeffrey C Wang, Jens R Chapman

Articles, Abstracts, and Reports

No abstract provided.

Lack Of Sleep And Its Association With Academic Progress Of Undergraduate Students Of Foundation University Medical College, Islamabad, Pakistan, Omair Ali Khan, Mahnoor Khalid, Usman Ali, Abdur Rehman Butt, Mahnoor Zafar, Mahnoor Sherazi

Pakistan Journal of Neurological Sciences (PJNS)

The objective of the study,isto compare the relationship between lack of sleep and the academic performance of the undergraduate students of a medical college of Pakistan. METHODS AND MATERIALS: A cross-sectional study was conducted in a medical college of Pakistanin April 2016. Subjects were recruited by non-probability convenient sampling. A total of 140 subjectswereasked questions about sleep by a properly designed questionnaire from 2nd to 5th Year MBBS. Students having a prior diagnosis of sleep disorder were excluded from study.Data was analyzed using SPSS version 18. RESULTS: A total of 101 females and 39 males participated in the study. Duringnon-exam …

A Clinical Practice Guideline For The Management Of Patients With Acute Spinal Cord Injury: Recommendations On The Use Of Methylprednisolone Sodium Succinate, Michael G. Fehlings, Jefferson R. Wilson, Lindsay A. Tetreault, Bizhan Aarabi, Paul A. Anderson, Paul M. Arnold, Darrel S. Brodke, Anthony S. Burns, Kazuhiro Chiba, Joseph R. Dettori, Julio C. Furlan, Gregory W. Hawryluk, Langston T. Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark R. Kotter, Shekar N. Kurpad, Brian Kwon, Ralph J. Marino, Allan R. Martin, Eric M. Massicotte, Geno J. Merli, James W. Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Andrea C. Skelly, Anoushka Singh, Eve Tsai, Alexander R. Vaccaro, Albert Yee, James S. Harrop

Department of Rehabilitation Medicine Faculty Papers

Introduction: The objective of this guideline is to outline the appropriate use of methylprednisolone sodium succinate (MPSS) in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MPSS in acute SCI. A multidisciplinary Guideline Development Group used this information, in combination with their clinical expertise, to develop recommendations for the use of MPSS. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: The main conclusions …

A Clinical Practice Guideline For The Management Of Patients With Acute Spinal Cord Injury: Recommendations On The Role Of Baseline Magnetic Resonance Imaging In Clinical Decision Making And Outcome Prediction, Michael G. Fehlings, Allan R. Martin, Lindsay A. Tetreault, Bizhan Aarabi, Paul Anderson, Paul M. Arnold, Darrel Brodke, Anthony S. Burns, Kazuhiro Chiba, Joseph R. Dettori, Julio C. Furlan, Gregory Hawryluk, Langston T. Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Brian K. Kwon, Ralph J. Marino, Eric Massicotte, Geno J. Merli, James W. Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C. Skelly, Eve C. Tsai, Alexander R. Vaccaro, Jefferson R. Wilson, Albert Yee, James Harrop

Department of Rehabilitation Medicine Faculty Papers

Introduction: The objective of this guideline is to outline the role of magnetic resonance imaging (MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI. This review focused on longitudinal studies that controlled for baseline neurologic status. A multidisciplinary Guideline Development Group (GDG) used this information, their clinical expertise, and patient input to develop recommendations on the use of MRI for SCI patients. Based on GRADE (Grading of Recommendation, Assessment, …

A Clinical Practice Guideline For The Management Of Patients With Acute Spinal Cord Injury: Recommendations On The Type And Timing Of Anticoagulant Thromboprophylaxis, Michael G. Fehlings, Lindsay A. Tetreault, Bizhan Aarabi, Paul Anderson, Paul M. Arnold, Darrel S. Brodke, Anthony S. Burns, Kazuhiro Chiba, Joseph R. Dettori, Julio C. Furlan, Gregory Hawryluk, Langston T. Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Brian K. Kwon, Ralph J. Marino, Allan R. Martin, Eric Massicotte, Geno J. Merli, James W. Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C. Skelly, Eve C. Tsai, Alexander R. Vaccaro, Jefferson R. Wilson, Albert Yee, James Harrop

Department of Rehabilitation Medicine Faculty Papers

Introduction: The objective of this study is to develop evidence-based guidelines that recommend effective, safe and cost-effective thromboprophylaxis strategies in patients with spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions relating to thromboprophylaxis in SCI. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: Based on conclusions from the systematic review and expert panel opinion, the following recommendations were developed: (1) “We suggest that anticoagulant thromboprophylaxis be offered routinely to reduce the …

Spontaneous Disc Resolution: Illustrative Cases With Supportive Argument For A More Conservative Approach, Muhammad Waqas Shaiq, Muhammad Shahzad Shamim

Pakistan Journal of Neurological Sciences (PJNS)

The phenomenon of spontaneous disc resolution is well described in literature, yet it is underappreciated and often overlooked in the process of clinical decision making. We report three different cases and discuss how the phenomenon of spontaneous disc resolution can affect clinical decision-making.

Use Of Smokeless Tobacco Among Young Patients With Acute Ischemic Stroke, Saba Zaidi

Pakistan Journal of Neurological Sciences (PJNS)

This cross sectional study was conducted from April to September 2015at emergency department of Aga khan university.A total of 135 patients presented with signs and symptoms of acute ischemic stroke were included in this research. Participants were selected throughNon probability consecutive samplingtechnique. SPSS 20 was used for data analysis.A predesigned proforma was filled. It has three parts including SocioDemographics, Factors for stroke like hypertension, diabetes Mellitus, dyslipidemia, cigarrete smoking and History of smokeless tobacco use.Young stroke was defined as patients between 20-49 years of age having symptoms of acute ischemic stroke. Smokeless Tobacco users: An individual taking greater than and …

Factors Affecting Compliances With Physiotherapy Among Stroke Patients: Physiotherapist's Perspective: A Study From Peshawar Pakistan., Rabia Basri, Maryam Naseen, Aatika Naz

Pakistan Journal of Neurological Sciences (PJNS)

Non-compliances to physiotherapy are common. Outside the Western nations, little is known to the factors responsible for non-compliances with physiotherapy. This study aimed to evaluate the factors affecting non-compliances with physiotherapy among stroke patients, in Peshawar, Pakistan. METHOD: Seven in practice physiotherapists from Peshawar, Pakistan, were invited to focus group discussion to discuss their opinions about factors affecting stroke patient's non-compliances and the strategies to manage with these factors. The dialogues were transcribed and analyzed. Significant words and statements describing noncompliances were identified. The cluster of meanings developed and used to write a combined description presenting the real meaning of …

A Clinical Practice Guideline For The Management Of Patients With Acute Spinal Cord Injury And Central Cord Syndrome: Recommendations On The Timing (≤24 Hours Versus >24 Hours) Of Decompressive Surgery, Michael G. Fehlings, Lindsay A. Tetreault, Jefferson R. Wilson, Bizhan Aarabi, Paul Anderson, Paul M. Arnold, Darrel S. Brodke, Anthony S. Burns, Kazuhiro Chiba, Joseph R. Dettori, Julio C. Furlan, Gregory Hawryluk, Langston T. Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Ralph J. Marino, Allan R. Martin, Eric Massicotte, Geno J. Merli, James W. Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C. Skelly, Eve C. Tsai, Alexander R. Vaccaro, Albert Yee, James S. Harrop

Department of Rehabilitation Medicine Faculty Papers

Objective: To develop recommendations on the timing of surgical decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome. Methods: A systematic review of the literature was conducted to address key relevant questions. A multidisciplinary guideline development group used this information, along with their clinical expertise, to develop recommendations for the timing of surgical decompression in patients with SCI and central cord syndrome. Based on GRADE, a strong recommendation is worded as “we recommend,” whereas a weak recommendation is presented as “we suggest.” Results: Conclusions from the systematic review included (1) isolated studies reported statistically significant and …

The Rna-Binding Protein Hur Contributes To Neuroinflammation By Promoting C-C Chemokine Receptor 6 (Ccr6) Expression On Th17 Cells., Jing Chen, Jennifer L. Martindale, Carole Cramer, Myriam Gorospe, Ulus Atasoy, Paul D. Drew, Shiguang Yu

Department of Neurology Faculty Papers

In both multiple sclerosis and experimental autoimmune encephalomyelitis (EAE), the C-C chemokine receptor 6 (CCR6) is critical for pathogenic T helper 17 (Th17) cell migration to the central nervous system (CNS). Whereas many cytokines and their receptors are potently regulated via post-transcriptional mechanisms in response to various stimuli, how CCR6 expression is post-transcriptionally regulated in Th17 cells is unknown. Here, using RNA-binding protein HuR conditional knock-out (KO) and wild-type (WT) mice, we present evidence that HuR post-transcriptionally regulates CCR6 expression by binding to and stabilizing Ccr6 mRNA and by promoting CCR6 translation. We also found that HuR down-regulates several microRNA …

Neuroimmunology: An Expanding Frontier In 21st Century Neurology, Mohammad Saeed, Arsalan Ahmad

Pakistan Journal of Neurological Sciences (PJNS)

The recent discovery of functional lymphatic vessels lining the dural sinuses shattered the long held view of the absence of CNS lymphatic vas culature and provided solid neuroanatomical ground for Neuroimmunology1. Moreover, it has been shown that there is the presence of what is known as the inflammatory reflex.

Neurological Disorder Burden In Faisalabad, Punjab-Pakistan:Data From The Major Tertiary Carecenters Of The City, Ghulam Hussain, Asif Shahzad, Haseeb Anwar, Shahid Mahmood Baig, Asghar Shabbir, Jose-Luis Gonzalez De Aaguilar

Pakistan Journal of Neurological Sciences (PJNS)

The burden of neurological disorders (NDs) in developing countries is 4-5%, compared to 10-11% in developed countries. This burden is rising in developing countries due to prolonged life expectancy, improved health facilities, easy access to diagnostic facilities, and a trend in urbanization. There is inadequate data about the epidemiology of major NDs in Pakistan and most available information are hospital-based estimations or physicians’ collected data.