Neurology Commons^™

Presurgical Thalamic "Hubness" Predicts Surgical Outcome In Temporal Lobe Epilepsy., Xiaosong He, Gaelle E. Doucet, Dorian Pustina, Michael R. Sperling, Ashwini D. Sharan, Joseph I. Tracy

Department of Neurology Faculty Papers

OBJECTIVE: To characterize the presurgical brain functional architecture presented in patients with temporal lobe epilepsy (TLE) using graph theoretical measures of resting-state fMRI data and to test its association with surgical outcome.

METHODS: Fifty-six unilateral patients with TLE, who subsequently underwent anterior temporal lobectomy and were classified as obtaining a seizure-free (Engel class I, n = 35) vs not seizure-free (Engel classes II-IV, n = 21) outcome at 1 year after surgery, and 28 matched healthy controls were enrolled. On the basis of their presurgical resting-state functional connectivity, network properties, including nodal hubness (importance of a node to the network; …

Hiding Within The Cracks: Case Report Of Rare Sutural Bone Found At The Nasion., Bryan Edwards, Joy Mh Wang, Joe Iwanaga, Jennifer Luviano, Marios Loukas, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Pathology such as skull fractures can be misdiagnosed in the presence of anatomical variations. One variant that has had little description in the literature are the sutural bones associated with the nasal bones. Herein, we describe a case of a rare sutural bone at the nasion, between the bones of the right nasal, frontal, and maxillary frontal process. To our knowledge, this is the first report of such a variant bone in this location, and such it should be considered by clinicians when evaluating patients for pathology in this region.

Single-Fiber Electromyography In The Orbicularis Oculi Muscle In Patients With Ocular Myasthenia Gravis Symptoms: Does Abnormal Jitter Predict Response To Treatment?, Goran Rakocevic, Mark Moster, Mary Kay Floeter

Department of Neurology Faculty Papers

BACKGROUND: Seronegative ocular myasthenia gravis (OMG) is diagnosed by ocular symptoms with supporting SFEMG, typically of frontalis or extensor digitorum muscles. We aimed to determine the sensitivity and specificity of orbicularis oculi SFEMG to diagnose and exclude myasthenia gravis and predict response to therapy.

METHODS: Orbicularis oculi SFEMG studies were conducted in 142 consecutive patients with symptoms and/or findings of OMG and negative AChR antibody during the period of 5 years. Retrospective chart review was conducted 2 years after the SFEMG to determine whether treatments were given and responses to treatment.

RESULTS: Orbicularis oculi SFEMG was abnormal in 31 patients …

Extent Of Resection And Timing Of Surgery In Adult Low Grade Glioma, Farhan A. Mirza, Muhammad Shahzad Shamim

Section of Neurosurgery

Low grade glioma is a group of WHO grade II tumours including diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. Strong evidence exists in literature now to support early surgery and higher extent of safe resection in improving outcomes. In this review, we are highlighting some of the important studies done in the last few years specifically addressing timing of surgery and extent of resection.

Neurology Training In Pakistan: Perspectives From Physicians In A Neurology Unit Working At Different Levels, Ali Zohair Nomani, Haris Majid Rajput, Misbah Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Pakistan is a developing country of South East Asia. It stands amongst the highest in the list of high disease burden countries including that for neurological diseases. The current number of trained neurologists in the country is extremely low and the facilities not too frequently available.

A Whole Lot Of Shakin' Going On: Movement Disorders Caused By Brain Trauma, Jack E. Hubbard, Samuel D. Hodge, Jr.

Cleveland State Law Review

There has been a lot of publicity directed to the consequence of brain trauma, such as headaches forgetfulness, irritability, and depression. That is only part of the sequelae. A little-known but challenging result of brain trauma is the development of or aggravation of a movement disorder such as a tremor, dystonia, a tic, or Parkinson’s Disease.

A movement disorder is an all-encompassing term that refers to a constellation of neurological issues that cause involuntary or voluntary movements or abnormal positioning of a body part. Various regions of the brain interact with each other to control movements of the body. If …

Knowledge And Trends Of Caffeine Consumption Among Medical And Non Medical Students Of Lahore Pakistan, Mubashir Ahmad, Rashk E Hinna, Ahmad Tayyab

Pakistan Journal of Neurological Sciences (PJNS)

To determine the rate of the caffeine consumption among students and to assess side effects and benefits of the caffeine among medical and non-medical students. METHODOLOGY: This cross-sectional study was included medical and non-medical students of various institutes of Lahore. The study duration was three months from May 2014 to July 2014. A predesigned structured questionnaire was used to collect data from the students, Consent was obtained on the form beforehand. RESULTS: Astonishingly 98.6%(74) of medical and 97.4%(73) of the Non-Medical students said that they consume caffeine in one form or another, the most popular caffeinated product turned out to …

Risk Of Incident Clinical Diagnosis Of Alzheimer's Disease-Type Dementia Attributable To Pathology-Confirmed Vascular Disease, Hiroko H. Dodge, Jian Zhu, Randy Woltjer, Peter T. Nelson, David A. Bennett, Nigel J. Cairns, David W. Fardo, Jeffrey A. Kaye, Deniz-Erten Lyons, Nora Mattek, Julie A. Schneider, Lisa C. Silbert, Chengjie Xiong, Lei Yu, Frederick A. Schmitt, Richard J. Kryscio, Erin L. Abner, Smart Data Consortium

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: The presence of cerebrovascular pathology may increase the risk of clinical diagnosis of Alzheimer's disease (AD).

METHODS: We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modeling of Aging and Risk of Transition study, a consortium of longitudinal cohort studies with more than 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate, or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with …

Hypertensive Supratentorial Intracerebral Hemorrhage: Early Surgery And Functional Outcome; A Tertiary Care Hospital Experience From Karachi, Pakistan., Muhammad Imran, Atiq Ahmed Khan, Syed Ijlal Ahmed, Shiraz Ahmed Ghouri, Muhammad Osama Farooqi, Alizay Rashid Khan, Majid Chandio

Pakistan Journal of Neurological Sciences (PJNS)

BACKGROUND: Spontaneous supratentorialintracerebral hemorrhage (ICH) has a high morbidity and mortality and places a significant burden on health and social services.The role and timing of operative neurosurgical intervention remain controversial and the practice and timing of surgery continue to be haphazard. METHODOLOGY: Our study was a descriptive study conducted at Civil hospital Karachi, Pakistan. Sample size was calculated. The sampling technique of our study was non probability. The data was collected and analyzed using spssvs 17. Data was observed for any descriptive and inferential statistics. RESULTS: There were 38 males (63.3%) and 22 females (36.7%). The mean age of patients …

Role Of Manual Activities Among Cerebral Palsy Children, Iqra Khan, Samreen Sadiq

Pakistan Journal of Neurological Sciences (PJNS)

Objective: Determine the role of manual activities in children presenting with spastic type of Cerebral Palsy. Methods: AQuasi experimental study was conducted in Children Hospital and Compass. A sample of 30 children with cerebral palsy aged between 6 to 12 years was studied and assessment was made before and after the implementation of treatment through ABILHAND kids Questionnaire. The duration of this study was 6 months from December 2014 to May 2015. The recruiting strategy used was convenience sampling. Intervention was given for a period of 90 hours for 9 weeks. Qualitative variables were expressed as proportions (percentages). Before and …

Histiocyt Ic Sarcoma Of The Flax Cerebri With Distant Metastasis, Ateeque Ahmed Khan, Mahnoor Hafeez

Pakistan Journal of Neurological Sciences (PJNS)

Histiocytic Sarcoma is an extremely rare CNS tumor and to the best of authors' knowledge, the extra-axial CNS histiocytic Sarcoma involving FalxCerebriin the humans has not been described earlier in the literature.We report an unusual case of22 year old male who presented to the Civil Hospital with symptoms of chronic headache and bilateral lower limb weakness. His MRI Brain showed an aggressive heterogeneously enhancing extraaxialfalxtumor with trans-calvarial invasion seen on interim CT scan and demonstration of distant metastases after resection and craniectomy. The immune-histochemical analysis was strongly positive CD68 and S-100 signifying Histiocytic Sarcoma.

Fat Embolism Syndrome, In A Patient With Bilateral Total Knee Replacement, Syeda Saba Zaidi, Noman Ishaque

Pakistan Journal of Neurological Sciences (PJNS)

Fat embolism syndrome is caused by the release of fat globules into the systemic circulation. The presentation varies from mild respiratory distress to a devastating clinical scenario that includes hypoxemia, petechial hemorrhages of the skin, and confusion that may lead to coma or death.It is prevalent in 1-5% of patients after trauma to the pelvis, long bones and rarely described in elective total knee replacement.

Respiratory Distress In Patients Of Guillain-Barre Syndrome With Sensory Manifestations, Maher Bano Malik, Haris Majid Rajput, Jahangir Shoro

Pakistan Journal of Neurological Sciences (PJNS)

Guillain-Barré syndrome (GBS) is one of the most frequent disorder of peripheral nervous system associated with respiratory distress. One clinical parameter that was found significant in heralding the onset of respiratory failure in GBS weresensory manifestations. The aim of the study was to determine the frequency of respiratory distress in patients of GuillainBarresyndrome with or without sensory manifestations in the disease. MATERIALS AND METHODS: This was a descriptive case seriesthat was conducted from January 19, 2013 to July 18, 2013 in Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad. All patients who met the inclusion criteria were selected for …

Advancing Gaming Technology In Neurological Rehabilitation, Samreen Sadiq, Iqra Khan

Pakistan Journal of Neurological Sciences (PJNS)

The consumption of gaming technology has recently gain unexpected significance in medical health care for neurological rehabilitation. With increasing interest in exergames study, numerous definitions and terminology have been introduced to describe this term. Researchers from health-related background acknowledged the fact that engaging in video gaming was not always sedentary and might act as a means to ensure more physical work. Simplifying the terminology exergames are those types of gaming technology or multimedia communications that necessitate the player to perform physical activity during play.

Infections In Post Stroke Setting: A Study From The Neurology Section Of Aga Khan University Hospital, Karachi, Rizwana Shahid, Azra Zafar, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is one of the commonest neurological disorders, contributing to the major burden of inpatient and outpatient neurology services. Infections after the stroke are the major factor, contributingto prolonged hospital stay and poor outcome in term of increasing morbidity and mortality. The aim of this study is to define the different types of infections in post stroke patients and their impact on the outcome of patients with stroke. METHOD: This is a descriptive, cross sectional study, that was carried out in the section of Neurology, Department of Medicine at Aga Khan University Hospital, Karachi over the span of one year. …

Discover The Ibn-E-Sina Within You' Annual Neurology Research Day, May 2017 Shifa International Hospital, Islamabad, Faaraea Haroon

Pakistan Journal of Neurological Sciences (PJNS)

Headaches are the most prevalent neurological disorders and the most frequent symptom seen in general practice. The need to know further of such disorders in medical students is essential to ensure a healthier studying environment, which will ultimately yield better, more capable, health care professionals.

Case Of A Young Girl With Hemichorea Induced By Oral Contraceptive Pills, Syeda Saba Zaidi

Pakistan Journal of Neurological Sciences (PJNS)

Chorea is an involuntary movement disorder characterized by brief, abrupt, non-repetitive, non-rhythmic movements with dance-like appearance, moving from one body part to another. When chorea involves half of the body then the term hemi-chorea is used, which usually signify structural pathology in the contralateral Basal ganglia. Use of Oral contraceptive pills, is a well-established but a rare cause of hemi-chorea. Mechanism includes either re-activation of Sydenham's chorea or drug induced lupus erythematosus. Although our case does not have any systemic manifestation of lupus but ANA positivity likely favors later mechanism. We described a case of a young girl who developed …

Neurosarcoidosis Presenting As Psychiatric Symptoms: A Diagnostic Challenge, Farheen Niazi, Tariq Hussain

Pakistan Journal of Neurological Sciences (PJNS)

Among patients having neurosarcoidosis, psychiatric manifestations can be seen in 20% of the patients.Sarcoidosis is extremely rare in Asia, being almost unknown in some countries like China and Southeast Asia.Neurosarcoidosis occurs in approximately 5% of patients with sarcoidosis. Neurosarcoidosis presenting as psychiatric manifestations has rarely been reported. We report a case of a young male who presented with psychiatric symptoms,was diagnosed with neurosarcoidosisand responded well to oral steroids.His symptoms were diffuseheadaches, and feelings of movement of fluid on top of headand certain other vague somatic complaints like body aches, vertigo etc. Such patients are difficult to diagnose as sarcoidosis is …

The First Histological Analysis Of The Tissues Lining The Fossa Navicularis: Insights To Its Etiology., Sarvenaz Sheikh, Joe Iwanaga, Steven Rostad, Tarush Rustagi, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The fossa navicularis (FN) is an anatomical variant on the ventral surface of the basilar part of the occipital bone that, to date, has only been investigated in bone specimens. We aim to clarify the structure of the fossa navicularis by gross anatomical, radiological, and histological methods. The FN was found in the occipital bone of the Caucasian male cadaver. There was no bony or histological continuity between the FN and posterior cranial fossa. The histological analysis found that the overlying tissue was composed of loose connective tissue with a mixture of collagen and elastic fibers and a vascular matrix …

Internal Hernia Of The Greater Omentum: Cadaveric Findings Of A Previously Unreported Variant., Andrea Andrea, Vy Tran, Cameron K Schmidt, Christian Fisahn, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Transomental hernias (TOHs) are a rare finding, constituting a fraction of all intestinal hernias. Here, we report the cadaveric discovery of a spontaneous TOH involving the sigmoid colon in an 82-year-old female and discuss the relevant literature. To our knowledge, a TOH involving the sigmoid colon has not been previously reported.