Neurology Commons^™

Stroke As A First Presentation Of Malignancy, Farheen Niazi, Puneet Kakar, Ratneshwari Jha, Reena Dhami, Farook Edoo

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is a frequent complication in patients with cancer occurring in nearly 15% of the cases. However cerebrovascular disease as the first presentation of malignancy has rarely been reported. We report two such cases who were admitted with acute stroke but were later on found to be having malignancy. Routine workup was unrewarding in both patients. Both patients developed pulmonary embolism as well during hospital stay suggesting hypercoagulable state as likely etiology. Reaching to the final diagnosis was an arduous journey but can help guide other clinicians facing similar cases. Non Hodgkins B cell lymphoma and Carcinoma Gall bladder were …

Quality Of Life After Stroke In Pakistan, Wardah Khalid, Shafquat Rozi, Tazeen S. Ali, Iqbal Azam Syed, Michael Mullen, Saleem Illyas, Qamarunnisa, Nabila Soomro, Ayeesha Kamran Kamal

Department of Medicine

Background: There is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden.

Methodology: We used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36. In addition; we assessed complications, psychosocial and functional disability of stroke survivors. Following this quantitative survey, …

Spectrum Of Acute Flaccid Paralysis In Children, Shaila Ali, M. Zia Ur Rehman, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Acute flaccid paralysis (AFP) is a clinical syndrome characterized by rapid onset of weakness in a child aged less than 15 years due to any cause when polio is suspected(1). Exact cause of AFP with its incidence is needed for proper management.

Brief Report On 16th International Neurology Update And Joint Phs, Pss & Mdsp Conference, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

Keeping up to date with new developments in medicine is a real challenge. But it's a challenge all neurologists must take if they are to do justice to their patients and aim for superior clinical expertise. Although neurology specialty is in growing stage & by the Grace of Almighty in last decade neurology bodies showed remarkable development to strengthen and continuing the training & development for the undergraduates, graduates & postgraduates in Pakistan. This year it was also unique precedence that in Karachi, national neurology body jointly organized four days conference with three sub-specialties national organizations.

Self-Reported Sleep Apnea And Dementia Risk: Findings From The Prevention Of Alzheimer's Disease With Vitamin E And Selenium Trial, Xiuhua Ding, Richard J. Kryscio, Joshua Turner, Gregory A. Jicha, Gregory E. Cooper, Allison M. Caban-Holt, Frederick A. Schmitt, Erin L. Abner

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVES: To investigate the association between baseline sleep apnea and risk of incident dementia in the Prevention of Alzheimer's Disease with Vitamin E and Selenium (PREADViSE) study and to explore whether the association depends on apolipoprotein E (APOE) ɛ4 allele status.

DESIGN: Secondary analysis based on data collected during PREADViSE.

SETTING: Participants were assessed at 128 local clinical study sites during the clinical trial phase and later were followed by telephone from a centralized location.

PARTICIPANTS: Men enrolled in PREADViSE (without dementia or other active neurological conditions that affect cognition such as major psychiatric disorders, including depression; N = …

Sleep Medicine: A Deserted Field In Pakistan, Bhojo A. Khealani

Pakistan Journal of Neurological Sciences (PJNS)

Sleep is an important and essential aspect of life and we spend about one third of our lives sleeping. Sleep disorders often manifest with insomnia and excessive daytime sleepiness. Large population based studies have shown that people who sleep longer and lesser have shorter life span1,2. Other symptoms of the slep disorders include snoring, abnormal motor behaviors etc.

Clinical Profiles, Management And Outcome Of Myasthenic Crisis In A Tertiary Care Center In Karachi, Pakistan, Sara , Khan, Dureshahwar Kanwar, Sadia Nishat

Pakistan Journal of Neurological Sciences (PJNS)

To determine the clinical profiles, management and outcome of myasthenic crisis (MC) in patients presenting to a tertiary care hospital in Karachi, Pakistan. This was a retrospective study of forty patients with Myasthenic crisis(MC) admitted at the Aga Khan University Hospital, Karachi between 1999 and 2014.Demographics, clinical presentation, hospital course, management and outcomes were reviewed. Ventilatory support for respiratory muscle or bulbar weakness was taken as crisis identification at arrival. Out of the total 40 patients with MC; generalized onset was seen in 28 (70%) and isolated bulbar symptoms in 12 (30%) patients. Fifteen patients (37.5%) had MC as a …

Epidemiology And Prevalence Of Deep Venous Thrombosis In Patients With Spinal Cord Injury, Aatik Arsh, Haider Darain, Syed Muhammad Ilyas

Pakistan Journal of Neurological Sciences (PJNS)

Pressure ulcers in patients with spinal cord injury (SCI) are associated with incredible financial cost and human sufferings. The aim of this retrospective study was to determine prevalence of pressure ulcers amongst patients with different levels of SCI.

Attitude And Perception Of Physical Therapists Towards Multidisciplinary Team Aproach In Stroke Rehabilitation, Muhammad Naveed Babur, Shiasta Habibullah, Anam Aftab

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is a long term disability in developing countries which is considered as major economic burden on part of Health care system. In developing countries multidisciplinary team approach for stroke rehabilitation is emerging in tertiary care hospitals and has considerably increased the chance of early independence, fast recovery and maximum outcome in daily activities of life. Objective: Objective of the study was to evaluate the attitude and perception of physical therapists towards multidisciplinary team approach working in stroke rehabilitation.

Concurrent Intracranial Chloromas And Leukemia Cutis In Chronic Myeloid Leukemia, Ateeque Ahmed Khan, Mahnoor Hafeez

Pakistan Journal of Neurological Sciences (PJNS)

Granulocytic sarcoma (chloroma) is an extramedullary solid tumor composed of immature white blood cells. Most common involvement sites are bone, periostium, soft tissue, lymph nodes and skin. Intracranial granulocytic sarcoma rarely occurs in meningeal or parenchymal form1. We report the of concurrent occurrence of intracranial chloromas and leukemia cutis in 26 years old male patient, known case of Chronic Myeloid Leukemia for 3 years [+ve Philadelphia (Ph) chromosome in bone marrow cells] who now presented to the Civil Hospital Karachi with continuous headache and multiple cutaneous nodules all over the body for last 2 months. The CT exam of the …

Nmda Encephalitis In An Elderly With Poor Prognosis, Farheen Niazi, Abdul Hameed, Tariq Hussain, Sarah Faiz, Hassan Atique

Pakistan Journal of Neurological Sciences (PJNS)

We present a case of a 65 years old man from Islamabad who presented with six months history of psychiatric and behavioural symptoms, significant weight loss. Later on he developed difficulty swallowing and altered sensorium. This was followed by an episode of shortness of breath leading to respiratory arrest, followed by ICU stay on ventilator support, then developed focal deficit in form of left sided weakness, dysautonomia, bradycardia leading to cardiac arrest and another cardiopulmonary resuscitation, myoclonic jerks, orofacial dyskinesias, status epilepticus, coma ultimately resulting in death of the patient. Patient was found to be NMDA receptor antibody positive. CT …

Rescue-Icp Trial, Muhammad Waqas, Muhammad Shahzad Shamim

Pakistan Journal of Neurological Sciences (PJNS)

Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension Peter J. Hutchinson, Angelos G. Kolias, Ivan S. Timofeev, Elizabeth A. Corteen, Marek Czosnyka, and other RESCUEicp Trial Collaborators N Engl J Med 2016; 375:1119-1130September 22, 2016DOI: 10.1056/NEJMoa1605215

Neurological Health Profile In Pakistan – A Health Systems Based Needs Assessment, Tauhid Awan, Arsalan Ahmad, Ather Javed, Mohammad Wasay, Muhammad Babar Khan, Haroon Awan

Pakistan Journal of Neurological Sciences (PJNS)

The aims of our study were to develop a neurological health profile in Pakistan from a health systems perspective, ascertain the readiness of neurology with regards to Sustainable Development Goals, and proffer recommendations for policy advocacy and planning in neurology.

Zika Virus-Associated Seizures, Ali Akbar Asadi-Pooya

Department of Neurology Faculty Papers

No abstract provided.

Blood-Brain Barrier Transport Machineries And Targeted Therapy Of Brain Diseases, Jaleh Barar, Mohammad Rafi, Mohamad Mostafa Pourseif, Yadollah Omidi

Department of Neurology Faculty Papers

Introduction: Desired clinical outcome of pharmacotherapy of brain diseases largely depends upon the safe drug delivery into the brain parenchyma. However, due to the robust blockade function of the blood-brain barrier (BBB), drug transport into the brain is selectively controlled by the BBB formed by brain capillary endothelial cells and supported by astrocytes and pericytes. Methods: In the current study, we have reviewed the most recent literature on the subject to provide an insight upon the role and impacts of BBB on brain drug delivery and targeting. Results: All drugs, either small molecules or macromolecules, designated to treat brain diseases …

Intravenous Ketamine For Subacute Treatment Of Refractory Chronic Migraine: A Case Series., Clinton Lauritsen, Santiago Mazuera, Richard B. Lipton, Sait Ashina

Department of Neurology Faculty Papers

BACKGROUND: Refractory migraine is a challenging condition with great impact on health related quality of life. Intravenous (IV) ketamine has been previously used to treat various refractory pain conditions. We present a series of patients with refractory migraine treated with intravenous ketamine in the hospital setting.

METHODS: Based on retrospective chart review, we identified six patients with refractory migraine admitted from 2010 through 2014 for treatment with intravenous ketamine. Ketamine was administered using a standard protocol starting with a dose of 0.1 mg/kg/hr and increased by 0.1 mg/kg/hr every 3 to 4 h as tolerated until the target pain score …

Empowering Nurses Through Evidence-Based Practice (Ebp), Quality Improvement (Qi), And Research, Eve Butler, Andrea Prentiss

All Publications

No abstract provided.

Return To Play After Cervical Spine Injuries: A Consensus Of Opinion., John C. France, Michael Karsy, James S. Harrop, Andrew T. Dailey

Department of Neurosurgery Faculty Papers

Study Design Survey. Objective Sports-related spinal cord injury (SCI) represents a growing proportion of total SCIs but lacks evidence or guidelines to guide clinical decision-making on return to play (RTP). Our objective is to offer the treating physician a consensus analysis of expert opinion regarding RTP that can be incorporated with the unique factors of a case for clinical decision-making. Methods Ten common clinical scenarios involving neurapraxia and stenosis, atlantoaxial injury, subaxial injury, and general cervical spine injury were presented to 25 spine surgeons from level 1 trauma centers for whom spine trauma is a significant component of their practice. …

Temporary Nerve Block At Selected Digits Revealed Hand Motor Deficits In Grasping Tasks, Aude Cateron, Kerry Mcpartlan, Christina Gioeli, Emily Reid, Matt Turturro, Barry Hahn, Cynthia Benson, Wei Zhang

Publications and Research

Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of …

Development, Validation And Application Of A New Fornix Template For Studies Of Aging And Preclinical Alzheimer's Disease, Christopher A. Brown, Nathan F. Johnson, Amelia J. Anderson-Mooney, Gregory A. Jicha, Leslie M. Shaw, John Q. Trojanowski, Linda J. Van Eldik, Frederick A. Schmitt, Charles D. Smith, Brian T. Gold

Physical Therapy Faculty Publications

We developed a merged younger-older adult template of the fornix and demonstrated its utility for studies of aging and preclinical Alzheimer's disease (AD). In Experiment 1, probabilistic tractography was used to reconstruct the fornix in younger and older adults and successful streamlines were then averaged to create a merged template in standard space. The new template includes the majority of the fornix from the hippocampal formation to the subcallosal region and the thalamus/hypothalamus. In Experiment 2, the merged template was validated as an appropriate measure for studies of aging, with comparisons against manual tracing measures indicating identical spatial coverage in …