Clinical pattern of partial epilepsy in Sudanese patients

To study the pattern of clinical presentation of partial epilepsy among Sudanese epileptic patients attending Elshaab Teaching Hospital from May 2005 to March 2006. Seizures are categorized as partial [with the initial activation of a limited number of neurons in a part of one hemisphere] or generalized [with the initial activation of neurons throughout both hemispheres]. The study was conducted at Elshaab Teaching Hospital May 2005- March 2006. Fifty patients with partial were included in a prospective cross- sectional hospital-based-study. The mean age is 35.96 years. Male to female ratio was 1.4:1. Abdominal aura predominates in 12%, followed by autonomic symptoms in 8%, fear in 6%, anxiety and visual hallucination in 4%, olfactory hallucination, auditory hallucination and automatism in 2%. Postictal confusion was found in 16% followed by post ictal sleep and Todd's paralysis in 8%, headache in 6% and amnesia in 4%. Abnormal neurological signs found in 30%. Space occupying lesions in 22% and cerebrovascular accident in 20% are the commonest causes for partial epilepsy, followed by brain atrophy in 6%, and arterioveneous malformation in 2% as detected by MRI. EEG was found abnormal in 56% i.e. 42% focal discharge, 10% focal discharge with secondary generalization and 4% generalized discharge. Prodromal symptoms like abdominal pain nausea and vomiting were the commonest symptoms in partial epilepsy. Confusion, sleep, Todd's paralysis, headache and amnesia were the commonest post ictal symptoms. Brain MRI detected space-occupying lesions in most of the patients. Interictal epileptic focal discharges [IEDs] were detected in more than half of the studied population

Cervical cord compression secondary to mycetoma infection

Mycetoma is a chronic granulomatous subcutaneous infection caused by actinomycetes [actinomycetoma] or by true fungi [eumycetoma]. Clinically the disease is characterized by swelling, and sinuses in the affected part. Another characteristic feature of mycetoma is the formation of aggregates of the organism [grains] in the tissues, which are visible to the naked eye and are discharged through sinuses in the skin. The grains vary in colour, size and consistency depending on the causative agent [1, 2]. These features are helpful in making a tentative diagnosis of the causative organism. We report a 75 year's Sudanese female with spastic paraplegia of gradual onset, she has discharging sinuses in her neck. Cervical X-RAY and cervical MRI showed destruction of cervical vertebrae. Identification of the agent was established by the histological examination of the grains, by culture and serologic techniques. Mycetoma is a local chronic and progressive infection of the skin, subcutaneous tissues and bone. It is characterized by swelling that is often grotesque and disfiguring and by multiple sinus tracts that drain granule-containing pus [3]