ABSTRACT
Objective: Acute transverse myelitis [ATM] is an acute disease affecting a focal area of the spinal cord. Our study was done to study the out-come in our patients and study the possible prognostic factors which affect the outcome
Subjects and Methods: 25 patients included in ourstudy, 10 males and 15 females, with clinically proved transverse myeli-tis from Neurology Department, Benha University Hospital. Their meanage was 38+2.1 years. They were examined clinically and M.R.I. was done. Follow up of all patients was done to assess the outcome after two months
Results: We analysed the clinical findings and MR imaging of the patients including the age, onset, severity of neurological deficit which assessed by Barthel score, bladder dysfunction and the type of treatment. We compare these results with the outcome after two months. 32% of patients had cervical sensory level, 40% had upper dorsal and 28% had lower dorsal. The site of lesion was not related to the outcome. The over-all outcome of our patients was 60% had a good outcome with ability to walk without help or with only one aid Barthel >60. 40% had poor out-come [inability to walk or walking with two aids, Barthel <60]. The out-come was not associated with the age, sex of the patients, the site or the extent of the lesions. The patients with good outcome in comparison with bad outcome group had more acute onset [P <0.05], less likely to had severe neurological deficit at the onset [P < 0.001], also less likely to had bladder dysfunction [P < 0.05] and lastly are more likely take prednisol one pulse therapy in comparison with patients with poor out-come [P < 0.05]
Conclusion : Our study showed that 60% of ATM patients had goodoutcome, and the outcome depend mainly on the onset, severity of initialneurological deficit, bladder dysfunction and prednisolone pulse therapyand the most predictor factor was the severity of initial neurological defi-cit, although a few patients with a severe impairment at the onset mayhave a good outcome
ABSTRACT
This study was designed to compare the frequency of neurological soft signs [NSS] in patients with obsessive-compulsive disorder [OCD] and healthy volunteers and to evaluate the applicability of these signs as a rest to identify patients with OCD among mixed population. The study comprised 20 patients with OCD diagnosed with the use of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fourth edition [DSM-IV] and 20 healthy volunteers of crossmatched age and sex as a control group. All study participants underwent a physical and neurological examination for soft signs [PANESS] by the neurologist who was blinded about the group enrollment. The frequency of occurrence of disturbances in these 7 main items was evaluated and the obtained results were redistributed according to group of study: Patients and controls. Only 8 patients [40%] were free of NSS: the other 12 patients [60%] showed varied NSS. On contrary, only 2 controls [10%] had NSS while the remaining 18 [90%] showed no NSS with a significantly increased [X[2]=5.8, p<0.01]frequency of NSS inpatients. Both patients and controls did not show NSS on examination of both motor movements and stereogonosis and no body had nystagmus. Three patients had apraxia and 3 had abnormal two-point discrimination: the other 6 patients had various combinations of abnormal results. There was a negative non-significant correlation between mean NSS scores and patients' age, sex and duration of symptoms. Using the receiver operating characteristic [ROC] curve analysis judged by the area under the curve [AUC] revealed that the presence of NSS could define patients with OCD out of a mixed population with high sensitivity but could not be considered specific for OCD as the AUC was 0.236. It could be concluded that the frequency of neurological soft signs is significantly higher in OCD patients and could identify them among a mixed population with high sensitivity but they are not specific to OCD