Ophthalmic Manifestations in Patients with Intracranial Tumours

Background: This study was aimed at determining the ophthalmic manifestations of patients presenting with brain tumours in a Nigerian tertiary hospital. Method: A retrospective crossectional review of patients with brain tumors in the Neurosurgical Unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from January 2003 to December 2007 was conducted. Data on biodata, source of referral, diagnosis, visual acuity at presentation and management were recorded and analyzed for simple frequency using the SPSS version 11. Visual acuity was classified using the WHO classification for presenting acuity in the better eye. Results: Out of a total of 94 patients, 88 with complete information were reviewed. There were 53 [60.2%] males and 35 [39.8%] females; the mean age was 36.2±20 years. Fourteen [15.9%] patients were referred by Ophthalmologists. Meningiomas(36.4%), craniopharyngioma(13.6%) and gliomas(9.1%) were the most common brain tumours encountered. Fifty nine(67.9%) had visual complains at presentation; poor vision (46.6%) and double vision (12.5%) were the most common ocular symptoms while opticatrophy was the commonest ocular sign (23.9%). 46 (52%) %) were blind while 14(16%) had visual impairment. Patients with visual impairment and blindness were more likely to have visual complains at presentation (88.3%) compared with 50% amongst patients with normal vision (P=0.003). Conclusion: Ophthalmic signs and symptoms form a major part of presentation in patients with intracranial tumours. Health education and complete ophthalmic evaluation is essential in patients with brain tumours

Seizure Variables and Cognitive Performance in Patients with Epilepsy

Background and Purpose Epilepsy is highly prevalent in developing African countries with significant morbidity; social stigmatization; poor quality of life and preventable mortality.There are scanty reports on the contributions of seizure variables like seizure types; frequency of seizures; duration of epilepsy; age at onset and anti-epileptic drugs to cognitive disturbances in Nigerian Africans. This study assessed the effects of seizure variables on the cognitive performances of patients with epilepsy. Methods The cognitive functions of 41 patients with epilepsy and 41 controls were assessed with a computer-assisted cognitive test battery; Iron Psychology (acronym - FePsy) using the simple and complex reaction time tasks for mental speed; recognition memory test (RMT) for memory and continuous performance test for attention. Results The cognitive performances of the patients using complex reaction time and the recognition memory tasks were worse than those of the controls (p0.05). The duration of treatment with anti-epileptic drugs negatively affected all cognitive domains assessed. The seizure frequency; duration of epilepsy and the use of phenytoin were associated with psychomotor retardation and impaired memory. Conclusions The seizure variables negatively affected cognitive performances of Nigerian patients with epilepsy. Cognitive assessment is recommended as part of regular evaluation of patients with epilepsy