Frequency of dementia in Parkinson's disease

To assess the frequency of dementia in Parkinson's disease. Study Design:Descriptive study Place and Duration:The study was performed inBolan Medical Complex Hospital, Quetta during Dec 2009 to Jun 2011 [One and half year]. Patients and Methods The purpose of this study was to assess the frequency of dementia in Parkinson's disease. The outdoor patients presented with features of Parkinson's disease were evaluated by using 'UKPDBB' [United Kingdom Parkinson Disease Brain Bank] diagnostic criteria,disease severity assessed by [Hoehn and Yahr scale] and later on they will be assessed for dementia by using 'Mini-Mental Examination'. The exclusion criteria were history of repeated stroke, encephalitis, drug induced Parkinson's disease, drug addiction and brain tumour. The data was collected on structured questionnaire. For descriptive purpose patients were divided into two groups, Parkinson disease [PD] and Parkinson disease with dementia [PDD]. The data was analyzed by SPSS version 17.0. The frequency distribution in number and percentage was calculated.ResultsiThere were 35 patients who presented with the clinical features of Parkinson disease. The features of dementia were found in 6 patients [17%], while 29 patients [83%] remained non-demented. Among demented patients 6 [100%] of Parkinson disease, there were five male [83.3%], while one patient [16.7%] was female.The entire demented patients had started symptoms after the 6th decade.. Regarding functional disability PD group had Hoehn and Yahr score of < 3, while PDD group had > 3. Positive primitive reflexes common in both groups 4 out of 6 in PDD group, while 15 out of 29 in PD group. Mild cognitive impairment was found in 4 [11.4%] patients, not fulfilling the criteria of dementia Dementia in PD was not quite high in our study. Most of the patients had cognitive impairment during their 6th or 7Jh decade of life

effectiveness of botulinum toxin in the management of benign essential blepharospasm and hemifacial spasm

To determine the effectiveness of Botulinum toxin in the treatment of Benign Essential Blepharospasm [BEB] and Hemifacial spasm [NFS] at a tertiary care hospital. Neurology Department, Bolan Medical Complex Hospital, Quetta. 30 months from 15 March 2010 to August 2012. Quasi experimental study. All patients referred to neurophysiology laboratory for Botox [BTX] injection were enrolled in the study after taking written consent. Botox injection 1.25 units was used for BEB and 3.0 units used for HFS given in the laboratory. Patients were observed for any immediate complications and then followed at two weeks for start of improvement and side effects and then at one, three and six months for duration of lasting improvement and any side effects. In this hospital based study we enrolled 30 patients with the diagnosis of BEB and HFS. The average age of the patients was 52.47 +/- 11.59. Out of 30 patients 57% were male and 43% were female with 1.3:1 male to female ratio. Blepharospasm was observed in 53.3% patients and hemifacial spasm was observed in 46.7% patients. In 50% of patients the onset of improvement was within 4-7 days. 93.4% of patients had improvement at the end of one month and 80% patients had improvement at 3 months follow up. Total duration of benefit lasted for up to 4-5 months in 46.6% of patients, 30% patients had benefit lasting for more than 5 months. 16.7% patients noticed benefit for up to 3 months and only 6.7% patients had benefit of only 2 months. Side effects such as Ptosis, diplopia, photophobia, redness of eyes, dry eyes and facial weakness occurred in 23% of patients in first week and up to one month while only 6.7% patients continued to have side effects at 3 months. This is the first study of its kind in our local population. This study concludes that the BTX is highly effective in the management of BEB and HFS and it is well tolerated