ABSTRACT
Background: Many people come to memory clinic for memory problems, most of them for the fear of developing dementia. Majority of such subjects are normal however a sizable number show cognitive decline on Neuro-psychological tests. Aim and objectives: The aim of this study was to find out the incidence of normal cognition, mild cognitive impairment and dementia in patients attending Memory Clinic of Gandhi Hospital with forgetfulness. Santhoshi Kumari CH, Kamera S, Narisetty V, Jala S, Pokalkar D. Cognitive functioning in patients presenting with memory problems: A study from Gandhi Hospital – A Tertiary Care Teaching Government Hospital of Hyderabad. IAIM, 2016; 3(10): 42-47. Page 43 Materials and methods: Patients attending Neurology OPD with memory complaints were initially screened for any neurological deficit by a neurologist. Then a Psychologist assessed cognition with Neuro-psychological tests. A total of 1894 patients attending the memory clinic from January 2007 to June 2015 were included in the study. Results: Normal cognition was seen in 62% (n=1,166) and were labeled as Worried Well. Another 17% (n=328) were with borderline problems in cognition and were categorized as Mild Cognitive Impairment and the remaining 21% (n=400) were diagnosed with abnormal cognition and diagnosed as dementia. Atherosclerotic risk factors such as hypertension, diabetes, coronary artery disease, smoking and alcoholism were higher in the subjects who had abnormal results on neurocognitive tests. Conclusion: Many patients seek medical help for forgetfulness and fear of developing dementia. Majority of them have normal cognition on neuropsychological tests. Patients having abnormality on cognitive evaluation also have atherosclerotic risk factors. Dementia was detected in 23% of patients attending Memory Clinic.
ABSTRACT
Background: Cases of quadriplegia, oculobulbar palsy and fasciculations are reported to two tertiary teaching hospitals of Hyderabad during monsoon season. Objective: To describe the clinical and electrophysiological features of cases of acute quadriplegia with oculobulbar palsy, fasciculations and myokymia reported during monsoon season. Materials and methods: All the patients with presentation of overnight onset rapidly progressive quadriplegia admitted in both teaching hospitals of Hyderabad, over the period of 11 years. All patients were subjected to routine biochemical tests and Electrodiagnostic tests. Patients were treated symptomatically along with invasive ventilator support when required. Results: A total of 97 such patients were identified. The clinical features observed were bilateral ptosis, external ophthalmoplegia, bulbar, facial, masticatory, axial and proximal muscle weakness. There were extensive fasciculations and myokymia. Respiratory insufficiency occurred at nadir of weakness. The electrodiagnostic tests showed normal motor, sensory conduction studies without any decrement on repetitive nerve stimulation tests. Concentric needle EMG showed fasciculation, fibrillation potentials and repetitive discharges with normal interference pattern. All patients made total functional recovery in a week time. Mortality was due to respiratory paralysis and its related complications. Conclusion: These unusual cases with typical clinical and electrophysiological features are not reported in the literature and might constitute “Monsoon Fasciculation - Paralysis Syndrome” possibly a new myasthenic syndrome of unknown etiology