Tremors; myths and misconceptions; a 7-year clinical survey 2002-2009

To determine the myths and misconceptions about [Tremors] among those who developed this disorder and their health seeking behavior, and also among those who never had tremors, at the psycho-neurology and medical OPD of Sindh Govt. Hospital, Liaqatabad no. 10, Karachi. A single centre based cross-sectional survey, conducted from year 2002 to 2009 at Sindh Govt. Hospital [SGH] Liaqatabad no.10, Karachi. 403 adult patients of either sex with tremors were selected from medical and psycho-neurology OPD's. For comparison 100 healthy individuals from general population, who never had tremors, of the same area were also included. Questionnaires regarding different myths and misconceptions about tremors were filled by the patients/normal healthy people after obtaining the consent. Out of 403 selected patients [61.53% males and 38.47% females] majority belonged to the urban areas. Out of hundred normal healthy people 73 [73%] were males and 27 [27%] were females. Only 8% of the patients considered tremor was a neurological illness, while 33% of the patients and 41% of the general population related it to magic or witchcraft. Overall, females were more inclined to choose alternative medicine and spiritual therapy than males. Myths and Misconceptions about tremors are present in our society because of strong belief and observations. Provision of primary education, health education and using electronic media can play a key role in abolishing these misconceptions

Unusual causes of cerebral venous thrombosis

Cerebral venous thrombosis is a relatively uncommon condition afflicting mostly young adults. Thrombosis of cerebral veins or sinuses results in variable and nonspecific clinical features, including headache, lethargy, motor or sensory deficits, seizures, neck stiffness and sometimes fever. A multitude of conditions have been attributed as risk factors for CVT. The more common conditions include hereditary thrombophilia, pregnancy and purperium, postoperative state, intracranial and local infections and the use of oral contraceptives. Frequently, the cause of CVT is multifactorial, and in less than twenty percent of cases no clear risk factor is identified. In this review, we have focused on relatively rare and unusual causes of cerebral venous thrombosis. Many of the conditions described have very few reported cases and the causal relationship is not well established

Clinical spectrum of spinal muscular atrophy

To evaluate the clinical pattern, frequency of occurrence and diagnostic approach to spinal muscular atrophy [SMA]. It was a descriptive study comprising 30 patients of different ages and both sexes having lower motor neuron signs compatible with different varieties of SMA, with electrophysiological evidence of anterior horn cell disease, and absence of sensory symptoms and upper motor neuron signs. Different varieties were screened during this study. Though most of the varieties were found, not all varieties were captured during the study period. SMA type III was the most common variety. Overall male to female ratio was 4:1. Family history was positive in only a quarter of cases. Limb weakness and wasting were the most common symptoms with more frequent proximal weakness than distal; and generalized weakness was the least common. Best diagnostic tool was electromyography [EMG] as apposed to muscle biopsy which can be reserved for cases with uncertain diagnosis. CPK was a highly non specific marker but helped to differentiate SMA from primary muscle disease at times. Many varieties of SMA are prevalent in our region and can be diagnosed with conventional techniques, EMG being the most sensitive and less invasive tool in the absence of molecular genetic testing