ABSTRACT
Introduction: There are 15 million people worldwide who suffer a stroke each year. According to the World Health Organization,stroke is the second leading cause of death for people above the age of 60 years, and the fifth leading cause in people aged15–59 years old.Aim: This study aims to study the clinical profile of patients presenting with stroke in South Tamil Nadu.Materials and Methods: The cross-sectional study was conducted in the Department of Medicine at Kanyakumari GovernmentMedical College from September 2018 to June 2019. A total of 140 patients who presented with symptoms of stroke wereassessed, for the relative frequency of ischemic and hemorrhagic stroke separately.Results: The incidence of stroke is maximum in the age group of 51–60 years comprise 34.28% with a mean age of 56 years.Cerebral infarction was more than hemorrhage. Hypertension was among leading risk factors for both types comprise 48.5%.Hemiplegia was the most common presentation followed by speech involvement and facial palsy. In ischemic stroke, the mostcommon site was internal (20.71%) followed by parietal (9.28%). In hemorrhage, the most common site was capsuloganglionic(7.85%) followed by thalamus (5.0%).Conclusion: Developing countries like India are facing a double burden of communicable and non-communicable diseases.Stroke is one of the leading causes of death and disability in India.
ABSTRACT
Bells palsy is an idiopathic disease of the seventh cranial nerve. This is the most frequent cranial mononeuropathy with an annual incidence of 10 to 40 cases per 100,000 population with geographical variations. Aim: To assess the efficacy of Steroids and Acyclovir in the management of Bell’spalsy. Methods: All the patients with Bell's palsy, without clinical evidence of other cranial nerve damage or central nervous system diseases were included. Patients were divided into 4 groups, control, steroid alone, steroid with acyclovir and acyclovir alone. The study groups of patients were clinically tested in a periodic manner within twelve months at various intervals. The severity of the facial nerve involvement is assessed with House- Brackmann grading (HB) system. Results: In 101 patients, Majority of patients come under grade IV (43.6%) and next comes to grade V (31.7%). 86% of the percentage of patients improved in grade IV, and 68.8% of patients improved in grade V. None of the patients from grade VI showed improvement. Combination of Steroids and acyclovir is definitely useful when compared to the control group. The combination scores over the control group by 1.37 times which is statistically significant (P value= 0.031668). Conclusion: Steroids are safe and are probably effective in the management of bells palsy which improves the rate ofrecovery. Acyclovir in combination with prednisolone is safe and has a definite role in improving facial functional outcomes in patients with Bell’s palsy than using the drugalone.
ABSTRACT
Introduction: Bell’s palsy is an idiopathic peripheral disease of the seventh cranial nerve. More than 70% of patients attaincomplete clinical recovery, with no noticeable residua. Electrophysiological tests may offer valuable information in defining theseverity of nerve injury and a possible subsequent dysfunction.Aim: This study aims to assess the prognostic value of electrophysiological tests in the management of Bell’s palsy.Materials and Methods: All the patients with Bell’s palsy and without clinical evidence of other cranial nerve damage or centralnervous system diseases were included in the study. Nerve conduction study was performed on the 14th day or on the firstvisit of the patient to the hospital.Results: In 101 patients, majority of patients come under Grade IV (43.6%) and next comes Grade V (31.7%). Eighty-twopatients (81.2%) had normal latency, among these, 73 cases recovered within 6 months. Of 17 who had prolonged latency,seven patients recovered fully.Conclusions: Electrophysiological studies can predict the duration of the clinical recovery and the outcome of the illness. Theamplitude ratio of compound muscle action potential is the most reliable parameter in assessing the prognosis.