Neuropsychological assessment of global and specific cognitive functions in children with epilepsy

Impairment of cognitive functions is an important problem in epileptic children that can burden their learning abilities and academic achievement. The present study aims at assessment of cognitive functions in epileptic children and to explore the relation of various neuropsychological functions to other variables such as seizure type, frequency, duration of epilepsy, EEG changes and antiepileptic drugs. The study included 58 epileptic children, 6-12 years old [39 males and 19 females]. All children were subjected to detailed history, full neurological and psychiatric examination, EEG and a battery of psychometric tests. Results confirmed that epileptic children have significant impairment in cognitive functions and this impairment is most evident in females, generalized seizures, higher frequency of seizures, right sided focus in EEG, poor seizure control and poly therapy

Neurological, neurophysiological and neuropsychological effects of exposure to pesticides

The present study is a cross sectional field study aimed to investigate long-term effects of pesticides on the nervous system. It was conducted in citrus farm in Sahel Sleim, Assuit Govemerate. It was composed of 3 groups: I .Directly exposed group which consisted of 30 men using organophosphorus compounds [OP]. They were involved directly in application of pesticides for variable durations of time. 2. Indirectly exposed group consisted of 30 men living at the same environment and exposed indirectly to the same compounds through water, air, vegetables and milk. 3. Control group, consisted of 30 men who were never exposed occupationally or environmentally to pesticides, they lived in urban areas. All groups were subjected to clinical assessment, neuropsychological examination with: Mini mental state examination [MMSE], Wechsler memory scale [WMS], and Beck's depression scale. Neurophysiological assessment [Event related pattern [P300], Visual evoked potential [VEP] and Brain stem auditory evoked potential [AEP] to detect minor and early affection of nervous system due to exposure to pesticides. The neurological symptoms [Asthenia, headache, and vertigo, dizziness, blurring of vision, numbness and tingling] were more frequent in the directly exposed group than other groups and the most frequent symptoms were dizziness and blurring of vision, which were present in 23.33%. Neurological signs [superficial sensory loss, deep sensory loss, decrease or lost ankle or deep reflexes, muscle weakness and trophic changes] were more frequent in directly exposed group than the other groups, and this increase is positively correlated to the duration of exposure to pesticides. The most frequent findings were abdominal complaint and respiratory signs, which were present in 30%. General signs and symptoms [abdominal, respiratory, topical and sexual] were not showing statistically significant differences between the three groups. There was prolonged latency of P300 in directly and indirectly exposed group than in control group, but the difference was not statistically significant, except in reaction time [P<0.02]. Auditory evoked potential demonstrated that there was statistically significant difference between directly exposed group and control group in the absolute latency of wave 111, 1 V, and V in both right and left sides. There was statistically significant difference between direct and indirect exposed groups in absolute latency of wave IV, V of both right and left sides. Visual evoked potential had showed a statistically significant difference [in latency of binocular YEP] between directly and indirectly exposed groups "in one hand "and non-exposed group" in the other hand". Mini mental state examination and Wechsler memory scale showed that there was affection in different components of them in relation to direct or indirect exposure to pesticides. This means that memory is affected by long term exposure to pesticides and this effect is more extensive when exposure is direct. Results of Beck's depression scale were showed a higher incidence of depression. in conclusion, the prolonged low level exposure to the organophosphorus compound can affect the nervous system, and this appeared in directly exposed people via formulation or handling of these compounds and the appeared in the form of increasing the frequencies of neurological as well as general symptoms and signs. Effects of pesticides exposure were also include brainstem dysfunction, memory, cognitive impairment and increased risk of depression as seen in different neurophysiological and neuropsychological testing

Stroke presentation of chronic subdural haematoma

This work was conducted on 803 cases presented to Neurosurgery and Neurology departments as stroke; 25 cases out of these 803 cases proved by brain C.T scan or MRI to be chronic subdural haematoma with percentage of 3.1% of the cases. This percentage is still questionable as there are no previous studies that estimate the stroke presentation of chronic subdural haematoma. Statistical studies of factors affecting final outcome of chronic subdural haematoma showed significant correlation between the onset-intervention interval and the final outcome. Chronic subdural haematoma with stroke presentation only was diagnosed by radiological investigation [brain C-T. scan or MRI]

Impairment of some renal and hepatic functions implicated in cerebrovascular stroke

The present study was conducted on 52 patients with recent onset cerebrovascular stroke [within 24 hours of onset] and 25 age and sex matched healthy control subjects. The study showed significantly higher levels of serum creatinine, blood urea and total serum bilirubin and lower level of serum albumin in stroke patients when compared with controls. While, this was not true for total proteins, AST, ALT and alkaline phosphatase, where the difference was not significant. Furthermore, significant differences reported beforeh and, almost, persisted between the three stroke subtypes and control. In general, a significant positive correlation was found between serum creatinine as well as blood urea nitrogen and diastolic blood pressure, while, a negative correlation was observed between serum albumin and glycosylated hemoglobin. These findings may be attributed, at least in part, to general vascular disease in such age group. In addition, in this country, endemic diseases known to have compromise on both liver and kidneys may contribute to such findings

Anal continence after perineal approach versus posterior abdominal rectopexy in complete rectal prolapse

Twenty-five cases of complete rectal prolapse [nine males and sixteen females] with a mean age of 49 years were operated upon. In fifteen cases [mean age 37 years], posterior abdominal rectopexy was performed [first group] and in ten cases [mean age 58 years], perineal rectopexy was used [second group]. Clinical evaluation and FMG of anal sphincters were performed in all cases preoperatively and three months postoperatively, competing the results in both groups. In the first group, eleven cases were incontinent to solid and /or liquid feces and four cases were incontinent to flatus before the operation. After the operation, complete prolapse was successfully controlled in thirteen cases and in two cases, there was partial rectal prolapse. It was concluded that both posterior abdominal rectopexy and perineal procedure are effective in controlling the associated anal incontinence with complete rectal prolapse. The perineal approach is less successful but it has an advantage of being safe in elderly high risk patients considered too unfit for transabdominal surgery

Inflammatory parameters implicated in cerebrovascular stroke

This study was conducted on 52 patients with recent onset cerebrovascular stroke and 25 age and sex matched healthy control subjects. It was aiming to assess some inflammatory parameters in recent stroke patients and analyze its relation to the traditional risk factors of stroke. A significant increase has been found in almost all traditional risk factors as well as inflammatory parameters in stroke patients and stroke subtypes as compared to control subjects. Some significant correlations have been found between traditional risk factors and inflammatory parameters in stroke patients as well as stroke subtypes but this was neither extensive nor consistent. Furthermore, no significant correlation was detected between different inflammatory parameters. Soluble tumor necrosis factor receptor one [STNFR1] was more sensitive and consistent than TNF in both stroke patients and subtypes and this was attributed to dilution in peripheral blood and the very unstable nature of TNF alpha or it may be explained by the fact that the effect of leukocyte activation and the release of some cytokines are more pronounced locally at the site of injury and inflammation