Peripheral neuropathy in thalasemia

Patients with thalassemia may complain of numbness and weakness of the lower extremities. The aim of the study was to document whether these patients suffer from a polyneuropathy and to determine any contributing factors for the development of neuropathy. We examined 30 patients with thalassemia major and intermedia, clinically and electrophysiologically. We corre_lated these findings with demographics, blood status, and treatment and compared electrophysiologic data with 30 age- and sex-matched normal subjects or historical controls. We found that 78% of thalassemic patients suffered from a mild sensory polyneuropathy. The neuropathy seemed to be worse in the intermedia type. Thalassemic patients who received blood transfusions and deferoxamine had better nerve function than those who did not, irrespective of the dose of deferoxamine. The neuropathy was worse for older patients, irrespective of sex. The hemoglobin level, and the fact that some patients underwent splenectomy, did not affect the status of the patients' nerves. Patients with thalassemia may suffer from a sensory polyneuropathy especially as they grow older and if they are not opti_mally treated

Spinal epidural abscess: a report of 10 cases and review of literature

spinal epidural abscess is a rare disease in neurology and neurosurgery. It is sometimes secondary to a systemic illness or infection and sometimes a complication of spine surgery. Epidural abscesses usually present with spinal cord compression and can be missed if not considered in the differential diagnosis. Early treatment is mandatory for good recovery. we performed a retrospective analysis of the 10 cases diagnosed at our center over a 20 year period. We studied the cases for risk factor, clinical presentation, laboratory data, radiographic findings, treatment and outcome. the study revealed that the most common organism causing spinal epidural abscess was staphylococcus aureus. The spread was haematogenous in most cases. Predisposing factors included surgery and trauma. The thoracic spine was the most common area where the abscess formed. Pain, leukocytosis and elevated ESR favoured the diagnosis of epidural abscess. Confirmation of the diagnosis was by magnetic resonance imaging [MRI]. Treatment involved the combination of surgical drainage, decompression and antibiotic therapy. spinal epidural abscess is a rare disorder. Early diagnosis is of utmost importance for early initiation of treatment and complete recovery. The key to early diagnosis is a high clinical suspicion and MRI confirmation