Frequency of Neurological Deficits in Sudanese Lepromatic Patients

"Leprosy has been a major burden on humanity over thousands of years. Perhaps no other disease in the history of mankind has been associated with such a strong social stigma as leprosy. Failure in early detection often leads to severe disability in spite of eradication of mycobacteria at a later date. Untreated the disease is progressive and results in permanent damage to the skin; nerves; limbs and eyes. Objectives: To study the pattern of neurological manifestations among adult Sudanese leprosy patients seen in Khartoum Dermatology Hospital in the period from March 2006 to August 2006.Methodology:This is a prospective cross-sectional hospital-based study. Seventy adult Sudanese leprosy patients were studied using simple; direct; standardized questionnaire including history and neurological examination; during the period from March to August 2006. Results: The most common age group affected was 18- 27 years. Male to female ratio was 3:1. Numbness was the most common neurological symptom seen in 77.14. Each of visual disturbance; headache and bilateral ulnar sensory impairment was detected in 7.14. Half of the patients had upper limbs sensory nerve dysfunction while 42.86exhibited sensory nerve dysfunction in the lower limbs. ""Gloves and stoking"" sensory impairment was the most common finding (30) while bilateral lateral popliteal sensory impairment was seen with the same percentage. Bilateral median and unilateral posterior tibial sensory impairment were found in 1.43each. Unilateral radial cutaneous sensory impairment was seen in 2.86. Approximately half (48.57) of the patients had upper limbs motor dysfunction. Bilateral ulnar distribution motor affection was seen in 40. A significant number (41.43) had upper limbs muscle wasting. Impaired olfaction was the most common cranial nerve sign seen in 12.86. Leprosy reactions were detected in 21.43; type 2 reaction in 14.29while type 1 reaction in 7.14. Conclusion:Numbness and limbs weakness were the most common neurological symptoms in leprosy patients. Peripheral nerve sensory impairment was found in half of the patients with ""Gloves and stokes"" peripheral sensory neuropathy being the most common sensory disturbance. Motor dysfunction was found in 48.57. Ulnar and median nerves motor affection was the most common motor dysfunctions. Signs related to cranial nerves involvement were less common. Leprosy reactions were present in one-fifth of the patients."

Prevalence of neurological manifestations of lung cancer among adult sudanese patients

The objective: is to study the prevalence of neurological manifestations among adults Sudanese patients with lung cancer seen in the Radiation and Isotope Centre in Khartoum. Methods: This is a prospective cross sectional hospital based study; conducted at Radiation and Isotope Centre in Khartoum. Sample of 52 adults Sudanese patients with lung cancer were included in the study. The period of the study was from February 2006 to July 2006. Data were collected by self administered questionnaire; this was constructed in sections to address the different aspects of the study as follows: personal data; presentation; physical examination; and investigations. The results: showed that 41 patients were males. Most of the patients were above 50 years of age. Fifty percent of our patients' were from Khartoum state. All of our patients had chest findings except one. The most common symptoms observed were of cranial nerves involvement; headache; limb weakness; numbness; and sphincteric disturbance. More than half of the patients were smokers. Other extrapulmonary manifestations noticed include: clubbing; lymph node enlargement; bone metastasis or fracture; gynaecomastia; superior vena cava obstruction; hepatomegaly; and ascites. Chest X-ray abnormalities showed pleural effusion; consolidation; hilar lymphadenopthy; collapsed lung; and fibrosis in the majority of patients. Most of our patients had adenocarcinoma; followed by squamous cell carcinoma; poorly differentiated carcinoma; and small cell carcinoma. Conclusion: The common neurological manifestations of lung cancer were found to be cranial nerves palsies; followed by lower limbs weakness; numbness; and sphincteric disturbances

The Patterns of Clinical Presentations of Cerebellar Syndromes among Adult Sudanese Patients

Cerebellar syndromes are one of the commonest neurological diseases.Objectives:To study the patterns of clinical presentations of cerebellar syndromes and to identify the possible causes.Methods:This is a prospective hospital based; cross-sectional study. One hundred adult Sudanese patients with cerebellar syndromes were included in the study during the period from January 2006 January 2007.Results:The most common age group affected was 18 - 25 years.Male to female ratio was 1.5:1unsteadiness on walking was the most common symptom (83).Gait-ataxia was the most common sign (83). Cerebrovascular disease was the most common etiology (25).Conclusion:Cerebellar syndromes are not rare in Sudan.However; they were diagnosed more commonly at the central regions of the country probably because of more awareness of patients and better facilities for diagnosis.The age of onset; the male predominance; the presentation and clinical findings were not different from reported literature.This also goes for the common causes apart from alcohol which is a strikingly rare as a cause in this study and could be accounted for the implementation of Elshariya (Islamic laws) Laws in Sudan