Difference in Stroke Knowledge between Rural and Urban Communities in a Developing Country after Community-Based Stroke Educational Campaigns: Results from a Cross-Sectional Study.

BACKGROUND: Ischemic stroke is a leading cause of disability and death in Mexico. Poor ability to identify signs and symptoms of ischemic stroke leads to longer hospital arrival times and precludes prompt treatment. The knowledge of stroke risk factors and warning signs in rural population is scarce. Since 2010, Stroke Education Campaigns are performed with a community-based approach. The aim of this study was to assess and compare stroke knowledge in rural and urban communities. METHODS: During World Stroke Campaign, a standardized questionnaire to assess knowledge of stroke risk factors and warning signs was applied in urban and non-urban communities of Nuevo Leon, Mexico. RESULTS: A total of 4,144 surveys were collected. Mean age was 44.2 ± 16.1 and 75.9% were women. People from rural and semi-urban areas mentioned > 3 risk factors (p < 0.001) and warning signs (p < 0.001) compared to the urban area. After logistic regression analysis, having received previous information about stroke remained significant for the knowledge of > 3 stroke risk factors and warning signs (p < 0.001; 95% CI 1.997-2.727; p < 0.001; 95% CI 1.880-3.787) respectively. CONCLUSIONS: Rural and semi-urban regions performed better than the urban population. Receiving stroke information is a determinant factor for stroke knowledge. Stroke Educational Campaigns are a cost-effective method for raising stroke awareness, thus reducing stroke burden.

Posterior reversible leukoencephalopathy syndrome (PRES) associated with severe eclampsia: Clinical and biochemical features.

OBJECTIVES: Posterior Reversible Encephalopathy Syndrome (PRES) and eclampsia share clinical characteristics and patients may present with a combination of these two entities. Our aim was to study the proportion of patients with eclampsia having evidence of PRES in their brain imaging. METHODS: Retrospective study of pregnant patients diagnosed as having eclampsia that underwent brain magnetic resonance imaging (MRI) during their hospitalization. MRI diagnosis of PRES was assessed by 2 investigators blinded to group. RESULTS: We included a total of 29 patients with eclampsia, out of which 17 (58.6%) had MRI evidence of PRES. When patients with eclampsia and eclampsia/PRES were compared, there was no difference in demographic characteristics such as age, weight or multiparity. Patients with eclampsia/PRES had higher levels of creatinine, liver enzymes, mean platelet volume and there was a trend towards higher proteinuria. Infants of mothers with eclampsia/PRES also had worse 1min APGAR scores. CONCLUSION: PRES appears to accompany eclampsia in over half of all cases. The clinical picture of patients with eclampsia with or without associated PRES is similar, but certain biochemical characteristics suggest that PRES might be indicative of a more severe disease process.

Alterations in balance and mobility in people with epilepsy.

PURPOSE: People with epilepsy (PWE) are burdened by physical disability and side effects of antiepileptic drugs (AED) such as drowsiness and blurred vision. These factors place them at risk for reduced mobility and falls. The purpose of this study was to evaluate mobility and balance in PWE. METHODS: This was a cross-sectional study of PWE and age- and sex-matched controls. We evaluated mobility and balance using the Timed Up and Go Test (TUG) and the Tinetti Mobility Test (TMT). Self-reported confidence in balance was assessed using the Activities-Specific Balance Confidence Scale (ABC). Clinical and demographic characteristics and particularly epilepsy-related variables were recorded. RESULTS: We included 33 PWE and 33 controls. PWE had a mean age of 36.7years, and 61% were male. They had a mean of 1.52 of seizures per month and used a mean of 1.6 anti-epileptic drugs (AEDs). PWE scored significantly worse in all measures (TUG, TMT, ABC) when compared with controls. PWE had poor performance in 60.6% of cases in the TUG and in 48.5% of cases in the TMT, compared to none in the control group. There was good correlation between the three instruments. TUG scores were correlated with epilepsy duration, but not age, seizure control or AED use. On multivariate logistic regression, poor performance TMT was significantly associated with poor confidence in balance, according to the ABC. CONCLUSIONS: PWE have significant alterations in balance and mobility, independently of AED use or seizure control. These alterations are reflected in a poor self-reported confidence in carrying out daily activities.