Troubles neurologiques

Background Intracerebral hemorrhage, despite being less frequent than ischemic stroke, has a worst early outcome and poorer prognosis. Intracerebral hematoma (ICH) size is one of the important predictors of outcome. CT scan is the gold standard for diagnosis and follows up of ICH yet needs the patient to be moved to radiology department which can be difficult for some ICU patients. Bedside ultrasound can be a potential reliable tool for assessing ICH size. Aim Assessing the utility of ultrasound in diagnosing and predicting outcome of ICH Subjects and method Thirty patients with spontaneous ICH has been selected and diagnosed by CT scan of the brain. Brain transcranial sonography (TCS) was done just after the CT. Multiple clinical scales were done and correlated to hematoma size detected by TCS. Results The results showed excellent reliability for hematoma volume assessment using CT and TCS, intra-class correlation coefficient (ICC) 95% CI 0.963 (0.923-0.983). Hematoma size by TCS showed a very good correlation to most of the clinical scales. Conclusion Bedside TCS can be a reliable tools for diagnosis and prediction of outcome of patients with ICH specially those who are difficult to be transported.

Introduction: Epilepsy is characterized by uncontrolled, recurrent seizure attacks in one or more body parts of a person. It is related to abnormal brain activity which can be genetic, can be caused by drugs or infections or may even be idiopathic in nature. Epilepsy is a widely stigmatized disease in Pakistan which affects a person’s mental and social wellbeing but the socio-personal effects of the disease have not been discussed immensely in this part of the world.

Methodology: The following article is a cross-sectional study conducted at the National Epilepsy Centre, Karachi from June, 2018 to March, 2019 for a span of 10 months after prompt approval from the institutional review board. Parents of 70 adolescents were handed out a questionnaire devised on the basis of Rutter-Parent Questionnaire and GHQ-30. The final data was analyzed by mean of Statistical package for Social Sciences (SPSS) version 22 using descriptive statistics and Pearson-correlation test. A p-value of <0.05 was considered significant.

Results: Out of the 70 adolescents, 46 (64.8%) attended school while 24 (35.18%) did not. Out of the 46 who attended school, males were 35 (50%) while females were 11 (15.7%). 14 (20%) had received primary education, 21 (30%) had received secondary education, 12 (17.1%) received higher education and 3 (4.3%) went to religious schools. 44 adolescents (62.8%) took active parts in sports, 8 (11.4%) never played sports, 35 (50%) faced difficulties in school, 35 (50%) had a good school life despite the disease. Teachers of 42 (60%) and peers of 36 (51.4%) children supported them in the process. Around 60 (85.7%) children made friends easily. 14 (20%) children were the reason for arguments in the family while parents of 44 (62.8%) children denied any family quarrels due to their children. 29 (40%) children had a good sleep free of nightmares due to their seizures, while 22 (31.4%) children complained of bad dreams.

Conclusion: Approximately a quarter of the total number of parents who took part in the study perceived epilepsy to be a burden for the healthy social and mental well-being of their children whereas the remaining parents were hopeful about their child’s disease. Further studies need to be done city-wide to study the psychosocial effects of the disease not only on the children but also the family.