Delayed post-anoxic encephalopathy.
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Adult↗
Biomedical subjects
A K Thacker
Publications and source records attributed to A K Thacker.
Bilateral anterior tibial compartment syndrome in association with hypothyroidism.
Local vascular and traumatic involvement are well-recognized causes of anterior tibial compartment syndrome (ATCS) terminating as myoneural ischaemia. However, in a large number of patients the cause of ATCS remains unidentified. We document the occurrence of bilateral ATCS in a patient of hypothyroidism, to our knowledge a previously unrecorded association.
Adult↗
Disappearing CT lesion in a nonepileptic patient.
Despite its high incidence, the exact cause of disappearing CT lesions in patients with epilepsy is not clear. We document a non-epileptic patient, whose clinical picture simulated idiopathic intracranial hypertension, but CT showed a spontaneously resolving ring enhancing lesion.
Adult↗
Thrombotic thrombocytopenic purpura.
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Adolescent↗
Clinical and computed tomography analysis of intracerebral haemorrhage.
The clinical records and computed tomography scans of 50 consecutive patients with intracerebral haemorrhage (ICH) were analysed. Putaminal (48%) and thalamic (16%) ICH comprised the largest group, followed by cerebellar haemorrhage (12%). Intraventricular haemorrhage was observed in 14 cases, a majority being secondary to parenchymal haemorrhage. Hypertension remained the most important risk factor, occurring in 64% of the whole group and 83% of those with putaminal ICH. No predisposing factors for the haemorrhage were identified in 28% of patients. Twenty-seven patients were comatose; the incidence of coma in association with intraventricular haemorrhage was 79%. At the third week, 13 patients had died, a mortality rate of 26%.
Adolescent↗
Fluorotic radiculomyelopathy in a Libyan male.
A middle-aged male resident of Benghazi, northeastern Libya, with radiological features of skeletal fluorosis associated with cervical radiculomyelopathy is reported. This is believed to be the first documentation of such a disorder from this non-tropical, non-endemic region.
Bone Diseases, Metabolic↗
Sickle cell trait and stroke in the young adult.
Two young patients with sickle cell trait (AS haemaglobinopathy) and ischaemic stroke are reported. The stroke involved the internal carotid artery territory in one and the brainstem in the other. A review of the literature is presented to suggest that the association of sickle cell trait and cerebral infarction is more than coincidental. Haemoglobin electrophoresis should be undertaken routinely in young subjects with ischaemic stroke.
Adolescent↗
Pyogenic cervical vertebral osteomyelitis.
A 54-year-old male with cervical spine osteomyelitis due to haematogenous spread of staphylococcal infection from an intravenous cannula is reported. A review of literature is presented to illustrate the diagnostic difficulties and neurological complications of pyogenic vertebral osteomyelitis.
Catheterization↗
Neuroleptic malignant syndrome in a girl without psychosis.
We report a successfully managed case of neuroleptic malignant syndrome in which the diagnosis was delayed by one week because of the absence of an established psychiatric disease. A high degree of clinical suspicion must be maintained if the diagnosis of this rare, curable but often fatal, complication of neuroleptic therapy is not to be missed.
Adolescent↗
Electrophysiologic evaluation for carpal tunnel syndrome in patients with angioaccess for haemodialysis.
The corrected distal motor latency along the median nerve in 50 upper limbs with the forearm Cimino-Brescia fistula for haemodialysis, when compared to that of the contralateral limb and the control value, showed no evidence of carpal tunnel syndrome (CTS) ascribed to angioaccess. Haemodialysis-associated CTS seems to be related to the predisposing factors, rather than the haemodynamic effects of the arteriovenous fistula or dialysis.
Adolescent↗
Conjugal motor neurone disease.
The occurrence of motor neurone disease (MND) in a Libyan couple who lived together for 40 years and in whom the disease developed within a 15-month period is reported. This is believed to be the second documentation of conjugal MND in the English literature.
Aged↗
A clinical, epidemiological and genetic study of hereditary motor neuropathies in Benghazi, Libya.
A 4-year-search for spinal muscular atrophies (hereditary motor neuropathies, HMN) in Benghazi, Libya, yielded a total of 24 patients, among whom 18 were index cases. This group comprised 6 acute infantile, 12 chronic childhood, and 3 each with adult-onset proximal, and distal forms of the disorder. Distal HMN constituted 12.5% of the total cases. The crude average annual incidence of acute infantile HMN was 0.3/100,000 total population and 1/12,500 births in Benghazi. The crude prevalence rates of chronic childhood, adult-onset proximal, and distal types of HMN were 2.3, 0.6, and 0.6/100,000 respectively. The segregation ratios, 0.26 for acute infantile HMN and 0.24 for chronic childhood HMN, suggested autosomal recessive inheritance. The consanguinity rates among parents of cases and the population did not differ significantly.
Acute Disease↗
Nerve conduction studies in upper limbs of patients with cervical spondylosis and motor neurone disease.
Proximal conduction studies by F-wave technique, with conventional distal motor and sensory conduction were performed along the ulnar nerves of 20 patients each with cervical spondylotic radiculopathy and/or myelopathy and with classical motor neurone disease (MND). Such F-wave parameters as shortest F-latency, F-conduction velocity, conduction time and F-ratio were calculated. Twenty-five age- and sex-matched healthy volunteers acted as controls. Proximal slowing associated with sensory conduction abnormalities and normal distal motor conduction favored cervical spondylosis (CS). Distal slowing with a normal proximal motor and sensory conduction was associated with motor neurone disease.
Cervical Vertebrae↗
Descriptive epidemiology of some rare neurological diseases in Benghazi, Libya.
During a 4-year study period, January 1983 to December 1986, 24 patients (18 index cases) with spinal muscular atrophy (hereditary motor neuropathy, HMN), 9 with myasthenia gravis (MG), 6 with progressive supranuclear palsy (PSP), and 5 with subacute sclerosing panencephalitis (SSPE) were diagnosed in Benghazi. The HMN group comprised 6 acute infantile, 12 chronic childhood, and 3 each with adult-onset proximal, and distal forms of the disease. The crude average annual incidence of acute infantile HMN was 0.3/100,000 total population and 1/12,500 births in Benghazi. The crude prevalence rates of chronic childhood, adult-onset proximal, and distal types of HMN were 2.3, 0.6 and 0.6/100,000, respectively. The larger family size and the high rate of consanguineous marriages contribute to the high frequency of HMN in the study area. Distal HMN constituted 12.5% of the total cases. The adjusted average incidence of MG was 4.4/million/year, 2.1 for males and 6.8 for females. The female:male incidence ratio was 3.2:1. The crude average annual incidence rates/million inhabitants for PSP asnd SSPE were 3 and 2.4, respectively. The frequency of occurrence of SSPE among the subtropical Arab community under investigation is comparable with other surveys from the Middle East and Mediterranean region.
Adolescent↗
Carpal tunnel syndrome complicating Cimino-Brescia fistula: an electrophysiologic evaluation.
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Adult↗
Cerebellar ataxia and total albinism.
In this report a family is described where cerebellar ataxia occurred along with total albinism. A possibility of syntenic condition of the two genes responsible for the traits could explain the occurrence of the two conditions. The presence of two traits singly in the sibs reflects a recombinant event and suggests that the linkage is not absolute. Chromosomal study did not show any structural or numerical anomalies except in 1/50 metaphase plates scored in the proband (with cerebellar ataxia) where in chromosome No. 14 proximal intense band (21) seemed to be shifted, inv. (14) (q13q23?). The affected sibs with ataxia and albinism or ataxia alone depicted relatively a lower sister chromatid exchange (SCE) rate than their parents and age matched controls.
Albinism↗
Muscle dysfunction in male hypogonadism.
Twenty-eight consecutive male patients with primary and secondary hypogonadism (14 each) were evaluated clinically and electrophysiologically for muscle dysfunction. Although generalised muscle weakness was initially reported by only 9 patients, on direct questioning, it was recorded in 19. Objective weakness was found in 13 patients and it involved both the proximal and distal limb muscles. Quantitative electromyography showed evidence of myopathy in the proximal muscle in 25 patients, i.e., reduced MUP duration and amplitude with increased polyphasia in the deltoid and the gluteus maximus. There were no denervation potentials. None of the patients showed clinical neuropathy or NCV abnormalities. Thus, the profile of muscle involvement in hypogonadism closely simulates limb-girdle muscular dystrophy and other endocrine myopathies. The incidence of muscle involvement was higher in secondary hypogonadism. Diminished androgens in primary hypogonadism and diminished growth hormone in the secondary hypogonadism are probably responsible for the myopathy.
Action Potentials↗