Prevalence Of Neurological Abnormalities Research Articles

NEUROLOGICAL ABNORMALITIES IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

Objective: The objective of the study is to find out the prevalence of neurological abnormalities in children between 5 and 15 years with type-1 diabetes mellitus (T1DM) of at least 2 years duration and the risk factors associated with the development of neurological abnormalities. Methods: Hospital-based cross-sectional study on 150 Children of 5–15 years of age having type I diabetes of at least 2 years’ duration by simple random sampling fulfilling the inclusion criteria, at Department of Pediatric Medicine, Sardar Patel Medical College and P.B.M. Hospital Bikaner. Results: Mean age was 10.9±3.6 years, male to female ratio was 1.63:1. The prevalence of peripheral neuropathy was 42.3% when 1 abnormal attribute in at least 1 nerve was considered, it was 7.3% when 2 abnormal attributes in 2 nerves were considered, 4.6% had autonomic neuropathy and 4% had cognitive abnormalities. The peripheral neuropathy was subclinical in a substantial number of cases as up to 39.4% and 39.3% of T1DM cases having peripheral neuropathy had normal neuropathic symptom score and neuropathic disability score, respectively. Female with longer duration of diabetes, higher mean age of diagnosis, and higher mean HbA1c level were significantly more likely to develop peripheral neuropathy. Conclusion: Neurological complications begin quite early and insidiously in T1DM patients highlighting the importance of early and regular screening by nerve conduction study.

Neurological Abnormalities in Opiate Addicts with and without Substitution Therapy

Background: Opiate addicts are generally prone to comorbidities, including neurological disease, because of the toxic effect of the drug, the combined use of opiates, and other neurotoxic substances, infections, bacteriemia from intravenous drug use, atherosclerosis from smoking or hyperlipidemia, trauma, reduced primitive reflexes during intoxication, compression neuropathies, rhabdomyolysis, or rhythm abnormalities and heart failure. Objective: Few data are available about neurological abnormalities in opiate addicts. Methods: Consecutively included were all in- and outpatients of the Department for Drug Disease, Otto Wagner Hospital, Vienna, Austria, between 2003 and 2005, with and without an opiate substitution therapy. All patients underwent a clinical neurological examination alternatively by two trainees. Results: A total of 460 patients (110 women, 350 men) aged 17–54 years were investigated. Opiate consumption lasted <2 years in 19 patients, 2–8 years in 187 patients, and >8 years in 196 patients. In 58 patients, no information about the duration of opiate consumption was available. Of the 460 patients 407 were under an opiate substitution therapy, 53 without. The neurological history was positive for epilepsy in 68 and for head trauma in 18 cases. The most frequent abnormalities were abnormal, dysdiadochokinesia, impaired stance, resting tremor, and miosis. The number of neurological abnormalities most frequently found in a single patient was eight (n = 269 patients). The number of neurological abnormalities increased with duration of addiction. The neurological diagnoses most frequently established were epilepsy (n = 22), polyneuropathy (n = 12), and pressure palsies (n = 4). Absence of direct or indirect reaction to light, miosis, abnormal heel-to-knee test, lower limb sensory disturbances, and unsafe gait were more frequent in patients under substitution than in patients without and vice versa for mydriasis, myopia, and resting tremor. Conclusion: All opiate addicts under substitution therapy present with neurological abnormalities. The high prevalence of neurological abnormalities in opiate addicts implies regular referral of these patients to the neurologist to improve their outcome.

Prevalence of neurological abnormalities in poor metabolic controlled children with short duration of type 1 diabetes

Prevalence of neurological abnormalities in poor metabolic controlled children with short duration of type 1 diabetes

Abnormalities on neurological examination among sheep farmers exposed to organophosphorous pesticides.

Organophosphates are effective pesticides which are frequently used in several agricultural settings. Although their acute effects are well characterised, it remains unclear whether long term exposure can damage the human nervous system. This study sought to investigate their long term effects by comparing abnormalities on neurological examination between groups of workers exposed to organophosphates and an unexposed group. 146 exposed sheep farmers and 143 unexposed quarry workers were recruited into a cross sectional study of symptoms and neuropsychological effects of long term exposure to organophosphates in sheep dip. From a symptom questionnaire given immediately after dipping the 10 most symptomatic and 10 least symptomatic farmers were selected. Several months later each of these, along with 10 of the unexposed quarry workers, underwent a standardised neurological examination similar to that which might be used in clinical practice, at at time as remote as possible from recent exposure to organophosphates so as to exclude any acute effects. All 30 selected subjects agreed to participate. The components of the examination which showed a significant difference were two point discrimination on the dorsum of the hand (symptomatic farmers 22 mm; asymptomatic farmers 13 mm; quarry workers 8 mm) and the dorsum of the foot (symptomatic farmers 34 mm; asymptomatic farmers 10 mm; quarry workers 11 mm), and mean calf circumference (symptomatic farmers 35.0 cm; asymptomatic farmers 36.3 cm; quarry workers 38.6 cm). Overall the prevalence of neurological abnormalities was low. The differences in neurological examination detected between groups were subtle and their clinical significance was unclear. However, they do suggest evidence of an adverse neurological effect from exposure to organophosphates. Further, larger scale studies will be required before it is possible to confirm or refute the differences detected.

Clinical and demographic characteristics of chronic inpatients: implication for treatment and research.

Clinical and demographic data were collected on 203 state mental hospital patients whose length of stay was greater than one year. They comprised 45% of the average adult census and 37% were less than 35 years old. Males were younger and females more educated and likely to have been married at one time. The majority have diagnoses of schizophrenia or organic mental disorders; a few have personality disorders. Patients were treated with drugs but risk/benefit parameters remain to be defined. Thirty-two percent of patients have had a violent episode during the past six months. The prevalence of neurological abnormalities supports the need for specialized neurological and neuropsychological consultation and medical consultation. Most patients require the level of care provided by a hospital, while 15% are ready for discharge but have no housing available. Intermediate care facilities could provide alternatives for some patients otherwise unable to leave the hospital. The implications raised by these findings are discussed.