International Neuropsychiatric Disease Journal

Subacute sclerosing panencephalitis (SSPE) is a progressive degenerative disease caused by measles infection with overall poor prognosis in spite multiple modalities of treatment. The course of the disease is characterized by progressive neurological decline in the form of behavioral and personality changes followed by a stage of characteristic periodic myoclonic spasms followed by a stage of quadriplegia movement disorder, vegetative state and frequently early death. Here we report two cases with atypical presentation of early rather than late movement disorder during illness and the unusual association of central precocious puberty preceding the course of illness in one of the cases.

Aim: The prevalence of intestinal parasitosis in relation to mental illness among inpatients of Federal Neuropsychiatric Hospital, Calabar was investigated with a view to improving the quality of their medical care.

Study Design: This was cross sectional study. Ethical approval and patients’ informed consent were sought and obtained before collection and processing of samples.

Place and Duration of Study: Federal Neuropsychiatric Hospital, Calabar, between February and August, 2016.

 Methodology: We included 246 (126 patients, 120 apparently healthy) subjects. Intestinal parasites were detected by direct stool microscopy and formol ether concentration technique and the cellophane anal swab method for Enterobius vermicularis. Chi square analysis was used to compare percentages.

Results: The prevalence of intestinal parasitosis among the 126 studied patients was 49.2% compared to 11.7% recorded among the 120 apparently healthy (control) subjects examined (P < 0.0001).  There was no significant association between intestinal parasites prevalence and gender in test as well as control subjects 60.0% v. 45.1%, respectively, p = 0.2022) and 14.3% v. 8.8%, respectively, P = 0.3113). Subjects with chronic mental cases insignificantly harbored more intestinal parasites than those with acute cases (53.8% v. 47.1%, respectively; P = 0.5699). Parasites detected in the study were Hookworm 34.6%, Entamoeba histolytica/dispar 25%, Ascaris lumbricoides 17.3%, Trichuris trichiura 9.6%, Enterobius vermicularis 5.8%, Giardia intestinalis 3.8%, Taenia species and Schistosoma mansoni 1.9% each.  Hookworm ranked highest 34.6% among the parasites encountered in the test subjects while Ascaris lumbricoides 33.3% took the lead in the control group. People diagnosed with Variance Psychosis disorder recorded highest infection rate (68.4%) while those with substance abuse had the least (28.0%).

Conclusion: Intestinal parasitosis may possibly play aetiologic or enhancement role in mental ill health. For effective management of the mental challenge, periodic parasitic investigations and appropriate therapy before and after admittance should be effected in all psychiatric institutions.

Background: The prevalence of breakthrough seizures in persons with epilepsy is very high in developing countries. Consequently, patients and physicians should be aware of the possible factors that may cause breakthrough seizures.

Objective: The aim of our study is to determine the possible factors that may be a precipitating cause for breakthrough seizures in patients with epilepsy.

Methods: This cross-sectional study included 100 persons with epilepsy with idiopathic epilepsy receiving antiepileptic drugs (AEDs). They were divided into two groups. Group 1 included 50 persons with epilepsy with a history of recent breakthrough seizures. Group 2 included 50 persons with epilepsy who had not experienced any recent breakthrough seizures. Patients were subjected to a thorough questionnaire addressing precipitating factors. All participants were subjected to an electroencephalogram (EEG) and medication adherence assessment.

Results: There was no significant differences between group 1 and group 2 regarding age, sex, age of onset of epilepsy, occupation and marital status (P value range 0.5 – 0.2). The patients in group 1 were found to have longer durations of epilepsy, lower adherence to AEDs (P = 0.001), more missed doses of AEDs (P = 0.0001), more side effects of AEDs (P = 0.0005), more sleep deprivation, lower level of AEDs (P = 0.0006), more frequently on AED polytherapy (P = 0.0002), and more flickering lights (P = 0.04) than the participants in group 2. In terms of the EEG, group 1 showed a higher percentage of abnormal EEGs and more frequent focal epileptiform discharges (P = 0.003). Also, pathological findings in MRI brain were associated with higher breakthrough seizures (P = 0.005). No significant difference was found in both group1 and group 2 regarding emotional stress (P = 0.55), substitution of brand AEDs by generic one (P = 0.83), concurrent illness (P = 1), or the use of non AEDs (P = 0.79).

Conclusion: The precipitating factors of breakthrough seizures are multifactorial and it is very important to educate patients about these precipitating factors to achieve better control of epilepsy.

Juvenile delinquency has become the most important subject matter of discussion in various fields. The disarray and destruction due to deviant behavior is assuming alarming proportions which is an awakening call to the society. The present study aims to assess various psychosocial factors which play a crucial part in the exhibition of delinquency behavior. Purposive sampling was implemented to collect data after obtaining informed consent from a sample of 30 juveniles (15 heinous and 15 non heinous offenders). Independent sample t test is used to see the difference of the different variables between heinous and non heinous offenses and product moment correlation is used to find the relationship between the different variables. Results indicated that resilience factors like emotional insight, empathy, and availability of the family, connectedness with family, negative cognition and social skills are found to have correlation with delinquent behavior. Temperamental characteristics like activation control, attention, inhibitory control and perceptual sensitivity is negatively correlated with the delinquent behavior while aggression is positively correlated. Significant difference is also found in these factors between heinous and no heinous offenses. It is also found that attachment with mother and peers play an important role in exhibiting delinquent behavior.

Background: Myofascial pain syndrome is a common multifactorial condition that presents with key manifestations and comorbid with many systemic diseases and regional pain syndromes. Objective: This study aims to concisely review clinical, diagnostic and integrative therapeutic aspects of myofascial pain syndrome.

Methods: E-searches (2000-2019) using keywords and Boolean operators were made and using exclusion and inclusion criteria, 50 full articles that focused on myofascial pain syndrome were retained for this review.

Results: Myofascial pain syndrome is a multidimensional musculoskeletal disorder with ill-understood etiopathogenesis and pathophysiology and characterized by tender taut muscle with myofascial trigger points, muscle twitch response, specific pattern of referred pain and autonomic symptoms. A variety of pharmacological and nonpharmacological therapies with variable efficacy are used in myofascial pain syndrome, the latter modalities such as education, stretching and exercises, moist hot and cold packs, dry needling and myofascial massage or myofascial trigger point massage are used as first line options.

Conclusion: Myofascial pain syndrome and trigger points initiated by repeated strains and injuries co-occur with diverse physical diseases and regional pain syndromes, which need comprehensive diagnostic evaluation using multiple methods. Several interventions are used in patients with myofascial pain syndrome who effectively respond to myofascial massage. This study calls for exploring etiopathogenesis and basic pathophysiological mechanisms underlying myofascial pain syndrome in future.