Serum magnesium in adult patients with idiopathic and symptomatic epilepsy in Maiduguri, Northeast Nigeria.

BACKGROUND: Alteration in the homeostasis of trace elements such as magnesium may play a role in the development of epileptic seizures. This study aims to investigate the levels of serum magnesium in people with idiopathic generalized epileptic (IGE) seizures and symptomatic seizures in Northeast Nigeria. MATERIALS AND METHODS: Serum magnesium level was measured using atomic absorption spectrometry among 40 adults with IGE, 20 adults with symptomatic epileptic seizures, and 30 healthy controls. Serum calcium, potassium, phosphate, and albumin were also measured. RESULTS: The mean serum magnesium level was significantly lower among people with epilepsy compared with the controls [0.79 ± 0.18 mmol/L vs 0.90 mmol/L ± 0.17, P = 0.007, 95% confidence interval (CI): (-0.189 to -0.031)]. People with IGE had significantly lower levels of magnesium compared with those with symptomatic seizures [0.74 ± 0.17 mmol/L vs 0.9 ± 0.16 mmol/L, P < 0.001 95% CI: (-0.251 to -0.069)]. The mean magnesium level for all groups was in the reference range, but the lowest levels were observed in those with IGE. There is no significant correlation between the level of serum magnesium and the severity of seizure attacks. There was significantly lower level of calcium in people with IGE compared with those with symptomatic seizures [2.3 ± 0.13 mmol/L vs 2.4 ± 0.16 mmol/L, P = 0.012, 95% CI: (-0.177 to 0.023)] or controls [2.3 ± 0.13 mmol/L vs 2.4 ± 0.12 mmol/L, P < 0.01, 95% CI: (-0.156 to -0.044)]. No significant differences were observed in the levels of potassium, phosphate, and albumin. CONCLUSION: This study suggests that low serum magnesium and calcium may play a role in IGE, and supplementation may be useful in reducing seizures in Black patients with epilepsy.

Antiphospholipids Antibodies and Migraine

Background: Antiphospholipids antibodies has been associated with non-thrombotic neurological conditions such as migraine. We set out to estimate the concentration of antiphospholipids antibody among patients with migraine and normal population. Methods: This is prospective case-control study of 158 subjects including 82 migraine patients who fulfilled the International Headache Society criteria for the diagnosis of migraine headache and 76 age and sex-matched controls who were mostly hospital staff and medical students. Blood samples were taken for quantification of antiphospholipids antibodies. Results: There were 28 males and 54 females among the migraine patients and 30 males and 46 females among the controls. Their mean ages were 28.8 + 8.4 years and 26.4 + 3.9 years; respectively. Migraine patients had increased level of aPL (lgG anti Beta2GP1) 27.76 + 14.47IU/ml compared to the normal healthy adults (21.43 + 9.4IU/ml) (p0.05). Similarly; antiphospholipid antibodies was significantly elevated in migraine patients with aura compared to those without aura; (?2

Validation study of the Siriraj stroke score in North-east Nigeria.

BACKGROUND: The management and prognosis of stroke depends on the correct assessment of its pathological sub-type. It is therefore pertinent to have a simple and quick means of evaluating patients with stroke. The Siriraj stroke score (SSS) was developed in Thailand based on clinical parameters and have a good predictive value. This study aims at validating the Siriraj stroke score, as the predictive value of any diagnostic score depends on the prevalence of the disease in the community. METHODOLOGY: Patients who had stroke less than fourteen days before admission were enrolled into the study. Clinical variables for calculating the Siriraj stroke score were documented all patients subsequently had computerized tomography scan performed. A total of fifty patients were studied from University of Maiduguri Teaching Hospital and the State Specialist Hospital Maiduguri. RESULTS: Twenty-seven patients had infarction while twenty-three patients had hemorrhagic strokes respectively, based on the CT scan findings. The Siriraj stroke score correctly diagnosed fourteen as infarction and twenty as having hemorrhagic strokes, sixteen subjects were unclassified. The SSS correctly diagnosed thirteen cases as infarctive and seventeen as hemorrhagic strokes as confirmed by CT scan. The sensitivity and the predictive value of the SSS were 76.2% and 93% for infarction and 94.4% and 85% for hemorrhagic stroke respectively with overall accuracy of 84.6%. The clinical variables such as headache, vomiting and atheroma markers did not show discriminant value independently in differentiating CI and CH. However, level of Consciousness (coma) and diastolic blood pressure of greater than 110 mmHg are discriminant variables in differentiating CI and CH. CONCLUSION: Siriraj stroke score is recommended to be used in this community especially where CT scan is not available or affordable and the physician wishes to start thrombolytic or/and anticoagulation therapy.

Serum antiphospholipid antibodies among healthy adults in northeastern Nigeria.

BACKGROUND: Antiphospholipid antibodies have been associated with variety of conditions. There is no standard health associated reference values required for the interpretation of antiphospholipid antibodies result available among adults in North- eastern Nigeria and Nigeria in general. The aim of this study is to determine the normal serum level (cutoffpoint) in healthy adult Nigerians. The need or otherwise for stratification of the reference values by sex would also be determined. METHODS: Seventy-six healthy adults' medical students and health workers were enrolled in the study over the period of twelve consecutive months. Blood samples were taken for quantification of antiphopholipid antibodies using Enzyme Linked Immunosorbent Assay (ELISA) technique. Apparently healthy adults age between 16-50 years who are neither human immunodeficiency virus positive nor VDRL positive were included in the study. Reference values were calculated by parametric method. RESULTS: The mean serum concentration of IgG Antiâ2GP1 for the sample population was 21.43 +/- 9.43 U/ml. The mean serum concentration of IgG Antiâ2GP1 for males was 18.6 +/- 7.6 U/ml while for the female sample population was 22.7+/-10.2 U/ml. There is no gender variation (P > 0.05). CONCLUSION: The reference value for serum antiphospholipid antibodies in healthy adults in Northeastern Nigeria was 21.43 +/- 9.43 U/ml. The reference values should be used in this environment for both sexes. Extension of the scope of the study to cover the entire homogenous society of Northern Nigeria is recommended.

Severe Burns as a Consequence of Epilepsy in a Rural Community of North Eastern Nigeria

Objective: Epilepsy; a common clinical disorder usually presents with generalized tonic clonic seizures resulting in a fall and loss of consciousness. Seizures occurring near a burning agent may lead to a fall onto the burning agent and result in severe burns. A prospective study of all patients who sustained burns during an epilepsy seizure presenting to Federal Medical Center Azare; Bauchi State; Nigeria between January 2003 and June 2005 was conducted. Methods: The age; sex; place of incidence; site and extent of injury; cause of burns and treatment outcome were analyzed. Results: A total of 79 patients presented with burns during the study period; nine (11) were as a result of an epileptic seizure. The nine patients comprised of 6 adults and 3 children. Majority were mothers and their children. The place of accident was the home in 7 patients while 2 occurred on the farm. Seven were flame burns and two scalds. Conclusion: This study highlights that epilepsy is an important cause of severe burns in our environment. Women at home and children dependent on them are more at risk hence the need for public enlightenment