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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.

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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

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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.

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Bleeding into the subarachnoid space (Subarachnoid Haemorrhage - SAH) is a dramatic and potentially fatal event that should not be missed. Modern trends have seen a decline in morbidity and mortality mainly due to advancements in neuroradiology and neurosurgical techniques coupled with early intervention. The review presents the problems faced in the past and highlights the developments in various aspects of this catastrophic disease whose morbidity and mortality remain unacceptably high despite the improvements

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A 26-year-old female had her first partial seizure at the age of five years. Further seizures occurred and later became generalised in nature. Control of the seizures became difficult despite the use of nine different anticonvulsants over a period of 20 years. She was not suitable for neurosurgical intervention because of the diffuse nature of her seizures. Cerebellar stimulation had only a marginal effect on seizure frequency. With time she became mentally retarded and was unable to benefit from formal education. Her illness demonstrates many of the long-term clinical features and management problems of intractable epilepsy.

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Forty-three Caucasians with transient ischaemic attacks (TIAs), all age- and sex-match controlled, were retrospectively studied. There was no difference in sex distribution. The peak age for TIAs was 55-64. The haematocrit and cholesterol levels of men were significantly elevated (0.01 greater than P greater than 0.001 for haematocrit, and 0.01 greater than P greater than 0.001 for cholesterol). Six patients were controlled hypertensives but in general there was no significant difference in the blood pressures of patients and controls. The risk factors for TIAs and strokes are discussed.

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Tic douloureux is a chronic disease characterised by paroxysmal facial pain. This seven-year account of a patient's symptoms and management is discussed with reference to the medical and surgical treatments now available.

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The case records of 53 consecutive Nigerian inpatients with stroke in the University of Maiduguri Teaching Hospital, Maiduguri were retrospectively reviewed. The mean age at presentation was 55 years and the male to female ratio was 2.5:1. The mean duration of symptoms before presentation was 11.1 weeks and the average duration of stay in hospital was 3 weeks. Thirty-three (63%) of the lesions were infarctive and 19 (37%) were haemorrhagic. Only 3 (6%) patients gave a history of prior transient ischaemic attacks (TIAs). Forty-two (79%) patients were hypertensive at presentation out of which 27 (64%) had the hypertension diagnosed for the first time. Four (8%) patients were non-insulin dependent diabetics. There were 11 hospital deaths (21%). Thus hypertension, more than half undiagnosed at admission, was the most common risk factor for stroke in the hospital population studied.

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