Search

Epilepsy/seizures are major indications for brain imaging in clinical neurology. Structural lesions that may cause seizures are numerous and are defined using various neuroimaging techniques, including magnetic resonance imaging. The resolution of MRI allows for better fine ultra-structural lesions delineation. The aim of this study was to describe the pattern and frequency of structural brain lesions in MRI of patients with seizures and no clinically evident focal neurological signs. This was a retrospective, descriptive study carried out in a private hospital in Enugu, South East Nigeria to review all MRI results of patients who presented with seizures without clinical evidence of focal neurologic deficits. The MRI reports of two-third of the patients (47.9%) revealed focal lesions and about a third of the patients (32.2%) had normal findings. The structural lesions reported were mostly brain tumors (16%), stroke (9.5%), central nervous system infections (6.5%), brain malformation (6%) and encephalomalacia/gliosis (5%). Frequency of focal lesions clearly increased with age. Young patients were mostly associated with normal findings. Brain tumors and stroke were noted to occur more in the middle and aged patients respectively. Brain Magnetic Resonance Imaging remains a useful tool in the workup of patients with seizures without neurologic deficits. Treatable lesions can easily be revealed using this imaging modality.

Objective: Dryopteris filix-mas (D. filix-mas) (L.) Schott, (Dryopteridaceae) is used in traditional medicine, particularly in the Southern parts of Nigeria for the treatment of inflammation, rheumatoid arthritis, wounds and ulcers. In this study, we evaluated the anti-inflammatory activity of its ethanolic leaf extract and fractions. Materials and Methods: The ethanolic leaf extract and fractions were screened for anti-inflammatory properties using egg-albumin-induced paw edema, xylene-induced topical ear edema, formaldehyde-induced arthritis and ulcerogenic models. The ethyl acetate most promising vacuum liquid chromatography fraction (VLC-E7) was purified using size exclusion chromatography technique (Sephadex LH-20) and its structure was elucidated using nuclear magnetic resonance (NMR) and mass spectrometry. Total phenolic and flavonoid contents were also determined. Results: From the study, ethyl acetate and butanol fractions elicited better anti-inflammatory activities in egg-albumin-induced paw edema, formaldehyde-induced arthritis and xylene-induced topical ear edema. The ethanol extract, ethyl acetate and butanol fractions were non-ulcerogenic at 200 and 400 mg/kg. The compound isolated from Sephadex fraction (SPH-E6) was quercetin-3-O-α-L-rhamnopyranoside. Conclusion: Results of this study justify the ethnomedicinal use of D. filix-mas leaf for treatment of inflammation and rheumatoid arthritis. We suggest that D. filix-mas could be a prospective anti-inflammatory agent with no gastric irritation side effect, due to its bioactive component, quercetin-3-O-α-L-rhamnopyranoside.

The extent of resection has been shown to influence the outcome of brain tumours. The concept of brain plasticity is to prevent damage to the eloquent areas while maximizing the extent of tumor resection. The present case report describes the usefulness of the near-infrared spectroscopy (NIRS) in evaluation of the possibility of functional preservation for surgeries in eloquent areas. We present a 46-year-old woman, who had previously undergone four sessions of internal decompression surgery for left frontal anaplastic ependymoma. She later underwent radical tumor resection surgery involving the superior and middle frontal gyri, anterior parietal gyrus, corpus callosum, coronal radiation and basal ganglia. Postoperatively, her right hemiparesis did not deteriorate and she could ambulate without much aid. Multichannel NIRS system revealed that hot spot location was in the right superior frontal gyrus and parietal lobe by the same task of right knee joint movement. We judged that her right brain motor function shifted to the contralateral hemisphere by the long course of her illness. It might be possible that if the NIRS was used earlier around the third or fourth perioperative period, with a reliable confirmation of migration of the right motor function to opposite side, the option of a more aggressive tumor resection may have been attempted. NIRS can be a useful and sensitive tool for predicting the location of eloquent areas and monitoring the extent of brain plasticity between surgeries.