A Double-Blind, Placebo-Controlled Study of Appropriate Site of Botulinum Toxin Therapy in Hemifacial Spasm.

Introduction: Hemifacial spasm (HFS) is a condition causing poor quality of life. Treatment with botulinum toxin A (BTX) injection is effective. Only one randomized controlled trial with a single-blind fashion has evaluated if oral injection is needed in HFS.

A Real Life Clinical Practice of Neurologists in the Ambulatory Setting in Thailand: A Pragmatic Study.

The burden of neurological disorders is high in developing countries. Real life data from neurologists as to how they practice in Thailand are limited in literature. Practices of neurologists in a university hospital clinical setting in Thailand were studied.

Melatonin in patients with cancer receiving chemotherapy: a randomized, double-blind, placebo-controlled trial.

Background: The MIRCIT trial was a randomized, double-blind, placebo-controlled study of advanced Non-small cell lung cancer (NSCLC).

Patients And Methods: Patients were randomized to receive 10 mg or 20 mg of melatonin or placebo. Assessment of health-related quality of life (HRQoL) was completed at baseline, and at 2, 3 and 7 months.

Cost minimization of HLA-B*1502 screening before prescribing carbamazepine in Thailand.

Background: Carbamazepine (CBZ) is broadly used for the treatment of epilepsy, neuropathic pain and other neurological diseases, owing to its effectiveness and low price. CBZ can induce Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). There are several studies that found an association between HLA-B*1502 and CBZ-induced SJS/TEN, especially in people of Thai origin.

How can clinicians ensure the diagnosis of meningitic angiostrongyliasis?

Meningitic angiostrongyliasis (MA), caused by Angiostrongylus cantonensis, is often diagnosed by clinical criteria alone, because the confirmative serologic tests are not always available in the rural endemic areas. In this study, we evaluated the relationship between various clinical parameters of MA and the sero-positivity to sort out the predictive parameters to ensure the diagnosis. We enrolled consecutive adults in whom MA had been clinically diagnosed, who had serologic results for A.

Abdominal epilepsy: an uncommon of non-convulsive status epilepticus.

Objective: To recognize abdominal epilepsy in adults.

Material And Method: Case report.

Results: Case 1: A 21-year-old woman with DM type I presented with a 2-month history involving four episodes of severe abdominal pain and vomiting, each of which lasted four to five days.

Peripheral eosinophilia as an indicator of meningitic angiostrongyliasis in exposed individuals.

The diagnosis of meningitic angiostrongyliasis (MA) is based on clinical criteria. A lumbar puncture is used as a diagnostic tool, but it is an invasive procedure. The blood eosinophil levels are also assessed and used in the diagnosis of this disease.

Prediction of seizure control in non-ketotic hyperglycemic induced seizures.

Background: To study the factors predictive for seizure control in non-ketotic hyperglycemic induced seizures (NKHS).

Methods: We studied 21 patients who were clinically diagnosed as NKHS at Khon Kaen University hospital, Thailand. Multiple linear regression analysis was used to identify the factors predictive for seizure control.

Clinical factors predictive of encephalitis caused by Angiostrongylus cantonensis.

Angiostrongylus cantonensis is mainly caused eosinophilic meningitis in humans, whereas a minority of patients develop encephalitic angiostrongyliasis (EA). EA is an extremely fatal condition, and the clinical factors predictive of EA have never been reported. A comparison study was conducted in a hospital situated in an endemic area of Thailand.

Predictive risk factors of seizure-related injury in persons with epilepsy.

Objective: The clinical risk factors for seizure-related injuries (SRI) in adult persons with epilepsy (PWE) were studied and analyzed to develop a predictive model.

Methods: We enrolled 300 consecutive cases from three epilepsy clinics in Northeast, Thailand. Subjects were eligible if reported to have at least one seizure attack during the past 12 months.

Very high dose phenobarbital for refractory status epilepticus.

Background: Refractory status epilepticus (RSE), defined as status epilepticus that fails to respond to first, second and third-line therapy. The RSE is associated with high morbidity and mortality. Treatment guidelines of RSE give a spectrum of options, such as, continuous intravenous (i.

Basic knowledge of epilepsy among medical students.

Background: The medical students' knowledge about basic medical neuroscience in the preclinical level may be fragmented and incomplete.

Objective: Evaluate the knowledge of students prior to a lecture on epilepsy in clinical level.

Material And Method: One hundred ten fourth-year medical students' knowledge was accessed by a self-administered questionnaire.

A case of Miller Fisher syndrome with anti GQ1b in Thailand.

Miller-Fisher syndrome (MFS) is a rare variant of Guillain-Barré syndrome (GBS) and is characterized by the clinical triad of ataxia, ophthalmoplegia, and areflexia. The incidence rate in Thailand has not been established but it occurred approximately 1-5% that of GBS. Here, the authors report a Thai patient diagnosed as MFS that had a positive test of antibodies against the ganglioside GQ1b.

Albendazole therapy for eosinophilic meningitis caused by Angiostrongylus cantonensis.

Eosinophilic meningitis in humans is commonly caused by the nematode Angiostrongylus cantonensis. A severe headache is the most common presenting symptom. A prospective, randomized, double-blind, placebo, controlled study was conducted to determine if albendazole was efficacious in relieving such headaches.

Intraocular angiostrongyliasis: clinical findings, treatments and outcomes.

Ocular angiostrongyliasis, diagnosed by identification of Angiostrongylus cantonensis in any part of the eye, is a very rare manifestation. We report seven cases of intraocular angiostrongyliasis in Srinagarind Hospital, Khon Kaen University, Thailand. From a total of 654 cases of angiostrongyliasis diagnosed between January 1995 and April 2005, 7 cases (1.

Communicating hydrocephalus as a complication of eosinophilic meningoencephalitis.

The authors reported an adult patient with communicating hydrocephalus in eosinophilic meningoencephalitis. He presented with localized peritonitis and then developed eosinophilic meningoencephalitis. Angiostrongylus cantonensis was the causative agent.

Seizure-related injuries in northeast Thailand.

Objective: The authors aimed to assess the frequency, characteristics, and risk of seizure-related injuries from traffic accidents, near-drowning, burns, fractures, head and soft tissue injuries.

Material And Method: Attending physicians assisted 300 consecutive seizure patients to complete a questionnaire. The types and frequency of injuries were then expressed in terms of the type of seizure and related activity.

Seizure presenting to the emergency department, Srinagarind Hospital.

The authors would like to evaluate the incidence, clinical manifestation, the appropriateness of treatment, and outcome of seizure at the emergency department (ED). All charts of patients who visited the ED of Srinagarind Hospital from 1 January 2003 to 31 December 2003 were reviewed. The profiles of patients and management at the ED were recorded.

Acetylcholine receptor antibody in Thai generalized myasthenia gravis patients.

The authors studied acetylcholine receptor antibody (AChR Ab) in twenty-six Thai patients diagnosed as having generalized myasthenia gravis and fifteen control cases. AChR Ab assay was done by radio-immunoassay technique and reported by titer in nmole/L. The positive result was defined by titer more than 0.

Knowledge of epilepsy among teachers in Khon Kaen Province, Thailand.

Introduction: Epileptic patients face social stigmatization due to negative attitudes and incorrect knowledge on epilepsy.

Objectives: To evaluate knowledge of epilepsy among teachers in Khon Kaen province.

Material And Method: A self-administered questionnaire distributed to 102 teachers who attended the training lectures on epilepsy.

Appropriateness of intravenous loading dose of phenytoin treatment in Srinagarind Hospital.

Intravenous loading dose of phenytoin treatment (ILP) is a useful treatment but may cause serious adverse events. The present study assessed the appropriate use of ILP in Srinagarind Hospital. The authors reviewed all charts that ILP was ordered between January 1st, 2000 and December 31st, 2001, about indication, the infusion rate, and side effects.

Kluver-Bucy syndrome after mycoplasmal bronchitis.

Kluver-Bucy syndrome is a rare neurobehavioral condition characterized by visual agnosia, excessive oral tendencies, hypermetamorphosis, placidity, altered sexual behavior, and changes in dietary habits. This description of a 14-year-old boy presenting with complete Kluver-Bucy syndrome after Mycoplasma pneumoniae bronchitis is the first such case report. MRI revealed left temporal horn dilation and asymmetry of both temporal lobes.

MR imaging findings in cauda equina gnathostomiasis.

We report a case of cauda equina syndrome caused by Gnathostoma spinigerum, which was confirmed by an immunoblotting test. MR imaging of the lumbosacral spine showed long, segmented hyperintensity along the cauda equina with irregular enhancement on the postcontrast study. The conus medullaris was slightly enlarged with abnormal enhancement.

Tuberculous meningitis in adults: a four-year review during 1997-2000.

We reviewed the charts of all HIV-negative patients 15 years of age or older in whom tuberculous meningitis was diagnosed and treated without corticosteroids at Srinagarind Hospital, Khon Kaen, Thailand during the period of 1997-2000. Forty-five patients were included in this study. The clinical manifestations were subacute to chronic meningitis and they presented in stages 1 and 2, except one case which was in stage 3.

MR imaging findings in cerebrospinal gnathostomiasis.

Human gnathostomiasis is an infection caused mainly by Gnathostoma spinigerum, a nematode. Infected humans can present with various clinical manifestations. Serology is the criterion standard for diagnosing gnathostomiasis, whereas MR imaging represents a complementary tool for assessing severity and extent of disease.