Displaying all 3 publications

  1. Lau YH, Chinnasami S
    J Neurovirol, 2021 02;27(1):183-185.
    PMID: 33528825 DOI: 10.1007/s13365-021-00950-8
    The association of dengue infection (DI) with atypical neurological manifestations was first reported in 1976. DENV-2 and DENV-3 serotypes are mostly related to neurological problems. DI has shown an overall risk of 21 autoimmune diseases, and 4% may develop neuromuscular complications. The pathogenetic mechanisms behind myasthenia gravis (MG) occurring during DI is thought to be linked to the neurotrophic effect of the infection. We report a unique case of DENV-1 infection presenting with bilateral ptosis and dysphagia in a previously healthy adult.
  2. Lim KS, Khoo CS, Fong SL, Tan HJ, Fong CY, Mohamed AR, et al.
    J Clin Neurosci, 2023 Aug;114:25-31.
    PMID: 37279626 DOI: 10.1016/j.jocn.2023.05.006
    INTRODUCTION: Early and effective treatment is fundamental in status epilepticus (SE) management. At the initiative of the Epilepsy Council of Malaysia, this study aimed to determine the treatment gap in SE across different healthcare settings in Malaysia.

    METHODS: A web-based survey was sent to clinicians involved in the management of SE, across all states and at all levels of healthcare services.

    RESULTS: A total of 158 responses were received from 104 health facilities, including 23 tertiary government hospitals (95.8% of all government tertiary hospitals in Malaysia), 4 (80.0%) universities, 14 (6.7%) private, 15 (11.5%) district hospitals and 21 clinics. Intravenous (IV) diazepam was available in 14 (93.3%) district and 33 (80.5%) tertiary hospitals for prehospital management. Non-IV benzodiazepine (rectal diazepam and intramuscular midazolam) was not widely available in prehospital services (75.8% and 51.5%). Intramuscular midazolam was underutilised (60.0% in district and 65.9% in tertiary hospitals). IV sodium valproate and levetiracetam were only available in 66.7% and 53.3% of the district hospitals, respectively. Electroencephalogram (EEG) services were available in only 26.7% of the district hospitals. Non-pharmacological therapies such as ketogenic diet, electroconvulsive therapy, and therapeutic hypothermia were not available in most district and tertiary hospitals for refractory and super-refractory SE.

    CONCLUSIONS: We identified several gaps in the current practice of SE management, including limited availability and underutilization of non-IV midazolam in prehospital services, underutilization of non-IV midazolam and other second-line ASMs, and lack of EEG monitoring in district hospitals and limited treatment options for refractory and super-refractory SE in tertiary hospitals.

  3. Fong SL, Lim KS, Tan L, Zainuddin NH, Ho JH, Chia ZJ, et al.
    Epilepsy Res, 2021 02;170:106551.
    PMID: 33440303 DOI: 10.1016/j.eplepsyres.2021.106551
    INTRODUCTION: The lifetime prevalence of epilepsy varies greatly from 1.5-14.0 per 1000 persons among the Asian countries. We aim to study the prevalence of epilepsy in Malaysia to have a better insight into the burden of disease in the country.

    METHODS: A population-based door-to-door survey was carried out throughout the country, using questionnaire for brief screening in ascertainment of epilepsy, using a questionnaire and its validated multilingual versions. Respondents who were screened positive underwent second-stage diagnostic phone interview by neurologists/ research assistants.

    RESULTS: A total 16, 686 respondents participated in the survey and 646 (3.8 %) respondents were screened positive during the first stage interview. A total of 185 consented for second stage diagnostic interview and 118 (63.8 %) respondents were contacted successfully for the second stage diagnostic phone interview, of which 17 (14.4 %) respondents were diagnosed to have epilepsy. An additional 68 (57.6 %) respondents had febrile seizures only. After applying a weighting factor to each respondent to adjust for non-response and for the varying probabilities of selection, the adjusted lifetime epilepsy prevalence was 7.8 in 1000 population, and the adjusted prevalence for active epilepsy was 4.2 in 1000 population in Malaysia.

    CONCLUSION: The prevalence of lifetime epilepsy in Malaysia is 7.8 per 1000 persons.

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