BackgroundCentral post-stroke pain (CPSP) is an under-recognized complication of stroke although it can lead to deterioration in quality of life and impairment in activities of daily living. Its estimated prevalence varies between 18.6 and 49%.ObjectiveTo investigate the prevalence and predictors of CPSP in ischemic stroke patients and to find its relationship with somatosensory evoked potentials (SSEPs) and magnetic resonance imaging.Patients and methodsSixty five consecutive patients with recent first attack of ischemic stroke who were admitted to the Neurology Department, Suez Canal University Hospitals were recruited. Patients were subjected to clinical assessment, Hamilton depression rating scale, brain MRI, short-form McGill Pain Questionnaire (SF-MPQ), daily pain rating scale (DPRS), stimulus evoked pain, and SSEPs.ResultsThe total prevalence rate of CPSP was 35.4% (n = 23). The mean age of the patients developed CPSP was significantly lower than those without CPSP (p = 0.004). Deep sensory dysfunction was statistically significantly higher among CPSP group than non-CPSP group (p = 0.001). CPSP group showed statistically significant higher prevalence of thalamic stroke (p = 0.007), as well as significant abnormalities in inter-peak interval (IPL) of median and tibial nerves SSEPs (p < 0.05). Thalamic group showed higher abnormalities in IPL of median and tibial nerves compared to extra-thalamic group, but without statistically differences.ConclusionThe prevalence of CPSP was found to be 35.4%. Predictors of CPSP include; deep sensory dysfunction, prolongation of tibial N21–P40 IPL, smoking history, age < 50 years, presence of thalamic stroke and prolongation of median N9–N20 IPL.

Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MGA) in healthy Egyptian subjects, and to discuss the available literature regarding MGA subtypes and their clinical implications. Methods: An electrophysiological study was conducted in both forearms of 140 healthy subjects. This included the ulnar and median nerves. Compound muscle action potentials were recorded from abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles. Other measurements included the compound motor action potential amplitude and its innervation ratio. Results: MGA was found in 56 of the 280 forearms. This included 20 men and 36 women. Type II MGA subtype was the most frequent in both genders. The MGA was bilateral in 6 subjects and more frequent on the right side. The highest mean amplitude and innervation ratio were recorded at first dorsal interosseus muscle. Conclusions: The prevalence of MGA in the studied sample of the Egyptian population is 20%. It is important for Hand, Orthopaedic and Neurosurgeons to be aware of this anatomic variation in order to explain paradoxical motor and sensory loss in patients.

Background: For decades, the role of vitamin D was limited to the formation and maintenance of bone as well as homeostasis of calcium and phosphate. Vitamin D is a steroid molecule, mainly synthesized in the skin from 7 dehydro cholesterol by ultraviolet irradiation or obtained through the diet. The major circulating metabolite of vitamin D is 25(OH) Vitamin D (25(OH)D), with a halflife of 21-30 days. Serum concentration of 25(OH) D is the most reliable biochemical index of vitamin status. Aim: The goal of the present study was to investigate the relationship between vitamin D levels and carpal tunnel syndrome (CTS) Patients and Methods: This study included 50 female patients with mild to moderate CTS and assessed their serum 25-hydroxyvitamin D levels. We included patients with a diagnosis of CTS based on both the clinical symptoms and positive neurophysiology. Controls (electrophysiological negative symptomatic patients) were evaluated 50 patients matched with sex and age clinically by rheumatologist. Results: the mean age of patients with CTS symptoms and control group were 49.2 ± 10.6 (range 21-54) and 49.7 ± 10.6 (range 20-55), respectively, with no significant difference between the two groups (p = 0.534). Patients with CTS symptoms had significantly lower 25(OH) D levels compared to controls. There's significance difference among the CTS patient regarding Boston Carpal Tunnel Questionnaire (BQ). Conclusion: a potential link between vitamin D status and the occurrence of CTS is suggested.

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Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs and systems. Studies with subjective sleep measures have shown that SLE patients have poor sleep quality. This study evaluates sleep quality and its contributors in women with SLE.