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Floudiotis N, Modi G, Mochan A. Motor neuron disease in black African patients at a tertiary care hospital in Soweto, South Africa. J Neurol Sci 2023; 451:120710. [PMID: 37379726 DOI: 10.1016/j.jns.2023.120710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION In this brief report, we describe the nature of ALS in a South African cohort of patients of Black African ancestry - a population which has been historically understudied. METHODS We performed a chart review of all patients attending the ALS/MND clinic at the Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, South Africa, during the period 1 January 2015 to 30 June 2020. Cross-sectional demographic and clinical data captured at the time of diagnosis was collected. RESULTS Seventy-one patients were included in the study. Males constituted 66% (n = 47), with a male to female sex ratio of 2:1. The median age at onset of symptoms was 46 years (IQR 40-57) with a median disease duration at diagnosis (diagnostic delay) of 2 years (IQR 1-3). The onset was spinal in 76% and bulbar in 23%. The median ALSFRS-R score at time of presentation was 29 (IQR 23-38.5). The median ALSFRS-R slope (unit/month) was 0.80 (IQR 0.43-1.39). Sixty five patients (92%) were diagnosed with the classic ALS phenotype. Fourteen patients were known to be HIV positive, and of those, 12 were on antiretroviral treatment (ART). None of the patients had familial ALS. CONCLUSION Our findings of an earlier age at symptom onset and seemingly advanced disease at presentation in patients with Black African ancestry support the existing literature on the African population.
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Affiliation(s)
- Niki Floudiotis
- Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown, 2193 Johannesburg, South Africa
| | - Girish Modi
- Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown, 2193 Johannesburg, South Africa
| | - Andre Mochan
- Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown, 2193 Johannesburg, South Africa.
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Abdul Aziz NA, Toh TH, Goh KJ, Loh EC, Capelle DP, Abdul Latif L, Leow AHR, Yim CCW, Zainal Abidin MF, Ruslan SR, Shahrizaila N. Natural history and clinical features of ALS in Malaysia. Amyotroph Lateral Scler Frontotemporal Degener 2020; 22:108-116. [DOI: 10.1080/21678421.2020.1832121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Nur Adilah Abdul Aziz
- Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tsun-Haw Toh
- Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khean-Jin Goh
- Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ee-Chin Loh
- Palliative Care Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - David Paul Capelle
- Palliative Care Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lydia Abdul Latif
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Alex Hwong-Ruey Leow
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Carolyn Chue-Wai Yim
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Fitry Zainal Abidin
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shairil Rahayu Ruslan
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nortina Shahrizaila
- Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Luna J, Diagana M, Ait Aissa L, Tazir M, Ali Pacha L, Kacem I, Gouider R, Henning F, Basse A, Cisse O, Balogou AAK, Kombate D, Agbetou M, Houinato D, Millogo A, Agba T, Belo M, Penoty M, Raymondeau-Moustafa M, Hamidou B, Couratier P, Preux PM, Marin B. Clinical features and prognosis of amyotrophic lateral sclerosis in Africa: the TROPALS study. J Neurol Neurosurg Psychiatry 2019; 90:20-29. [PMID: 30242088 DOI: 10.1136/jnnp-2018-318469] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/06/2018] [Accepted: 07/14/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We describe and compare the sociodemographic and clinical features, treatments, and prognoses and survival times of patients with amyotrophic lateral sclerosis (ALS) in Africa. METHODOLOGY We conducted a multicentre, hospital-based cohort study in Africa. Patients with ALS diagnosed in the neurology departments of participating hospitals from 2005 to 2017 were included. Subgroup analysis was performed by subcontinent. Survival analyses were conducted using the Cox proportional hazards model. RESULTS Nine centres from eight African countries participated. A total of 185 patients with ALS were included: 114 from Northern Africa, 41 from Western Africa and 30 from Southern Africa. A male predominance (male to female ratio 2.9) was evident. The median age at onset was 53.0 years (IQR 44.5-64.0 years). The onset was bulbar in 22.7%. Only 47 patients (26.3%) received riluzole, mainly in Northern and Western Africa. The median survival from the time of diagnosis was 14.0 months (95% CI 10.7 to 17.2 months). The median survival was longer in Northern Africa (19.0 months, 95% CI 10.8 to 27.2 months) than in Western (4.0 months, 95% CI 0.8 to 7.1 months) and Southern (11.0 months, 95% CI 5.6 to 16.4 months) Africa (Breslow test, p<0.0001). Both subcontinental location and riluzole treatment independently affected survival. CONCLUSION More African patients with ALS were male and younger and exhibited a lower proportion of bulbar onset compared with patients with ALS from Western nations. Survival was consistent with that in Western registers but far shorter than what would be expected for young patients with ALS. The research improves our understanding of the disease in Africa.
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Affiliation(s)
- Jaime Luna
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Mouhamadou Diagana
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,Département de Neurologie, CHU de Nouakchott, Nouakchott, Mauritania
| | - Leila Ait Aissa
- Laboratoire de Recherche en Neurosciences, Service de Neurologie, CHU Mustapha, Sidi M'Hamed, Algeria
| | - Meriem Tazir
- Laboratoire de Recherche en Neurosciences, Service de Neurologie, CHU Mustapha, Sidi M'Hamed, Algeria
| | - Lamia Ali Pacha
- Laboratoire de Recherche en Neurosciences, Service de Neurologie, CHU Mustapha, Sidi M'Hamed, Algeria
| | - Imen Kacem
- Faculty of Medicine of Tunis, University Tunis el Manar, La Manouba, Tunisia.,Department of Neurology, Razi Hospital, La Manouba, Tunisia
| | - Riadh Gouider
- Faculty of Medicine of Tunis, University Tunis el Manar, La Manouba, Tunisia.,Department of Neurology, Razi Hospital, La Manouba, Tunisia
| | - Franclo Henning
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,Centre for Research in Neurodegenerative Disease, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Anna Basse
- Département de Neurologie, CHNU Fann, UCAD, Dakar, Senegal
| | - Ousmane Cisse
- Département de Neurologie, CHNU Fann, UCAD, Dakar, Senegal
| | | | - Damelan Kombate
- Département de Neurologie, CHU Campus Université de Lomé, Lomé, Togo
| | - Mendinatou Agbetou
- Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, University of Abomey-Calavi, Cotonou, Benin.,Neurology Unit, CNHU Cotonou, Cotonou, Benin
| | - Dismand Houinato
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, University of Abomey-Calavi, Cotonou, Benin.,Neurology Unit, CNHU Cotonou, Cotonou, Benin
| | - Athanase Millogo
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,Département de Neurologie, CHU Sourô Sanou, Bobo-Dioulasso, Burkina Faso.,University of Ouagadougou, Ouagadougou, Burkina Faso
| | | | | | - Marie Penoty
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Service de Neurologie, Centre Expert SLA, Limoges, France
| | - Marie Raymondeau-Moustafa
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - Bello Hamidou
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Philippe Couratier
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Service de Neurologie, Centre Expert SLA, Limoges, France
| | - Pierre Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - Benoit Marin
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France .,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
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Fávero FM, Voos MC, Castro ID, Caromano FA, Oliveira ASB. Epidemiological and clinical factors impact on the benefit of riluzole in the survival rates of patients with ALS. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:515-522. [DOI: 10.1590/0004-282x20170083] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 04/15/2017] [Indexed: 12/12/2022]
Abstract
ABSTRACT Objective To investigate the impact of epidemiological and clinical factors on the benefit of riluzole in patients with amyotrophic lateral sclerosis (ALS). Methods The survival rate of 578 patients with ALS (1999-2011) was analyzed by descriptive statistics and Kaplan-Meier curves. Considering the median of the sample survival time (19 months), patients were divided in two groups: below (B19) and above the median (A19). Kaplan-Meier curves compared the survival rates of patients treated with riluzole and with patients who did not take the medication. Results Riluzole increased the survival rates of patients with lower limb onset who were diagnosed after the first appointment in B19. Patients with bulbar onset and diagnosed on the first, or after the first appointment showed higher survival rates in A19. Males lived longer than females in both groups. Conclusion Epidemiological and clinical factors influenced the benefit of riluzole in the survival rates of patients with ALS.
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Marin B, Logroscino G, Boumédiene F, Labrunie A, Couratier P, Babron MC, Leutenegger AL, Preux PM, Beghi E. Clinical and demographic factors and outcome of amyotrophic lateral sclerosis in relation to population ancestral origin. Eur J Epidemiol 2015; 31:229-45. [DOI: 10.1007/s10654-015-0090-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/05/2015] [Indexed: 01/08/2023]
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Couratier P, Marin B, Lautrette G, Nicol M, Preux PM. [Epidemiology, clinical spectrum of ALS and differential diagnoses]. Presse Med 2014; 43:538-48. [PMID: 24703738 DOI: 10.1016/j.lpm.2014.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 02/19/2014] [Accepted: 02/24/2014] [Indexed: 11/18/2022] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is the most common motor neuron disease in adults. Its incidence in France is estimated at 2.5 per 100,000 population and its prevalence between 5 and 8 per 100,000 inhabitants. Good prognostic factors are age of early onset, a longer time to diagnosis, initial damage to the spinal onset, early management of undernutrition and restrictive respiratory failure. The diagnosis of ALS is primarily clinical and is based on the evidence of involvement of the central motor neuron and peripheral neuron (NMP) in different territories or spinal or bulbar. The EMG confirms the achievement of NMP, shows the extension to clinically preserved areas and allows to exclude some differential diagnoses. The clinical spectrum of ALS is broad: conventional forms beginning brachial, lower limb or bulbar onsets, rarer forms to start breathing, pyramidal forms, forms with cognitive and behavioural impairment. In 5-10% of cases, ALS is familial. In 15% of cases, it is associated with frontotemporal degeneration rather than orbito-frontal type. The main differential diagnoses are guided by the clinic: combining pure motor neuropathy with or without conduction block, post-polio syndrome, cramp-fasciculation syndrome, myasthenia gravis, paraneoplastic syndromes, Sjögren syndrome, retroviral infections, some endocrine disorders, some metabolic diseases, genetic diseases (Kennedy and SMA) and inclusion body myositis.
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Affiliation(s)
- Philippe Couratier
- CHU de Limoges, centre de compétence SLA, service de neurologie, 87000 Limoges, France; Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France.
| | - Benoît Marin
- Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France
| | - Géraldine Lautrette
- CHU de Limoges, centre de compétence SLA, service de neurologie, 87000 Limoges, France
| | - Marie Nicol
- CHU de Limoges, centre de compétence SLA, service de neurologie, 87000 Limoges, France; Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France
| | - Pierre-Marie Preux
- Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France
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Zafar SF, Ubogu EE. Subacute brachial diplegia associated with west nile virus myelitis. Muscle Nerve 2012; 45:900-4. [DOI: 10.1002/mus.23315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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8
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Marin B, Kacem I, Diagana M, Boulesteix M, Gouider R, Preux PM, Couratier P. Juvenile and adult-onset ALS/MND among Africans: incidence, phenotype, survival: A review. ACTA ACUST UNITED AC 2012; 13:276-83. [DOI: 10.3109/17482968.2011.648644] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Benoit Marin
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU Limoges, Unité Fonctionnelle de Recherche Clinique et de Biostatistiques,
Limoges, France
| | - Imen Kacem
- CHU Limoges, Service de Neurologie, Centre SLA,
Limoges, France
- Department of Neurology Razi Hospital – La Manouba,
Tunis, Tunisia
| | - Mouhamadou Diagana
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU de Nouakchott, Service de Neurologie,
Nouakchott, Mauritania
| | - Marion Boulesteix
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- Tropals Collaboration
(in alphabetic order of countries): Burkina Faso: Athanase Milogo; France: Benoît Marin, Philippe Couratier, Pierre Marie Preux, Michel Druet-Cabanac; Gabon: Philomène Kouna Ndouongo, Yvonne Assegone Zeh, Gertrude Mouangue; Guinea: Amara Cisse, Fode Abass Cisse, Lansana Laho Diallo; Mauritania: Mouhamadou Diagana, Abderrahmane Moulaye, Cheikh Ould Hace; Tunisia: Riadh Gouider, Imen Kacem, Amina Gargouri
| | - Riadh Gouider
- Department of Neurology Razi Hospital – La Manouba,
Tunis, Tunisia
| | - Pierre Marie Preux
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU Limoges, Unité Fonctionnelle de Recherche Clinique et de Biostatistiques,
Limoges, France
- Tropals Collaboration
(in alphabetic order of countries): Burkina Faso: Athanase Milogo; France: Benoît Marin, Philippe Couratier, Pierre Marie Preux, Michel Druet-Cabanac; Gabon: Philomène Kouna Ndouongo, Yvonne Assegone Zeh, Gertrude Mouangue; Guinea: Amara Cisse, Fode Abass Cisse, Lansana Laho Diallo; Mauritania: Mouhamadou Diagana, Abderrahmane Moulaye, Cheikh Ould Hace; Tunisia: Riadh Gouider, Imen Kacem, Amina Gargouri
| | - Philippe Couratier
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU Limoges, Service de Neurologie, Centre SLA,
Limoges, France
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Kataoka H, Kiriyama T, Kitauti T, Kawahara M, Sugie K, Ueno S. Flail arm syndrome with motor neuron disease rapidly progressing to respiratory failure: a case series and clinical analysis. Eur J Neurol 2010; 17:e90-e91. [PMID: 20629716 DOI: 10.1111/j.1468-1331.2010.03146.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Kataoka
- Department of Neurology, Nara Medical University, Kashihara, Nara, Japan
| | - T Kiriyama
- Department of Neurology, Nara Medical University, Kashihara, Nara, Japan
| | - T Kitauti
- Department of Neurology, Nara Medical University, Kashihara, Nara, Japan
| | - M Kawahara
- Department of Neurology, Nara Medical University, Kashihara, Nara, Japan
| | - K Sugie
- Department of Neurology, Nara Medical University, Kashihara, Nara, Japan
| | - S Ueno
- Department of Neurology, Nara Medical University, Kashihara, Nara, Japan
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Nalini A, Desai A, Mahato SK. Flail arm-like syndrome associated with HIV-1 infection. Ann Indian Acad Neurol 2010; 12:127-30. [PMID: 20142861 PMCID: PMC2812739 DOI: 10.4103/0972-2327.53084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Revised: 06/02/2008] [Accepted: 07/09/2008] [Indexed: 11/04/2022] Open
Abstract
During the last 20 years at least 23 cases of motor neuron disease have been reported in HIV-1 seropositive patients. In this report we describe the clinical picture of a young man with HIV-1 clade C infection and flail arm-like syndrome, who we were able to follow-up for a long period. We investigated and prospectively monitored a 34-year-old man with features of flail arm syndrome, who developed the weakness and wasting 1 year after being diagnosed with HIV-1 infection after a routine blood test. He presented in 2003 with progressive, symmetrical wasting and weakness of the proximal muscles of the upper limb of 2 years' duration. He had severe wasting and weakness of the shoulder and arm muscles. There were no pyramidal signs. He has been on HAART for the last 4 years and the weakness or wasting has not worsened. At the last follow-up in July 2007, the patient had the same neurological deficit and no other symptoms or signs of HIV-1 infection. MRI of the spinal cord in 2007 showed characteristic T2 hyperintense signals in the central part of the spinal cord, corresponding to the central gray matter. Thus, our patient had HIV-1 clade C infection associated with a 'flail arm-like syndrome.' The causal relationship between HIV-1 infection and amyotrophic lateral sclerosis (ALS)-like syndrome is still uncertain. The syndrome usually manifests as a lower motor neuron syndrome, as was seen in our young patient. It is known that treatment with antiretroviral therapy (ART) stabilizes/improves the condition. In our patient the weakness and atrophy remained stable over a period of 3.5 years after commencing HAART regimen.
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Affiliation(s)
- A Nalini
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Barohn RJ. CLINICAL SPECTRUM OF MOTOR NEURON DISORDERS. Continuum (Minneap Minn) 2009. [DOI: 10.1212/01.con.0000300010.02717.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ray RA, Street AF. Non-finite loss and emotional labour: family caregivers? experiences of living with motor neurone disease. J Clin Nurs 2007; 16:35-43. [PMID: 17518867 DOI: 10.1111/j.1365-2702.2006.01722.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES This paper aims to add to nurses' knowledge concerning the losses and emotional labour family caregivers face caring for people living with neurodegenerative, life-limiting illnesses such as motor neurone disease. BACKGROUND Motor neurone disease is a relentless, progressive illness resulting in progressive loss of voluntary muscle mass and function. Previous caregiver research presents the salient losses such as social, financial and relationship loss. However, the non-finite, unpredictable losses faced every day by caregivers and the emotional labour experienced are not effectively represented and have not been explored for caregivers of adult patients with life-limiting, degenerative, illness. DESIGN/METHODS Semi-structured interviews, ecomaps of social support networks and field notes were used to collect data for this ethnographic case study. Data were attained at three time points over a 10-month period from 18 primary caregivers and once from six peripheral caregivers. RESULTS Data revealed new information about the psychosocial and emotional losses experienced daily, when living with motor neurone disease. The impact of the constancy of voluntary muscle degeneration and the uncertainty of the illness progression in terms of available time and functional loss, threatened people's understanding and expectations of life, their relationships, their personal identity and their future. Managing their relationship with the patient and their reactions to the devastation of motor neurone disease is consistent with the concept of emotional labour. CONCLUSIONS Family caregivers living with relentless, life-limiting illness experience non-finite losses and emotional labour on a daily basis. While each individual's experience of loss is unique, nurses need to include caregivers as well as patients, in their spectrum of supportive care. RELEVANCE TO CLINICAL PRACTICE Nurses can be independent confidants who share the emotional labour and work with caregivers to develop interventions to assist them to manage their losses and their changing needs for psychological and emotional support.
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Affiliation(s)
- Robin A Ray
- School of Nursing & Midwifery, La Trobe University, Melbourne, Australia.
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Pradat PF, Bruneteau G. Quels sont les critères cliniques de la sclérose latérale amyotrophique en fonction des formes cliniques ? Rev Neurol (Paris) 2006. [DOI: 10.1016/s0035-3787(06)75162-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pradat PF, Bruneteau G. Quels sont les diagnostics differentiels et les formes frontières de SLA ? Rev Neurol (Paris) 2006. [DOI: 10.1016/s0035-3787(06)75168-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chapter 8 Genetic Aspects of Amyotrophic Lateral Sclerosis/Motor Neuron Disease. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s1877-3419(09)70109-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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