Background: Stroke is the third leading cause of death worldwide. Stroke mortality has been noted to be higher in blacks in biracial studies. There have been few studies on stroke mortality and its predictors in Nigeria. This study examines mortality of stroke and its predictors in a Northern Nigerian teaching hospital. Methods: This was a prospective study that was carried out at Jos University Teaching Hospital in Nigeria. One hundred and twenty stroke patients admitted into the medical wards within one year were assessed. Demographic data was recorded. Patients were examined and ancillary investigations were carried out. The deaths and predictors were recorded. Multivariate logistic regression was used to identify independent predictors of mortality. Results: There were one hundred and twenty participants. Forty two (35%), patients died. Most (76.2%) deaths occurred within the first week. Predictors of mortality on univariate analysis were age ≥ 60 years, male sex, loss of consciousness, high NIHSS score (≥16), the presence of co-morbid conditions and presence of complications. On multivariate analysis, the predictors of mortality were the presence of co-morbid conditions, GCS<10 and high NIHSS score. Conclusion: Stroke mortality was quite high in this study. Predictors of mortality were the indices of severity and the presence of co-morbid conditions.

Background and Aim. Epilepsy remains a stigmatized disease especially in Sub-Saharan Africa. Lack of information and illiteracy has been blamed as the cause of the stigmatization. This stigmatization stems from the fact that the traditional African belief views epilepsy as a spiritual disease. We studied the knowledge, attitude, and perception towards epilepsy amongst medical students comparing the knowledge of the clinical students with that of the basic medical (preclinical) students. Methodology. The participants were medical students in University of Uyo. We administered questionnaires which explored the knowledge of etiology (perceived and medically proven). We studied the beliefs in infectivity of epilepsy, treatment together with their attitudes, and perception to persons with epilepsy. Results. Most of the participants do not have a good knowledge of epilepsy. The knowledge, however, was much better amongst the clinical students. There is some difference in the attitudes of the clinical students compared with the basic students. Conclusion. There is a knowledge gap in epilepsy even amongst medical students. Participants still harbor the traditional African beliefs that epilepsy is a spiritual disease. Mercifully, the knowledge is better amongst the clinical students. This is not surprising since the clinical students have had clinical exposure to epilepsy.

Background: Stroke is one of the major public health problems in the world today. It is the third leading cause of death worldwide after ischaemic heart disease and cancer. Stroke mortality is especially high in sub Saharan Africa (SSA) which accounts for as much as 87% of all the stroke deaths. Stroke however has become a treatable disease.

Background Clinical disease registries are useful for quality improvement in care, benchmarking standards, and facilitating research. Collaborative networks established thence can enhance national and international studies by generating more robust samples and credible data and promote knowledge sharing and capacity building. This report describes the methodology, baseline data, and prospects of the Nigeria Parkinson Disease Registry. Methods This national registry was established in November 2016. Ethics approval was obtained for all sites. Basic anonymized data for consecutive cases fulfilling the United Kingdom Parkinson's Disease Brain Bank criteria (except the exclusion criterion of affected family members) are registered by participating neurologists via a secure registry website (http://www.parkinsonnigeria.com) using a minimal common data capture format. Results The registry had captured 578 participants from 5 of 6 geopolitical zones in Nigeria by July 2019 (72.5% men). Mean age at onset was 60.3 ± 10.7 years; median disease duration (interquartile range) was 36 months (18–60.5 months). Young‐onset disease (<50 years) represented 15.2%. A family history was documented in 4.5% and 7.8% with age at onset <50 and ≥ 50, respectively. The most frequent initial symptom was tremor (45.3%). At inclusion, 93.4% were on treatment (54.5% on levodopa monotherapy). Per‐capita direct cost for the registry was $3.37. Conclusions This is the first published national Parkinson's disease registry in sub‐Saharan Africa. The registry will serve as a platform for development of multipronged evidence‐based policies and initiatives to improve quality of care of Parkinson's disease and research engagement in Nigeria. © 2020 International Parkinson and Movement Disorder Society

ParticipantsThe sample size was calculated using the formula for comparison of two means and each group had 30 participants. All the participants had acute supratentorial ischaemic stroke and presented within 14 days of ictus. Their ages were between 18 -85 years. Enrolled were J Neurol Stroke. 2019;9(1):47-51. 47 AbstractBackground: Hemiparesis and hemiplegia are sequelae of stroke and constitute major disability. Studies have shown heightened brain plasticity in the first one month post stroke with positive influence on motor recovery. We set out to identify a role for early commencement for the drug fluoxetine in enhancing motor recovery in patients with acute ischaemic stroke. Methods:This was a single-blind, randomized, controlled trial carried out at the University of Uyo Teaching Hospital, Uyo. Participants were patients older than 18 years of age with clinical and neuroimaging evidence of stroke, hemiparetic with FMMS < 55, NIHSS <16 and enrolled after giving informed consent. Block randomisation was done, with patients assigned to two groups in a 1:1 ratio; fluoxetine 20 mg once a day + hospital stroke protocol or hospital stroke protocol alone for one month starting as soon as patients were enrolled. Outcome measures were the FMMS and the Barthel index at enrolment and exit.Results: Thirty eight participants were analysed using intention to treat principle. The mean change in FMMS showed a positive trend in the fluoxetine group. Furthermore, the mean Barthel index at exit in the fluoxetine group was significantly higher than the control group p<0.03.Conclusion: Fluoxetine, if started in the acute phase of ischaemic stroke may improve functional status. It also shows a positive trend towards enhancing motor recovery.Citation: Dike FO, Ekeh BC, Ogun AS, et al. Pharmacological enhancement of motor function recovery in patients with acute ischaemic stroke: a trial of fluoxetine.Citation: Dike FO, Ekeh BC, Ogun AS, et al. Pharmacological enhancement of motor function recovery in patients with acute ischaemic stroke: a trial of fluoxetine.

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Background Data on non‐motor symptoms (NMS) in black Africans with Parkinson's disease (PD) are sparse. Objective To describe the profile of NMS in the Nigeria PD Registry (NPDR) cohort and explore the relationship between NMS and PD motor phenotype. Methods We conducted a cross‐sectional study of the frequency and burden of NMS, based on the non‐motor symptoms scale (NMSS) and the Chaudhuri method respectively in our cohort. Baseline demographics, disease characteristics (Hoehn and Yahr stage, MDS‐UPDRS total score and Part III motor score), motor phenotype (based on Stebbin et al's algorithm), and levodopa equivalent daily dose (LEDD) were documented. Results Data are presented for 825 PD whose mean age at study was 63.7 ± 10.1 years, female sex—221 [26.8%] while median PD duration was 36 months. PD phenotypes included tremor‐dominant 466 (56.5%), postural instability and gait disorder (PIGD) 259 (31.4%), and indeterminate 100 (12.1%). 82.6% were on treatment (median LEDD of 500 mg/24 hours). 804 (97.5%) endorsed at least 1 NMS. The median NMSS score was 26.0 while subscores for urinary and sexual function domains were significantly higher in males (P < 0.05). PIGD‐PD had more frequent NMS and higher frequency of severe/very severe NMSS burden (P = 0.000 for both). Nocturia and fatigue were the most prevalent NMS overall and across motor subtypes. PIGD phenotype and total UPDRS scores were the independent determinants of NMSS scores (P = 0.000). Conclusion The profile and burden of NMS, and association with motor subtype in our black African cohort is largely similar to descriptions from other populations.

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