1.Case series of probable Creutzfeldt- Jacob Disease admitted in a tertiary hospital in Metro Manila
Myleene F. Erola-Fuentes ; Jo Ann R. Soliven
Philippine Journal of Neurology 2024;27(1):38-48
Background:
Creutzfeldt-Jakob disease is a rapidly progressive, fatal, transmissible neurodegenerative
disorder caused by a prion protein. It is characterized by cognitive decline, motor dysfunction,
and eventually, death. It occurs globally with 1 case per one million population/year. And It is
still considered rare in countries like the Philippines due to challenges in its diagnosis and the
under recognition of its clinical features. As of now, the local prevalence or incidence of this
disease in our country remains unknown, as only a single case report has been documented. As
of now, the local prevalence or incidence of this disease in our country remains unknown, as
only a single case report has been documented.
Objective:
To report a series of patients with probable sporadic CJD from a tertiary hospital in the Philippines.
Materials and Methods:
Patients with rapidly developing dementia fulfilling the diagnostic criteria for sCJD were
included. All were investigated in detail to find out any possible treatable cause, including
electroencephalography (EEG), magnetic resonance imaging (MRI) of the brain, and
cerebrospinal fluid analysis.
Results:
A total of 3 patients with probable sCJD were diagnosed using the European diagnostic criterion
from January 2022 to April 2023. The clinical features are consistent with other reported
series. All 3 patients had the classical EEG findings, typical MRI features, and positive for
14-3-3 assay, and one was positive for RT-QuIC. Two patients died within 13 months from the
disease onset.
Conclusion
This is the first reported case series of probable sCJD in the Philippines from a tertiary hospital
in Metro Manila. Like in our patients, this disease should be considered in individuals with
rapidly progressive dementia associated with myoclonus, neuropsychiatric symptoms, akinetic
mutism, visual abnormality, and ataxia with signs of pyramidal and extra-pyramidal
dysfunction. Although a definitive diagnosis must be histopathological, there are ancillary tests
that are currently available that allow us to make a probable diagnosis of sCJD possible. Our
study raises question about the prevalence of this disease in the Philippines which needs more
validated studies from other parts of the country.
Creutzfeldt-Jakob Syndrome
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Neurodegenerative Diseases
2.Emerging utility of endovascular thrombectomy in the Philippines: A single-center clinical experience
Glenn Anthony A. Constantino ; Miguela Marie A. Señ ; ga ; Jo Ann R. Soliven ; Victor Erwin D. Jocson
Acta Medica Philippina 2023;57(5):44-50
Background and Objective:
Stroke has remained one of the primary causes of significant morbidity and mortality. Among the therapeutic options for acute stroke management, endovascular thrombectomy is intended to remove the thrombi within the intracerebral vasculature and restore adequate perfusion to the surrounding penumbra. It is recommended up to 24 hours from onset of neurologic symptom. In the Philippines, only a few tertiary healthcare institutions are able to offer and perform endovascular thrombectomies. The aim was to describe the profile and discharge outcomes of endovascular thrombectomy for acute ischemic stroke at a tertiary hospital in our country.
Methods:
We conducted a retrospective records review among 924 patients admitted for acute ischemic stroke from October 2018 to August 2021 who underwent mechanical thrombectomy. Clinical and functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Score (mRS).
Results:
Among 31 patients included in the study, 29 subjects (93.5%) had moderate to severe disability (mRS 3–5), and 25 (80.6%) had moderate stroke (NIHSS 6–21) on admission. The identified site of the cerebrovascular thrombi was within the M1 segment of the middle cerebral artery (41.9%, n=13). The stent retriever approach was performed in 19 participants (61.2%). Upon discharge, only 7 (22.6%) had favorable functional outcomes (MRS 0–2), and 9 (29.0%) resulted in mortality. Successful reperfusion was achieved in 92.3% of the patients.
Conclusion
Overall, endovascular thrombectomy is a possible treatment option for large vessel acute ischemic stroke in developing countries.
thrombectomy
;
endovascular procedures
;
ischemic stroke
;
treatment outcomes