There have been multiple reports already regarding acute carbon monoxide/CO poisoning in the Philippines secondary to misuse of portable generators, especially during the times of typhoon. We present a case of unintentional carbon monoxide poisoning in a Filipino household wherein three of its members were found dead and leaving other five unconscious before they were rushed to the hospital. The index patient had increased serum fraction percentage of carboxyhemoglobin level and presented with rhabdomyolysis during admission. Neuroimaging confirmed a hypoxic-ischemic encephalopathy secondary to carbon monoxide intoxication. Even without hyperbaric oxygen therapy, patient improved with adequate hydration, early rehabilitation and trauma-focused psychotherapy.
Carbon Monoxide Poisoning ; Carbon Monoxide ; Family Characteristics

The CNS Infection Censuses for 2011 and 2012 from 9 neurology training programs in 7 institutions in the Philippines were collated to determine the types of CNS infections seen in the country and their relative frequencies. A comparison with a similar survey done in 1999 was made. A total of 1629 cases of CNS infections were recorded. There were 23 categories. Bacterial meningitis (34.3%) and TB meningitis (30.7%) were the top two infections, constituting more than half of all CNS infections seen. When the adult and pediatric census were separated, TB meningitis came up to be the most common infection in adults (43%) with bacterial meningitis a poor second at 19.4%. The reverse is seen in the pediatric population – bacterial meningitis (41.7%) vs. TB meningitis (24.6%). Cryptococcal meningitis was more frequent in the adult census (8.1%) compared with the pediatric census (0.1%). These patterns were seen in a similar census done in 1999. A significant increase in relative frequency in cryptococcal cases was seen in the later census (2.8% vs. 2.0%), the increase being due to the marked increase in the adult group (8.1% vs. 4.3%), probably due to the upward trend in the incidence of HIV cases in the country. No increase in this category was seen in the pediatric population. The benefits of collaboration among institutions in coming up with a large number of cases of CNS infections and a greater variety to study was highlighted. The study was conducted by the CNS Infection Council of the Philippine Neurological Association.
Central Nervous System Protozoal Infections ; Censuses ; Philippines

Introduction: This study aimed to describe retinal microvascular changes in patients diagnosed to have stroke and determine the association between retinal microvascular changes and type of stroke (lacunar and non-lacunar). Methods: This is a cross-sectional descriptive study conducted among stroke patients seen at the Neurology Ward and Neurology Out-Patient Clinic of the UERM Memorial Medical Center. The patients' demographic characteristics and risk factors were obtained through a standardized questionnaire. Retinal photographs of both eyes were taken in eligible patients who consented to join the study. Retinal vascular changes were identified and their association with the type of stroke was determined. Results : Thirty-seven patients, 64% of whom had small artery occlusion type of lacunar stroke, were enrolled in the study. The most prevalent retinal abnormalities for each type of stroke were AV nicking and focal arteriolar narrowing. The prevalence of abnormal retinal findings between patients with lacunar stroke and non-lacunar stroke were compared and showed insufficient evidence to demonstrate a statistical significance between abnormal retinal findings and lacunar stroke. Conclusion There is no significant association between abnormal retinal findings and lacunar stroke.
Stroke ; Stroke, Lacunar

INTRODUCTION

Spinocerebellar ataxia 7 (SCA7) is a slowly progressive autosomal dominant neurodegenerative disorder characterized clinically by cerebellar ataxia associated with cone-rod and retinal dystrophy. In the Philippines, only a few case reports are documented regarding spinocerebellar ataxias.

CLINICAL PRESENTATION

D.I. is an 1 8-year old female who presented with a 4-year history of progressive blurring of vision and ataxia. Pertinent findings in the neurologic examination include impaired visual acuity, optic disc pallor with bull's eye maculopathy, hyperreflexia, and ataxia.

DIAGNOSTIC WORK-UP

Cranial CT scan revealed mild atrophy of the midbrain and pons, and moderate cerebellar atrophy. Follow-up cranial MRI showed multiple non-enhancing punctuate foci of increased T2 signal involving the subcortical and periventricular white matter bilaterally seen in demyelinating disease, vasculitis as well as chronic migraine headaches, with no associated mass effect. Mild to moderate atrophy of the cerebellar hemispheres, pons and middle cerebellar peduncles bilaterally were seen. CSF analysis, CSF IgG and BAER results were normal. Flouroscein angiography confirmed the presence of Bull's eye maculopathy. Goldmann perimetry revealed bilateral central scotoma. Visual evoked potential was abnormal s uggestive of a pre-chiasmatic l esion. Electroretinogram findings were consistent with tapetoretinal degeneration.

TREATMENT AND FOLLOW UP

Treatment modalities for the spinocerebellar ataxias are supportive. Genetic counseling is recommended. Plans for molecular genetic testing for the patient and her family are currently underway.

Human ; Female ; Adolescent: 13-18 Yrs Old ; Olivopontocerebellar Atrophies ; Spinocerebellar Ataxias ; Spinocerebellar Ataxia Type 7