East African Journal of Neurological Sciences

Three Years Of The East African Journal Of Neurological Sciences (EAJNS)

Felix Mburu Njoroge, Faisal M Nageyle, Philip Maseghe Mwachaka — Wed, 19 Feb 2025 00:00:00 +0000

The East African Journal of Neurological Sciences is a premier journal dedicated to advancing the field of neurological sciences by publishing high-quality, innovative research. Since its inception three years ago, the journal has consistently showcased groundbreaking studies spanning basic, translational, and clinical neurosciences. With 9 issues published to date, it has steadily grown in both reach and impact, attracting contributions from esteemed researchers across Africa and beyond. Over the years, the journal has not only expanded its readership but has also strengthened its editorial team, bringing together a diverse group of experts committed to upholding rigorous scientific standards and fostering knowledge exchange. As we continue to evolve, our mission remains steadfast: to be at the forefront of neurological research, providing a trusted platform for scientific discovery and collaboration in Africa and globally.

Differences In The Histomorphology Of The Neural Retina In Rattus Norvegicus Offspring Due To Varying Maternal Peri-gestational Dietary Folate Levels

Wallace Munyiri, Kevin Ongeti, Anne Pulei, Philip Maseghe Mwachaka — Wed, 19 Feb 2025 00:00:00 +0000

Background: Nutrition, particularly folate, is crucial for embryonic development, affecting processes like retinogenesis. However, the impact of varying maternal folate levels on the neural retina's structure remains underexplored. Objective: This study aims to describe the histomorphological differences in the neural retina of Rattus norvegicus offspring due to varying maternal perigestational dietary folate levels. Study Design: The study used primary data from a previous randomized experimental study on 20 rats (40 retinas) divided into four groups: folate-deficient (0 mg/kg), control (2 mg/kg), folate-supplemented (8 mg/kg), and folate-suprasupplemented (40 mg/kg). The morphology of the neural retina was studied across the groups. Results: The folate-deficient diet group exhibited significant retinal disruptions, including focal widening of intercellular spaces in the inner nuclear layer, vacuolisation in the ganglion cell layer, and detachment of the internal limiting membrane. In contrast, the folate-supplemented diet group showed preserved retinal structure with an intact internal limiting membrane. However, the folate supra-supplemented diet group displayed retinal abnormalities similar to the deficient group, with focal widening of intercellular spaces, internal limiting membrane detachment, and retinal folding. Conclusion: Folate deficiency and suprasupplementation both disrupt retinal morphology, while normal supplementation preserves retinal structure, highlighting the importance of balanced folate intake for maintaining retinal health.

Prevalence of the Posterior Ponticulus and Arcuate Foramen in a Kenyan Population: A Cross-Sectional Radiological Study

Wed, 19 Feb 2025 00:00:00 +0000

Background: Complete posterior ponticuli and the resultant arcuate foramen may compress the third part of the vertebral artery and the sub occipital nerve as they cross the neural arch of the atlas. This may manifest with neurological deficits and also complicate surgical access to lesions in the craniovertebral junction. The prevalence of the ponticulus has been shown to have sexual dimorphism and population differences. The aim of this study was to determine its prevalence and distribution across the sexes in the study population. Methodology: This was a cross-sectional Survey of 116 patients (equal numbers of males and females) done between August and October 2021 at the Radiology Department of Kenyatta National Hospital after ethical approval. Far lateral sagittal Computed tomography scans of the Craniovertebral junction and 3D reconstructions were analyzed in PACS software. The presence and completeness of the posterior ponticulus and arcuate foramen was determined. Chi square test was used to analyze gender differences in their distribution. Results: The prevalence of complete posterior ponticuli was at 15.5%, with unilateral ponticuli more common than bilateral ones (twelve versus six). There were no significant gender differences in terms of distribution. Conclusion: Variations of the posterior arch of the atlas are relatively high in the studied population, necessitating a low threshold for imaging before surgery, and high index of suspicion in neurological deficits involving the posterior circulation of the brain

Female African Neuroscientists of Tomorrow: Assessing the Impact of Ubongo Brain Awareness Workshops on Kenyan High School Girls' Interest in Neuroscience Careers

Wed, 19 Feb 2025 00:00:00 +0000

Background: Africa faces a significant disparity in neurological care due to a shortage of specialized practitioners. This is further compounded by the underrepresentation of women in neuroscience careers. This study aimed to assess the impact of the Ubongo Brain Awareness Campaign on female high school students' interest and perceptions regarding neuroscience careers. Methodology: This study used a cross-sectional survey with female high school students from twos schools in Nairobi who participated in the Ubongo Brain Awareness Campaign. Workshops included lectures and practical sessions on neuroscience. Data was collected through surveys and analyzed using descriptive statistics and thematic analysis to assess students' interest and knowledge in neuroscience. Results: The study involved 42 female high school students (ages 14-18) who participated in the Ubongo Brain Awareness Campaign. Post-campaign, students reported increased interest in neuroscience, with average interest levels rising from 3.88 to 4.14 on a 5-point scale. Nearly 98% felt more informed about career opportunities in neuroscience, and 75% experienced a positive perception change. Key challenges included lack of resources, financial constraints, and concerns about the demanding nature of the profession. Students suggested more practical workshops, continuous engagement, expanded outreach, and detailed career information to enhance future neuroscience campaigns and support their career aspirations. Conclusion: The Ubongo Brain Awareness Campaign significantly boosted students' interest in neuroscience, highlighting the campaign's success. Key challenges included resource shortages, financial barriers, and limited mentorship. Recommendations include increasing hands-on activities, continuous engagement, expanded outreach, and mentorship programs to address gender disparities in neuroscience.

Encephaloceles In Kenya: A Retrospective Analysis Of Risk Factors, Caregiver Burden, And Healthcare Challenges

Faisal Nageyle, Nyakio Mburu, Mwenda Muriuki, Michael A Magoha — Wed, 19 Feb 2025 00:00:00 +0000

Introduction: Encephaloceles are rare congenital defects characterised by a cranial defect with herniated content resulting from the failure of skull bone fusion or rostral neuropore closure. The specific aetiology of the condition is unknown but may result from maternal micronutrient deficiency, infections, genetic predisposition, environmental factors, and drug use. Methods: A case series study was carried out at Kenyatta National Hospital to identify the risk factors for encephalocele among patients treated there between 2015 and 2021. Telephone interviews were also conducted to determine the presence of emotional and psychological distress among the patients' carers. The transcription and analysis of recordings were done. Results: A total of 47 patient files were included in the study, and 16 caregivers completed the telephone interviews. The most common type of encephalocele was occipital and was more common among males. Most patients were diagnosed at birth; 56% of mothers attended four or more ANC visits; only 25% completed a folic acid regimen; 6% of caregivers had extreme depression; and 13% had severe depression. Conclusion: Encephaloceles impose considerable emotional, psychological, and financial burdens on caregivers, hence indicating a substantial need for psychological support.

Unusual Headaches Revealing Neurolupus In Lome: Case Report And Review Of Literature

Wed, 19 Feb 2025 00:00:00 +0000

Systemic lupus erythematosus (SLE) is a chronic idiopathic autoimmune disease that affects various organs, including the central nervous system (CNS) and peripheral nervous system (PNS). Neurological and psychiatric manifestations of systemic lupus erythematosus or neurolupus (NPSLE) may present as a headache. We report a case of neurolupus characterized by diagnostic wandering. The patient, a 38-year-old woman, was admitted because of persistent headaches refractory to analgesics in the context of chronic headaches that had developed since adolescence diagnosed as migraine. Her personal medical history was marked by pyrosis, polyarthralgias, dermatosis. She was admitted to the hospital with right hemicorporeal paresthesias and worsening headaches, and the clinical examination found hyperreflexia, a malar rash, multiple hypochromic sequelae lesions of dermatosis in all 4 limbs. Brain MRI showed a non-systematised left parieto-occipital lesion on T1 isosignal, T2 and FLAIR hypersignal, not enhanced by gadolinium. The cerebrospinal fluid showed a relative hyperproteinorrhea, the presence of red blood cells (05/mm³), and leukocytes (46/mm³). Blood biology found an inflammatory syndrome with moderate anaemia, an accelerated sedimentation rate of 100 mm at the first hour, a C-Reactive Protein (CRP) at 22.8 g/l (normal less than 5 g/l), positive rheumatoid factors, positive antinuclear antibodies in the indirect immunofluorescence assay (on Hep 10-20 slides), at a titer of 1/320, negative deoxyribonucleic acid antibodies and positive anti-Smith antibodies. The diagnosis of SLE was confirmed based on the American College of Rheumatology (ACR) criteria with a score of 23. Excluding primary and secondary headaches, the patient's headaches satisfied the criteria for NPSLE. She was treated with corticosteroids and then methotrexate. After 3 months of treatment, a regression of headaches and cerebral signal abnormalities was noted.

Spontaneous Thoracic Epidural Hematoma Linked to Heavy Weight Lifting in a 29-Year-Old Male: A Case Report

Kyombya Peter — Wed, 19 Feb 2025 00:00:00 +0000

Background: Spontaneous spinal epidural hematoma (SSEH) is a rare and serious condition characterized by the accumulation of blood in the epidural space of the spine without any apparent cause. Although it is an uncommon clinical entity, SSEH can lead to acute neurological deficits and requires prompt intervention. This report explores the potential link between heavy lifting and the onset of SSEH in a young, otherwise healthy individual. Case Presentation: We present the case of a 29-year-old male who developed severe upper back pain following an episode of heavy lifting, which progressed to sudden paralysis. MRI revealed a thoracic epidural hematoma extending from T1 to T3, causing significant spinal cord compression. The patient underwent urgent posterior decompression surgery, which led to full neurological recovery within 24 hours. Discussion: This case underscores the potential for heavy lifting to trigger SSEH, a condition that can lead to rapid neurological decline. Early recognition, accurate diagnosis through MRI, and prompt surgical intervention are essential to prevent permanent damage and optimise patient outcomes. Conclusion: Physicians should consider SSEH in patients presenting with acute spinal cord symptoms following exertional activities like heavy lifting. Immediate intervention is crucial to ensure favourable outcomes in this rare but potentially devastating condition

Coexistence of Pituitary Macroadenoma and Dacryoadenitis: A Complex Presentation in a Patient.

Wed, 19 Feb 2025 00:00:00 +0000

Pituitary adenomas are slow-growing, benign tumors of the anterior pituitary gland. While their small size usually makes their presence unknown, macroadenomas may cause clinical symptoms due to their mass effect. Dacryoadenitis is inflammation of the lacrimal gland, usually associated with infection. This case report details the clinical assessment and diagnostic journey of a 57-year-old male farmer, J.M., presenting with a constellation of symptoms including bilateral visual deterioration, persistent headaches, and left eye protrusion. Clinical examinations, imaging studies, and histological findings culminated in the identification of a coexisting pituitary macroadenoma and dacryoadenitis. This report highlights the challenges in diagnosing and managing such intricate presentations and emphasizes the necessity of interdisciplinary collaboration for accurate diagnosis and tailored treatment plans. Advancements in minimally invasive surgical techniques and targeted medical therapies have significantly improved patient outcomes and reduced treatment-related morbidity. Future practice should focus on early recognition and effective management of these complex presentations to enhance patient quality of life.

Neuroanatomical Basis of Addiction: A narrative Review

Joshua Falade, ajiboyeoluwafemi938@gmail.com — Wed, 19 Feb 2025 00:00:00 +0000

Background: The review titled "A Neuroanatomical Basis of Addiction" explores the complex neurobiological mechanisms that lead to addiction, particularly focusing on the transition from recreational use to substance use disorders. It introduces a heuristic framework that categorizes addiction into three stages: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation, each linked to specific neurocircuitries. Aim: The aim of the review is to elucidate the neuroanatomical underpinnings of addiction and to discuss how neuroplastic changes contribute to compulsive behaviors associated with substance use disorders. Methodology: The review synthesizes recent advancements in neuroimaging and neurogenetic research, examining the neurochemical pathways and microcircuits involved in addiction-related behaviors. It emphasizes the role of key brain regions, including the basal ganglia, extended amygdala, and prefrontal cortex, in the addiction process. Results: Findings reveal that alterations in incentive salience, emotional regulation, and executive function within these circuits drive the compulsive nature of addiction. The review highlights the significance of individual differences in neurobiology, which can inform targeted interventions. Conclusion: The insights gained from the neuroanatomical framework have important implications for public health policies and prevention strategies, especially amid the ongoing opioid crisis and the legalization of substances like marijuana. The review advocates for a deeper integration of neuroscience in addiction research to enhance clinical practices and recovery outcomes.

The Status of Neuroscience in East Africa: A Narrative Review

Wed, 19 Feb 2025 00:00:00 +0000

Background: The rising prevalence of neurological disorders in East Africa highlights a significant disparity between the escalating disease burden and the region's capacity for neuroscience research and healthcare provision. Factors such as inadequate training, limited funding, insufficient research infrastructure, and brain drain of skilled professionals exacerbate this gap. Objective: This narrative review examines the current state of neuroscience in East Africa, identifies key challenges, explores recent innovations, and proposes strategic solutions to enhance neuroscience research, education, and healthcare delivery in the region.Methods: A narrative review approach was adopted, involving a comprehensive analysis of published literature, regional reports, and relevant case studies. Sources included peer-reviewed journals, organizational reports, and data from neuroscience initiatives and collaborations. Emphasis was placed on identifying systemic barriers, successful interventions, and actionable recommendations for improving neuroscience in East Africa. Findings: Innovative diagnostic and treatment techniques, such as neuroimaging and telemedicine, have shown promise in addressing some challenges. Regional and international collaborations, including initiatives by organizations such as the Society of Neuroscientists of Africa (SoNA), Pan African Association of Neurological Sciences (PAANS), and East African Association of Neurological Surgeons (EAANS), have contributed significantly to advancing neuroscience research and education. However, these efforts remain insufficient in addressing the broader systemic challenges. Conclusions: Addressing the challenges in neuroscience research and healthcare in East Africa requires a multifaceted approach emphasizing educational enhancement, investment in indigenous biodiversity research, and improved funding and infrastructure. Strengthened regional and international partnerships are critical for building sustainable neuroscience capacities, ultimately improving the management and treatment of neurological disorders in the region.