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Sunmonu, TA, Afolabi OT, Komolafe MA, Ogunrin AO.  2011.  Patients' knowledge about their disorder: Perspective of patients with epilepsy in a tertiary health facility in southwestern Nigeria, 2011. Epilepsy and Behavior. 20(3) Abstract

Objective: Previous studies have shown that patients with epilepsy do not have adequate knowledge about their disorder, suggesting that patient education is a vital part of comprehensive care for epilepsy. The goal of this study was to evaluate what Nigerian patients with epilepsy know about their disorder. Methods: Forty-six patients with EEG- and clinically confirmed epilepsy participated in the study. The patients completed the Epilepsy Patients Knowledge Questionnaire. The questionnaire includes topics related to etiology of epilepsy, safety, compliance, legal issues of driving, and employment. The questionnaire scores were correlated with demographic variables, duration of epilepsy, and level of education of the patients. Results: The mean age of the respondents was 26.78 ± 9.27. years; there were 27 males and 19 females. The mean duration of epilepsy in the group was 7.6 ± 7.5. years. The mean rates of correct responses to the issues of safety and compliance were 31.6 and 76.8%, respectively. The mean scores on legal issues of driving and employment were 45.7 and 42.4%, respectively. The lowest score (10.9%) was on the etiology of epilepsy. Conclusion: Nigerian patients with epilepsy lack adequate knowledge about their disorder, and there is a need for improved educational intervention in these patients. © 2010.

Sunmonu, TA, Komolafe MA, Ogunrin AO, Oladimeji BY, Ogunniyi A.  2008.  Intellectual impairment in patients with epilepsy in Ile-Ife, Nigeria, 2008. Acta Neurologica Scandinavica. 118(6) Abstract

Introduction - Epilepsy is the most common non-infectious neurologic disease in developing countries such as Africa, including Nigeria. This study was designed to assess the intellectual performance of patients with epilepsy (PWE) in Nigeria hoping that the result will serve as the basis for educational, vocational, and social counseling. Methods - Forty-one PWE were studied along with 41 age-, sex- and education-matched healthy controls. A questionnaire was developed and applied to all subjects and history was taken from patients and eyewitness. The intellectual function of each subject was assessed with the aid of Wechsler Adult Intelligence Scale adapted for Nigerians. All patients subsequently had electroencephalography (EEG) performed and the EEG findings were noted. SPSS statistical package was used to analyze the data. Result - The PWE performed poorly on the verbal IQ, performance IQ, and full scale IQ scores when compared with controls (P < 0.05) and 20% of PWE had mental retardation. Long duration of epilepsy, long duration of antiepileptic drug therapy, younger age at onset of epilepsy, increased frequency of seizures, and low educational status were found to have negative impacts on intellectual performance in PWE (P < 0.05) while seizure types and type of antiepileptic drugs (carbamazepine or phenytoin) did not influence intellectual performance. Conclusion - This study shows that PWE had significant intellectual impairment when compared with controls. In addition, long duration of epilepsy, long duration of AED therapy, earlier age of onset, increased seizure frequency, and low educational status had a negative impact on intellectual functioning in PWE. Copyright © 2008 The Authors.

Sunmonu, TA, Adekanle O, Komolafe MA, Ndububa DA.  2012.  Cognitive function in patients with liver cirrhosis without overt hepatic encephalopathy: Assessment using an automated neuropsychological test battery, 2012. Arab Journal of Gastroenterology. 13(1) Abstract

Background and study aims: A wide range of neuropsychiatric disorders occur in patients with liver cirrhosis without overt hepatic encephalopathy. Cognitive dysfunctions do occur and these tend to impair patients' vocational and social life as well as activities of daily living. The aim of this study is to evaluate cognitive functions in patients with liver cirrhosis without overt HE in Nigeria. Patients and methods: Thirty-four patients with liver cirrhosis and 41 normal subjects as control were studied. Medical history and general physical/neurological examinations were carried out on all the subjects. Blood samples were obtained for viral serological markers and liver functions tests. The 'Fepsy' automated neuropsychological test battery was performed for the assessment of auditory reaction time (psychomotor speed). Recognition memory test (memory), binary choice reaction task (psychomotor speed/attention) and vigilance task were also administered. The data were analysed with the aid of Statistical Package for Social Sciences (SPSS) version 15.0 software. Results: The mean age of patients with liver cirrhosis was 45.00. ±. 13.83. years, while that of control subjects was 41.88. ±. 139.49. years. The visual/auditory reaction time, binary choice reaction time and computerised visual reaction time were prolonged in patients with liver cirrhosis when compared with control subjects. However, there were differences in the recognition memory test and vigilance performances between the two groups. The patients with liver cirrhosis who had hepatitis C virus infection had poor psychomotor speed when compared with patients who were hepatitis C virus negative, but there was no statistical significant correlation between other aspects of liver function tests and cognitive functions in patients with cirrhosis. Conclusion: Patients with liver cirrhosis had similar cognitive functions on measures of memory and vigilance when compared with normal control subjects. However, there were significant differences in other aspects of cognitive functions between the two groups. © 2012 Arab Journal of Gastroenterology.

Sunmonu, TA, Ogunrin O, Komolafe MA, Ogunniyi A.  2008.  Seizure variables and cognitive performance in patients with epilepsy, 2008. African Journal of Neurological Sciences. 27(2) Abstract

Background and Purpose: Epilepsy is highly prevalent in developing African countries with significant morbidity, social stigmatization, poor quality of life and preventable mortality. There are scanty reports on the contributions of seizure variables like seizure types, frequency of seizures, duration of epilepsy, age at onset and anti-epileptic drugs to cognitive disturbances in Nigerian Africans. This study assessed the effects of seizure variables on the cognitive performances of patients with epilepsy. Methods: The cognitive functions of 41 patients with epilepsy and 41 controls were assessed with a computer-assisted cognitive test battery, Iron Psychology (acronym - FePsy) using the simple and complex reaction time tasks for mental speed, recognition memory test (RMT) for memory and continuous performance test for attention. Results: The cognitive performances of the patients using complex reaction time and the recognition memory tasks were worse than those of the controls (p<0.05). The duration of treatment with anti-epileptic drugs negatively affected all cognitive domains assessed. The seizure frequency, duration of epilepsy and the use of phenytoin were associated with psychomotor retardation and impaired memory. Conclusions: The seizure variables negatively affected cognitive performances of Nigerian patients with epilepsy. Cognitive assessment is recommended as part of regular evaluation of patients with epilepsy. © 2002 African Journal of Neurological Sciences. All rights reserved.

Sunmonu, TA, Sellner J, Ogunrin OA, Imarhiagbe FA, Komolafe MA, Afolabi OT, Ilesanmi OS, Olanrewaju F, Oladimeji BY.  2015.  Intellectual impairment in patients with newly diagnosed HIV infection in southwestern Nigeria, 2015. BioMed Research International. 2015 Abstract

Neurocognitive impairment is a detrimental complication of HIV infection. Here, we characterized the intellectual performance of patients with newly diagnosed HIV infection in southwestern Nigeria. We conducted a prospective study at Owo Federal Medical Center by using the adapted Wechsler Adult Intelligence Scale (WAIS). The raw scores were converted to standardized scores (z-scores) and correlated with clinical and laboratory findings. Fifty-eight HIV positive patients were recruited; 72% were in WHO stages 3 and 4. We detected a high rate of intellectual impairment in HIV positive patients and controls (63.8% and 10%, resp.; P<0.001). HIV positive patients performed worse throughout the subtests of both verbal and performance intelligence quotients. Presence of opportunistic infections was associated with worse performance in the similarities and digit symbol tests and performance and full scale scores. Lower body weight correlated with poor performance in different WAIS subtests. The high rate of advanced disease stage warrants measures aimed at earlier diagnosis and treatment. Assessment of neurocognitive performance at diagnosis may offer the opportunity to improve functioning in daily life and counteract disease progression.

Sunmonu, TA, Komolafe MA, Ogunrin AO, Ogunniyi A.  2009.  Cognitive assessment in patients with epilepsy using the Community Screening Interview for Dementia, 2009. Epilepsy and Behavior. 14(3) Abstract

Objective: Epilepsy is the most common neurological disease worldwide. It may be complicated by cognitive impairments with consequent deleterious effects on education, vocation, and social and family life of affected individuals. We assessed the cognitive functions of Nigerian patients with epilepsy using the modified Community Screening Interview for Dementia (CSID) questionnaire. Methods: Eighty-two subjects (41 patients with epilepsy and 41 normal controls) participated in the study. The CSID was used to assess language, memory, orientation, attention, calculation, and praxis. The SPSS statistical package was used for data analysis. Results: The mean ages (in years) of patients with epilepsy and controls were 28.32 ± 9.22 and 25.98 ± 7.72, respectively. The patients with epilepsy performed poorly when compared with the controls (P < 0.05) in the domains Language, Memory, Attention and Calculation, and Praxis, whereas there was no statistically significant difference between the patients and controls in Orientation scores. Duration of epilepsy and of antiepileptic drug (AED) therapy had a significant negative impact on all domains of the CSID (P < 0.05), whereas type of AED used did not. The CSID had a sensitivity of 91.7%. Conclusion: This study showed that patients with epilepsy have significant cognitive impairments compared with controls, and duration of epilepsy and AED therapy have deleterious effects on their cognitive performance. In addition, the CSID has acceptable sensitivity and predictive value. It is recommended that cognitive function assessment should be an integral part of routine evaluation of patients with epilepsy. © 2009 Elsevier Inc. All rights reserved.

Sunmonu, TA, Komolafe MA, Adewuya A, Olugbodi AA.  2008.  Clinically diagnosed Guillain-Barre syndrome in Ile-Ife, Nigeria., 2008. West African journal of medicine. 27(3) Abstract

BACKGROUND: Guillain Barre Syndrome (GBS) is a neurological disorder that poses a great challenge to medical care. It affects all age groups, gender and socio-economic groups. OBJECTIVE: To determine the pattern of clinical presentation as well as the factors that determine morbidity and mortality in Guillain Barre Syndrome (GBS) patients. METHODS: The case records of all the patients with diagnosis of GBS from 1988-2005 were retrieved. Socio-demographic, clinical data and laboratory investigations were collated. RESULTS: There were a total of 14 patients managed during this period, which comprised seven males and seven females. The mean(SD) age was 23.6 (13.3) years. Nine (64.3%) patients were students, only one (8%) patient was a professional and the rest 4 (36%) were artisans. Five (36%) patients presented with weakness of both upper and lower limbs while another five (36%) patients presented with weakness of the lower limbs only and four (28%) patients had bulbar symptoms in addition to weakness of the upper and lower limbs. The most common prodromal symptoms were headache, fever and joint pains. The common symptoms at presentation were excessive sweating paraesthesia (43%), urinary hesitancy and retention (35%). Physical findings include Flaccid quadriparesis 13 (93%), autonomic dysfunction 9 (64.3%), sensory impairment (71.4%) and cranial neuropathies 6 (43.5%). Albuminocytological dissociation was present in the cerebrospinal fluid of five (56%) of nine patients who had lumbar puncture done and erythrocyte sedimentation rate (ESR) was elevated in five patients (38%). The sex, age presenting complaints and treatment given were found not to have correlation with clinical outcome. The pattern of motor paresis and the nature of discharge patient had were significantly correlated with clinical outcome. CONCLUSION: Guillain Barre syndrome present impotant challenge to medical care in Nigeria and it is hoped that this study would sensitize clinicians to the clinical burden of Guillain Barre syndrome among Nigerians.