Neurological syndromes management and prognosis in sickle-cell anaemia

Neurological complications of sickle cell anemia in Nigerian Africans--a case-control study

PURPOSE

To determine the neurological complications associated with sickle cell anaemia (SCA) in Nigerians and evaluate the relative frequencies.

METHODOLOGY

Six-hundred-thirteen patients with SCA attending outpatient clinics of Lagos University Teaching Hospital and 616 control subjects were evaluated using a uniform structured questionnaire to determine the occurrence of neurological complications. The relative frequencies of neurological abnormalities in patients and controls were compared.

RESULTS

Neurological abnormalities occurred in a significantly higher percentage of patients (76%) compared to controls (32.1%). Among children, these abnormalities included stroke, febrile seizures and headache. Among adolescents and adults, the abnormalities included paraplegia, epileptic seizures and localized sensory neuropathy. Headache occurred in a significantly higher percentage in children and adolescents compared to controls, but not in adults.

CONCLUSIONS

We conclude that SCA is associated with neurological complications: stroke and febrile seizures in children, epileptic seizures, paraplegia and localized sensory neuropathy in adolescents and adults, headache in children and adolescents. Detailed studies of each of these complications would be required to provide further insight into their significance.

Auditory event-related potentials and reaction times during simple sensorymotor tasks in subjects with sickle cell disease and related hemoglobinopathies

40 subjects of both sexes assigned to five groups of 8: healthy students, homozygous sicklemics, hemoglobin SC sicklemics, sickle cell Bo thalassemics, and sickle cell B+ thalassemics were subjected to 1/simple auditory stimuli; 2/paired auditory stimuli. The subjects were asked to respond quickly, by pressing a push button on detection of the simple stimulus or the unconditional stimulus of paired stimuli. A subsequent increase in reaction times and a reduction in event-related potential component amplitudes were obvious in major (SS and SC) sicklemics compared to controls and sickle cell B thalassemics. Between simple and paired auditory conditions, reaction times were more increased in sicklemics than in controls. These findings suggest that impairment of attentiveness, performance and cognitive capability in sicklemics is a function of sickle cell anemia severity.