$316 Wednesday, November 9, 2005 Poster Abstracts

neurological disorder and myoclonicjerks. Of these 55 patients 42 were from EHP, including 32 whose onset was in the 2-year period 1997- 1998. Results: The atnmal incidence o f SSPE in EHP in these 2 years was 98 per million populat ion under 20 years of age, the trighest ever reported. The mean age of onset of SSPE was 7.7 years (range 2.8- 14.8 years) and the interval between measles and the onset of SSPE, where known, had a mean of 5.9 years and a range o f 2.5-11.1 years. A m o n g the SSPE patients 19 had a documented history of measles vaccination. Eight of these 19 also had documentat ion of previous measles illness; of these, seven were vaccinated after the development of measles and one was vaccinated 20 days before measles illness. Two non-SSPE children received vaccination twice which was documented subsequently developed measles which was also substantiated by documentation. Two patients with SSPE yielded amplified nucleotide sequences of measles virus that were different from any of the vaccine strains. We found no evidence to implicate measles vaccination in the development of SSPE. Conclusion: This incidence (98 per million populat ion under 20 years of age annually) was more than ten times higher than the highest incidence in the prevaccine era reported from elsewhere. We found no evidence to implicate measles vaccination in the development of SSPE.

0847 Predictors of stroke in palients wilh Tuberculous Meningilis

Tan, K 1, Chai 31, Lint C 1, Venketasubramatrian N 1. 1National Neuroseienee Institute, Singapore

Background: Cerebral infarctions among patients with tuberculous meningitis (TBM) may be due to basal meningitis-induced vasculitis. There are presently no predictors of stroke in TBM patients. We aim to identify the clinical, pathological and radiological factors that predispose these patients to cerebral infarctions. Methods: We reviewed retrospectively all patients diagnosed with TBM from a regional hospital f rom 1994 to 2003. The clinical findings, relevant laboratory and neuroimaging results as well as outcome were recorded. Analysis was performed with SPSS. Results: Forty-three patients were identified (24 males, 19 females). The racial distribution was 19 Chinese (44.2%), 10 Malays (23.3%), 11 Indians (125.6%) and 3 Other Races (17%). Eighteen (41.9%) had definite and 25 (158.1%) had probable TBM. Seventeen (39.5%) developed symptomatic ischaemic strokes; there were no haemorrhagic strokes. Severity of meningitis as graded by Medical Research Council (MRC) stage on admission was positively correlated with the likelihood of developing strokes (p - 0.012). Patient 's age, gender, race, symptoms, im_munocompetency, haematological and cerebrosp- inal chemical markers and radiological features were not predictive for the development of strokes. Outcomes of disability as measured by Rankin scale at discharge and death did not differ between the 2 groups (]3 - 0.06 and p -- 0.58 respectively). Conclusion: Patients with more severe tuberculous meningitis at presentation were more likely to develop strokes. Wi thout other good predictors of strokes in this group of patients, clinicians need to be alert to any change in each patient 's condition and have a high index of suspicion for strokes if the patient deteriorates. Patients who developed strokes were not more likely to become more disabled or die.

0848 Todd's Paralysis disclosing neurocysticercosis

TomaseUi, p1,3, Tournier, M 1, Trevisol-Bittencour t pl,Z,3,4, Pioner, L L3, Nahoum, R L3, Bittencourt, F %4, Collares, C L%3'4.s. ~Universidade Federal de Santa Catarina, Florian@olis/SC, Brasil," 2Hospital Santa Teresa, S~o Pedro de Aledntara/SC, Brasil; 3Hospital Universitdrio/ UFSC, Florian@olis/SC, Brasil; ¢Cl/nica Interdisciplinar de Epilepsia do Estado de SC, Florian@olis/SC, Brasil; 5Centro de Controle de IntoxicacJes de Sdo Paulo, Brasil

Background: Transient neurological deficits are well-known pheno- mena after epileptic seizures. Robert Bentley Todd (11809-1860), an Irish physician, was the first to describe the transient hemiparesis or henriplegia that may follow some seizures. His remarkable observation was published in 1854 where he noticed it as "a neurological state that recovers completely after a few time". Since then many non-motor equivalents of Todd 's paralysis (TP) have been described as well. Methods: To describe a young woman presenting TP secondary to partial status epilepticus. Results: DA, 26 years old, went to a neurological centre due to stroke. She had left hemiplegia in the initial assessment. However, as she didn't show any risk factors to vascular disease the stroke's diagnosis was questioned. Moreover, after rigorous clinical history the correct diagnosis was disclosed. She had been complaining from a lot of episodic and "strange symptoms" in the last weeks such as persecatory ideas; sudden and unexplained fear; memory disturbances (ddjd vu and jamais vu) and just a day before the "stroke" site had had repetitive tremor in her left hand and a major tonic-clonic seizure in the same night. DA gradually recovered and in 3 days she was completely normal. c r scan showed many typical neurocysticercosis (NCC) lesions in different evolutive stages, one of them close to the right motor area. A routine EEG showed irritative activity in right temporal lobe. Conclusion: DA has partial symptomatic epilepsy due to N C C and TP was the first major symptom of its condition.

0849 Cerebral and spinal sparganosis in Thais

Unnwol~gse K, Phani tphong T, Chanplakorn N, Phudtrichareom'ats S, Petkaew K. Prasat Neurological Institute, Bangkok, Thailand

Sparganosis is an u n c o m m o n parasitic, disease due to plerocercoid tapeworm larva (sparganum) of Spirometra Mansoni , with neurolo- gical manifestation being extremely rare in comparison to other organs. Previous literatures have revealed only 7 known cases of spinal sparganosis with most incidences occuring in East and Southeast Asia. Tiffs series report comprised of 4 inpatient cases diagnosed and treated at Prasat Neurological Institute, Thailand. The involved areas varied from thoracohimbar and conus medullaris, suprasellar cistern and thoracohimbar, and interpeduncular fossa in first, second and third case respectively. The fourth case was affected at right temporal lobe. All cases are natives of the central and nor thern provinces of Thai land who were suspected to contact the disease due to their diet of raw amphibians, a known intermediate host of sparganum. The diagnosis were based on radiological, operative and histopathologic findings. Surgical removal of degenerative parasites were performed in all cases with the placement of ventriculoperitoneal shunt placed in those with obstructive hydrocephalus. Clinical status o f all cases were unchanged after the operation. The availability ELISA test for sparganum-specific antibody in both serum and CSF would prove invaluable for diag- nostic and prognostic purposes. Health education concerning sparga- nosis should be promoted in rural areas affected with the disease.

0850 A natural history study of central nervous system Tyine disease with neurohnaging pre and post-treahnent

Vaithianathar L l, Matthews E ~, Thomas A 1, Turner D 1, Bajaj N ~. 1Queens Medical Centre, Nottingham, United Kingdom; ~Derbyshire Royal Infirmary, Derby, United Kingdom

Background: We highlight the clinical, laboratory and radiological findings, pre and post-treatment, of early disseminated Lyme Borreliosis in a thirty-three year old gentleman presenting with multiple cranial neuropathies. Case: Over a one-month period our patient developed headaches, facial numbness , hyperacuisis, recurrent facial weakness, diploplia, vertigo, arthralgia, night sweats, weight loss and fatigue. There was no preceding history of a tick bite or skin rash but he had recently visited two endemic