MyMedR

Fulltext Abdominal Distension-An Unexpected Gift

Khoo CS

Perm J, 2017;21:17-026.

Fulltext Dengue Cerebellitis: A Case Report and Literature Review

Khoo CS

Am J Case Rep, 2018 Jul 24;19:864-867.

PMID: 30038209 DOI: 10.12659/AJCR.909884

BACKGROUND Dengue-associated neurological manifestations have recently been on the rise. Cerebellar syndrome complicating dengue fever has rarely been reported in the literature. We present a case report of dengue-associated cerebellar syndrome and performed a literature review to draw attention to this rare neurological complication. CASE REPORT A 60-year-old man presented with 4 days of fever, myalgia, arthralgia, headaches, and warning symptoms (persistent diarrhea and vomiting). He was admitted with serologically-confirmed dengue fever. He had been well until day 8 of illness, when he developed cerebellar signs and symptoms. The temporal relationship with the recent dengue fever suggested that he had dengue cerebellitis. He recovered well, with no neurological sequelae upon our clinic visit. CONCLUSIONS Dengue cerebellitis is a rare but recognized manifestation, which should be considered in patients from endemic areas of dengue fever who develop cerebellar syndrome.

Fulltext To Pace or Not To Pace? A Narrative Review of VIP Syndrome

Khoo CS

Perm J, 2018;22:18-081.

PMID: 30227913 DOI: 10.7812/TPP/18-081

Early career in epilepsy in Malaysia

Khoo CS

Epilepsy Behav, 2023 Oct;147:109416.

PMID: 37683425 DOI: 10.1016/j.yebeh.2023.109416

Fulltext The Effect of Parent Training Programmes on Screen Time and Social Function in Children with Autism Spectrum Disorder

Khoo CS, Ramachandram S

Malays J Med Sci, 2022 Dec;29(6):146-157.

PMID: 36818902 DOI: 10.21315/mjms2022.29.6.14

BACKGROUND: Children with autism spectrum disorder (ASD) are susceptible to excessive electronic screen media (ESM) use. This study aimed to evaluate the effectiveness of a parent training programme in improving the screen time and social functioning of children with ASD.

METHODS: This pre-/post-test quasi-experimental study involved parents by providing them with structured education based on the American Academy of Pediatrics (AAP)' screen time recommendations. In total, 259 children with ASD aged 3 years old-12 years old were eligible. Of those children, 26 were excluded due to comorbidities or taking medications. Additionally, 28 parents participated. Children's screen time were recorded, and social behaviour was scored using the Social Responsiveness Scale pre- and post-intervention.

RESULTS: There were significant reductions in the average daily screen time of children with ASD after their parents attended the training programme (-51.25 min; 95% CI: -78.40, -24.10). In subgroups with reduced screen time, the treatment effect of the intervention was significant in improving the social responsiveness total score (-3.09; 95% CI: -5.96, -0.22), the social communication scale (-3.64; 95% CI: -5.91, -1.36) and the restricted interest and repetitive behaviour (RRB) scale (-5.27; 95% CI: -10.29, -0.25).

CONCLUSION: Parental training is effective in reducing screen time and improving social functioning in children with ASD.

Elbow clonus

Arifin NM, Khoo CS

Neurol Clin Pract, 2019 Feb;9(1):e10.

PMID: 30859015 DOI: 10.1212/CPJ.0000000000000558

Brainstem tuberculoma masquerading as a glioma

Lim KY, Khoo CS

Acta Neurol Belg, 2023 Jun;123(3):1125-1128.

PMID: 35347640 DOI: 10.1007/s13760-022-01927-y

Fulltext Prominent Oromandibular Dystonia as Levodopa-induced Dyskinesia in Idiopathic Parkinson's Disease

Tee TY, Khoo CS, Norlinah MI

Mov Disord Clin Pract, 2019 Apr;6(4):330-331.

PMID: 31061844 DOI: 10.1002/mdc3.12759

Fulltext A Case of Herpes Simplex Virus Type 1 (HSV-1) Encephalitis as a Possible Complication of Cosmetic Nasal Dermal Filler Injection

Khoo CS, Tan HJ, Sharis Osman S

Am J Case Rep, 2018 Jul 13;19:825-828.

PMID: 30002360 DOI: 10.12659/AJCR.909883

BACKGROUND Dermal fillers are increasingly used for medical and aesthetic purposes in clinical practice. Common complications following filler injections include bruising, itching, infections, allergic reactions, and tissue necrosis. This case is the first report of Herpes simplex virus type 1 (HSV-1) encephalitis as a possible complication of dermal filler injection. CASE REPORT A 27-year-old woman with no past medical history presented with altered mental state, headaches, and seizures. She had a nasal dermal filler injection for aesthetic purpose five weeks before her acute presentation. A diagnosis of HSV-1 encephalitis was made based on brain imaging with computed tomography and magnetic resonance imaging (MRI) findings that showed bilateral frontotemporal lobe hyperintensity. Analysis of her cerebrospinal fluid (CSF) confirmed the presence of HSV-1 DNA. Despite anti-viral treatment with acyclovir, she developed postencephalitic syndrome. CONCLUSIONS This case report highlights the possibility that among the complications of the use of cosmetic dermal fillers, the transmission of HSV-1 and the development of HSV-1 encephalitis should be recognized.

Spontaneous pneumomediastinum

Khoo CS, Ab Rahman SS

Med J Aust, 2017 11 20;207(10):421.

PMID: 29129168

Modified French Osteotomy for Humeroradial Synostosis in a Child with Multiple Synostoses Syndrome: A Case Report

Sahdi H, Rasit AH, Khoo CS, Bojeng A, Nur-Alyana BA

Malays Orthop J, 2019 Jul;13(2):52-55.

PMID: 31467654 DOI: 10.5704/MOJ.1907.011

Congenital humeroradial synostosis can occur as an isolated clinical entity or as part of a syndrome. Bilateral elbow fixed flexion deformity is very incapacitating and challenging to treat. Here we present the case of a boy with fixed flexion deformity of both elbows due bilateral humeroradial synostosis. Other characteristic features of multiple synostoses syndrome were also present in this child, his elder brother and mother. We elected to improve the position of the right elbow by adapting the modified French osteotomy described by Bellemore et al.

Teaching NeuroImages: Neuroimaging in hemiplegic migraine

Tee TY, Khoo CS, Raymond AA, Syazarina SO

Neurology, 2019 08 06;93(6):e626-e627.

PMID: 31383811 DOI: 10.1212/WNL.0000000000007905

Fulltext A Treatable Encephalopathy in a Peritoneal Dialysis Patient - Cefepime-Induced Encephalopathy

Khoo CS, Tee TY, Tan HJ, Ali RA

J Neurosci Rural Pract, 2019 4 20;10(2):324-326.

PMID: 31001027 DOI: 10.4103/jnrp.jnrp_315_18

We report a patient with end-stage renal disease on peritoneal dialysis, who developed encephalopathy after receiving a few doses of cefepime. He recovered clinically and electroencephalographically after having discontinued the culprit agent and undergone hemodialysis. This case highlights the importance of promptly recognizing this reversible encephalopathy, which can lead to the avoidance of unnecessary workup, reduce the length of hospital stay, and thereby improve the patients' outcome.

Bilateral foot drop in a young woman

Ag Lamat MSN, Khoo CS, Shaaya F

Acta Neurol Belg, 2020 Dec;120(6):1437-1438.

PMID: 32643118 DOI: 10.1007/s13760-020-01438-8

Fulltext A Double Whammy of Mycotic Aneurysms and Acquired Dysfibrinogenemia in a Patient with Septicemia

Sim CY, Khoo CS, Mustafar R, Chai JN

Balkan Med J, 2021 01;38(1):55-56.

PMID: 32720494 DOI: 10.4274/balkanmedj.galenos.2020.2020.5.208

Fulltext A rare extrapyramidal manifestation in a patient with primary central nervous system lymphoma

Tee TY, Khoo CS, Ibrahim NM, Osman SS

Neurol India, 2019 3 13;67(1):297-299.

PMID: 30860142 DOI: 10.4103/0028-3886.253620

Dilated pupils in an anxious patient

Hassan Basri M, Khoo CS, Che Hamzah J

Acta Neurol Belg, 2021 Apr;121(2):573-574.

PMID: 33068282 DOI: 10.1007/s13760-020-01519-8

Reply letter to "Are the self-administered questionnaires appropriate to uncover undiagnosed depression among people with epilepsy?"

Tan JK, Khoo CS, Baharudin A, Tan HJ

Epilepsy Res, 2022 Feb 15;181:106889.

PMID: 35182826 DOI: 10.1016/j.eplepsyres.2022.106889

Fulltext Case Series of Osmotic Demyelination Syndrome Treated With Plasmapheresis: Experience From Two Tertiary Hospitals

Lim KY, Chia YK, Khoo CS, Tan HJ

J Clin Neurol, 2022 Jan;18(1):117-119.

PMID: 35021290 DOI: 10.3988/jcn.2022.18.1.117

Efficacy and safety of adjunctive treatment with perampanel in epilepsy patients

Lim KY, Khoo CS, Rajah R, Tan HJ, Tajurudin FW

Med J Malaysia, 2023 Sep;78(5):635-638.

PMID: 37775491

INTRODUCTION: Epilepsy is a neurological disease with high global prevalence. Almost one-third of epilepsy patients continue having seizures despite adequate treatment. Perampanel has been widely used in the Western countries as an adjunctive therapy for both generalized and focal seizures. Owing to its high cost, the use of perampanel is limited in our country.

MATERIALS AND METHODS: We conducted a descriptive, retrospective study among epilepsy patients treated with perampanel. We aimed to assess the efficacy and safety of perampanel as an adjunctive in our hospital.

RESULTS AND CONCLUSIONS: From our cohort of 25 patients, most of the patients were either on one or three anti-seizure medications (ASMs) prior to initiation of perampanel. Perampanel was added in 88% of them due to persistent seizures. Twenty-two (88%) patients experienced reduction in seizure frequency. 12% experienced mild side effects, which were leg cramps, hyponatremia and drowsiness. Only 1 patient stopped perampanel due to its side effects.

CONCLUSION: Perampanel is a well-tolerated ASM that should be widely used as an adjunctive. More studies with regards to its efficacy and safety involving more centres are encouraged in Malaysia.

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