In computerized tomography (CT-Scan), iodine solution was used as a contrast medium to improve imaging. But the iodine solution has different side effects for patients. In the present work, one of the gold compounds AuCl4 was used as an alternative contrast agent. The study used rabbits in an in vivo method to examine both the organs of the heart and the kidneys. Hounsfield unit (HU) values from computed tomography of rabbit and kidney angiography findings were found and compared with HU values for iodine contrast medium. Iodine solution is the only contrast medium currently used in the present study, gold tetrachloride (AuCl4) solution has been chosen as an alternative contrast medium in computed tomography scanning (CT-scan). It was found that using AuCl4 solution as an alternative contrast medium in rabbits enhanced the CT-scan imaging in the resolution and increasing the of heart and kidney organs in comparison with the iodine compound without any side effects. Rabbit’s heart and kidney were selected to study the effect of using 1.4 M iodine solution and 0.1 M AuCl4 as an alternative contrast medium in CT-scan. The HU value for the heart has 53 HU when used high concentration of Iodine complex, while the HU value at low concentration of alternative contrast medium of 0.1 M of gold compound has 50.5. The same results were found in the kidney organ. From these results, the resolution of the CT image is good and cleared when an alternative contrast medium (AuCl4) used. We can conclude that the alternate contrast medium for AuCl4 solution has high HU values for both heart and kidney compared to iodine solution.
在计算机断层扫描(ct)中，碘溶液被用作造影剂以改善成像。但是碘溶液对病人有不同的副作用。在本工作中，其中一种金化合物AuCl4被用作替代造影剂。这项研究用兔子在体内的方法来检查心脏和肾脏的器官。兔计算机断层扫描和肾血管造影结果的Hounsfield单位(HU)值被发现并与碘造影剂的HU值进行比较。碘溶液是目前研究中唯一使用的造影剂，四氯化金(AuCl4)溶液已被选择作为计算机断层扫描(ct)的替代造影剂。结果发现，与碘化合物相比，AuCl4溶液作为家兔的替代造影剂，增强了ct扫描成像的分辨率，增加了心脏和肾脏器官的功能，且无任何副作用。选择家兔心脏和肾脏，研究1.4 M碘溶液和0.1 M AuCl4作为ct扫描对比剂的效果。使用高浓度碘络合物时，心脏的HU值为53 HU，而在低浓度的替代造影剂0.1 M金络合物时，心脏的HU值为50.5。在肾脏器官中也发现了同样的结果。从这些结果来看，当使用替代造影剂(AuCl4)时，CT图像的分辨率很好，并且清晰。我们可以得出结论，与碘溶液相比，AuCl4溶液的替代造影剂对心脏和肾脏都具有较高的HU值。
{"title":"The use of the gold compound (AuCl4) solution as an alternative contrast medium for iodine in computed tomography (CT-Scan) imaging","authors":"M. Radhi","doi":"10.37897/rjn.2022.4.8","DOIUrl":"https://doi.org/10.37897/rjn.2022.4.8","url":null,"abstract":"In computerized tomography (CT-Scan), iodine solution was used as a contrast medium to improve imaging. But the iodine solution has different side effects for patients. In the present work, one of the gold compounds AuCl4 was used as an alternative contrast agent. The study used rabbits in an in vivo method to examine both the organs of the heart and the kidneys. Hounsfield unit (HU) values from computed tomography of rabbit and kidney angiography findings were found and compared with HU values for iodine contrast medium. Iodine solution is the only contrast medium currently used in the present study, gold tetrachloride (AuCl4) solution has been chosen as an alternative contrast medium in computed tomography scanning (CT-scan). It was found that using AuCl4 solution as an alternative contrast medium in rabbits enhanced the CT-scan imaging in the resolution and increasing the of heart and kidney organs in comparison with the iodine compound without any side effects. Rabbit’s heart and kidney were selected to study the effect of using 1.4 M iodine solution and 0.1 M AuCl4 as an alternative contrast medium in CT-scan. The HU value for the heart has 53 HU when used high concentration of Iodine complex, while the HU value at low concentration of alternative contrast medium of 0.1 M of gold compound has 50.5. The same results were found in the kidney organ. From these results, the resolution of the CT image is good and cleared when an alternative contrast medium (AuCl4) used. We can conclude that the alternate contrast medium for AuCl4 solution has high HU values for both heart and kidney compared to iodine solution.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43793535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. Migraine is a common type of primary headache disorder, distinguished by recurrent attacks of moderate to severe unilateral throbbing pain. The goal of this study is to analyze the epigenetic influences of diet and their effects on patients with migraine headaches. Materials and methods. 130 patients with migraine headaches were analyzed (13.7% male and 86.3% female). The subjects were divided into two groups; Group A patients subsequently followed an epigenetic diet enriched with 5 mg of folic acid. Group B patients didn’t follow any type of diet. Results. When analyzing the data before the start of the study, it was found that the average concentration of folic acid in Group A was 2.8+3.6 ng/ml, which was significantly lower than in Group B (p=0.003). The average level of homocysteine was significantly different in both groups (р=0.04). Furthermore, a significant decrease in the intensity and frequency of headache was found (р = 0.02; р = 0.04), and a decrease in the average level of anxiety according to the Hamilton Anxiety Scale was found (from 15.0+3.5 points to 9+2 points) (p=0.03). Conclusion. A significant effect from homocysteine and folic acid levels in migraine patients on headache severity and quality of life was observed.
{"title":"Influence of an epigenetic diet on migraine patients","authors":"O. Kopchak, Olena Hrytsenko","doi":"10.37897/rjn.2022.4.7","DOIUrl":"https://doi.org/10.37897/rjn.2022.4.7","url":null,"abstract":"Objective. Migraine is a common type of primary headache disorder, distinguished by recurrent attacks of moderate to severe unilateral throbbing pain. The goal of this study is to analyze the epigenetic influences of diet and their effects on patients with migraine headaches. Materials and methods. 130 patients with migraine headaches were analyzed (13.7% male and 86.3% female). The subjects were divided into two groups; Group A patients subsequently followed an epigenetic diet enriched with 5 mg of folic acid. Group B patients didn’t follow any type of diet. Results. When analyzing the data before the start of the study, it was found that the average concentration of folic acid in Group A was 2.8+3.6 ng/ml, which was significantly lower than in Group B (p=0.003). The average level of homocysteine was significantly different in both groups (р=0.04). Furthermore, a significant decrease in the intensity and frequency of headache was found (р = 0.02; р = 0.04), and a decrease in the average level of anxiety according to the Hamilton Anxiety Scale was found (from 15.0+3.5 points to 9+2 points) (p=0.03). Conclusion. A significant effect from homocysteine and folic acid levels in migraine patients on headache severity and quality of life was observed.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41589638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alina Ioana Nacu-Florescu, O. Schreiner, T. Schreiner
Multiple sclerosis (MS), the most common autoimmune neurological disease of young people, is a significant burden for the patient, significantly decreasing the quality of life. Besides motor deficits, sensory problems, and vision loss, in recent years, neurologists have focused also on the cognitive impairment related to this condition. The early detection of cognitive disturbances is currently an essential part of MS patients’ follow-ups, as any worsening suggests the inefficiency of the applied treatment and the need for a therapeutic switch. In this regard, this review aims to highlight the importance of cognitive screening tests in the periodical evaluation of MS patients. While in the first part, the most frequently used cognitive screening tests in Romania are presented in a detailed manner, in the second part of the article, the clinical impact of these tests is highlighted, based on the results of the most relevant randomized clinical trials published during the last 10 years. Finally, the authors suggest future research directions to improve cognitive screening testing in MS patients after exposing the limitations of currently used screening batteries.
{"title":"Screening tests for the evaluation of cognitive impairment in multiple sclerosis patients","authors":"Alina Ioana Nacu-Florescu, O. Schreiner, T. Schreiner","doi":"10.37897/rjn.2022.4.1","DOIUrl":"https://doi.org/10.37897/rjn.2022.4.1","url":null,"abstract":"Multiple sclerosis (MS), the most common autoimmune neurological disease of young people, is a significant burden for the patient, significantly decreasing the quality of life. Besides motor deficits, sensory problems, and vision loss, in recent years, neurologists have focused also on the cognitive impairment related to this condition. The early detection of cognitive disturbances is currently an essential part of MS patients’ follow-ups, as any worsening suggests the inefficiency of the applied treatment and the need for a therapeutic switch. In this regard, this review aims to highlight the importance of cognitive screening tests in the periodical evaluation of MS patients. While in the first part, the most frequently used cognitive screening tests in Romania are presented in a detailed manner, in the second part of the article, the clinical impact of these tests is highlighted, based on the results of the most relevant randomized clinical trials published during the last 10 years. Finally, the authors suggest future research directions to improve cognitive screening testing in MS patients after exposing the limitations of currently used screening batteries.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47586962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Mega, Adriana Damayanti, C. Siswantoro, Irene Purnamawati
COVID-19, a pandemic caused by the SARS-CoV-2 infection, has many fatal complications related to neurological and cardiovascular events such as seizures and arrhythmia leading to cardiac arrest. The direct and indirect mechanisms of SARS-CoV-2 played a significant role to generate its clinical manifestation. Near-sudden unexpected death in epilepsy (SUDEP) is a reversal of cardiopulmonary arrest in an epileptic patient which is very dangerous if not treated well. Here we present a 27-year-old man with VF and near sudden unexpected death due to status epilepticus (SE) and COVID-19 infection that was successfully managed in a rural area emergency setting. Prompt treatment in the emergency room followed by supportive management is important for patient survival. This rare and complex case possibly happened and should be differentiated whether the cause is COVID-19 or SUDEP to establish definitive management though the supportive management is still the same. Prevention of COVID-19 complications and SUDEP should also be done to reduce morbimortality.
{"title":"A rare case of managing near sudden unexpected death in status epilepticus with COVID-19 infection in rural area: what is the possible cause?","authors":"G. Mega, Adriana Damayanti, C. Siswantoro, Irene Purnamawati","doi":"10.37897/rjn.2022.3.11","DOIUrl":"https://doi.org/10.37897/rjn.2022.3.11","url":null,"abstract":"COVID-19, a pandemic caused by the SARS-CoV-2 infection, has many fatal complications related to neurological and cardiovascular events such as seizures and arrhythmia leading to cardiac arrest. The direct and indirect mechanisms of SARS-CoV-2 played a significant role to generate its clinical manifestation. Near-sudden unexpected death in epilepsy (SUDEP) is a reversal of cardiopulmonary arrest in an epileptic patient which is very dangerous if not treated well. Here we present a 27-year-old man with VF and near sudden unexpected death due to status epilepticus (SE) and COVID-19 infection that was successfully managed in a rural area emergency setting. Prompt treatment in the emergency room followed by supportive management is important for patient survival. This rare and complex case possibly happened and should be differentiated whether the cause is COVID-19 or SUDEP to establish definitive management though the supportive management is still the same. Prevention of COVID-19 complications and SUDEP should also be done to reduce morbimortality.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44145834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Elhidsi, Dyah Ayu Kusumoputri Buwono, Eka Musridharta, D. Soehardiman, P. Prasenohadi
Acute respiratory failure (ARF) is a life-threatening condition that often results from the acute onset of neuromuscular disease (NMD) and often coexists with other cardiorespiratory conditions. For more than two decades, existing studies have shown that non-invasive ventilation (NIV) is the main ventilatory support and provides a good clinical outcome in ARF with various conditions, but its use in NMD patients with ARF is still limited. In patients with ARF, NIV can be initiated in fully awake patients with hemodynamically stable, without upper airway obstruction, and airway secretions can be overcome. Furthermore, expiratory positive airway pressure (EPAP) and inspiratory positive airway pressure (IPAP) settings with backup rates are recommended. Additionally, some studies have reported that the application of NIV in NMD with ARF can also be beneficial as a weaning strategy. Hence, further studies need to be conducted to generate evidence regarding the role of NIV in NMD patients with ARF.
{"title":"Non-invasive ventilation in neuromuscular disease with acute respiratory failure: A narrative review","authors":"M. Elhidsi, Dyah Ayu Kusumoputri Buwono, Eka Musridharta, D. Soehardiman, P. Prasenohadi","doi":"10.37897/rjn.2022.3.4","DOIUrl":"https://doi.org/10.37897/rjn.2022.3.4","url":null,"abstract":"Acute respiratory failure (ARF) is a life-threatening condition that often results from the acute onset of neuromuscular disease (NMD) and often coexists with other cardiorespiratory conditions. For more than two decades, existing studies have shown that non-invasive ventilation (NIV) is the main ventilatory support and provides a good clinical outcome in ARF with various conditions, but its use in NMD patients with ARF is still limited. In patients with ARF, NIV can be initiated in fully awake patients with hemodynamically stable, without upper airway obstruction, and airway secretions can be overcome. Furthermore, expiratory positive airway pressure (EPAP) and inspiratory positive airway pressure (IPAP) settings with backup rates are recommended. Additionally, some studies have reported that the application of NIV in NMD with ARF can also be beneficial as a weaning strategy. Hence, further studies need to be conducted to generate evidence regarding the role of NIV in NMD patients with ARF.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41625534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Migraine is a neurological condition that is the third highest cause of disability in the population under 50 years old. The Increasing incidence of migraine will affect the quality of life and increase the financial burden on the patient. Vitamin D is one of the supplementation agents that is thought to be associated with headaches and has anti-inflammatory and antioxidant effects. There is an increasing prevalence of vitamin D deficiency in migraine patients but there is no consensus regarding the provision of vitamin D supplementation as a complementary therapy in migraine. This article aims to explain the role of vitamin D in the mechanism of headache, especially migraine, and vitamin D supplementation therapy as a complementary therapy in migraine. Vitamin D is thought to play a role in the pathogenesis of headache through several mechanisms, namely as an anti-inflammatory effect, regulates the immune system, reduces nitric oxide (NO) levels, suppresses prostaglandin synthesis, and is associated with changes in several neurotransmitters such as glutamine, noradrenaline, dopamine, and serotonin. Several studies have reported that vitamin D supplementation in patients with migraine can improve the frequency of headache attacks. Most migraine patients can experience vitamin D deficiency. Vitamin D supplementation is also thought to reduce the frequency of headache attacks in migraine patients. However, further research is still needed to confirm these results.
{"title":"The role of vitamin D in migraine, from mechanism to therapy: literature review","authors":"Igm Ardika Aryasa, I. M. Oka Adnyana","doi":"10.37897/rjn.2022.3.1","DOIUrl":"https://doi.org/10.37897/rjn.2022.3.1","url":null,"abstract":"Migraine is a neurological condition that is the third highest cause of disability in the population under 50 years old. The Increasing incidence of migraine will affect the quality of life and increase the financial burden on the patient. Vitamin D is one of the supplementation agents that is thought to be associated with headaches and has anti-inflammatory and antioxidant effects. There is an increasing prevalence of vitamin D deficiency in migraine patients but there is no consensus regarding the provision of vitamin D supplementation as a complementary therapy in migraine. This article aims to explain the role of vitamin D in the mechanism of headache, especially migraine, and vitamin D supplementation therapy as a complementary therapy in migraine. Vitamin D is thought to play a role in the pathogenesis of headache through several mechanisms, namely as an anti-inflammatory effect, regulates the immune system, reduces nitric oxide (NO) levels, suppresses prostaglandin synthesis, and is associated with changes in several neurotransmitters such as glutamine, noradrenaline, dopamine, and serotonin. Several studies have reported that vitamin D supplementation in patients with migraine can improve the frequency of headache attacks. Most migraine patients can experience vitamin D deficiency. Vitamin D supplementation is also thought to reduce the frequency of headache attacks in migraine patients. However, further research is still needed to confirm these results.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48543449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An 89 years-old female patient was brought in by the family for altered mental status and left-sided motor deficit. Medical history revealed high blood pressure for which the patient was receiving anti-hypertensive treatment. Upon examination, the patient presented altered mental status, dysarthria, dysphagia, left central facial palsy, ataxic tetraparesis with marked paralysis on the left side, bilateral Babinski signs, right-sided ophthalmoplegia with limitation of gaze in all directions, left-sided skew deviation, limited abduction and upgaze movements of the left eye, and bilateral ptosis (complete on the right side and incomplete on the left side). The clinical picture was thus compatible with a vertebrobasilar stroke. A possible diagnosis of Weber syndrome was suggested, given the left-sided hemiparesis and right-sided ophthalmoplegia. Both head CT and brain MRI confirmed this by demonstrating a right-sided thalamo-mesencephalic subacute ischemic stroke. No cardio-embolic source was identified on cardiac assessment. Consequently, the patient was discharged with antiplatelet therapy, statin and anti-hypertensive treatment. We provide a short review on Weber syndrome, emphasizing the correlations between the clinical pictures and imaging findings.
{"title":"Weber syndrome – clinical-imaging correlations","authors":"I. Lupescu, D. Anghel, A. Dulamea","doi":"10.37897/rjn.2022.3.9","DOIUrl":"https://doi.org/10.37897/rjn.2022.3.9","url":null,"abstract":"An 89 years-old female patient was brought in by the family for altered mental status and left-sided motor deficit. Medical history revealed high blood pressure for which the patient was receiving anti-hypertensive treatment. Upon examination, the patient presented altered mental status, dysarthria, dysphagia, left central facial palsy, ataxic tetraparesis with marked paralysis on the left side, bilateral Babinski signs, right-sided ophthalmoplegia with limitation of gaze in all directions, left-sided skew deviation, limited abduction and upgaze movements of the left eye, and bilateral ptosis (complete on the right side and incomplete on the left side). The clinical picture was thus compatible with a vertebrobasilar stroke. A possible diagnosis of Weber syndrome was suggested, given the left-sided hemiparesis and right-sided ophthalmoplegia. Both head CT and brain MRI confirmed this by demonstrating a right-sided thalamo-mesencephalic subacute ischemic stroke. No cardio-embolic source was identified on cardiac assessment. Consequently, the patient was discharged with antiplatelet therapy, statin and anti-hypertensive treatment. We provide a short review on Weber syndrome, emphasizing the correlations between the clinical pictures and imaging findings.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47827311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sravya Inumpudi, Maheedhar Reddy N, P. Hazeena, S. Shanmugam, S. Venkatasubramanian
Background. Idiopathic intracranial hypertension (IIH) also termed pseudotumor cerebri syndrome (PTCS). It mainly affects young overweight women of the reproductive age group. There is a scarcity of literature on IIH among the Indian population. Objective. To evaluate the clinical, demographic profile, laboratory parameters and outcomes of Idiopathic Intracranial hypertension (IIH) patients. Materials and method. The current study was a prospective observational study on 43 patients who were diagnosed as primary PTCS presenting to the neurology department of Sri Ramachandra Medical College and Research Institute from December 2019 to August 2021. Patients were assessed for BMI, papilledema, CSF manometry, MRI brain with MR venography was done. Co-guide software, V.1.03, was used for statistical analysis. Results. The mean age was 33.12 ± 12.29 years (ranged 14 to 55) in the study population. There were 5(11.63%) males and 38(88.37%) females. The mean BMI was 26.72 ± 3.56 kg/m2 (ranged from 17.40 to 34.20). The mean duration of headache was 28.41 ± 26.23 days (ranged 3 to 120) in the study population, and 39(90.69%) had papilledema. The mean CSF manometry was 29.6 ± 5.88(ranged from 16 to 42) cmH2O. Conclusion. In the Indian subcontinent, obesity may not be considered as a major risk factor in the causation of IIH.
{"title":"Profile of idiopathic intracranial hypertension in Indian population – A prospective study","authors":"Sravya Inumpudi, Maheedhar Reddy N, P. Hazeena, S. Shanmugam, S. Venkatasubramanian","doi":"10.37897/rjn.2022.3.12","DOIUrl":"https://doi.org/10.37897/rjn.2022.3.12","url":null,"abstract":"Background. Idiopathic intracranial hypertension (IIH) also termed pseudotumor cerebri syndrome (PTCS). It mainly affects young overweight women of the reproductive age group. There is a scarcity of literature on IIH among the Indian population. Objective. To evaluate the clinical, demographic profile, laboratory parameters and outcomes of Idiopathic Intracranial hypertension (IIH) patients. Materials and method. The current study was a prospective observational study on 43 patients who were diagnosed as primary PTCS presenting to the neurology department of Sri Ramachandra Medical College and Research Institute from December 2019 to August 2021. Patients were assessed for BMI, papilledema, CSF manometry, MRI brain with MR venography was done. Co-guide software, V.1.03, was used for statistical analysis. Results. The mean age was 33.12 ± 12.29 years (ranged 14 to 55) in the study population. There were 5(11.63%) males and 38(88.37%) females. The mean BMI was 26.72 ± 3.56 kg/m2 (ranged from 17.40 to 34.20). The mean duration of headache was 28.41 ± 26.23 days (ranged 3 to 120) in the study population, and 39(90.69%) had papilledema. The mean CSF manometry was 29.6 ± 5.88(ranged from 16 to 42) cmH2O. Conclusion. In the Indian subcontinent, obesity may not be considered as a major risk factor in the causation of IIH.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41593110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Stan, N. Gherghel, N. C. Drăghici, M. Tămaș, D. Muresanu
Sensory ganglionopathies (SG) are a rare but distinct clinical subgroup of peripheral neuropathies characterized by damage to dorsal root ganglia. Typical manifestations include early gait and limb ataxia, widespread diminished or absent deep tendon reflexes accompanied by Romberg sign and pseudo athetoid movements. The diagnosis of SG is valuable since it may prompt towards early recognition of an underlying malignancy or autoimmune disorder. We report the case of a female diagnosed with mixed connective tissue disease (MCTD) along with severe SG. To our knowledge, such disease association has not been reported yet. The pathophysiology in cases linked to MCTD is unclear and asks for further studies. Moreover, the important degree of disability associated with this condition highlights the need for effective therapies’ development.
{"title":"Severe sensory ganglionopathy as a manifestation of mixed connective tissue disease","authors":"A. Stan, N. Gherghel, N. C. Drăghici, M. Tămaș, D. Muresanu","doi":"10.37897/rjn.2022.3.10","DOIUrl":"https://doi.org/10.37897/rjn.2022.3.10","url":null,"abstract":"Sensory ganglionopathies (SG) are a rare but distinct clinical subgroup of peripheral neuropathies characterized by damage to dorsal root ganglia. Typical manifestations include early gait and limb ataxia, widespread diminished or absent deep tendon reflexes accompanied by Romberg sign and pseudo athetoid movements. The diagnosis of SG is valuable since it may prompt towards early recognition of an underlying malignancy or autoimmune disorder. We report the case of a female diagnosed with mixed connective tissue disease (MCTD) along with severe SG. To our knowledge, such disease association has not been reported yet. The pathophysiology in cases linked to MCTD is unclear and asks for further studies. Moreover, the important degree of disability associated with this condition highlights the need for effective therapies’ development.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49454279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. The treatment of peripheral diabetic neuropathy is difficult to treat considering the pain is severe, long-lasting and does not respond to analgesics. Gabapentin has been recommended as the first line treatment for DPN but owing to cognitive dysfunction and other side effects the drug is discontinued. Recent studies suggest that oxcarbazepine; an antiepileptic drug has good-efficacy in management of DPN. This prospective, observational and comparative study was done to compare gabapentin and oxcarbazepine monotherapy in patient of DPN. Objectives. We assessed the efficacy of Oxcarbazepine monotherapy in terms of pain score, sleep score and quality of life and compared with gabapentin monotherapy. Methods. 100 patients with DPN or examinations suggesting DPN were divided into 2 groups to receive gabapentin 300-1200 mg/day or Oxcarbazepine 300-600mg/day. Assessment of pain scores, sleep score and quality of life were done at different duration during the course of therapy. Results. Out of total subject selected, the maximum (46%) subjects were between age group 60-90 years and the least effected were (24%) between age group 50-59 years. Male were more prevalent with 57% when compared to females with 43%. Improvement in Sleep was seen on using Group II with p value (0.0005). However, the correlation of Pain and Quality of life with the treatment shows p –value 0.24, 0.31 and 0.27 respectively showing non-significance. Conclusion. The sleep improved statistically correlated in patients with DPN, but not with quality of life and pain as the calculated p value was (p= 0.24, 0.31 and 0.27) respectively. Findings of this study suggest that oxcarbazepine can be used as an alternative treatment owing to its similar analgesic efficacy and improvement in sleep.
{"title":"Efficacy of Gabapentin vs Oxcarbazepine in terms of pain, sleep and quality of life in patients with diabetic peripheral neuropathy","authors":"Wadha Nawal Zaffer, Faiz Unnisa, Farath Unnisa, Ayesha Tahoora Fatima, Azmath Unnisa Begum, Mohammed Zoheb","doi":"10.37897/rjn.2022.3.8","DOIUrl":"https://doi.org/10.37897/rjn.2022.3.8","url":null,"abstract":"Background. The treatment of peripheral diabetic neuropathy is difficult to treat considering the pain is severe, long-lasting and does not respond to analgesics. Gabapentin has been recommended as the first line treatment for DPN but owing to cognitive dysfunction and other side effects the drug is discontinued. Recent studies suggest that oxcarbazepine; an antiepileptic drug has good-efficacy in management of DPN. This prospective, observational and comparative study was done to compare gabapentin and oxcarbazepine monotherapy in patient of DPN. Objectives. We assessed the efficacy of Oxcarbazepine monotherapy in terms of pain score, sleep score and quality of life and compared with gabapentin monotherapy. Methods. 100 patients with DPN or examinations suggesting DPN were divided into 2 groups to receive gabapentin 300-1200 mg/day or Oxcarbazepine 300-600mg/day. Assessment of pain scores, sleep score and quality of life were done at different duration during the course of therapy. Results. Out of total subject selected, the maximum (46%) subjects were between age group 60-90 years and the least effected were (24%) between age group 50-59 years. Male were more prevalent with 57% when compared to females with 43%. Improvement in Sleep was seen on using Group II with p value (0.0005). However, the correlation of Pain and Quality of life with the treatment shows p –value 0.24, 0.31 and 0.27 respectively showing non-significance. Conclusion. The sleep improved statistically correlated in patients with DPN, but not with quality of life and pain as the calculated p value was (p= 0.24, 0.31 and 0.27) respectively. Findings of this study suggest that oxcarbazepine can be used as an alternative treatment owing to its similar analgesic efficacy and improvement in sleep.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42644866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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