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Assessment of excessive daytime sleepiness in cirrhotic patients 肝硬化患者日间过度嗜睡的评估
Q4 Medicine Pub Date : 2022-12-31 DOI: 10.37897/rjn.2022.4.4
I. Lupescu, S. Iacob, C. Pietrăreanu, L. Gheorghe
Background. It is known that alterations of the sleep-wake cycle are present from the early stages of hepatic encephalopathy (starting with grade I on the West Haven criteria). However, minimal hepatic encephalopathy (which is not included in the West Haven criteria) defines the earliest form of HE, with no obvious clinical manifestations, but with subtle alterations in cognitive domains such as attention, visuo-spatial perception, psychomotor speed and response inhibition. Aim. To determine if liver cirrhosis in otherwise asymptomatic individuals (without clinically manifest hepatic encephalopathy) is associated with an increased risk of altered sleep rhythm or excessive daytime sleepiness. Additionally, to determine if this risk is correlated with liver disease severity or other clinical and biological parameters Material and methods. Cross-sectional study involving 25 adult patients with liver cirrhosis. Patients were evaluated through a standard neurological examination and with the Epworth Sleepiness Scale. Liver disease severity was measured using the MELD and Child-Pugh scores. Blood ammonia levels were also measured. Results. Mean age of the patients was 50±12 years-old. There was a predominance of males (68%, n=17). Mean MELD score was 17±7 points. Mean Child-Pugh score was 8±2 points. Mean blood ammonia level was 34±17 μg/dL. Subjective daytime somnolence was reported by 24% of patients (n=6). Mean ESS score was 6±5 points. No correlation was noted between the ESS scores and liver disease severity as measured by the Child-Pugh and MELD scores. Only three patients (12%) scored over 10 points on the ESS (none of them obese) and were consequently diagnosed with excessive daytime sleepiness (EDS). This proportion falls into the accepted prevalence of EDS in the general population. Conclusions. In our study, liver cirrhosis was not associated with a higher prevalence of excessive daytime sleepiness than in the general population.
背景。众所周知,从肝性脑病的早期阶段(从West Haven标准的I级开始)就存在睡眠-觉醒周期的改变。然而,最小肝性脑病(不包括在West Haven标准中)定义了HE的最早形式,没有明显的临床表现,但在注意力、视觉空间感知、精神运动速度和反应抑制等认知领域有细微的改变。的目标。目的:确定无其他症状的肝硬化患者(无临床表现的肝性脑病)是否与睡眠节律改变或白天过度嗜睡的风险增加有关。此外,确定这种风险是否与肝病严重程度或其他临床和生物学参数相关的材料和方法。横断面研究纳入25例成年肝硬化患者。通过标准的神经学检查和爱普沃斯嗜睡量表对患者进行评估。使用MELD和Child-Pugh评分来衡量肝病严重程度。他们还测量了血氨水平。结果。患者平均年龄50±12岁。男性占多数(68%,n=17)。平均MELD评分为17±7分。Child-Pugh评分平均为8±2分。平均血氨34±17 μg/dL。24%的患者报告主观白天嗜睡(n=6)。ESS平均评分为6±5分。ESS评分与Child-Pugh和MELD评分测量的肝脏疾病严重程度之间没有相关性。只有3名患者(12%)在ESS上得分超过10分(没有肥胖),因此被诊断为白天过度嗜睡(EDS)。这一比例在一般人群中属于可接受的EDS患病率。结论。在我们的研究中,与一般人群相比,肝硬化与日间过度嗜睡的患病率并不相关。
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引用次数: 0
Influence of an epigenetic diet on migraine patients 表观遗传饮食对偏头痛患者的影响
Q4 Medicine Pub Date : 2022-12-31 DOI: 10.37897/rjn.2022.4.7
O. Kopchak, Olena Hrytsenko
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.
目标。偏头痛是一种常见的原发性头痛疾病,以反复发作的中度至重度单侧搏动性疼痛为特征。本研究的目的是分析饮食的表观遗传影响及其对偏头痛患者的影响。材料和方法。分析了130例偏头痛患者(男性13.7%,女性86.3%)。受试者被分为两组;A组患者随后采用富含5毫克叶酸的表观遗传饮食。B组患者不遵循任何类型的饮食。结果。在分析研究开始前的数据时,发现A组的叶酸平均浓度为2.8+3.6 ng/ml,明显低于B组(p=0.003)。两组患者同型半胱氨酸平均水平差异有统计学意义(χ =0.04)。此外,发现头痛的强度和频率显著降低(χ 2 = 0.02;p= 0.04),汉密尔顿焦虑量表的平均焦虑水平有所下降(从15.0+3.5分降至9+2分)(p=0.03)。结论。观察到偏头痛患者的同型半胱氨酸和叶酸水平对头痛严重程度和生活质量的显著影响。
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引用次数: 0
Screening tests for the evaluation of cognitive impairment in multiple sclerosis patients 评估多发性硬化症患者认知障碍的筛查试验
Q4 Medicine Pub Date : 2022-12-31 DOI: 10.37897/rjn.2022.4.1
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.
多发性硬化症(MS)是年轻人最常见的自身免疫性神经疾病,对患者来说是一个巨大的负担,会显著降低生活质量。除了运动缺陷、感觉问题和视力丧失外,近年来,神经学家还关注与这种情况相关的认知障碍。认知障碍的早期检测目前是多发性硬化症患者随访的重要组成部分,因为任何恶化都表明应用治疗的效率低下,需要进行治疗转换。在这方面,这篇综述旨在强调认知筛查测试在MS患者定期评估中的重要性。在第一部分中,详细介绍了罗马尼亚最常用的认知筛查测试,而在文章的第二部分中,根据过去10年中发表的最相关的随机临床试验的结果,强调了这些测试的临床影响。最后,作者在暴露了目前使用的筛查电池的局限性后,提出了改进MS患者认知筛查测试的未来研究方向。
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引用次数: 0
A rare case of managing near sudden unexpected death in status epilepticus with COVID-19 infection in rural area: what is the possible cause? 农村地区一例罕见的癫痫持续状态合并COVID-19感染患者近乎突然意外死亡的处理:可能的原因是什么?
Q4 Medicine Pub Date : 2022-09-30 DOI: 10.37897/rjn.2022.3.11
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.
新冠肺炎是由SARS-CoV-2感染引起的一种流行病,有许多与神经和心血管事件有关的致命并发症,如癫痫发作和心律失常导致心脏骤停。严重急性呼吸系统综合征冠状病毒2型的直接和间接机制在其临床表现的产生中发挥了重要作用。癫痫近乎猝死(SUDEP)是癫痫患者心肺骤停的逆转,如果治疗不当,这是非常危险的。在这里,我们介绍了一名27岁的男子,他患有VF,并因癫痫持续状态(SE)和新冠肺炎感染而几乎突然意外死亡,在农村地区的紧急情况下成功地得到了治疗。急诊室的及时治疗和支持性管理对患者的生存至关重要。这种罕见而复杂的病例可能发生,应区分病因是新冠肺炎还是SUDEP,以建立明确的管理,尽管支持性管理仍然相同。还应预防新冠肺炎并发症和SUDEP,以降低发病率。
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引用次数: 0
Non-invasive ventilation in neuromuscular disease with acute respiratory failure: A narrative review 无创通气治疗伴有急性呼吸衰竭的神经肌肉疾病:叙述性综述
Q4 Medicine Pub Date : 2022-09-30 DOI: 10.37897/rjn.2022.3.4
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.
急性呼吸衰竭(ARF)是一种危及生命的疾病,通常由神经肌肉疾病(NMD)的急性发作引起,并经常与其他心肺疾病共存。二十多年来,现有研究表明,无创通气(NIV)是ARF的主要通气支持,在各种情况下都能提供良好的临床结果,但其在NMD ARF患者中的应用仍然有限。在ARF患者中,NIV可以在血液动力学稳定、无上呼吸道阻塞、完全清醒的患者中启动,并且可以克服呼吸道分泌物。此外,建议使用具有备用速率的呼气正压通气(EPAP)和吸气正压通气设置。此外,一些研究报告称,NIV在NMD伴ARF中的应用也可能是有益的断奶策略。因此,需要进行进一步的研究,以产生关于NIV在NMD伴ARF患者中的作用的证据。
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引用次数: 0
Weber syndrome – clinical-imaging correlations 韦伯综合征-临床影像学相关性
Q4 Medicine Pub Date : 2022-09-30 DOI: 10.37897/rjn.2022.3.9
I. Lupescu, D. Anghel, A. Dulamea
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.
一名89岁的女性患者因精神状态改变和左侧运动障碍被家人带进来。病史显示患者患有高血压,正在接受抗高血压治疗。经检查,患者表现为精神状态改变、构音障碍、吞咽困难、左侧中枢性面瘫、共济失调性四肢瘫痪伴左侧明显瘫痪、双侧巴宾斯基征、右侧眼肌麻痹伴全方位凝视受限、左侧偏斜、左眼外展和向上凝视运动受限,和双侧上睑下垂(右侧完全,左侧不完全)。因此,临床图像与椎基底动脉卒中相一致。鉴于左侧偏瘫和右侧眼肌麻痹,建议对韦伯综合征进行可能的诊断。头部CT和脑部MRI都证实了这一点,显示右侧丘脑-中脑亚急性缺血性中风。心脏评估中未发现心脏栓塞来源。因此,患者通过抗血小板治疗、他汀类药物和抗高血压治疗出院。我们提供了一篇关于韦伯综合征的简短综述,强调了临床图片和影像学发现之间的相关性。
{"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":null,"pages":null},"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}
引用次数: 0
The role of vitamin D in migraine, from mechanism to therapy: literature review 维生素D在偏头痛中的作用,从机制到治疗:文献综述
Q4 Medicine Pub Date : 2022-09-30 DOI: 10.37897/rjn.2022.3.1
Igm Ardika Aryasa, I. M. Oka Adnyana
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.
偏头痛是一种神经系统疾病,是50岁以下人群致残的第三大原因。偏头痛发病率的增加会影响患者的生活质量,增加患者的经济负担。维生素D是一种补充剂,被认为与头痛有关,并具有抗炎和抗氧化作用。偏头痛患者中维生素D缺乏症的发病率越来越高,但对于补充维生素D作为偏头痛的补充疗法尚无共识。本文旨在阐述维生素D在头痛,特别是偏头痛中的作用机制,以及维生素D补充治疗作为偏头痛的补充治疗。维生素D被认为通过几种机制在头痛的发病机制中发挥作用,即抗炎作用、调节免疫系统、降低一氧化氮(NO)水平、抑制前列腺素合成,并与谷氨酰胺、去甲肾上腺素、多巴胺和血清素等几种神经递质的变化有关。几项研究报告称,偏头痛患者补充维生素D可以改善头痛发作的频率。大多数偏头痛患者都缺乏维生素D。补充维生素D也被认为可以减少偏头痛患者头痛发作的频率。然而,还需要进一步的研究来证实这些结果。
{"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":null,"pages":null},"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}
引用次数: 0
Profile of idiopathic intracranial hypertension in Indian population – A prospective study 印度人群特发性颅内高压的特征——一项前瞻性研究
Q4 Medicine Pub Date : 2022-09-30 DOI: 10.37897/rjn.2022.3.12
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.
背景特发性颅内高压(IIH)也称为大脑假瘤综合征(PTCS)。它主要影响育龄期的年轻超重妇女。印度人口中关于IIH的文献很少。客观的评估特发性颅内高压(IIH)患者的临床、人口学特征、实验室参数和结果。材料和方法。目前的研究是一项前瞻性观察性研究,针对2019年12月至2021年8月在斯里兰卡拉马昌德拉医学院和研究所神经内科就诊的43名被诊断为原发性PTCS的患者。对患者进行了BMI、视乳头水肿、CSF测压、MRI脑和MR静脉造影评估。联合指导软件V.1.03用于统计分析。后果研究人群的平均年龄为33.12±12.29岁(14至55岁)。男性5例(11.63%),女性38例(88.37%)。研究人群的平均BMI为26.72±3.56 kg/m2(17.40至34.20)。头痛的平均持续时间为28.41±26.23天(3至120),39人(90.69%)患有视乳头水肿。平均CSF测压为29.6±5.88(范围从16到42)cmH2O。结论在印度次大陆,肥胖可能不被认为是IIH病因的主要风险因素。
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引用次数: 0
Severe sensory ganglionopathy as a manifestation of mixed connective tissue disease 以混合结缔组织疾病为表现的严重感觉神经节病
Q4 Medicine Pub Date : 2022-09-30 DOI: 10.37897/rjn.2022.3.10
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.
感觉神经节病变(SG)是一种罕见但独特的以背根神经节损伤为特征的外周神经病变临床亚组。典型的表现包括早期步态和肢体共济失调,广泛的深肌腱反射减弱或缺失,伴有Romberg征和假性无神论运动。SG的诊断是有价值的,因为它可能促使早期识别潜在的恶性肿瘤或自身免疫性疾病。我们报告了一例女性被诊断为混合结缔组织病(MCTD)伴严重SG的病例。据我们所知,这种疾病的相关性尚未报道。MCTD相关病例的病理生理学尚不清楚,需要进一步研究。此外,与这种情况相关的重要残疾程度突出了开发有效疗法的必要性。
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引用次数: 0
Efficacy of Gabapentin vs Oxcarbazepine in terms of pain, sleep and quality of life in patients with diabetic peripheral neuropathy 加巴喷丁与奥卡西平对糖尿病周围神经病变患者疼痛、睡眠和生活质量的疗效
Q4 Medicine Pub Date : 2022-09-30 DOI: 10.37897/rjn.2022.3.8
Wadha Nawal Zaffer, Faiz Unnisa, Farath Unnisa, Ayesha Tahoora Fatima, Azmath Unnisa Begum, Mohammed Zoheb
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.
背景考虑到周围糖尿病神经病变的疼痛严重、持久且对止痛药没有反应,因此治疗很困难。加巴喷丁已被推荐为DPN的一线治疗药物,但由于认知功能障碍和其他副作用,该药物已停用。最近的研究表明,奥卡西平;一种抗癫痫药物在DPN的治疗中具有良好的疗效。这项前瞻性、观察性和比较性研究是为了比较加巴喷丁和奥卡西平单药治疗DPN患者。目标。我们从疼痛评分、睡眠评分和生活质量方面评估了奥卡西平单药治疗的疗效,并与加巴喷丁单药治疗进行了比较。方法。将100例DPN或检查提示DPN的患者分为两组,分别接受加巴喷丁300-1200 mg/天或奥卡西平300-600 mg/天。在治疗过程中,在不同的持续时间对疼痛评分、睡眠评分和生活质量进行评估。后果在所选的受试者总数中,最大(46%)受试者年龄在60-90岁之间,受试者影响最小(24%)年龄在50-59岁之间。男性的患病率为57%,而女性为43%。第二组的睡眠改善,p值为(0.0005)。然而,疼痛和生活质量与治疗的相关性分别为p值0.24、0.31和0.27,无显著性。结论DPN患者的睡眠改善具有统计学相关性,但与生活质量和疼痛无关,因为计算的p值分别为(p=0.24、0.31和0.27)。这项研究的结果表明,奥卡西平可以作为一种替代治疗方法,因为它具有类似的镇痛效果和改善睡眠的效果。
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引用次数: 0
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