I. Vienažindytė, R. Balnytė, Dž. Šleiteris, M. Ališauskienė
Currently, a significant number of post-COVID-19 disease neurological disorders still occur, and precise analysis of them could expand the knowledge of the neurological community for future pandemics. It is important to evaluate and recognize potential neurological manifestations and complications of COVID-19, as some of them can progress rapidly and require urgent treatment.We present a clinical case of transverse myelitis after a COVID-19 in a 35-year-old man who was treated at the Neurology Department of the Hospital of Lithuanian University of Health Sciences Kaunas Clinics.
{"title":"Skersinis mielitas po COVID-19: klinikinis atvejis","authors":"I. Vienažindytė, R. Balnytė, Dž. Šleiteris, M. Ališauskienė","doi":"10.29014/ns.2022.26.21","DOIUrl":"https://doi.org/10.29014/ns.2022.26.21","url":null,"abstract":"Currently, a significant number of post-COVID-19 disease neurological disorders still occur, and precise analysis of them could expand the knowledge of the neurological community for future pandemics. It is important to evaluate and recognize potential neurological manifestations and complications of COVID-19, as some of them can progress rapidly and require urgent treatment.We present a clinical case of transverse myelitis after a COVID-19 in a 35-year-old man who was treated at the Neurology Department of the Hospital of Lithuanian University of Health Sciences Kaunas Clinics.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738624","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. Makarevičius, K. Pilypaitė, G. Terbetas, G. Šustickas, G. Bulotienė
Background. Recent studies have shown that the prevalence of fatigue in patients after subarachnoid haemorrhage (SAH) is high. However, data on patients with good clinical outcome are still scarce, since in clinical practice, the condition of patients is usually judged by physical parameters and mental condition is rarely considered. Thus, we aimed to determine the risk factors and prevalence of chronic fatigue among SAH patients in Lithuania.Material and methods. Patients with good clinical outcome (Glasgow outcome scale=5, no major paresis) who were diagnosed with SAH and treated at the Republican Vilnius University Hospital between January 2018 – January 2021 were studied at least 6 months after discharge from the hospital. Patients diagnosed with other medical conditions known to result in chronic fatigue were excluded. To evaluate fatigue symptoms, patients were asked to fill in the Lithuanian version of the Multidimensional Fatigue Inventory (MFI-20L) questionnaire. Analyses were performed using RStudio version 2022.02.1. Results were considered statistically significant at p value <0.05. Results. Total of 30 patients participated in our study: 20 female (66.67%) and 10 male (33.33%), median age 47 years (range 29-68). The median duration between SAH and fatigue evaluation was 37.5 months (range 11-46). Mean MFI-20L scores on fatigue subscales were 0.59±0.27 for general, 0.57±0.27 for physical, 0.55±0.29 for mental fatigue, 0.55±0.29 for reduced activity, and 0.44±0.22 for reduced motivation subscales. There were no statistically significant mean differences of general fatigue score between different age (p=0.64) and sex (p=0.20) groups. Mean general fatigue score between patients who had vasospasm (p=0.21) or any complication (p=0.68) after SAH did not differ statistically significantly from those who had not. Mean general fatigue score was statistically significantly higher in patients with poorer condition on admission (defined as Hunt and Hess grade >2) (p=0.02) and in patients with a longer period after SAH (p=0.02).Conclusions. Fatigue is pronounced in patients who survive SAH. This is most evident in those patients who had poorer clinical condition on admission and worsened over time. General and physical fatigue were the most pronounced types of fatigue in our study group.
背景。最近的研究表明，在蛛网膜下腔出血(SAH)患者疲劳的患病率很高。然而，临床预后良好的患者的数据仍然很少，因为在临床实践中，通常以身体参数来判断患者的状况，很少考虑患者的精神状况。因此，我们的目的是确定立陶宛SAH患者慢性疲劳的危险因素和患病率。材料和方法。2018年1月至2021年1月期间在维尔纽斯共和国大学医院诊断为SAH并接受治疗的临床结果良好的患者(格拉斯哥结局量表=5，无严重轻瘫)在出院后至少6个月进行研究。被诊断患有其他已知导致慢性疲劳的疾病的患者被排除在外。为了评估疲劳症状，患者被要求填写立陶宛版多维疲劳量表(MFI-20L)问卷。使用RStudio版本2022.02.1进行分析。p值为<0.05，认为结果具有统计学意义。结果。本研究共纳入30例患者，其中女性20例(66.67%)，男性10例(33.33%)，中位年龄47岁(29-68岁)。从SAH到疲劳评估的中位持续时间为37.5个月(范围11-46)。MFI-20L疲劳量表的平均得分为:一般(0.59±0.27)、体力(0.57±0.27)、精神(0.55±0.29)、活动减少(0.55±0.29)、动机减少(0.44±0.22)。不同年龄组(p=0.64)、性别组(p=0.20)一般疲劳评分均值差异无统计学意义。SAH后发生血管痉挛(p=0.21)或任何并发症(p=0.68)的患者的平均一般疲劳评分与未发生血管痉挛的患者无统计学差异。入院时病情较差的患者(定义为Hunt and Hess分级>2)的平均一般疲劳评分(p=0.02)和SAH后时间较长的患者(p=0.02)均有统计学意义。在SAH存活的患者中，疲劳是明显的。这在入院时临床状况较差并随时间恶化的患者中最为明显。在我们的研究组中，一般疲劳和身体疲劳是最明显的疲劳类型。
{"title":"Nuovargis po subarachnoidinės hemoragijos: geros klinikinės išeities pacientų tyrimas","authors":"G. Makarevičius, K. Pilypaitė, G. Terbetas, G. Šustickas, G. Bulotienė","doi":"10.29014/ns.2022.26.11","DOIUrl":"https://doi.org/10.29014/ns.2022.26.11","url":null,"abstract":"Background. Recent studies have shown that the prevalence of fatigue in patients after subarachnoid haemorrhage (SAH) is high. However, data on patients with good clinical outcome are still scarce, since in clinical practice, the condition of patients is usually judged by physical parameters and mental condition is rarely considered. Thus, we aimed to determine the risk factors and prevalence of chronic fatigue among SAH patients in Lithuania.Material and methods. Patients with good clinical outcome (Glasgow outcome scale=5, no major paresis) who were diagnosed with SAH and treated at the Republican Vilnius University Hospital between January 2018 – January 2021 were studied at least 6 months after discharge from the hospital. Patients diagnosed with other medical conditions known to result in chronic fatigue were excluded. To evaluate fatigue symptoms, patients were asked to fill in the Lithuanian version of the Multidimensional Fatigue Inventory (MFI-20L) questionnaire. Analyses were performed using RStudio version 2022.02.1. Results were considered statistically significant at p value <0.05. Results. Total of 30 patients participated in our study: 20 female (66.67%) and 10 male (33.33%), median age 47 years (range 29-68). The median duration between SAH and fatigue evaluation was 37.5 months (range 11-46). Mean MFI-20L scores on fatigue subscales were 0.59±0.27 for general, 0.57±0.27 for physical, 0.55±0.29 for mental fatigue, 0.55±0.29 for reduced activity, and 0.44±0.22 for reduced motivation subscales. There were no statistically significant mean differences of general fatigue score between different age (p=0.64) and sex (p=0.20) groups. Mean general fatigue score between patients who had vasospasm (p=0.21) or any complication (p=0.68) after SAH did not differ statistically significantly from those who had not. Mean general fatigue score was statistically significantly higher in patients with poorer condition on admission (defined as Hunt and Hess grade >2) (p=0.02) and in patients with a longer period after SAH (p=0.02).Conclusions. Fatigue is pronounced in patients who survive SAH. This is most evident in those patients who had poorer clinical condition on admission and worsened over time. General and physical fatigue were the most pronounced types of fatigue in our study group.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135697161","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}
Tuberous sclerosis complex (TSC) is a rare genetic disorder characterized by the presence of benign tumors in many organs. The pathogenic mutation is found in either the TSC1 or TSC2 tumor suppressor genes. The presence of cortical or subcortical tubers is associated with focal epileptiform discharges on the electroencephalogram and subclinical seizures prior to the onset of clinical seizures. It is known that epileptic seizures in tuberous sclerosis are very resistant to the treatment, therefore, developmental delay usually occurs. In the last decade, more attention has been paid to early recognition and control of seizures (with vigabatrin or everolimus) in tuberous sclerosis complex, as this is highly correlated with improved developmental and neurological outcomes.The article reviews epilepsy and preventive antiepileptic treatment for tuberous sclerosis complex.
{"title":"Tuberozinės sklerozės kompleksas ir epilepsija. Literatūros apžvalga","authors":"I. Kasiulevičiūtė","doi":"10.29014/ns.2022.26.9","DOIUrl":"https://doi.org/10.29014/ns.2022.26.9","url":null,"abstract":"Tuberous sclerosis complex (TSC) is a rare genetic disorder characterized by the presence of benign tumors in many organs. The pathogenic mutation is found in either the TSC1 or TSC2 tumor suppressor genes. The presence of cortical or subcortical tubers is associated with focal epileptiform discharges on the electroencephalogram and subclinical seizures prior to the onset of clinical seizures. It is known that epileptic seizures in tuberous sclerosis are very resistant to the treatment, therefore, developmental delay usually occurs. In the last decade, more attention has been paid to early recognition and control of seizures (with vigabatrin or everolimus) in tuberous sclerosis complex, as this is highly correlated with improved developmental and neurological outcomes.The article reviews epilepsy and preventive antiepileptic treatment for tuberous sclerosis complex.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738617","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}
U. Masilionytė, E. Zarambaitė, B. Glebauskienė, A. Radžiūnas
Optic nerve glioma (ONG) is usually a low-grade tumor of the optic nerve. ONG can affect not only the optic nerve, but also the optic nerve chiasma and optic nerve tract. ONG can be classified as associated with neurofibromatosis type 1 (NF1) or sporadic ONG. Sporadic gliomas are more commonly diagnosed in adults, have an aggressive course, and are known to have a poor outcome. The disease can be asymptomatic. ONG often causes visual disturbances such as reduced visual acuity, visual field defects, and impaired color vision; due to the tumor mass effect, proptosis, strabismus, and diplopia are possible. As the disease progresses, various neurological symptoms can appear, including headache, hemiplegia, and endocrine disorders such as early maturation, growth hormone hypersecretion, or deficiency. A presumed diagnosis is based on clinical presentation and neuroimaging findings. Meanwhile, biopsy should be avoided due to the high probability of optic nerve damage. Treatment is individual for each patient, but remains controversial to this day. Thus, in this article, we review the prevalence, clinic, diagnostic and treatment options of ONG.
{"title":"Regos nervo glioma","authors":"U. Masilionytė, E. Zarambaitė, B. Glebauskienė, A. Radžiūnas","doi":"10.29014/ns.2022.26.18","DOIUrl":"https://doi.org/10.29014/ns.2022.26.18","url":null,"abstract":"Optic nerve glioma (ONG) is usually a low-grade tumor of the optic nerve. ONG can affect not only the optic nerve, but also the optic nerve chiasma and optic nerve tract. ONG can be classified as associated with neurofibromatosis type 1 (NF1) or sporadic ONG. Sporadic gliomas are more commonly diagnosed in adults, have an aggressive course, and are known to have a poor outcome. The disease can be asymptomatic. ONG often causes visual disturbances such as reduced visual acuity, visual field defects, and impaired color vision; due to the tumor mass effect, proptosis, strabismus, and diplopia are possible. As the disease progresses, various neurological symptoms can appear, including headache, hemiplegia, and endocrine disorders such as early maturation, growth hormone hypersecretion, or deficiency. A presumed diagnosis is based on clinical presentation and neuroimaging findings. Meanwhile, biopsy should be avoided due to the high probability of optic nerve damage. Treatment is individual for each patient, but remains controversial to this day. Thus, in this article, we review the prevalence, clinic, diagnostic and treatment options of ONG.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696456","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}
Pediatric optic neuritis is an optic nerve inflammation occuring in 1 to 5 children out of 100,000 per year. In children, optic neuritis is rarely associated with multiple sclerosis, more often it can be associated with specific infections, such as diseases of the adjacent sinuses or orbital structures and infectious or infiltrative diseases of the brain or meninges, or it may develop as a separate pathological condition. This pathology is characterized by a sudden loss of vision, pain, especially associated with eye movements, and impaired color perception. It is diagnosed by performing visual function examination, morphological and radiological examinations. Optic neuritis is treated with corticosteroids, while pulse therapy can even speed up recovery in children from 7 to 2 weeks.The aim of this article is to review the symptoms, etiology, pathogenesis, diagnosis, treatment options, and prognosis of pediatric optic neuritis described in the literature.
{"title":"Pediatric optic neuritis: literature review","authors":"S. Bubnytė, J. Andrulionytė","doi":"10.29014/ns.2022.26.15","DOIUrl":"https://doi.org/10.29014/ns.2022.26.15","url":null,"abstract":"Pediatric optic neuritis is an optic nerve inflammation occuring in 1 to 5 children out of 100,000 per year. In children, optic neuritis is rarely associated with multiple sclerosis, more often it can be associated with specific infections, such as diseases of the adjacent sinuses or orbital structures and infectious or infiltrative diseases of the brain or meninges, or it may develop as a separate pathological condition. This pathology is characterized by a sudden loss of vision, pain, especially associated with eye movements, and impaired color perception. It is diagnosed by performing visual function examination, morphological and radiological examinations. Optic neuritis is treated with corticosteroids, while pulse therapy can even speed up recovery in children from 7 to 2 weeks.The aim of this article is to review the symptoms, etiology, pathogenesis, diagnosis, treatment options, and prognosis of pediatric optic neuritis described in the literature.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738780","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. Migraine is a primary headache disorder described by episodic attacks that can progress to chronic migraine. Preventive treatment of anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) is currently being widely investigated worldwide.Materials and methods. A total of 85 patients with migraine were enrolled in a retrospective study conducted in 2019-2021. Demographic and clinical data were collected and analyzed. Subjects were divided into groups by migraine course: chronic migraine (CM) and episodic migraine (EM), and according to the medicine used (erenumab, fremanezumab). Treatment efficacy was assessed at 3 and 6 months after the start of treatment. A reduction of >50% in monthly headache days (MHDs) was considered a good response. Statistical analysis was performed using IBM SPSS statistics 27.0, the χ² test of homogeneity, Fisher’s exact, Student’s t, and Mann-Whitney tests.Results. Of the 85 migraine patients, 75 (88.2%) were women. EM was diagnosed in 33 (38.8%) and CM in 52 (61.2%) patients. After treatment, the number of MHDs was significantly reduced in both anti-CGRP mAbs therapy groups (p<0.001). The response to anti-CGRP mAbs was similar between the EM and CM groups. A slightly better response was achieved with fremanezumab than erenumab (83.3% vs. 73.1% at 3 months; 83.3% vs. 65.7% at 6 months), but the difference was not significant (p=0.541; p=0.149). In 24 (58.5%) patients initially given 70 mg erenumab, after a median follow-up of 3 months (interquartile range: 2-6) it was decided to increase the dose of erenumab to 140 mg due to insufficient effect. The initial dose was increased more often in patients with chronic migraine (p=0.027).Conclusions. Erenumab and fremanezumab are equally effective and equivalent for both migraine types. It was observed that more than half of the patients required a dose increase when treated with erenumab 70 mg, especially in CM group.
背景。偏头痛是一种原发性头痛疾病，发作性发作可发展为慢性偏头痛。抗降钙素基因相关肽单克隆抗体(anti-CGRP mab)的预防性治疗目前在世界范围内得到广泛研究。材料和方法。共有85名偏头痛患者参加了2019-2021年进行的回顾性研究。收集和分析人口统计学和临床资料。受试者根据偏头痛病程分为组:慢性偏头痛(CM)和发作性偏头痛(EM)，并根据使用的药物(erenumab, fremanezumab)。在治疗开始后3个月和6个月评估治疗效果。每月头痛天数(mhd)减少50%被认为是良好的反应。统计学分析采用IBM SPSS statistics 27.0、χ 2齐性检验、Fisher精确检验、Student t检验和Mann-Whitney检验。85例偏头痛患者中，75例(88.2%)为女性。EM 33例(38.8%)，CM 52例(61.2%)。治疗后，抗cgrp单克隆抗体治疗组的mhd数量显著减少(p<0.001)。EM组和CM组对抗cgrp单克隆抗体的反应相似。fremanezumab的疗效略好于erenumab(3个月时为83.3% vs. 73.1%;83.3% vs. 65.7% 6个月)，但差异无统计学意义(p=0.541;p = 0.149)。在24例(58.5%)最初给予70mg erenumab的患者中，在中位随访3个月(四分位数间距:2-6)后，由于效果不足，决定将erenumab的剂量增加到140mg。慢性偏头痛患者初始剂量增加较多(p=0.027)。Erenumab和fremanezumab对两种偏头痛类型同样有效。观察到，超过一半的患者在使用伊瑞那单抗70 mg治疗时需要增加剂量，特别是CM组。
{"title":"A retrospective analysis of migraine prophylaxis with anti-CGRP monoclonal antibodies at the hospital of Lithuanian University of Health Sciences Kaunas Clinics","authors":"V. Karpavičiūtė, K. Statkevičienė, G. Žemgulytė","doi":"10.29014/ns.2022.26.10","DOIUrl":"https://doi.org/10.29014/ns.2022.26.10","url":null,"abstract":"Background. Migraine is a primary headache disorder described by episodic attacks that can progress to chronic migraine. Preventive treatment of anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) is currently being widely investigated worldwide.Materials and methods. A total of 85 patients with migraine were enrolled in a retrospective study conducted in 2019-2021. Demographic and clinical data were collected and analyzed. Subjects were divided into groups by migraine course: chronic migraine (CM) and episodic migraine (EM), and according to the medicine used (erenumab, fremanezumab). Treatment efficacy was assessed at 3 and 6 months after the start of treatment. A reduction of >50% in monthly headache days (MHDs) was considered a good response. Statistical analysis was performed using IBM SPSS statistics 27.0, the χ² test of homogeneity, Fisher’s exact, Student’s t, and Mann-Whitney tests.Results. Of the 85 migraine patients, 75 (88.2%) were women. EM was diagnosed in 33 (38.8%) and CM in 52 (61.2%) patients. After treatment, the number of MHDs was significantly reduced in both anti-CGRP mAbs therapy groups (p<0.001). The response to anti-CGRP mAbs was similar between the EM and CM groups. A slightly better response was achieved with fremanezumab than erenumab (83.3% vs. 73.1% at 3 months; 83.3% vs. 65.7% at 6 months), but the difference was not significant (p=0.541; p=0.149). In 24 (58.5%) patients initially given 70 mg erenumab, after a median follow-up of 3 months (interquartile range: 2-6) it was decided to increase the dose of erenumab to 140 mg due to insufficient effect. The initial dose was increased more often in patients with chronic migraine (p=0.027).Conclusions. Erenumab and fremanezumab are equally effective and equivalent for both migraine types. It was observed that more than half of the patients required a dose increase when treated with erenumab 70 mg, especially in CM group.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135695814","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}
D. Matuliauskas, I. Stražnickaitė, A. Samuilis, D. Jatužis
Background. Artificial intelligence (AI) in medical imaging is a growing and promising technology that can be applied in stroke diagnosis. The study aims to overview studies that compare diagnostic performance of AI applications in stroke detection and seg- mentation of stroke lesions with and without human clinicians, appraising the models, study design, and metrics used.
Materials and methods. This systematic review was performed using the PubMed search engine including articles published in the time frame of 2015 January 1 to 2021 July 23. A to- tal of 438 studies were found, out of which 60 were chosen for the review.
Results. Only 2 out of 60 (3.3%) studies were prospective. Minimum unique computer tomography (CT) scans included for validation – 10, maximum – 21586, mean – 599, me- dian – 100, standard deviation – ±2801.1. The training set sizes consisted of minimum 28 CT scans, maximum – 24214, mean – 1279, median – 153, standard deviation – ±5006.7. Most popular software used in the studies were Brainomix (n=12, 20% of studies) and RAPID (n=12, 20%), 6 studies (10%) used convolutional neural networks, and 6 studies did not iden- tify the model or name of software used. The average value of the ROC AUC results reported was 0.884 and the average accuracy was 0.857. The average reported sensitivity and specific- ity were 0.746 and 0.862, respectively. 27 out of 60 studies used human operators, with the average number of human operators per study being 3.7±2.9.
Conclusions. AI solutions can be widely applied in computation of infarct volumes. Us- ing AI in stroke diagnosis still requires further research with more prospective studies, more expert human operators, and more focus on evaluating secondary outcomes.
{"title":"Machine Learning in Acute Stroke Neuroimaging. A Systematic Literature Review","authors":"D. Matuliauskas, I. Stražnickaitė, A. Samuilis, D. Jatužis","doi":"10.29014/ns.2022.26.6","DOIUrl":"https://doi.org/10.29014/ns.2022.26.6","url":null,"abstract":"Background. Artificial intelligence (AI) in medical imaging is a growing and promising technology that can be applied in stroke diagnosis. The study aims to overview studies that compare diagnostic performance of AI applications in stroke detection and seg- mentation of stroke lesions with and without human clinicians, appraising the models, study design, and metrics used.
 Materials and methods. This systematic review was performed using the PubMed search engine including articles published in the time frame of 2015 January 1 to 2021 July 23. A to- tal of 438 studies were found, out of which 60 were chosen for the review.
 Results. Only 2 out of 60 (3.3%) studies were prospective. Minimum unique computer tomography (CT) scans included for validation – 10, maximum – 21586, mean – 599, me- dian – 100, standard deviation – ±2801.1. The training set sizes consisted of minimum 28 CT scans, maximum – 24214, mean – 1279, median – 153, standard deviation – ±5006.7. Most popular software used in the studies were Brainomix (n=12, 20% of studies) and RAPID (n=12, 20%), 6 studies (10%) used convolutional neural networks, and 6 studies did not iden- tify the model or name of software used. The average value of the ROC AUC results reported was 0.884 and the average accuracy was 0.857. The average reported sensitivity and specific- ity were 0.746 and 0.862, respectively. 27 out of 60 studies used human operators, with the average number of human operators per study being 3.7±2.9.
 Conclusions. AI solutions can be widely applied in computation of infarct volumes. Us- ing AI in stroke diagnosis still requires further research with more prospective studies, more expert human operators, and more focus on evaluating secondary outcomes.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135695993","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}
One of the most common vascular brain malformations is developmental venous anomaly (DVA). This anomaly is usually considered to be asymptomatic but there are some reports in the literature about DVA causing neurological symptoms due to neurovascular compression, obstructive hydrocephalus, venous infarction, or intracerebral hemorrhage.There are no publications on DVA causing psychiatric symptoms. This paper presents a clinical case of DVA in which the patient develops a mood disorder along with neurological symptoms that are typical for a parietal brain lesion. Along with this clinical case, a review of literature is presented which includes classification of vascular brain malformations, prevalence of DVA, clinical manifestations, and characteristics in imaging studies. The article also reviews the functions of the parietal lobe, discusses mood disorders possibly related to parietal lesions, and briefly introduces cyclothymic disorder.
{"title":"Neurologiniai ir psichiatriniai simptomai, sukelti įgimtos veninės anomalijos","authors":"M. Gataveckaitė, R. Burbienė, R. Mameniškienė","doi":"10.29014/ns.2022.26.13","DOIUrl":"https://doi.org/10.29014/ns.2022.26.13","url":null,"abstract":"One of the most common vascular brain malformations is developmental venous anomaly (DVA). This anomaly is usually considered to be asymptomatic but there are some reports in the literature about DVA causing neurological symptoms due to neurovascular compression, obstructive hydrocephalus, venous infarction, or intracerebral hemorrhage.There are no publications on DVA causing psychiatric symptoms. This paper presents a clinical case of DVA in which the patient develops a mood disorder along with neurological symptoms that are typical for a parietal brain lesion. Along with this clinical case, a review of literature is presented which includes classification of vascular brain malformations, prevalence of DVA, clinical manifestations, and characteristics in imaging studies. The article also reviews the functions of the parietal lobe, discusses mood disorders possibly related to parietal lesions, and briefly introduces cyclothymic disorder.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696162","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}
Headache is one of the most common neurological symptoms associated with coronavirus disease 19 (COVID-19), which can mimic primary headache phenotypes. COVID-19 and quarantine have affected both the course of primary headache and patient care strategies. The safety of migraine treatment with anti-CGRP (calcitonin gene-related peptides) monoclonal drugs has become important. Another challenge posed by the introduction of mass vaccination is vaccine-related headache, the most common neurological adverse event, and a less common complication, cerebral venous thrombosis. The article provides a brief overview of COVID-19 induced headache and its features, vaccination-induced headache, the impact of COVID-19 and quarantine on primary headache, the safety of anti-CGRP monoclonals, and the advantages and disadvantages of remote consultations on primary headaches.
{"title":"Ką naujo sužinojome apie galvos skausmą per COVID-19 pandemiją? Literatūros apžvalga","authors":"E. Januškevičiūtė, J. Grigaitė, K. Ryliškienė","doi":"10.29014/ns.2022.26.16","DOIUrl":"https://doi.org/10.29014/ns.2022.26.16","url":null,"abstract":"Headache is one of the most common neurological symptoms associated with coronavirus disease 19 (COVID-19), which can mimic primary headache phenotypes. COVID-19 and quarantine have affected both the course of primary headache and patient care strategies. The safety of migraine treatment with anti-CGRP (calcitonin gene-related peptides) monoclonal drugs has become important. Another challenge posed by the introduction of mass vaccination is vaccine-related headache, the most common neurological adverse event, and a less common complication, cerebral venous thrombosis. The article provides a brief overview of COVID-19 induced headache and its features, vaccination-induced headache, the impact of COVID-19 and quarantine on primary headache, the safety of anti-CGRP monoclonals, and the advantages and disadvantages of remote consultations on primary headaches.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696458","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}
Facioscapulohumeral muscular dystrophy is the third most common muscular dystrophy characterised by weakness of the face, scapula, upper arm, and other muscles. It can also lead to problems with the eyes, hearing, breathing, heart, and central nervous system. The disease is divided into two types: the first type occurs in 95% of patients and the second type occurs in 5%. The phenotypic differences between the two types are not distinct, both resulting from dysregulation of DUX4 expression leading to skeletal muscle toxicity. The first type is characterised by a reduction in D4Z4 repeats, while the second type is characterised by mutations in genes encoding epigenetic regulators such as SMCHD1. In recent years, significant progress has been made in understanding the pathogenesis, clinical features, and progression of the disease, but there is still no specific treatment due to the obstacles in the development of gene therapy. However, supportive measures, including physiotherapy and orthotics, can help improve muscle function and mobility, slow the progression of the disease, and control other symptoms. The disease can present in many ways, from an asymptomatic form to a life dependent on a wheelchair, so it is important for doctors to keep up to date with the latest information so they can identify this genetic disorder faster and help the patient live a full life.
{"title":"Veido-mentės-žasto raumenų distrofija: patogenezės, klinikinių simptomų ir gydymo apžvalga","authors":"T. Mikalauskas, B. Burnytė","doi":"10.29014/ns.2022.26.17","DOIUrl":"https://doi.org/10.29014/ns.2022.26.17","url":null,"abstract":"Facioscapulohumeral muscular dystrophy is the third most common muscular dystrophy characterised by weakness of the face, scapula, upper arm, and other muscles. It can also lead to problems with the eyes, hearing, breathing, heart, and central nervous system. The disease is divided into two types: the first type occurs in 95% of patients and the second type occurs in 5%. The phenotypic differences between the two types are not distinct, both resulting from dysregulation of DUX4 expression leading to skeletal muscle toxicity. The first type is characterised by a reduction in D4Z4 repeats, while the second type is characterised by mutations in genes encoding epigenetic regulators such as SMCHD1. In recent years, significant progress has been made in understanding the pathogenesis, clinical features, and progression of the disease, but there is still no specific treatment due to the obstacles in the development of gene therapy. However, supportive measures, including physiotherapy and orthotics, can help improve muscle function and mobility, slow the progression of the disease, and control other symptoms. The disease can present in many ways, from an asymptomatic form to a life dependent on a wheelchair, so it is important for doctors to keep up to date with the latest information so they can identify this genetic disorder faster and help the patient live a full life.","PeriodicalId":479531,"journal":{"name":"Neurologijos seminarai","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696404","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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