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Different attitudes in the management of different types of status epilepticus: A survey study among neurologists demonstrating evidence gap 不同类型癫痫持续状态管理的不同态度:一项显示证据差距的神经学家调查研究
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_70_20
Y. Gomceli, Ebru Altındağ, B. Baykan
Purpose: The aim is to identify current diagnostic and therapeutic approach to different types of status epilepticus (SE) including convulsive SE (CSE), non-CSE (NCSE), and epilepsia partialis continua (EPC) to detect unmet needs and problems encountered during the management of these neurological emergencies in our country, Turkey. Methods: The specifically designed SE survey included 31 questions that were related to the incidence, the distribution of etiological causes, the diagnostic process, and the treatment approaches of the neurologists and individual electroencephalography (EEG) facilities of the institutions. Results: The total number of respondents was 152 with a median years of experience in professional practice of 10.8 years (1–39 years). The great majority of the neurologists preferred diazepam plus phenytoin as the first choice drug in the treatment of CSE. Of the respondents, only 55% accepted the SE as refractory after applying the second drug and they monitored these patients in the intensive care unit (ICU). Most of the participants (67.7%) did not provide any treatment except the standard medical approaches, while only 39 (30.7%) had used immunotherapy in the treatment of super-refractory SE. Forty-seven respondents (37%) indicated that they had difficulty identifying NCSE on EEG. While 37% of the participants treated EPC patients with preserved consciousness in ICU by general anesthesia, only 15% were previously applied immunotherapy. Strikingly, 41% of the participants stated that they did not feel themselves as sufficiently competent in terms of practical and theoretical knowledge about the management of SE. Conclusion: We demonstrated that there are no standardized attitudes for the management of different types of SE among neurologists. It is worth to emphasize that the neurologists did not feel themselves sufficiently competent in terms of practical and theoretical knowledge, especially with regard to the subtypes of SE.
目的:目的是确定当前不同类型癫痫持续状态(SE)的诊断和治疗方法,包括惊厥性SE (CSE),非CSE (NCSE)和部分持续性癫痫(EPC),以发现在我国土耳其处理这些神经紧急情况时未满足的需求和遇到的问题。方法:采用专门设计的SE调查问卷,包括31个问题,涉及发病率、病因分布、诊断过程、神经科医生的治疗方法和机构的个体脑电图(EEG)设备。结果:调查对象总人数152人,从业经验中位数为10.8年(1-39年)。绝大多数神经科医师首选地西泮加苯妥英作为治疗CSE的首选药物。在受访者中,只有55%的人在使用第二种药物后接受SE为难治性,并在重症监护病房(ICU)对这些患者进行监测。大多数参与者(67.7%)没有提供除标准医学途径外的任何治疗,而只有39人(30.7%)在治疗超难治性SE时使用了免疫疗法。47名受访者(37%)表示他们在脑电图上难以识别NCSE。虽然37%的参与者在ICU中使用全身麻醉治疗EPC患者,但只有15%的患者以前应用过免疫治疗。引人注目的是,41%的参与者表示,他们认为自己在管理SE的实践和理论知识方面没有足够的能力。结论:神经科医师对不同类型SE的处理没有统一的态度。值得强调的是,神经科医生并不认为自己在实践和理论知识方面有足够的能力,特别是在SE的亚型方面。
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引用次数: 0
The effects of ozone oxidative preconditioning on subarachnoid hemorrhage via rat cerebral vasospasm model 臭氧氧化预处理对大鼠脑血管痉挛模型蛛网膜下腔出血的影响
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_74_20
H. Suslu, N. Tatarlı, D. Ceylan, H. Süslü, S. Bozkurt, Timucin Avşar, B. Güçlü
Objective: Cerebral vasospasm after subarachnoid hemorrhage (SAH) is a major cause of morbidity and mortality. Inflammation is the major molecular mechanism observed in vasospastic SAH. Ozone (O3) has been used as a therapeutic agent in the treatment of various conditions and diseases for years. The aim of this study was to evaluate the anti-inflammatory effect of ozone oxidative preconditioning (OOP) in a rat model of SAH in order to assess the therapeutic potential of O3 in SAH therapy. Materials and Methods: In the presented study, an experimental in vivo SAH rat model that provided constriction of large cerebral arteries was used. The inflammatory response of cerebral vasospasm after SAH and the effects of OOP were evaluated by comparing the mRNA levels of inflammatory molecules (tumor necrosis factor-α, interleukin-1β, and intercellular adhesion molecule-1) in the serum samples of rats. Results: The level of inflammatory molecules increased in vasospasm at 12 h, 24 h, and 48 h in the posttreatment groups. However, intraperitoneal OOP decreased the level of inflammatory molecules dramatically. Conclusions: Our study indicated that O3 treatment has potential in the management of inflammation created in a rat SAH model. These findings may inform further studies investigating possible uses of O3 in the treatment of vasospasm.
目的:蛛网膜下腔出血(SAH)后的脑血管痉挛是导致发病率和死亡率的主要原因。炎症是观察到的血管痉挛性蛛网膜下腔出血的主要分子机制。臭氧(O3)多年来一直被用作治疗剂,用于治疗各种疾病。本研究的目的是评估臭氧氧化预处理(OOP)在SAH大鼠模型中的抗炎作用,以评估臭氧在SAH治疗中的治疗潜力。材料和方法:在本研究中,使用了一种提供大脑大动脉收缩的实验性体内SAH大鼠模型。通过比较大鼠血清中炎症分子(肿瘤坏死因子-α、白细胞介素-1β和细胞间粘附分子-1)的mRNA水平,评估SAH后脑血管痉挛的炎症反应和OOP的作用。结果:治疗后12小时、24小时和48小时,血管痉挛时炎症分子水平升高。然而,腹膜内OOP显著降低了炎症分子的水平。结论:我们的研究表明,O3治疗在大鼠蛛网膜下腔出血模型中产生的炎症具有潜力。这些发现可能为进一步研究O3在治疗血管痉挛中的可能用途提供信息。
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引用次数: 0
Investigation of oxidative stress in relapse and remission periods of patients with relapsing-Remitting multiple sclerosis 复发缓解型多发性硬化症患者复发和缓解期氧化应激的研究
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/nsn.nsn_142_20
S. Oncel, M. Ozturk, R. Gozubatik-Celik, A. Soysal, S. Baybaş
Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. The role of oxidative stress has gained importance in the pathogenesis of free radicals in cells such as protein, lipid, and nucleic acids by showing myelin loss and axonal degeneration. In this study, serum total oxidant level total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and paraoxonase (PON) in patients with relapsing-remitting-MS (RRMS) were examined. The hypothesis was that antioxidants might indicate the attack phase or the progression phase. Methods: Twenty-four patients with RRMS known to have undergone new attacks and 24 healthy controls whose demographic data were appropriate were included. PON and TAS/TOS measurements were performed once in the healthy group and twice in the serum samples of patients during relapse and remission periods. The Number Cruncher Statistical System 2007 and Power Analysis and Sample Size 2008 Statistical Software (Utah, USA) program was used for statistical analysis. Results: TAS, TOS, and PON levels were similar in the patient and control groups during the attack. In remission, only a positive, statistically significant relationship between the duration of the disease and TAS measurements was noted (r = 0.435; P = 0.034). No significant relationship was found between sociodemographic characteristics, illness duration, laboratory/imaging findings, and antioxidant parameters in blood. Conclusion: In this study, TOS, TAS, OSI, and PON serum levels had no role in determining attack and remission periods in RRMS. There were only significant differences between disease duration and TAS results during the remission period. Following TAS results may help in monitoring progression in patients with early MS.
引言:多发性硬化症(MS)是一种中枢神经系统的慢性炎症性脱髓鞘疾病。氧化应激在蛋白质、脂质和核酸等细胞中自由基的发病机制中的作用越来越重要,表现为髓鞘丢失和轴突变性。在本研究中,检测了复发-缓解型多发性硬化症(RRMS)患者的血清总氧化剂水平、总氧化剂状态(TOS)、总抗氧化状态(TAS)、氧化应激指数(OSI)和对氧磷酶(PON)。该假说认为抗氧化剂可能指示发作期或进展期。方法:纳入24名已知有新发作的RRMS患者和24名人口统计学数据适当的健康对照组。PON和TAS/TOS测量在健康组中进行一次,在复发和缓解期对患者的血清样本进行两次。使用2007年数字Cruncher统计系统和2008年幂分析和样本量统计软件(美国犹他州)程序进行统计分析。结果:发作期间,患者组和对照组的TAS、TOS和PON水平相似。在病情缓解时,疾病持续时间和TAS测量值之间只有统计学意义上的正相关关系(r=0.435;P=0.034)。社会人口统计学特征、疾病持续时间、实验室/影像学检查结果和血液中的抗氧化参数之间没有显着关系。结论:在本研究中,TOS、TAS、OSI和PON血清水平对RRMS的发作期和缓解期没有影响。在病情缓解期间,疾病持续时间和TAS结果之间只有显著差异。以下TAS结果可能有助于监测早期MS患者的进展。
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引用次数: 1
Reliability and validity of the Turkish version of the morningness – Eveningness questionnaire 土耳其版早-晚性问卷的信度和效度
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_110_20
Firat Ozdalyan, Ö. Tütüncü, H. Gümüş, O. Açıkgöz
Background: People are divided into different chronotypes in relation to their circadian rhythm features. The Morningness–Eveningness Questionnaire (MEQ), developed by Horne and Östberg, was the first and is the most used questionnaire for determining the chronotype of people. The reliability and validity of MEQ were tested in this study due to some deficiencies and inconsistencies in previous reliability and validity studies for the Turkish versions of MEQ and deficiencies regarding the validity and reliability of other versions of MEQ. Subjects and Methods: MEQ was translated into Turkish based on the opinions of five academics who were experts in their respective fields and the suitability and content validity of the questionnaire were ensured. The Turkish MEQ was administered to 419 undergraduate students aged 18–34 years. Robust minimum rank factor analysis (MRFA) was used to reveal the construct validity of the questionnaire. Results: As a result of the analyses, the questionnaire was examined in three factors. None of the items were excluded from the study and all items were collected under three factors. The explained total variance value was 42.7%, and the factors explained 64% of common (shared) variance in MRFA. According to the reliability analysis, Cronbach's alpha value for the MEQ Turkish version was satisfactory for the overall questionnaire (0.765). Conclusions: The MEQ version developed in this study is more valid and reliable compared with other versions. However, these results support that a more detailed instrument for morningness and eveningness can be developed.
背景:人们根据他们的昼夜节律特征被分为不同的时型。由Horne和Östberg开发的晨昏问卷(MEQ)是第一个也是最常用的用于确定人的时间类型的问卷。由于以往对土耳其语版MEQ的信度效度研究存在不足和不一致之处,其他版本MEQ的信度效度也存在不足,本研究对MEQ的信度效度进行了检验。研究对象和方法:MEQ根据5位各自领域的专家学者的意见翻译成土耳其语,确保问卷的适用性和内容效度。对419名18-34岁的本科生进行了土耳其MEQ测试。采用稳健最小秩因子分析(MRFA)揭示问卷的结构效度。结果:根据分析结果,问卷从三个方面进行了检验。没有一个项目被排除在研究之外,所有的项目都被收集在三个因素下。总方差解释值为42.7%,因子解释MRFA共有(共享)方差的64%。信度分析显示,土耳其版MEQ的Cronbach α值对整体问卷满意(0.765)。结论:与其他版本相比,本研究开发的MEQ版本更有效、可靠。然而,这些结果支持可以开发更详细的早晨和晚上的工具。
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引用次数: 1
Renal involvement in children with tuberous sclerosis 结节性硬化症患儿肾脏受累
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_35_20
A. Keskinoğlu, H. Tekgül, C. Kabasakal
Objectives: Tuberous sclerosis (TS) is a multisystemic disease with a genetic component. The central nervous system is most commonly involved. Renal involvement is also common. In this study, renal involvement was investigated descriptively and analytically in children with TS. Methods: A retrospective cohort study was performed on TS patients followed in a neurology clinic. The result variable is renal involvement. Other demographic, health-related, and family characteristics were examined as independent variables. Other system involvements in children with TS were presented analytically. Descriptive and analytical statistics were performed with SPSS 24.0 software. Results: The total number of children diagnosed with TS was 52. Renal involvement was found in 9 (17.3%) of these children. Frequency of renal involvement was not statistically increased according to independent characteristics which were obtained from patient files (demographic characteristics, presence of neurological problems in the family, weight and height percentiles, and other system involvements in children with TS). Conclusion: In our study, renal involvement was found to be less frequent than the reported in the literature. It may be more relevant to conduct studies with higher number of children with TS for risk assessment of renal involvement.
目的:结节性硬化症(TS)是一种具有遗传成分的多系统疾病。中枢神经系统最常受累。肾脏受累也很常见。在本研究中,对TS患儿的肾脏受累情况进行了描述性和分析性的调查。方法:回顾性队列研究对神经内科门诊的TS患者进行了随访。结果变量是肾脏受累。其他人口统计学、健康相关和家庭特征作为独立变量进行检查。对TS患儿的其他系统干预进行了分析。采用SPSS 24.0软件进行描述性统计和分析性统计。结果:诊断为TS的患儿总数为52例。其中9例(17.3%)患儿肾脏受累。根据从患者档案中获得的独立特征(人口统计学特征、家庭中是否存在神经问题、体重和身高百分位数以及TS患儿的其他系统受累),肾脏受累的频率在统计学上没有增加。结论:在我们的研究中,发现肾脏受累比文献报道的要少。对更多的TS患儿进行肾脏受累风险评估可能更有意义。
{"title":"Renal involvement in children with tuberous sclerosis","authors":"A. Keskinoğlu, H. Tekgül, C. Kabasakal","doi":"10.4103/NSN.NSN_35_20","DOIUrl":"https://doi.org/10.4103/NSN.NSN_35_20","url":null,"abstract":"Objectives: Tuberous sclerosis (TS) is a multisystemic disease with a genetic component. The central nervous system is most commonly involved. Renal involvement is also common. In this study, renal involvement was investigated descriptively and analytically in children with TS. Methods: A retrospective cohort study was performed on TS patients followed in a neurology clinic. The result variable is renal involvement. Other demographic, health-related, and family characteristics were examined as independent variables. Other system involvements in children with TS were presented analytically. Descriptive and analytical statistics were performed with SPSS 24.0 software. Results: The total number of children diagnosed with TS was 52. Renal involvement was found in 9 (17.3%) of these children. Frequency of renal involvement was not statistically increased according to independent characteristics which were obtained from patient files (demographic characteristics, presence of neurological problems in the family, weight and height percentiles, and other system involvements in children with TS). Conclusion: In our study, renal involvement was found to be less frequent than the reported in the literature. It may be more relevant to conduct studies with higher number of children with TS for risk assessment of renal involvement.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"33 - 36"},"PeriodicalIF":0.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42130236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effects of melatonin treatment on headache and vasomotor reactivity in patients with chronic tension-type headache 褪黑素治疗对慢性紧张型头痛患者头痛及血管舒缩反应性的影响
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/nsn.nsn_7_21
E. Eroğlu, B. Öztürk, A. Özön, G. Koc, Ö. Karadaş
Objectives: Chronic tension-type headache (TTH) is a serious disease that disrupts quality of life. In this study, the effect of prophylactic oral melatonin treatment on headache and cerebral vasomotor reactivity (VMR) was investigated in patients diagnosed with chronic TTH per the International Classification of Headache Disorders criteria. Subjects and Methods: Twenty patients with chronic TTH and 20 healthy individuals were included in the study. The patients were administered a melatonin treatment at 3 mg/day for 12 weeks. The number of monthly painful days and pain severity were recorded with the “Visual Analog Scale” before and after the treatment. Cerebral VMR measurements were performed at baseline in the control group and in patients before and after the treatment. Results: The median number of monthly painful days was 20 (15–27) before the treatment and 10 (4–18) after the treatment; the median pain severity score was 70.00 (45–80) before the treatment and 42.50 (15–75) after the treatment. The difference was statistically significant (P = 0.001). No statistically significant difference between the VMR values was observed (P > 0.05). Conclusions: Melatonin treatment was effective in reducing the pain severity and decreasing the number of monthly painful days in patients with chronic TTH but demonstrated no effect on the cerebral VMR.
目的:慢性紧张型头痛(TTH)是一种严重影响生活质量的疾病。在这项研究中,根据国际头痛疾病分类标准,研究了预防性口服褪黑素治疗对诊断为慢性TTH的患者头痛和脑血管舒缩反应性(VMR)的影响。受试者和方法:本研究包括20名慢性TTH患者和20名健康人。患者接受了为期12周的3 mg/天褪黑素治疗。在治疗前后用“视觉模拟量表”记录每月疼痛天数和疼痛严重程度。在基线时对对照组和治疗前后的患者进行大脑VMR测量。结果:治疗前每月疼痛天数中位数为20天(15-27天),治疗后每月疼痛天数中值为10天(4-18天);中位疼痛严重程度评分在治疗前为70.00(45-80),治疗后为42.50(15-75)。差异有统计学意义(P=0.001)。VMR值之间无统计学意义(P>0.05)。结论:褪黑素治疗可有效降低慢性TTH患者的疼痛程度和每月疼痛天数,但对大脑VMR无影响。
{"title":"The effects of melatonin treatment on headache and vasomotor reactivity in patients with chronic tension-type headache","authors":"E. Eroğlu, B. Öztürk, A. Özön, G. Koc, Ö. Karadaş","doi":"10.4103/nsn.nsn_7_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_7_21","url":null,"abstract":"Objectives: Chronic tension-type headache (TTH) is a serious disease that disrupts quality of life. In this study, the effect of prophylactic oral melatonin treatment on headache and cerebral vasomotor reactivity (VMR) was investigated in patients diagnosed with chronic TTH per the International Classification of Headache Disorders criteria. Subjects and Methods: Twenty patients with chronic TTH and 20 healthy individuals were included in the study. The patients were administered a melatonin treatment at 3 mg/day for 12 weeks. The number of monthly painful days and pain severity were recorded with the “Visual Analog Scale” before and after the treatment. Cerebral VMR measurements were performed at baseline in the control group and in patients before and after the treatment. Results: The median number of monthly painful days was 20 (15–27) before the treatment and 10 (4–18) after the treatment; the median pain severity score was 70.00 (45–80) before the treatment and 42.50 (15–75) after the treatment. The difference was statistically significant (P = 0.001). No statistically significant difference between the VMR values was observed (P > 0.05). Conclusions: Melatonin treatment was effective in reducing the pain severity and decreasing the number of monthly painful days in patients with chronic TTH but demonstrated no effect on the cerebral VMR.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"28 - 32"},"PeriodicalIF":0.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47888979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coexistence of hypokalemic periodic paralysis with central hypersomnolence: An attack of paralysis in polysomnographic recording 低钾性周期性麻痹与中枢性嗜睡共存:多导睡眠图记录的一次麻痹发作
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_145_20
G. Şenel, D. Karadeniz
{"title":"Coexistence of hypokalemic periodic paralysis with central hypersomnolence: An attack of paralysis in polysomnographic recording","authors":"G. Şenel, D. Karadeniz","doi":"10.4103/NSN.NSN_145_20","DOIUrl":"https://doi.org/10.4103/NSN.NSN_145_20","url":null,"abstract":"","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"79 - 80"},"PeriodicalIF":0.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44823954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pembrolizumab-induced myasthenia gravis in a patient with thymic carcinoma: A case report and review of the literature Pembrolizumab诱发胸腺癌患者重症肌无力1例报告及文献复习
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_105_20
S. Aykac, Büşra Erkılınç, B. Uludaǧ
Pembrolizumab is an immune checkpoint inhibitor. Most cases of myasthenia gravis (MG) reported with the use of immune checkpoint inhibitors have been in melanomas, and small and non-small cell lung carcinoma, but there are no reported cases in thymic epithelial carcinoma. A 57-year-old male with thymic carcinoma presented with symptoms of diplopia, drooping eyelids, and difficulty in talking and swallowing after a second dose of pembrolizumab. Contrast-enhanced brain magnetic resonance imaging, laboratory tests, and electroneuromyography were normal. Single-fiber electromyography showed increased jitter (six muscle fibers were collected, range of jitter 29–140 μs, mean 75 μs; normal <35 μs) in bilateral orbicularis oculi muscles supporting MG. Serum screening showed no any positivity for acetylcholine receptor and muscle-specific tyrosine kinase autoantibodies. The patient died of bulbar dysfunction related to aspiration pneumonia despite receiving intravenous immunoglobulin and methylprednisolone therapy. Physicians should be alert to possible exacerbations of autoimmune diseases and associated risks, especially during treatment with checkpoint inhibitors in thymic malignancy.
Pembrolizumab是一种免疫检查点抑制剂。大多数使用免疫检查点抑制剂报告的重症肌无力(MG)病例发生在黑色素瘤、小细胞和非小细胞肺癌中,但胸腺上皮癌中没有报告病例。一名57岁男性胸腺癌患者在第二剂pembrolizumab后出现复视、眼睑下垂、说话和吞咽困难的症状。对比增强脑磁共振成像、实验室检查和神经肌肉电图均正常。单纤维肌电图显示,支持MG的双侧眼轮匝肌抖动增加(采集了6条肌纤维,抖动范围29-140μs,平均75μs;正常<35μs)。血清筛查显示乙酰胆碱受体和肌特异性酪氨酸激酶自身抗体没有任何阳性。尽管患者接受了静脉注射免疫球蛋白和甲基强的松龙治疗,但仍死于与吸入性肺炎相关的延髓功能障碍。医生应警惕自身免疫性疾病的可能恶化和相关风险,尤其是在胸腺恶性肿瘤的检查点抑制剂治疗期间。
{"title":"Pembrolizumab-induced myasthenia gravis in a patient with thymic carcinoma: A case report and review of the literature","authors":"S. Aykac, Büşra Erkılınç, B. Uludaǧ","doi":"10.4103/NSN.NSN_105_20","DOIUrl":"https://doi.org/10.4103/NSN.NSN_105_20","url":null,"abstract":"Pembrolizumab is an immune checkpoint inhibitor. Most cases of myasthenia gravis (MG) reported with the use of immune checkpoint inhibitors have been in melanomas, and small and non-small cell lung carcinoma, but there are no reported cases in thymic epithelial carcinoma. A 57-year-old male with thymic carcinoma presented with symptoms of diplopia, drooping eyelids, and difficulty in talking and swallowing after a second dose of pembrolizumab. Contrast-enhanced brain magnetic resonance imaging, laboratory tests, and electroneuromyography were normal. Single-fiber electromyography showed increased jitter (six muscle fibers were collected, range of jitter 29–140 μs, mean 75 μs; normal <35 μs) in bilateral orbicularis oculi muscles supporting MG. Serum screening showed no any positivity for acetylcholine receptor and muscle-specific tyrosine kinase autoantibodies. The patient died of bulbar dysfunction related to aspiration pneumonia despite receiving intravenous immunoglobulin and methylprednisolone therapy. Physicians should be alert to possible exacerbations of autoimmune diseases and associated risks, especially during treatment with checkpoint inhibitors in thymic malignancy.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"73 - 78"},"PeriodicalIF":0.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48890836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Sensory brain responses and lateralization in nonpainful tactile stimuli during sleep 睡眠中无痛触觉刺激的感觉脑反应和侧化
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_102_20
Gonca Inanc, M. Özgören, A. Öniz
Aims and Objectives: The aim of this study was to investigate the difference between sensory brain responses of nonpainful tactile stimuli applied to the fingers of the right-hand dominant individuals between the hemispheres. Materials and Methods: Nineteen healthy volunteers (9 women, mean age ± standard deviation: 23.00 ± 2.24 years) participated in the study. Electroencephalogram (EEG) recordings were taken from 40 channels polysomnography system. A uniform nonpainful stimulus was applied to two fingers (index and middle fingers) of the right and left hand with a pneumatic stimulator unit. Results: Non-rapid eye movement sleep (NREM) whole night sleep-related potentials were evaluated. When the stimulus was applied to the right hand, central and parietal regions of the P50 response component appeared significantly earlier in the left hemisphere. When the left-hand stimulus was applied, the P50 and N100 response components appeared significantly early in central, parietal, and temporal regions in the left hemisphere. Hence, amplitudes of the right-hand response components (P50 and N100) were found to be greater in the central, parietal, and temporal regions in the left hemisphere. When the stimulus is applied to the left hand, the amplitude of the P50 component was greater in the central and temporal regions in the left hemisphere. Conclusion: P50 and N100 are components related to sensory processing. The difference in latency and amplitude observed in these components between hemispheres indicates the presence of lateralization in sensory processing during sleep.
目的和目的:本研究的目的是研究大脑半球之间对右手优势个体手指施加的非触觉刺激的感觉反应之间的差异。材料和方法:19名健康志愿者(9名女性,平均年龄±标准差:23.00±2.24岁)参加了这项研究。脑电图(EEG)记录取自40通道多导睡眠图系统。用气动刺激器单元对右手和左手的两根手指(食指和中指)施加均匀的非漏斗状刺激。结果:评估了非快速眼动睡眠(NREM)整夜睡眠相关电位。当对右手施加刺激时,P50反应成分的中央和顶叶区域在左半球明显更早出现。当施加左侧刺激时,P50和N100反应成分在左半球的中央、顶叶和颞叶区域显著早期出现。因此,发现右侧反应成分(P50和N100)的振幅在左半球的中央、顶叶和颞叶区域更大。当对左手施加刺激时,P50分量的振幅在左半球的中央和颞部区域更大。结论:P50和N100是与感觉加工有关的成分。在大脑半球之间观察到的这些成分的潜伏期和振幅的差异表明睡眠期间感觉处理存在偏侧化。
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引用次数: 3
The effect of vision on top.down modulation of hand blink reflex 视觉对眨眼反射上下调节的影响
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-01-01 DOI: 10.4103/NSN.NSN_77_20
F. Çalıkuşu, A. Gündüz, M. Kiziltan
Objective: The magnitude of hand blink reflex (HBR) increases when a threatening stimulus is positioned in the peripersonal space (PPS) compared with stimulus in the extrapersonal space (EPS). We hypothesized that the reflex increase in PPS might change depending on whether the stimulus was seen. We aimed to investigate the alterations in HBR response to understand the effects of vision on cortical modulation of HBR. Methods: The HBR was recorded from 11 healthy volunteers while the hand was far away from the face (EPS), close to the face with eyes open (PPS-eyes open), and close to the face with eyes closed (PPS-eyes closed). Changes in the response magnitudes were compared between the three conditions. Results: HBR was obtained in all subjects. As expected, there was an increase in the reflex magnitude in the PPS-eyes open condition relative to EPS. In the PPS-eyes closed condition, the duration and latency were shorter and the area under the curve was significantly smaller compared with the PPS-eyes open condition. Conclusion: The enhancement of HBR in PPS is attributed to tonic top-down modulation. Our study provides evidence for the special sensory modulation of the PPS effect on HBR and may suggest cortical modulation of top-down modulation of brainstem neural circuits.
目的:与个人外空间(EPS)的刺激相比,当威胁性刺激位于人外空间(PPS)时,眨眼反射(HBR)的幅度增加。我们假设PPS的反射增加可能会随着是否看到刺激而改变。我们旨在研究HBR反应的改变,以了解视觉对HBR皮层调节的影响。方法:记录11名健康志愿者的HBR,同时手远离面部(EPS)、睁开眼睛靠近面部(PPS眼睛睁开)和闭着眼睛靠近面部。比较了三种条件下响应幅度的变化。结果:所有受试者均获得HBR。不出所料,PPS睁眼条件下的反射幅度相对于EPS有所增加。在PPS闭眼条件下,与PPS睁眼条件相比,持续时间和潜伏期更短,曲线下面积显著更小。结论:PPS中HBR的增强可归因于紧张性自上而下的调节。我们的研究为PPS对HBR的特殊感觉调节提供了证据,并可能提示脑干神经回路自上而下的皮层调节。
{"title":"The effect of vision on top.down modulation of hand blink reflex","authors":"F. Çalıkuşu, A. Gündüz, M. Kiziltan","doi":"10.4103/NSN.NSN_77_20","DOIUrl":"https://doi.org/10.4103/NSN.NSN_77_20","url":null,"abstract":"Objective: The magnitude of hand blink reflex (HBR) increases when a threatening stimulus is positioned in the peripersonal space (PPS) compared with stimulus in the extrapersonal space (EPS). We hypothesized that the reflex increase in PPS might change depending on whether the stimulus was seen. We aimed to investigate the alterations in HBR response to understand the effects of vision on cortical modulation of HBR. Methods: The HBR was recorded from 11 healthy volunteers while the hand was far away from the face (EPS), close to the face with eyes open (PPS-eyes open), and close to the face with eyes closed (PPS-eyes closed). Changes in the response magnitudes were compared between the three conditions. Results: HBR was obtained in all subjects. As expected, there was an increase in the reflex magnitude in the PPS-eyes open condition relative to EPS. In the PPS-eyes closed condition, the duration and latency were shorter and the area under the curve was significantly smaller compared with the PPS-eyes open condition. Conclusion: The enhancement of HBR in PPS is attributed to tonic top-down modulation. Our study provides evidence for the special sensory modulation of the PPS effect on HBR and may suggest cortical modulation of top-down modulation of brainstem neural circuits.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"6 - 11"},"PeriodicalIF":0.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41371261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Neurological Sciences and Neurophysiology
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