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Comparison of awake electroencephalography, electroencephalography after sleep deprivation, and melatonin-induced sleep electroencephalography sensitivity in the diagnosis of epilepsy in adults 清醒脑电图、睡眠剥夺后脑电图及褪黑素诱发的睡眠脑电图敏感性在成人癫痫诊断中的比较
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_101_22
B. Demirtaş, I. Uludag, U. Şener, Y. Zorlu
Introduction: The aim of this study was to compare routine awake electroencephalography (r-EEG), melatonin-induced sleep EEG (m-EEG) and EEG (d-EEG) after sleep deprivation studies in terms of epileptiform anomalies (EA), and to compare d-EEG and m-EEG studies in terms of sleep induction in patients requiring differential diagnosis of epileptic seizure/nonepileptic seizure. Methods: The study included 45 patients aged 18–45 years who had at least one seizure suspected to be epileptic but could not be diagnosed with epilepsy with clinical and laboratory findings. Each patient underwent r-EEG on the 1st day, d-EEG on the 2nd day after 24 h of sleeplessness, and m-EEG on the 3rd day after the administration of 6 mg melatonin following 7 h night sleep. Three separate EEG tracings of the patients were compared for EA. The d-EEG and m-EEG methods were examined for their ability to achieve sleep, total sleep time (ST), and sleep latency (SL). Results: When the detection rate of EA in d-EEG and m-EEG was compared with that of r-EEG, it was found to be significantly higher (P < 0.001) (73.3% with d-EEG, 75.6% with m-EEG, and 35.6% with r-EEG). Sleep was achieved at a rate of 100% after receiving melatonin and at a rate of 97.8% with sleep deprivation. There was no significant difference between d-EEG and m-EEG in terms of mean ST and SL (ST = 58.6 ± 12.6 min and 59.7 ± 8.3 min, respectively; SL = 287.6 ± 484.3 s and 152.2 ± 178.7 s after the start of the EEG, respectively). Conclusions: Sleep EEG is superior to awake EEG in terms of detecting EA. In an EEG study, where melatonin was used to induce sleep, the sleep rate and SL were similar to those of d-EEG, and melatonin did not have an EA increasing or suppressing effect on EEG. Given the ease of application and low side effect profile, it is thought that m-EEG may be an applicable method in the diagnosis of epilepsy.
引言:本研究的目的是比较癫痫样异常(EA)睡眠剥夺研究后的常规清醒脑电图(r-EEG)、褪黑素诱导的睡眠脑电图(m-EEG)和脑电图(d-EEG),并比较需要鉴别诊断癫痫发作/非癫痫发作的患者在睡眠诱导方面的d-EEG和m-EEG研究。方法:该研究包括45名年龄在18-45岁之间的患者,他们至少有一次癫痫发作被怀疑是癫痫,但根据临床和实验室结果无法诊断为癫痫。每位患者在失眠24小时后的第1天接受r-EEG,第2天接受d-EEG,在夜间睡眠7小时后给予6mg褪黑素后的第3天接受m-EEG。比较了三个独立的患者脑电图描记的EA。检查d-EEG和m-EEG方法实现睡眠的能力、总睡眠时间(ST)和睡眠潜伏期(SL)。结果:d-EEG和m-EEG的EA检出率与r-EEG相比,有显著性差异(P<0.001)(d-EEG为73.3%,m-EEG为75.6%,r-EEG为35.6%)。接受褪黑激素治疗后,睡眠率为100%,睡眠不足时睡眠率为97.8%。在平均ST和SL方面,d-EEG和m-EEG之间没有显著差异(ST=58.6±12.6分钟和59.7±8.3分钟;SL=287.6±484.3秒和152.2±178.7秒)。结论:睡眠脑电图在检测电针方面优于清醒脑电图。在一项使用褪黑素诱导睡眠的脑电图研究中,睡眠率和SL与d-EEG相似,褪黑素对脑电图没有增加或抑制EA的作用。鉴于m-EEG的易用性和低副作用,人们认为m-EEG可能是诊断癫痫的一种适用方法。
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引用次数: 0
Neuroanatomical and Etiological Approaches to Secondary Narcolepsy 继发性发作性睡病的神经解剖学和病因学方法
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_5_22
G. Şenel, D. Karadeniz
Narcolepsy is one among the disorders of central hypersomnolence characterized by excessive daytime sleepiness not related to disturbances in nocturnal sleep or misalignment in circadian rhythms. The cardinal symptom of this group of disorders is disabling daytime sleepiness, characterized by the repeated episodes of irresistible daytime sleepiness or lapses into sleep in monotonous situations, but also under unusual conditions such as eating. Narcolepsy is defined as type 1 and type 2 on the basis of the presence of cataplexy. The most pathognomonic feature of narcolepsy type 1 is cataplexy, which is characterized by sudden episodes of brief loss of muscle tone-sparing consciousness, usually triggered by strong emotions. Other nonspecific symptoms associated with rapid eye movement sleep dissociation include fragmentation of nocturnal sleep, hypnagogic or hypnopompic hallucinations, and sleep paralysis. The pathophysiology of narcolepsy type 1 is well established as the deficiency of hypocretin (orexin) signaling in the lateral hypothalamus. In narcolepsy type 2, on the other hand, hypocretin levels are not decreased, and it has been suggested that there is probably a partial deficiency in hypocretin signaling system to cause excessive daytime sleepiness but not severe enough to cause cataplexy. Instead of types 1 and 2, primary (idiopathic) narcolepsy, familial narcolepsy, secondary (symptomatic) narcolepsy, and narcolepsy plus (hereditary forms with additional neurological symptoms) forms were suggested to better classify the clinical entities. In this paper, the diagnosis of symptomatic or secondary narcolepsy is reviewed and classified based on the underlying pathophysiologic mechanisms.
嗜睡症是一种中枢性嗜睡障碍,其特征是白天过度嗜睡,与夜间睡眠障碍或昼夜节律失调无关。这类疾病的主要症状是使人无法在白天嗜睡,其特征是反复发作的无法抗拒的白天嗜睡或在单调的情况下入睡,但也在不寻常的情况下,如进食。发作性睡病在出现猝倒的基础上被定义为1型和2型。发作性睡病1型最典型的特征是猝发性发作,其特征是肌张力保留意识的短暂突然丧失,通常由强烈的情绪引发。与快速眼动睡眠分离相关的其他非特异性症状包括夜间睡眠碎片化、入睡幻觉或催眠幻觉和睡眠瘫痪。1型发作性睡病的病理生理机制是由于下丘脑外侧分泌的食欲素(食欲素)信号缺乏。另一方面,在2型发作性睡症中,下丘脑泌素水平没有下降,有人认为可能是下丘脑泌素信号系统的部分缺乏导致白天过度嗜睡,但没有严重到引起猝倒。代替1型和2型,原发性(特发性)发作性睡病、家族性发作性睡病、继发性(症状性)发作性睡病和发作性睡病加型(遗传形式与额外的神经症状)被建议更好地分类临床实体。本文就症状性或继发性发作性睡病的诊断进行综述,并根据其潜在的病理生理机制进行分类。
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引用次数: 0
Detection of freezing of gait episodes in patients with parkinson's disease using electroencephalography and motion sensors: A protocol and its feasibility results 利用脑电图和运动传感器检测帕金森病患者步态冻结:一种方案及其可行性结果
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_104_22
U. Eliiyi, T. Kahraman, A. Genç, P. Keskinoğlu, Ahmet Özkurt, B. Dönmez
Objective: Freezing of gait (FOG) is an important concern for both patients with Parkinson's disease (pwPD) and physicians. In this study, we aimed to introduce a study protocol and our initial data. The data were subsequently used in machine learning models to detect FOG episodes using brain activity signals and motion data in the laboratory setting using complex FOG-evoking activities in a sample of pwPD with and without FOG compared with age-matched healthy controls. Subjects and Methods: An experimental task to evoke a FOG episode was designed. This experimental task was tested on two pwPD with FOG in “on” and “off” periods and one healthy control. Brain activity signals and motion data were collected simultaneously using electroencephalography (EEG) and inertial measurement units (IMUs). Results: The whole procedure took about 2 h, during which around 30 min were spent on walking tasks, involving 35 complete tours in the designed 8-m hallway by pwPD. Both EEG and IMUs sensor data could be collected, accompanied by FOG episode data marked by the neurologist. The video recordings of the patient's walking tasks were checked and reanalyzed by the neurologist sometime after the data experiment for marking the beginnings and ends of the observed FOG episodes more precisely. In the end, 24 stops were marked as FOG, which corresponded to 11% of the sensor data collected during the walking tasks. Conclusion: The designed FOG-evoking task protocol could be performed without any adverse effects, and it created enough FOG episodes for analysis. EEG and motion sensor data could be successfully collected without any significant artifacts.
目的:步态冻结(FOG)是帕金森病(pwPD)患者和医生关注的一个重要问题。在本研究中,我们旨在介绍一个研究方案和我们的初步数据。随后,在机器学习模型中使用这些数据,在实验室环境中使用大脑活动信号和运动数据来检测FOG发作,与年龄匹配的健康对照组相比,在有和没有FOG的pwPD样本中使用复杂的FOG唤起活动。受试者和方法:设计了一项唤起FOG发作的实验任务。这项实验任务在两个有FOG的pwPD上进行了测试,分别处于“开启”和“关闭”阶段,以及一个健康对照组。使用脑电图(EEG)和惯性测量单元(IMU)同时收集大脑活动信号和运动数据。结果:整个过程耗时约2小时,其中约30分钟用于步行任务,涉及pwPD在设计的8米走廊中进行的35次完整参观。脑电图和IMU传感器数据都可以被收集,同时伴有神经学家标记的FOG发作数据。神经科医生在数据实验后的某个时候检查并重新分析了患者行走任务的视频记录,以更准确地标记观察到的FOG发作的开始和结束。最终,24个站点被标记为FOG,相当于步行任务期间收集的传感器数据的11%。结论:所设计的FOG唤起任务方案可以在没有任何不良反应的情况下执行,并且它产生了足够的FOG发作供分析。可以在没有任何显著伪影的情况下成功地收集EEG和运动传感器数据。
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引用次数: 0
The Relationship Between Intracranial Hemorrhage After Intravenous Thrombolytic Therapy and the Need for Antihypertensive Treatment During and After Infusion in Acute Ischemic Stroke 急性缺血性脑卒中患者静脉溶栓治疗后颅内出血与输注期间及输注后降压治疗需求的关系
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_30_22
E. Bahadır, M. Sorgun, C. Işıkay
Background: This study aims to determine which factors increase the risk of intracerebral hemorrhage after tissue plasminogen activator (tPA) treatment in patients with acute ischemic stroke and to investigate whether there is a relationship between the need for antihypertensive therapy during and after tPA infusion and the risk of intracerebral hemorrhage. Materials and Methods: Consecutive patients who applied to our stroke center with acute ischemic stroke and received IV tPA treatment in the first 4.5 h between 2012 and 2020 were included in the study. The demographic data of patients, stroke risk factors, drugs used before the stroke, neurological examinations, cranial computed tomographys (CTs) before and after tPA, antihypertensive usage during IV tPA and in the 24-h period after treatment, hospital mortality rates, and modified Rankin Scale scores in the 3rd month were evaluated retrospectively. Patients with intracerebral bleeding were divided into groups according to bleeding subtypes and whether they were symptomatic. Results: Intracranial bleeding was detected in 48 of 214 patients included in this study. Nineteen of these (8.8%) were classified as symptomatic intracerebral hemorrhage according to the National Institute of Neurological Disorders and Stroke and 14 (6.5%) according to the definition of the European Cooperative Acute Stroke Study. In the multiple logistic regression analysis, intracranial bleeding was significantly associated with 24th h systolic blood pressure and the need for antihypertensive usage. Conclusions: Blood pressure regulation should be done carefully during tPA infusion and in the first 24 h. In addition, cranial CT scanning in patients who need antihypertensive usage may enable earlier detection of intracranial bleeding.
背景:本研究旨在确定哪些因素会增加急性缺血性卒中患者组织纤溶酶原激活剂(tPA)治疗后脑出血的风险,并探讨tPA输注期间和输注后是否需要降压治疗与脑出血风险之间是否存在关系。材料与方法:纳入2012年至2020年期间连续向我中心申请急性缺血性脑卒中并在前4.5 h内接受静脉tPA治疗的患者。回顾性评价患者的人口学资料、卒中危险因素、卒中前用药、神经学检查、tPA前后颅脑ct检查、静脉tPA期间及治疗后24小时内抗高血压药物使用情况、住院死亡率及第3个月的修正Rankin量表评分。脑出血患者根据出血亚型及有无症状进行分组。结果:214例患者中有48例出现颅内出血。其中19例(8.8%)根据国家神经系统疾病和中风研究所被归类为症状性脑出血,14例(6.5%)根据欧洲急性中风合作研究的定义。在多元logistic回归分析中,颅内出血与24 h收缩压及降压药使用需求显著相关。结论:在tPA输注期间和最初24小时内应仔细调节血压。此外,需要使用降压药的患者进行颅脑CT扫描可以早期发现颅内出血。
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引用次数: 0
Disentangling the P300 Components of Evoked Potentials Elicited using Subliminal Oddball Tasks in Reward-Directed Motivation 在奖励导向动机中应用阈下奇球任务挖掘诱发电位P300成分
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_109_22
K. Kaya, E. Gelir, Eda Karaismailoğlu, Serkan Karaismailoglu
Objective: The objective of this study was to investigate neural responses during subliminal oddball tasks concerning reward-directed motivation to distinguish the P3a and P3b components of evoked P300 potentials. Methods: The subliminal oddball task included congruent/incongruent stimuli and masked prime subliminal stimuli. The task was to push the button when an incongruent stimulus appeared. Participants underwent two pre- and post-break electroencephalogram (EEG) recordings. During the break, the thirst scores of the participants were evaluated. Then, participants consumed three different salty foods in the same amount and completed the remaining two post-break EEG recordings, followed by the second thirst scores evaluation. Finally, participants physically selected lettered cards (A, B, C, and D) to receive a reward and quench their thirst. Results: Thirty participants were enrolled, 28 of whom were included for data analysis. Ten participants selected lettered cards as the given subliminal stimulus (sub(+) group), and 18 participants selected different lettered cards from the given subliminal stimulus (sub(–) group). We found a significant increase in post-P3a and post-P3b amplitudes in the sub(+) group at the Pz/Oz electrodes. Changes in P3b amplitude were significantly higher in the sub(+) group (2.83 ± 1.14 μV) than in the sub(–) group (0.62 ± 2.29 μV) at the Pz/Oz electrodes. Correlation analysis revealed that higher thirst scores resulted in higher P3b amplitudes in the sub(+) group. Conclusion: These findings suggest that reward-directed motivation increases parietal-posterior P3b amplitudes, signifying the involvement of cognitive processes to achieve a reward.
目的:本研究的目的是研究与奖励导向动机有关的潜意识古怪任务中的神经反应,以区分诱发P300电位的P3a和P3b成分。方法:阈下古怪任务包括一致/不一致刺激和掩蔽的主要阈下刺激。任务是在出现不协调的刺激时按下按钮。参与者接受了两次课间休息前和课间休息后的脑电图(EEG)记录。在休息期间,对参与者的口渴评分进行了评估。然后,参与者食用三种相同量的不同咸味食物,并完成剩余的两次休息后脑电图记录,然后进行第二次口渴评分评估。最后,参与者亲自挑选字母卡(A、B、C和D),以获得奖励并解渴。结果:30名参与者被纳入研究,其中28人被纳入数据分析。10名参与者选择字母卡片作为给定的潜意识刺激(子(+)组),18名参与者从给定的潜意识激励(子(-)组)中选择不同的字母卡片。我们发现在Pz/Oz电极的亚(+)组中,P3a后和P3b后振幅显著增加。Pz/Oz电极处,亚(+)组P3b振幅的变化(2.83±1.14μV)显著高于亚(-)组(0.62±2.29μV)。相关分析显示,在亚(+)组中,口渴评分越高,P3b振幅越高。结论:这些发现表明,奖励导向的动机增加了顶叶后部P3b的振幅,表明参与了实现奖励的认知过程。
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引用次数: 0
The value of arterial spin labeling magnetic resonance imaging in the periictal period: A case with continuous lateralized periodic discharges 动脉自旋标记磁共振成像在围周期的价值:1例连续偏侧周期性放电
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_85_22
N. Dericioğlu, R. Göçmen
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引用次数: 0
Is tattoo in the operative field a disadvantage in posterior thoracolumbar surgery? 后胸腰椎手术中手术野纹身是一个不利因素吗?
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_71_22
M. Yılmaz, K. Yucesoy, E. Ozgiray
Objective: Tattooing has become more popular, especially in Western culture. We aimed to analyze the impacts of the presence of tattoos in the operative field for posterior thoracolumbar surgery. Methodology: This study was performed using data extracted from the medical files of 15 patients who underwent posterior thoracolumbar surgery between April 2013 and May 2020 in the neurosurgery department of our tertiary care center. Therapeutic, clinical, and cosmetic outcomes after surgery necessitating incision on the tattoo are presented together with a brief discussion of the current literature. Results: Our series consisted of nine women and six men with an average age of 31.03 (range, 17–45) years. The duration of follow-up was 52 (range, 6–90) months. Ten patients underwent posterior spinal stabilization, and a simple discectomy was performed on five patients. The therapeutic outcomes and clinical improvement were satisfactory in all patients. No complications attributed to the presence of tattoos were detected in any patients. Conclusion: Posterior thoracolumbar surgery usually necessitates a midline incision that may unavoidably result in the deformation of a tattoo. Our results yielded that therapeutic and cosmetic results in patients with tattoos in the operative field were acceptable in the vast majority of cases after posterior thoracolumbar surgery.
目的:纹身越来越流行,尤其是在西方文化中。我们旨在分析胸腰椎后部手术中纹身的影响。方法:本研究使用从2013年4月至2020年5月在我们三级护理中心神经外科接受胸腰椎后段手术的15名患者的医疗档案中提取的数据进行。手术后的治疗、临床和美容结果需要在纹身上切开,并简要讨论了当前的文献。结果:我们的系列包括9名女性和6名男性,平均年龄为31.03岁(17-45岁)。随访时间为52个月(范围为6-90个月)。10名患者接受了脊柱后部稳定术,5名患者进行了简单的椎间盘切除术。所有患者的治疗结果和临床改善均令人满意。在任何患者中均未发现纹身引起的并发症。结论:胸腰椎后部手术通常需要中线切口,这可能不可避免地导致纹身变形。我们的研究结果表明,在胸腰椎后部手术后的绝大多数病例中,手术区纹身患者的治疗和美容效果是可以接受的。
{"title":"Is tattoo in the operative field a disadvantage in posterior thoracolumbar surgery?","authors":"M. Yılmaz, K. Yucesoy, E. Ozgiray","doi":"10.4103/nsn.nsn_71_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_71_22","url":null,"abstract":"Objective: Tattooing has become more popular, especially in Western culture. We aimed to analyze the impacts of the presence of tattoos in the operative field for posterior thoracolumbar surgery. Methodology: This study was performed using data extracted from the medical files of 15 patients who underwent posterior thoracolumbar surgery between April 2013 and May 2020 in the neurosurgery department of our tertiary care center. Therapeutic, clinical, and cosmetic outcomes after surgery necessitating incision on the tattoo are presented together with a brief discussion of the current literature. Results: Our series consisted of nine women and six men with an average age of 31.03 (range, 17–45) years. The duration of follow-up was 52 (range, 6–90) months. Ten patients underwent posterior spinal stabilization, and a simple discectomy was performed on five patients. The therapeutic outcomes and clinical improvement were satisfactory in all patients. No complications attributed to the presence of tattoos were detected in any patients. Conclusion: Posterior thoracolumbar surgery usually necessitates a midline incision that may unavoidably result in the deformation of a tattoo. Our results yielded that therapeutic and cosmetic results in patients with tattoos in the operative field were acceptable in the vast majority of cases after posterior thoracolumbar surgery.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"191 - 194"},"PeriodicalIF":0.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47934290","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
Tinnitus and Underlying Theoretical Mechanism: The Key and Lock? 耳鸣和潜在的理论机制:钥匙和锁?
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-10-01 DOI: 10.4103/nsn.nsn_55_22
S. Durankaya, A. Çetin, B. Mutlu, Selhan Gurkan, G. Kırkım, M. Şerbetçioğlu
Background and Aim: To evaluate the association between psychoacoustical characteristics of tinnitus and audiogram configurations and reveal which theoretical mechanism dominates tinnitus. Materials and Methods: The medical charts of 110 adult participants' 164 ears with tinnitus were retrospectively reviewed. Audiological results, edge frequency, and psychoacoustical characteristics of tinnitus were assessed. Participants were divided into two groups as follows: normal hearing (NH) and sensorineural hearing loss (SNHL). Results: No significant relationship was observed between age, gender, tinnitus pitch, and loudness between the two groups. In the SNHL group, there was a weak positive correlation between tinnitus pitch and frequency of maximum hearing loss (FMHL), and a strong positive correlation between the mean tinnitus loudness at the tinnitus pitch and FMHL. Besides, the edge frequency was positively and weakly correlated with the tinnitus pitch and FMHL. No statistically significant difference was observed between the groups regarding the tinnitus pitch. However, tinnitus loudness was statistically higher in the NH group. No relationship was observed between the audiogram shapes and tinnitus timbre, pitch, and FMHL. In addition, the most likened tinnitus timbre was found to be tonal/whistle in both groups. A moderate positive correlation was observed between the tinnitus pitch and edge frequency in the gradual slope audiograms. Conclusions: The findings obtained in this study supported homeostatic plasticity theories for the SNHL group, and hidden hearing loss for the NH group.
背景与目的:探讨耳鸣的心理声学特征与听力图结构之间的关系,揭示耳鸣的理论机制。材料与方法:回顾性分析110例成人耳鸣患者164耳的病历资料。评估耳鸣的听力学结果、边缘频率和心理声学特征。参与者分为正常听力组(NH)和感音神经性听力损失组(SNHL)。结果:两组患者的年龄、性别、耳鸣音高、响度无显著相关性。SNHL组耳鸣音高与最大听力损失频率(FMHL)呈弱正相关,平均耳鸣响度与最大听力损失频率(FMHL)呈强正相关。边缘频率与耳鸣音高、FMHL呈显著正、弱相关。两组间耳鸣音高差异无统计学意义。然而,NH组的耳鸣响度在统计学上更高。听力图形状与耳鸣音色、音高和FMHL之间没有关系。此外,两组人中耳鸣音色最相似的是音调/哨音。耳鸣音高与边缘频率呈中度正相关。结论:本研究结果支持SNHL组的稳态可塑性理论和NH组的隐性听力损失理论。
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引用次数: 0
Neurological manifestations and mortality in hospitalized coronavirus disease 2019 patients 2019年住院冠状病毒病患者的神经系统表现和死亡率
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-07-01 DOI: 10.4103/nsn.nsn_117_21
Tugba Ozel, N. Erdem, A. Ünal, A. Yalcin, D. Inan, Nevruz İlhanli, H. Uysal
Purpose: The purpose of the study is to analyze the neurological manifestations and to determine the association between these symptoms and mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). Materials and Methods: Five hundred and forty-seven hospitalized patients with positive reverse transcriptase-polymerase chain reaction tests for severe acute respiratory syndrome coronavirus in a nasopharyngeal swab were included in this study. The demographic features, laboratory data, and radiologic imaging, neurological symptoms of hospitalized patients with COVID-19 were collected. Results: Of 547 hospitalized COVID-19 patients, the median age was 61 (range 18–93), 61.4% were male. Three hundred and forty-seven (63.4%) patients had a severe infection and 200 (36.6%) patients had a mild infection. Eighty-eight patients (16.1%) died during hospitalization. One hundred and fifty-four (28.2%) patients had at least one neurological symptom. Thirty-five (6.4%) patients manifested with only neurological symptoms at hospital admission. The most frequent neurological symptoms were headache (15.2%), taste and smell disorders (9.1%), and myalgia (6.6%). The other initial neurological manifestations were acute cerebral ischemic stroke, impaired consciousness, epileptic seizure, and posterior reversible encephalopathy. The late-onset neurological complications were autoimmune encephalitis and Guillain-Barre syndrome. The neurological manifestation was linked to the severity of disease (P = 0.005) but not correlated with mortality (P = 0.137). Conclusion: Neurological symptoms were frequent in COVID-19 patients. The neurological symptoms can be the initial symptoms or can be late-onset complications of COVID-19.
目的:本研究旨在分析2019冠状病毒病(新冠肺炎)住院患者的神经系统表现,并确定这些症状与死亡率之间的关系。材料和方法:本研究纳入了547名鼻咽拭子中严重急性呼吸综合征冠状病毒逆转录聚合酶链式反应检测呈阳性的住院患者。收集新冠肺炎住院患者的人口学特征、实验室数据、放射学成像和神经系统症状。结果:在547名住院新冠肺炎患者中,中位年龄为61岁(18-93岁),61.4%为男性。347名(63.4%)患者有严重感染,200名(36.6%)患者有轻度感染。88名患者(16.1%)在住院期间死亡。154名(28.2%)患者至少有一种神经系统症状。35名(6.4%)患者入院时仅表现出神经系统症状。最常见的神经系统症状是头痛(15.2%)、味觉和嗅觉障碍(9.1%)和肌痛(6.6%)。其他最初的神经系统表现是急性缺血性脑卒中、意识受损、癫痫发作和后部可逆性脑病。迟发性神经系统并发症为自身免疫性脑炎和格林-巴利综合征。神经系统表现与疾病严重程度相关(P=0.005),但与死亡率无关(P=0.137)。结论:新冠肺炎患者神经系统症状多见。神经系统症状可以是新冠肺炎的最初症状,也可以是晚发性并发症。
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引用次数: 2
Comparison of semiologic characteristics of psychogenic nonepileptic seizures and frontal and temporal lobe seizures 心因性非癫痫发作与额颞叶癫痫发作的符号学特征比较
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-07-01 DOI: 10.4103/nsn.nsn_4_22
Kubra Isık, G. Morkavuk, B. Mete, G. Koc
Introduction: Video electroencephalography monitoring (VEM) is the gold standard for differentiating epileptic seizures and psychogenic nonepileptic seizures (PNES). This study aimed to compare the semiologic characteristics of PNES and frontal and temporal seizures. Materials and Methods: This study was conducted retrospectively on the records of patients aged over 18 years with PNES and frontal and temporal lobe seizures, who were followed up as inpatients in the Ufuk University Neurology Clinic VEM unit between 2016 and 2020. Seventy-two patients who met the study criteria and were hospitalized during this period were included in the study. The preictal, ictal, and postictal semiologic characteristics of the patients were examined and compared in terms of the seizure type. Results: Of the 72 patients included in the study, 29.2% had PNES, 15.3% had frontal lobe epilepsy, and 41.7% had temporal lobe epilepsy. The mean age of the patients was 32.74 ± 9.84 years. In patients with PNES, frequent semiologic changes, frequent medical visits, ability to execute commands, remembering test words, forced eye closure, subjective sensory symptoms, ictal crying, tremor in extremities, gradual onset, fluctuating course, postictal pseudo-sleep, pelvic thrusting movement, and arrhythmic synchronous extremity movement manifestations were determined to be significantly higher compared with frontal and temporal lobe epilepsies. Conclusion: Seizure semiology is important in the differential diagnosis of epileptic seizures and PNES. VEM remains the gold standard for differentiating PNES and epileptic seizures.
视频脑电图监测(VEM)是鉴别癫痫发作和心因性非癫痫发作(PNES)的金标准。本研究旨在比较PNES与额叶和颞叶癫痫的符号学特征。材料与方法:本研究回顾性分析了2016年至2020年在Ufuk大学神经内科VEM单元随访的18岁以上PNES合并额叶和颞叶癫痫发作患者的记录。72名符合研究标准并在此期间住院的患者被纳入研究。检查患者的先期、先期和后期符号学特征,并根据癫痫发作类型进行比较。结果:纳入研究的72例患者中,29.2%为PNES, 15.3%为额叶癫痫,41.7%为颞叶癫痫。患者平均年龄32.74±9.84岁。在PNES患者中,频繁的符号学变化、频繁的就诊、执行命令的能力、记忆测试单词、强迫闭眼、主观感觉症状、突发哭闹、四肢震颤、逐渐发作、波动过程、后假睡眠、骨盆突突运动和不规则的肢体同步运动表现被确定为与额叶和颞叶癫痫患者相比显着升高。结论:癫痫符号学在癫痫发作和PNES的鉴别诊断中具有重要意义。VEM仍然是鉴别PNES和癫痫发作的金标准。
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Neurological Sciences and Neurophysiology
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