Spontaneous regression of a cerebral arteriovenous malformations (AVMs) is a rare and poorly understood phenomenon. We present a case of unruptured cerebral AVM in a patient presenting with intermittent headache. In order to reduce hemorrhagic risk, the patient underwent partial embolization of the AVM with Onyx glue. Follow-up digital subtraction angiography (DSA) showed complete obliteration of the residual AVM three months after the treatment. In conclusion, partial Onyx embolization of cerebral AVM may be an etiological factor of spontaneous regression. In order to reduce hemorrhagic risk, targeted partial embolization of the AVM may be an alternative treatment for some cases.
{"title":"Partial Onyx embolization triggers spontaneous regression of cerebral AVM: A case report","authors":"Yihui Ma, Zejin Li, Tingbao Zhang, Yu Feng, Wenyuan Zhao","doi":"10.54029/2023xkw","DOIUrl":"https://doi.org/10.54029/2023xkw","url":null,"abstract":"Spontaneous regression of a cerebral arteriovenous malformations (AVMs) is a rare and poorly understood phenomenon. We present a case of unruptured cerebral AVM in a patient presenting with intermittent headache. In order to reduce hemorrhagic risk, the patient underwent partial embolization of the AVM with Onyx glue. Follow-up digital subtraction angiography (DSA) showed complete obliteration of the residual AVM three months after the treatment. In conclusion, partial Onyx embolization of cerebral AVM may be an etiological factor of spontaneous regression. In order to reduce hemorrhagic risk, targeted partial embolization of the AVM may be an alternative treatment for some cases.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637783","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}
The caveolin-3 protein encoded by the CAV-3 gene is a muscle-specific protein found in skeletal, smooth, and cardiac muscle. Caveolin-3 defects lead to several muscle diseases: rippling muscle disease (RMD), limb-girdle muscular dystrophy (LGMD1C), distal myopathy, familial hypertrophic cardiomyopathy, and asymptomatic hyper-CK-emia. While some variants that cause mutations in this gene cause a pure type of disease, some variants may appear as overlap syndromes. Even in the same variants of CAV-3 mutation, the type of muscle disease, its severity, and time of occurrence can be variable. For this reason, it should be known that CAV-3-related diseases and all overlapping diseases can be seen over time, and the patient should be followed up. We report here a 9-year- old boy and his 38-year-old mother who were investigated for asymptomatic hyper-CK-emia and diagnosed with caveolinopathy. The boy had calf hypertrophy and percussion-induced rapid muscle contraction (PIRCs). His mother had calf hypertrophy, contractions due to percussion, and proximal muscle weakness. Mother’s proximal muscles and m. gastrocnemius magnetic resonance imaging (MRI) was normal. The mother had complaints of weakness, showing slow progression starting from the second decade. Heterozygous (ENST000003cav3849.2) c.298A>T p.Ile100Phe variant in exon 2 was detected in the CAV-3 gene. This mutation is classified as pathogenic according to The American College of Medical Genetics and Genomics (ACMG) criteria (PM1, PM2, PP3, PM5). In conclusion, calves’ pseudohypertrophy and mildly raised CK without weakness can be the initial presentation of caveolinopathy. Percussion-induced muscle contractions, rather than muscle rippling, can occur at a young age. The onset of muscle weakness can be delayed during adolescence and can have a slowly deteriorating course associated with myalgia.
{"title":"CAV-3-related age-dependent muscle diseases: A novel mutation in mother and son","authors":"Hande Tekin, Pınar Edem","doi":"10.54029/2023scy","DOIUrl":"https://doi.org/10.54029/2023scy","url":null,"abstract":"The caveolin-3 protein encoded by the CAV-3 gene is a muscle-specific protein found in skeletal, smooth, and cardiac muscle. Caveolin-3 defects lead to several muscle diseases: rippling muscle disease (RMD), limb-girdle muscular dystrophy (LGMD1C), distal myopathy, familial hypertrophic cardiomyopathy, and asymptomatic hyper-CK-emia. While some variants that cause mutations in this gene cause a pure type of disease, some variants may appear as overlap syndromes. Even in the same variants of CAV-3 mutation, the type of muscle disease, its severity, and time of occurrence can be variable. For this reason, it should be known that CAV-3-related diseases and all overlapping diseases can be seen over time, and the patient should be followed up. We report here a 9-year- old boy and his 38-year-old mother who were investigated for asymptomatic hyper-CK-emia and diagnosed with caveolinopathy. The boy had calf hypertrophy and percussion-induced rapid muscle contraction (PIRCs). His mother had calf hypertrophy, contractions due to percussion, and proximal muscle weakness. Mother’s proximal muscles and m. gastrocnemius magnetic resonance imaging (MRI) was normal. The mother had complaints of weakness, showing slow progression starting from the second decade. Heterozygous (ENST000003cav3849.2) c.298A>T p.Ile100Phe variant in exon 2 was detected in the CAV-3 gene. This mutation is classified as pathogenic according to The American College of Medical Genetics and Genomics (ACMG) criteria (PM1, PM2, PP3, PM5). In conclusion, calves’ pseudohypertrophy and mildly raised CK without weakness can be the initial presentation of caveolinopathy. Percussion-induced muscle contractions, rather than muscle rippling, can occur at a young age. The onset of muscle weakness can be delayed during adolescence and can have a slowly deteriorating course associated with myalgia.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"17 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638085","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}
Objective: This study aimed to determine the effect of discharge training and telephone counseling service on patients’ functional status and caregiver burden after stroke. Methods: This study was conducted as a randomized controlled trial in 69 stroke patients and their caregivers. Discharge training and telephone counseling were given to the caregivers in the intervention group. Caregivers also received telephone counseling by calling researcher when needed. Information form for participants, Modified Rankin Scale, Barthel Index and The Zarit Caregiver Burden Scale were used for data collection. Pre-tests were applied to the intervention and control groups before discharge. Three months after discharge post-tests were performed for the two groups. Results: Three months after discharge, caregivers’ burden was significantly lower in the intervention group compared to the control group. The mean Modified Rankin Scale score of the patients in the intervention group was significantly lower than the control group three months after discharge. Although the mean Barthel Index score of the patients in the intervention group was statistically significant higher than before discharge, but the difference between the groups was not statistically significant. Conclusion: Discharge training and telephone counseling provided to the caregivers of stroke patients reduced the caregiver burden and had a positive effect on the improvement of the functional status of the patients.
{"title":"The effect of discharge training and telephone counseling service on patients’ functional status and caregiver burden after stroke: A randomized controlled trial","authors":"Deniz Ezgi BİTEK, Özgül EROL","doi":"10.54029/2023xmx","DOIUrl":"https://doi.org/10.54029/2023xmx","url":null,"abstract":"Objective: This study aimed to determine the effect of discharge training and telephone counseling service on patients’ functional status and caregiver burden after stroke. Methods: This study was conducted as a randomized controlled trial in 69 stroke patients and their caregivers. Discharge training and telephone counseling were given to the caregivers in the intervention group. Caregivers also received telephone counseling by calling researcher when needed. Information form for participants, Modified Rankin Scale, Barthel Index and The Zarit Caregiver Burden Scale were used for data collection. Pre-tests were applied to the intervention and control groups before discharge. Three months after discharge post-tests were performed for the two groups. Results: Three months after discharge, caregivers’ burden was significantly lower in the intervention group compared to the control group. The mean Modified Rankin Scale score of the patients in the intervention group was significantly lower than the control group three months after discharge. Although the mean Barthel Index score of the patients in the intervention group was statistically significant higher than before discharge, but the difference between the groups was not statistically significant. Conclusion: Discharge training and telephone counseling provided to the caregivers of stroke patients reduced the caregiver burden and had a positive effect on the improvement of the functional status of the patients.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638086","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}
Weiyuan Yuan, YiMeng Feng, Ting Yang, Kedierya Mahemuti, Ensheng Yao
Objective: As an inflammatory mediator, serum galectin-3 is involved in a variety of biological processes, including fibrosis, angiogenesis, apoptosis and immune activation, as well as in the physiological and pathological processes of multiple nervous system diseases. The aim of this study was to investigate the relationship between serum galectin-3 and post-stroke depression in acute ischemic stroke (AIS) patients. Methods: Baseline data of patients with AIS admitted to the Department of Neurology, First Affiliated Hospital, Shihezi University School of Medicine from October 2021 to May 2022 were continuously collected. The general data of the patients were collected and serum galectin-3 levels were measured. Hamilton Depression Scale was used to evaluate the occurrence of post-stroke depression. Results: The level of serum galectin-3 was increased in AIS patients with post-stroke depression. The prevalence of post-stroke depression increased with the increase of serum galectin-3 level, suggesting that serum galectin-3 was associated with post-stroke depression. The findings from the ROC curve showed that the area under the curve of serum galectin-3 as a possible biomarker for diagnosing post- stroke depression in AIS patients was 0.719. The sensitivity and specificity were 78.1% and 65.2%, respectively. Multivariate logistic regression analysis showed that serum galectin-3 level remained to be a predictor of post-stroke depression. Conclusions: Elevated serum galectin-3 levels are linked to a higher risk of post-stroke depression. Serum galectin-3 may be a promising biomarker for clinical monitoring of post-stroke depression.
{"title":"Serum galectin-3 as a potential predictive biomarker Is associated with post-stroke depression","authors":"Weiyuan Yuan, YiMeng Feng, Ting Yang, Kedierya Mahemuti, Ensheng Yao","doi":"10.54029/2023szm","DOIUrl":"https://doi.org/10.54029/2023szm","url":null,"abstract":"Objective: As an inflammatory mediator, serum galectin-3 is involved in a variety of biological processes, including fibrosis, angiogenesis, apoptosis and immune activation, as well as in the physiological and pathological processes of multiple nervous system diseases. The aim of this study was to investigate the relationship between serum galectin-3 and post-stroke depression in acute ischemic stroke (AIS) patients. Methods: Baseline data of patients with AIS admitted to the Department of Neurology, First Affiliated Hospital, Shihezi University School of Medicine from October 2021 to May 2022 were continuously collected. The general data of the patients were collected and serum galectin-3 levels were measured. Hamilton Depression Scale was used to evaluate the occurrence of post-stroke depression. Results: The level of serum galectin-3 was increased in AIS patients with post-stroke depression. The prevalence of post-stroke depression increased with the increase of serum galectin-3 level, suggesting that serum galectin-3 was associated with post-stroke depression. The findings from the ROC curve showed that the area under the curve of serum galectin-3 as a possible biomarker for diagnosing post- stroke depression in AIS patients was 0.719. The sensitivity and specificity were 78.1% and 65.2%, respectively. Multivariate logistic regression analysis showed that serum galectin-3 level remained to be a predictor of post-stroke depression. Conclusions: Elevated serum galectin-3 levels are linked to a higher risk of post-stroke depression. Serum galectin-3 may be a promising biomarker for clinical monitoring of post-stroke depression.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637773","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}
Background & Objectives: Stroke is an acute cerebrovascular disease with high morbidity, high mortality and high disability rate. Acupuncture has been widely used in the treatment of stroke. However, bibliometrics on acupuncture for stroke are still lacking. This study aims to analyze the global research trend of acupuncture treatment for stroke in the past 20 years. Methods: A systematic search was conducted in Web of Science about acupuncture in the treatment of stroke. The databases were searched from inception to August 2022. Citespace is a service that researches the underlying knowledge in the scientific literature. We used it to analyze the relationship between publication year and country, institution, journal, author, bibliography, and keywords about acupuncture for stroke. Results: A total of 897 articles were included for analysis. Over the past 20 years, the results showed a steady increase in the number of articles about acupuncture treatment for stroke. The country with the largest number of publications is the People’s Republic of China (670), and the institution with the largest number of publications is Beijing University of Traditional Chinese Medicine (66). Keyword analysis showed that acupuncture in the treatment of post-stroke conscious cognitive impairment is the research development trend and focus on this field. Conclusion: This study provides a visual analysis method for the trends and frontiers of acupuncture treatment for stroke. Acupuncture is the research development trend for the treatment of post-stroke conscious cognitive impairment. Although most studies conclude that acupuncture has a positive effect on stroke, a large sample, randomized controlled trials are still needed to analyze the efficacy and physiological mechanisms of acupuncture in the treatment of stroke.
背景,目的:脑卒中是一种高发病率、高死亡率、高致残率的急性脑血管疾病。针灸已被广泛应用于中风的治疗。然而，针灸治疗中风的文献计量仍然缺乏。本研究旨在分析近20年来全球针灸治疗脑卒中的研究趋势。方法:系统检索Web of Science中有关针灸治疗脑卒中的文献。该数据库从建立到2022年8月进行了搜索。Citespace是一个研究科学文献中潜在知识的服务。我们用它来分析发表年份与针灸治疗中风的国家、机构、期刊、作者、参考书目和关键词之间的关系。结果:共纳入897篇文献进行分析。在过去的20年里，研究结果显示，关于针灸治疗中风的文章数量稳步增加。发表论文数量最多的国家是中华人民共和国(670篇)，发表论文数量最多的机构是北京中医药大学(66篇)。关键词分析表明，针刺治疗脑卒中后意识认知障碍是该领域的研究发展趋势和重点。结论:本研究为针刺治疗脑卒中的趋势和前沿提供了一种直观的分析方法。针刺是脑卒中后意识认知障碍治疗的研究发展趋势。虽然大多数研究结论认为针灸对脑卒中有积极作用，但仍需要大样本、随机对照试验来分析针灸治疗脑卒中的疗效和生理机制。
{"title":"Acupuncture in the treatment of stroke: A bibliometric analysis based on Citespace","authors":"Yajing Zhang, Yu Shen, Xixi Dang, Xiaomeng Chen, Yirong Yang, Ying Xiong, Daojun Hong","doi":"10.54029/2023tie","DOIUrl":"https://doi.org/10.54029/2023tie","url":null,"abstract":"Background & Objectives: Stroke is an acute cerebrovascular disease with high morbidity, high mortality and high disability rate. Acupuncture has been widely used in the treatment of stroke. However, bibliometrics on acupuncture for stroke are still lacking. This study aims to analyze the global research trend of acupuncture treatment for stroke in the past 20 years. Methods: A systematic search was conducted in Web of Science about acupuncture in the treatment of stroke. The databases were searched from inception to August 2022. Citespace is a service that researches the underlying knowledge in the scientific literature. We used it to analyze the relationship between publication year and country, institution, journal, author, bibliography, and keywords about acupuncture for stroke. Results: A total of 897 articles were included for analysis. Over the past 20 years, the results showed a steady increase in the number of articles about acupuncture treatment for stroke. The country with the largest number of publications is the People’s Republic of China (670), and the institution with the largest number of publications is Beijing University of Traditional Chinese Medicine (66). Keyword analysis showed that acupuncture in the treatment of post-stroke conscious cognitive impairment is the research development trend and focus on this field. Conclusion: This study provides a visual analysis method for the trends and frontiers of acupuncture treatment for stroke. Acupuncture is the research development trend for the treatment of post-stroke conscious cognitive impairment. Although most studies conclude that acupuncture has a positive effect on stroke, a large sample, randomized controlled trials are still needed to analyze the efficacy and physiological mechanisms of acupuncture in the treatment of stroke.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637774","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}
Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing demyelinating and inflammatory disease of the central nervous system, mediated by aquaporin-4 (AQP4)-immunoglobulin G (IgG) autoimmunity. Although NMOSD is most commonly an idiopathic autoimmune condition, it may also occur as a paraneoplastic syndrome in rare instances. Hereby, we report a rare case of a 61-year-old lady with paraneoplastic AQP4-IgG NMOSD associated with adenocarcinoma of sigmoid colon.
{"title":"Paraneoplastic seropositive AQP4-IgG neuromyelitis optica spectrum disorder associated with sigmoid adenocarcinoma","authors":"Sarah Hasnor Abu Hassan, Sumit Kumar Sonu","doi":"10.54029/2023kvu","DOIUrl":"https://doi.org/10.54029/2023kvu","url":null,"abstract":"Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing demyelinating and inflammatory disease of the central nervous system, mediated by aquaporin-4 (AQP4)-immunoglobulin G (IgG) autoimmunity. Although NMOSD is most commonly an idiopathic autoimmune condition, it may also occur as a paraneoplastic syndrome in rare instances. Hereby, we report a rare case of a 61-year-old lady with paraneoplastic AQP4-IgG NMOSD associated with adenocarcinoma of sigmoid colon.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637778","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}
Khalilah Mastura Zahari, Nurul 'Ain Masnon, Othmaliza Othman, Kartikasalwah Abd Latif, Noraini Mohd Dusa
Intracranial capillary haemangioma (ICH) is rare. We report a unique case of a young man with ICH who was presented with papilledema and acute profound visual loss. A 27-year-old man presented with bilateral eye reduced vision for 2 weeks with headaches. Examination showed optic disc swelling with severe visual loss. Neuroimaging revealed a vascular tumour epicentre at the sphenoid sinus with sellar and parasellar extensions. The patient developed massive bleeding during transsphenoidal surgery, in which intraarterial embolization was done, followed by a second surgery. Histopathology revealed benign capillary haemangioma. There was minimal visual improvement. He then developed tumour recurrence at 4 months postoperatively. ICH may cause rapid and acute blindness. Management is challenging with a guarded visual prognosis.
{"title":"Papilledema with acute profound visual loss in capillary haemangioma of the sphenoid sinus with sellar and parasellar extensions – a triple rarity presentation","authors":"Khalilah Mastura Zahari, Nurul 'Ain Masnon, Othmaliza Othman, Kartikasalwah Abd Latif, Noraini Mohd Dusa","doi":"10.54029/2023hxu","DOIUrl":"https://doi.org/10.54029/2023hxu","url":null,"abstract":"Intracranial capillary haemangioma (ICH) is rare. We report a unique case of a young man with ICH who was presented with papilledema and acute profound visual loss. A 27-year-old man presented with bilateral eye reduced vision for 2 weeks with headaches. Examination showed optic disc swelling with severe visual loss. Neuroimaging revealed a vascular tumour epicentre at the sphenoid sinus with sellar and parasellar extensions. The patient developed massive bleeding during transsphenoidal surgery, in which intraarterial embolization was done, followed by a second surgery. Histopathology revealed benign capillary haemangioma. There was minimal visual improvement. He then developed tumour recurrence at 4 months postoperatively. ICH may cause rapid and acute blindness. Management is challenging with a guarded visual prognosis.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637958","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}
Seongeun Park, Ji Cheol Shin, Kye Hee Cho, Sang Hee Im
Here, we report the case of a 62-year-old man with herpes zoster-related phrenic nerve palsy, which was evident in clinical, radiological, and electrodiagnostic studies. To aid clinical recovery and preserve pulmonary function, we designed a home-based pulmonary rehabilitation program consisting of air-stacking exercises using ambu-bagging, respiratory muscle training to improve the strength and endurance of inspiratory and expiratory muscles, and aerobic and resistance exercises of the upper and lower limbs to improve and prevent the decline of cardiorespiratory fitness. The patient was monitored, and the exercises were adjusted through regular outpatient follow-up. During the overall follow-up period of 26 months, pulmonary rehabilitation led to an increase in forced vital capacity from 2,020 to 3,160 mL, and improved the diaphragmatic height index from -4.46 to 0.28. Clinical symptoms also showed notable improvement, as the Borg Rating of Perceived Exertion scale score decreased from 17 to 7. We found that a home-based, self-performed pulmonary rehabilitation program could promote recovery from herpes zoster-related phrenic nerve palsy. Not only is this important for the rapid restoration of respiratory function and symptomatic relief, it can also protect patients from respiratory complications.
{"title":"A case of herpes zoster-related phrenic nerve palsy: Effect of home-based pulmonary rehabilitation","authors":"Seongeun Park, Ji Cheol Shin, Kye Hee Cho, Sang Hee Im","doi":"10.54029/2023znv","DOIUrl":"https://doi.org/10.54029/2023znv","url":null,"abstract":"Here, we report the case of a 62-year-old man with herpes zoster-related phrenic nerve palsy, which was evident in clinical, radiological, and electrodiagnostic studies. To aid clinical recovery and preserve pulmonary function, we designed a home-based pulmonary rehabilitation program consisting of air-stacking exercises using ambu-bagging, respiratory muscle training to improve the strength and endurance of inspiratory and expiratory muscles, and aerobic and resistance exercises of the upper and lower limbs to improve and prevent the decline of cardiorespiratory fitness. The patient was monitored, and the exercises were adjusted through regular outpatient follow-up. During the overall follow-up period of 26 months, pulmonary rehabilitation led to an increase in forced vital capacity from 2,020 to 3,160 mL, and improved the diaphragmatic height index from -4.46 to 0.28. Clinical symptoms also showed notable improvement, as the Borg Rating of Perceived Exertion scale score decreased from 17 to 7. We found that a home-based, self-performed pulmonary rehabilitation program could promote recovery from herpes zoster-related phrenic nerve palsy. Not only is this important for the rapid restoration of respiratory function and symptomatic relief, it can also protect patients from respiratory complications.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637963","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}
Jun Hui Ho, Kay Sin Tan, Wei Kang Lim, Choong Yi Fong, Tsun Haw Toh, Kar Foo Lau, Zhen Shun Chan, Sharon Mei Ling Tai, Kartini Rahmat, Farah Diana Tarmizi Thayaparan, Sumitha Murugesu, Ching Ching Ng
Background: Ring finger protein 213 (RNF213) is a major susceptibility gene for moyamoya disease (MMD). A single nucleotide variant known as c.14429G>A (p.R4810K, rs112735431) is strongly associated with MMD, weakly associated with moyamoya syndrome (MMS) and intracranial atherosclerosis (ICAS) in East Asians. The percentage of patients carrying p.R4810K and the effect sizes vary between different racial backgrounds. We aimed to investigate the prevalence of p.R4810K in MMD, MMS, and ICAS patients in Malaysia. Methods: We genotyped p.R4810K in DNA extracted from 9 MMD, 13 MMS, 15 ICAS cases, and 45 controls using TaqMan SNP genotyping assay. Clinical and neuroradiological data was collected for each patient and the distribution of genotype frequencies compared between cases and controls and tested for association. Results: Two of seven (28.6%) Chinese MMD cases had heterozygous p.R4810K (GA) genotype. The remaining MMD cases (5 Chinese and 2 Malays), all 13 MMS, 15 ICAS cases and 45 controls had homozygous wild-type (GG) genotype. Higher frequency of GA genotype was observed in Chinese MMD patients compared with controls, indicating an association between p.R4810K and Chinese MMD subgroup under a dominant model (P=0.0398). Conclusion: This is the first study reporting p.R4810K in a multiracial Asian population. The p.R4810K missense mutation was detected in MMD cases of Chinese descent in Malaysia. Further studies are needed to identify other susceptibility variants and genes in Malaysian patients with moyamoya and ICAS.
{"title":"RNF213 p.R4810K variant in moyamoya disease in adults and children from a Malaysian tertiary center","authors":"Jun Hui Ho, Kay Sin Tan, Wei Kang Lim, Choong Yi Fong, Tsun Haw Toh, Kar Foo Lau, Zhen Shun Chan, Sharon Mei Ling Tai, Kartini Rahmat, Farah Diana Tarmizi Thayaparan, Sumitha Murugesu, Ching Ching Ng","doi":"10.54029/2023jsj","DOIUrl":"https://doi.org/10.54029/2023jsj","url":null,"abstract":"Background: Ring finger protein 213 (RNF213) is a major susceptibility gene for moyamoya disease (MMD). A single nucleotide variant known as c.14429G>A (p.R4810K, rs112735431) is strongly associated with MMD, weakly associated with moyamoya syndrome (MMS) and intracranial atherosclerosis (ICAS) in East Asians. The percentage of patients carrying p.R4810K and the effect sizes vary between different racial backgrounds. We aimed to investigate the prevalence of p.R4810K in MMD, MMS, and ICAS patients in Malaysia. Methods: We genotyped p.R4810K in DNA extracted from 9 MMD, 13 MMS, 15 ICAS cases, and 45 controls using TaqMan SNP genotyping assay. Clinical and neuroradiological data was collected for each patient and the distribution of genotype frequencies compared between cases and controls and tested for association. Results: Two of seven (28.6%) Chinese MMD cases had heterozygous p.R4810K (GA) genotype. The remaining MMD cases (5 Chinese and 2 Malays), all 13 MMS, 15 ICAS cases and 45 controls had homozygous wild-type (GG) genotype. Higher frequency of GA genotype was observed in Chinese MMD patients compared with controls, indicating an association between p.R4810K and Chinese MMD subgroup under a dominant model (P=0.0398). Conclusion: This is the first study reporting p.R4810K in a multiracial Asian population. The p.R4810K missense mutation was detected in MMD cases of Chinese descent in Malaysia. Further studies are needed to identify other susceptibility variants and genes in Malaysian patients with moyamoya and ICAS.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637964","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}
Objective: This study aimed to test the comparative efficacy of virtual balance training (VBT) and conservative rehabilitation (CR) relative to CR alone on balance in chronic stroke patients. Methods: Thirty patients with chronic stroke (>6-months post-stroke) were allocated into 2 groups (n=15) as Group CR and Group VBT. CR was performed for 60 min, 4 times a week, for 8 weeks in both groups. VBT was applied for 20 min, 4 times a week, for 8 weeks along with the CR, in Group VBT. Brunnstrom motor recovery (BMR) stage, spasticity degrees, Functional Ambulation Scale (FAS), Short Form-36 (SF-36) scale, Berg Balance Scale (BBS) in both groups were assessed before and after treatment. Mann-Whitney U, Wilcoxon signed rank tests were used to evaluate BBS data (p<0.05). Results: Although, no significant difference was observed between groups in terms of BBS scores, BMR stages, FAS scores, SF-36 scale scores, and spasticity degrees before and after treatment; significant improvements were observed in BBS scores, BMR stages, and FAS scores after treatment in both groups (p<0.05). Comparing the SF-36 subscale scores before and after treatment, significant differences were noted in emotional role limitation scores for Group VBT (p=0.03) and in pain scores for Group CR (p=0.01). Conclusion: VBT along with the CR in chronic stroke patients was not superior to the CR alone, in terms of improving balance, motor recovery, ambulation level, and quality of life.
目的:比较虚拟平衡训练(VBT)和保守康复(CR)对慢性脑卒中患者平衡能力的影响。方法:30例慢性脑卒中患者(脑卒中后6个月)分为2组(n=15)，分别为CR组和VBT组。两组CR均为60 min，每周4次，共8周。VBT组应用VBT 20 min，每周4次，与CR一起持续8周。对治疗前后两组患者进行Brunnstrom运动恢复(BMR)分期、痉挛程度、功能行走量表(FAS)、SF-36量表、Berg平衡量表(BBS)评定。采用Mann-Whitney U, Wilcoxon符号秩检验评价BBS数据(p<0.05)。结果:组间治疗前后BBS评分、BMR分期、FAS评分、SF-36评分、痉挛程度均无显著差异;两组治疗后BBS评分、BMR分期、FAS评分均有显著改善(p < 0.05)。比较治疗前后SF-36量表评分，VBT组情绪角色限制评分(p=0.03)、CR组疼痛评分(p=0.01)差异有统计学意义。结论:VBT联合CR治疗慢性脑卒中患者在改善平衡、运动恢复、活动水平和生活质量方面并不优于单纯CR治疗。
{"title":"Effects of virtual balance training and conservative rehabilitation on balance in chronic stroke patients","authors":"SERDAR KILINC, Chasan Mola ALİ, Isıl Doganer, Elif Yaksi, Ferda Ozdemir","doi":"10.54029/2023kcw","DOIUrl":"https://doi.org/10.54029/2023kcw","url":null,"abstract":"Objective: This study aimed to test the comparative efficacy of virtual balance training (VBT) and conservative rehabilitation (CR) relative to CR alone on balance in chronic stroke patients. Methods: Thirty patients with chronic stroke (>6-months post-stroke) were allocated into 2 groups (n=15) as Group CR and Group VBT. CR was performed for 60 min, 4 times a week, for 8 weeks in both groups. VBT was applied for 20 min, 4 times a week, for 8 weeks along with the CR, in Group VBT. Brunnstrom motor recovery (BMR) stage, spasticity degrees, Functional Ambulation Scale (FAS), Short Form-36 (SF-36) scale, Berg Balance Scale (BBS) in both groups were assessed before and after treatment. Mann-Whitney U, Wilcoxon signed rank tests were used to evaluate BBS data (p<0.05). Results: Although, no significant difference was observed between groups in terms of BBS scores, BMR stages, FAS scores, SF-36 scale scores, and spasticity degrees before and after treatment; significant improvements were observed in BBS scores, BMR stages, and FAS scores after treatment in both groups (p<0.05). Comparing the SF-36 subscale scores before and after treatment, significant differences were noted in emotional role limitation scores for Group VBT (p=0.03) and in pain scores for Group CR (p=0.01). Conclusion: VBT along with the CR in chronic stroke patients was not superior to the CR alone, in terms of improving balance, motor recovery, ambulation level, and quality of life.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638080","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}
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