Ideggyogyaszati Szemle-Clinical Neuroscience最新文献

The treatment of migraine is complex, and non-pharmacological methods are useful and necessary complements or alternatives to pharmacotherapy. We reviewed techniques that can be recommended for the treatment of episodic and chronic migraine attacks and prevention, and described methods for which there is no evidence of effectiveness. The most important of the therapies that can be recommended for migraine prevention are the elimination of provoking factors, lifestyle modification and regular exercise, and some diets have also been suggested to be beneficial. Based on the available evidence, supplementing preventive treatment with acupuncture or psychological therapy reduces the frequency of headaches in episodic migraine, and some psychological techniques may also be recommended for chronic migraine or attack therapy. Among the nutritional supplements, the effectiveness of riboflavin, magnesium and Q10 have been clinically proven to be effective in the preventive treatment of migraine. Interventional and invasive neuromodulation techniques are not widespread due to specific equipment requirements and increased risk of complications, however, based on good tolerability, some non-invasive methods can be recommended in the treatment of chronic migraine attacks and prevention. A large proportion of patients try other complementary or alternative methods, the efficacy or ineffectiveness of which has not been clinically proven, and therefore cannot be recommended.

Background and purpose: Stroke is a leading cause of death globally, placing a particularly high burden on Hungary and China. Our study aimed to compare the epidemiology, acute management, and stroke prevention strategies based on Hungarian and Chinese data.

Methods: We conducted a comprehensive literature review using Hungarian and Chinese epidemiological data, national health reports and guidelines, local protocols for stroke management, and publications related to prevention strategies. Data collection involved PubMed and MEDLINE databases; we also included results from the Global Burden of Disease Study to compare stroke incidence and mortality data in the two populations. The analysis of data from the two countries allowed for the identification of key trends.

Results: Despite the global decline in stroke-related mortality, Hungary's age-standardized stroke mortality rate remains above the European average, while a 32% increase has been seen in stroke-related deaths since 1990 in China. Even with the implementation of national stroke prevention initiatives, an increasing trend is observed in the prevalence of cardiovascular risk factors in both countries. The stroke management protocols of both nations align with international guidelines, including recommendations for intravenous thrombolysis and mechanical thrombectomy, as well as efforts to establish stroke center networks and systems that enhance prehospital care efficiency.

Conclusion: While advancements in stroke management are evident in both Hungary and China, challenges persist in optimizing stroke prevention, reducing "stroke-to-needle time", and expanding rehabilitation services.

Background and purpose: To assess the effectiveness of Gasserian ganglion block and pulsed radiofrequency in managing chronic cluster headache (CCH).

Methods: We enrolled 38 patients with treatment-resistant CCH who were admitted between March 2020 and January 2024 and underwent Gasserian ganglion pulsed radiofrequency (PRF) combined with a ganglion block. Patients were followed up for six months, with pain severity assessed using the 0-10 Numerical Pain Rating Scale (NPRS).

Results: Among 38 patients (mean age 30.8 ± 8.6 years), the mean headache duration before treatment was 29.72 ± 17.65 months, and patients reported an average of 19.11 ± 2.01 headache days per month. Before the procedure, the mean NPRS score was 8.81 ± 0.80, which significantly decreased to 4.13 ± 3.74 post-treatment (p=0.001) and further declined to 3.38 ± 1.59 at the six-month follow-up (p=0.002). Four patients became pain-free, while 13 did not benefit from the procedure. The mean number of headache days dropped to 6.40 ± 4.22 per month (p.

Conclusion: Our results showed a significant reduction in pain and attack frequency with Gasserian ganglion block and PRF for treating CCH resistant to standard therapies, with many patients requiring less medication. The procedure was well-tolerated, with mild and temporary side effects; these findings suggest it may be a promising option for drug-resistant CCH. Future studies should include controlled trials for further evaluation.

Background and purpose: Pregnant women diagnosed with epilepsy are in the high-risk group for maternal and neonatal complications. We aimed to analyze pregnant patients admitting to the emergency department (ED) with epileptic seizures, to investigate the treatment regimens applied during pregnancy, and to examine the effects of seizure frequency during pregnancy on neonatal outcomes.

Methods: This retrospective study included 53 pregnant epilepsy patients presenting to the ED with seizures. Demographic and clinical data, medication use, outcomes, along with neonatal APGAR scores, were recorded using a standard form.

Results: In the study, 32.1% of patients were hospitalized, and 41.5% discontinued their medication, with 47% of this subgroup experiencing hospitalization (p.

Conclusion: This study reveals that the hospitalization rates of pregnant patients presenting to the ED with epileptic seizures are significantly affected by factors such as the type of antiepileptic drug used, medication compliance, and admission lactate levels. Additionally, irregular use of medications is associated with higher incidences of seizures during pregnancy and adverse neonatal outcomes.

Background and purpose: Parkinson's disease is a neurodegenerative disorder cha- racterized by motor symptoms such as tremor, rigidity and bradykinesia. However, it can also lead to non-motor symptoms such as cognitive impairments and sarcopenia. The aim of this study is to evaluate the relationship between screening and diagnostic methods for sarcopenia and temporal muscle thickness in Parkinson's disease patients, and to assess the utility of temporal muscle thickness measurement as an indicator of sarcopenia.

Methods: An observational study was conducted with Parkinson's disease patients in a single neurology clinic. A total of 38 patients were included. Temporal muscle thickness was measured manually using brain computed tomography and muscle strength was assessed with handheld dynamometer. Malnutrition risk, sarcopenia risk and functional disease stage (Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Hoehn and Yahr stage) were also evaluated in entire group.

Results: The mean temporal muscle thickness and handgrip strength were 6.12±1.05 mm and 18.30±5.55 kg respectively. Mean disease duration was 8.13±3.11 years and the median H&Y stage was 2.21. There was a significant correlation between temporal muscle thickness and age (r=-0.326, p=0.046), SARC-F score (r=-0.738, p.

Conclusion: Measurement of temporal muscle thickness using brain computed tomography in Parkinson' s disease patients may be a useful method for muscle mass determination and treatment of sarcopenia.

Background and purpose: Headache is a prevalent health concern among children and adolescents, affecting approximately 54.4% of this population. It has a negative impact on functionality and is associated with psychiatric conditions. The aim of this study is to examine the prevalence and comorbidity of headache among adolescents seeking care at a child psychiatry outpatient clinic and to compare the psychiatric conditions of adolescents with and without headache by using specific assessment scales.

Methods: The study included a total of 306 patients (201 females, 105 males), comprising 108 adolescents with headache and 198 without headache, who were admitted to the Child&Adolescent Psychiatry Outpatient Clinic of a Mental and Nervous Diseas- es Training and Research Hospital. Patients presenting with complaints of headache were referred to the neurology department of the hospital for diagnosis and classification. The Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version-Turkish Adaptation was administered to all participants. Additional self-report scales including the State-Trait Anxiety Inventory (STAI) Forms 1 and 2, the Children's Depression Inventory (CDI), and the Young Internet Addiction Test - Short Form were given. Parents filled out the Conners' Parent Rating Scale and the Turgay DSM-IV-Based Child and Adolescent Disruptive Behavior Disorders Screening and Rating Scale.

Results: Among participants, 35.3% (n=108) have reported headache, divided into two subgroups; 58 had migraine and 50 had tension-type headache. The prevalence of Generalized Anxiety Disorder as a comorbid diagnosis was found to be significantly higher in the migraine group compared to those without headache (p=0.009). Nevertheless, there was no difference between migraine and tension type headache groups in terms of comorbid psychiatric diagnoses (p>0,05). The participants in both headache groups exhibited significantly elevated scores on the CDI, STAI-1 and STAI-2 in comparison to those without headache (p < 0.001). A positive correlation was identified between headache severity and both depression and trait anxiety severity among participants with headache. When classified according to the course of headache, chronic migraine was associated with higher Turgay and Conners scores, while chronic tension-type headache showed significantly higher CDI, STAI-1, and STAI-2 scores compared to episodic forms (p = .003-.038).

Conclusion: Psychiatric comorbidities are common in adolescents with headache, necessitating a comprehensive assessment that considers both conditions. This approach is crucial, as it has the potential to significantly influence the diagnosis, severity, progression, and treatment of these comorbidities, thereby ensuring comprehensive care and superior outcomes for affected individuals.

Background and purpose: Phrenic nerve conduction studies, including comprehensive recording of compound muscle action potentials (CMAP) from all regions of the dia- phragm, can be useful in both neurolo-gical conditions affecting the phrenic nerve or diaphragm and non-neurological conditions such as COPD and GERD, and may have potential diagnostic value. It was aimed (a) to determine the most convenient stimulation and recording sites for phrenic nerve conduction studies (NCS), (b) to record CMAPs reflecting the activity of the posterior part of the diaphragm with surface recording electrodes, (c) to define normative values for these studies.

Methods: Sixty-three healthy subjects were included in the study and CMAPs were recorded simultaneously with two anterior and two posterior electrode derivations while stimulating the phrenic nerve behind the sternocleidomastoid muscle.

Results: Among the four different electrode placements, the recording electrode pairs providing the highest amplitude CMAPs were those placed 5 cm above the xiphoid process (active) and 16 cm laterally on the costal margin (reference). With this placement method, the upper limit of CMAP latency was 7.70 ms, the lower limit of base-topeak amplitude was 0.30 mV and the lower limit of peak-to-peak amplitude was 0.45 mV. Diaphragmatic CMAPs have been obtained from the majority of volunteers with surface electrodes placed in the posterior regions of the diaphragm, albeit with lower amplitude. Age is the only independent factor affecting the CMAP latency in this study.

Conclusion: Normative values with the best recording sites for phrenic NCSs were determined. The posterior aspect of the diaphragm could be recorded with surface electrodes despite the lower amplitude and reliability compared to the anterior part.

Introduction - Cytotoxic lesion of corpus callosum (CLOCC) is a rare but increasingly recognized entity. It is associated with various etiologies including drug-related toxicity, epilepsy, infections, metabolic disturbances, and many other conditions. Here we present a rare case of CLOCC due to cerebral venous sinus thrombosis (CVST) in the postpartum period.Case report - A 25-year-old female was admitted due to persistent headaches on the third day of her postpartum period. The neurological examination did not reveal any focal neurological signs. She was diagnosed with CVST and splenium of corpus callosum (SCC) lesion with imaging features of FLAIR/ T2/DWI hyperintensity, ADC hypointensity, and lack of contrast enhancement. Extensive work-up did not unveil any other etiology. She was treated with low-molecular-weight heparin, warfarin, and acetazolamide. Six weeks later, brain imaging showed recanalization of the cerebral sinuses without any signs of permanent lesion in SCC. She was symptom-free at the two-year follow-up.Conclusion - It is crucial to recognize CLOCC and thus to unveil and treat its potential etiology. CVST should be considered in CLOCC cases, particularly in patients with prothrombotic states such as the postpartum period.

Background and purpose: An unpleasant symptom of prostate hyperplasia is that older men get up to urinate at night. However, from the point of view of wake-up stroke, this can be an advantage, as they can detect their neurological deficit sooner due to the urge to urinate and can ask for help and receive definitive care sooner.

Methods: Between January 1. 2021 and May 30. 2024, at the Neurology Department of Borsod County University Teaching Hospital, we performed thrombolysis in 298 cases due to stroke within 4,5 hours.

Results: We treated 60.4% men and 39.6% women. In this period, we treated 61 wake-up stroke patients, 80.3% of them were men (all were more than 60 years old).

Conclusion: In our region more than four times as many male patients can receive definitive care as female patients with regard to wake-up stroke. The awakening caused by prostate hyperplasia can play an important role in detecting symptoms in time.