Acta neurologica Belgica最新文献

Background: Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy.

Case report: We present two patients, aged 23 and 29 years, with drug-resistant epilepsy who experienced increased seizures and status epilepticus after application of VNS.

Conclusion: VNS is generally well tolerated and provides benefits for patients. However, both patients and their families and clinicians should be alert to the rare side effect of triggering seizures.

Background: Detection rate of chronic cerebral very small cortical infarctions (VSCI) is low. Few data are available on chronic cerebellar VSCI. Our aim was to study the ability of 1.5T FLAIR and T2-weighted imaging to detect chronic VSCI and compare cerebral and cerebellar VSCI location.

Methods: We prospectively included stroke patients with ≥ 1 acute cerebral or cerebellar VSCI ≤ 10 mm on DWI. Follow-up FLAIR and T2-weighted imaging with the same 1.5T-magnet was performed after six months. Images were evaluated unblinded to initial MRI to detect signal changes at the same location as initial acute VSCI. Variables influencing chronic VSCI detection were analyzed in uni- and multivariate analyses.

Results: We analyzed 57 patients (median age 65, 44% women) with 111 acute VSCI on initial MRI. These constituted 47 cerebellar and 64 cerebral acute VSCI, with median DWI size of 5.9 mm and initial FLAIR positivity of 70%, without difference between cerebellar and cerebral location. On 6-month follow-up MRI, chronic VSCI detection on FLAIR and T2 was similar for cerebral lesions (p = 0.81), whereas for cerebellar lesions T2 showed a 2.4-fold higher detection rate than FLAIR (p < 0.0001). Univariate analysis using a logistic mixed model for T2 detection of chronic VSCI was associated with cerebellar VSCI location (p < 0.0001) and hypertension history (p = 0.008). Multivariate analysis confirmed the strong association between cerebellar location and T2 detection of chronic VSCI (p < 0.0001, AOR = 7.25, 95% CI = 2.83-18.56) adjusted for hypertension.

Conclusion: Compared to FLAIR, T2-weighted imaging shows highest detection rates for cerebellar VSCI, with cerebellar VSCI location as strongest predictor of chronic VSCI detection.

Clinical trial registration: URL http//www.

Clinicaltrials: gov. Unique identifier NCT06218576.

Neurological or psychiatric side-effects can be seen with antimicrobial medications. A 66-year-old male patient with no known disease was brought to the emergency room due to a speech disorder and aggressive and unconscious behaviours following an initial dose of amoxicillin (1 gram orally). For treatment of the agitation without suppressing breathing, the patient was sedated with dexmedetomidine. After approximately 30 h of intensive care follow-up, the patient was discharged with complete recovery. This case emphasizes the importance of considering the effects of antibiotics in the differential diagnosis of delirium or acute psychosis cases.

Neurodegenerative diseases like Alzheimer's, Parkinson's, Huntington's, and amyotrophic lateral sclerosis are growing more common worldwide, yet treatment is still poor. Conventional therapies can have unforeseen side effects, produce poor medication reactions, and take longer to work. This persistent treatment gap highlights the need for novel approaches to these disorders' complex distinctions. Pharmacogenomics, which examines how genetic differences affect drug response, is a promising new subject and an urgent solution. Pharmacogenomics tailors medicine selection and administration to each patient's genetic profile, addressing the main causes of poor treatment response and preventable side effects. This research has enabled precision medicine that can improve neurodegenerative disease therapy and reduce harm. In this in-depth research, we examine neurodegenerative disease management issues, pharmacogenomics breakthroughs, and how incorporating genetics to clinical practice can improve outcomes. We examine the latest evidence that genetics affect drug breakdown, efficacy, and toxicity. We also discuss the challenges and opportunities of applying this knowledge. Pharmacogenomic approaches must be widely applied to make medicines for these awful disorders safer, more effective, and really suited to patient needs, according to our compilation.

Introduction: Migraine is a chronic neurovascular disease classified into two main subtypes: migraine with and without aura. Aura occurs in approximately 30 percent of migraine patients. Few studies have reported a higher frequency of aura among healthcare workers. This study aimed to investigate the frequency of aura in migraineurs among healthcare and non-healthcare workers and compare their aura characteristics.

Methods: A total of 482 migraine patients, 117 healthcare workers, and 371 non-healthcare workers were included. Demographic data, migraine, and aura characteristics were recorded during a face-to-face survey.

Results: The number of male participants was significantly higher in the healthcare worker group (p:0.013). In this group, the migraine diagnosis age was younger (p:0.001) and the migraine duration was longer (p:0.031). The presence of aura was significantly more frequent in the healthcare worker group (46.2%) (p:0.001). In the healthcare worker group, the presence of aura in all attacks was more frequent (p:0.012). The duration of aura was similar in both groups (p:0.518). The frequency of aura was higher in doctors (47.7%) than in nurses (41.9%), but the difference was not significant (p:0.583). Neurologists (50%) and non-neurologists (46.4%) had similar aura frequencies (p:0.752).

Conclusions: We found aura frequency higher in healthcare workers with migraine than in the general population. Our findings may indicate that the aura prevalence is underestimated in the general population with migraine. Identifying migraine with aura, given its association with serious disorders, may enable a more thorough evaluation of the affected individuals and potentially improve patient outcomes.

Background: Mental chronometry tests, including upper and lower extremity functions, evaluate the temporal congruence component of motor imagery. This study aimed to compare the utilization of upper and lower extremity functions in mental chronometry tests.

Methods: This study included 70 individuals with multiple sclerosis and was designed based on an a priori power analysis. Mental chronometry tests, including the Box and Block Test (BBT) and the Timed Up and Go Test (TUG), were administered, and execution times, motor imagery times, and mental chronometry ratios were compared between the most and least affected extremities.

Results: A significant difference was observed in execution times between the most and least affected extremities in BBT (p = 0.001). Similarly, motor imagery times in BBT were significantly different between most and least affected extremities (p = 0.009). However, no significant difference was found in mental chronometry ratio between the most and least affected extremities (p = 0.179). Comparisons between upper and lower extremity tests revealed that the mental chronometry ratio was significantly higher for BBT than for TUG test in both the most affected and least affected extremities (p = 0.001).

Conclusion: Individuals with MS showed differences in imagery-execution congruence between upper- and lower-extremity mental chronometry tasks, with higher congruence observed in the upper-extremity task. These findings support a task-specific interpretation of motor imagery performance rather than a generalized advantage of upper-extremity motor imagery.

Trial registration: Not applicable. This study was observational and did not involve a clinical trial registration.