A case with Parkinsonism secondary to bilateral subdural hematoma

Subdural hematoma is a rare cause of secondary Parkinsonism. In this study, we presented a case of Parkinsonian syndrome caused by a bilateral subdural hematoma. The patient’s Parkinsonism completely healed following successful surgical removal of the hematomas without any anti-parkinson drug

Clinical and Demographic Features of Pseudotumor Cerebri Syndrome Diagnosed in a University Hospital

Objective: Pseudotumor cerebri syndrome (PTCS) is characterized by symptoms and signs of increased intracranial pressure without ventriculomegaly, intracranial tumor or mass. This study aimed to explore and analyze 34 patients with PTCS according to age, sex, symptoms of the disorder, cranial magnetic resonance images findings, etiology, and treatment. Materials and Methods: A total of 34 patients who were diagnosed as having PTCS and followed up between January 2011 and August 2016 by Dicle University Medical School Neurology Department were included in this study. PTCS was diagnosed in accordance with the modified Dandy criteria. Results: Thirty-four patients were identified as having PTCS. Twenty-one (91.2%) had headache, 19 (55.9%) had blurred vision, 6 (17.6%) had diplopia, 2 (5.9%) had vertigo, 1 (2.9%) had tinnitus, and 1 (2.9%) had numbness of the face. Twenty-seven patients were diagnosed as having idiopathic intracranial hypertension, 21 (61.8%) had no etiologic factors. Six (17.6%) patients were obese, one of whom had recently gained weight and another had polycystic ovary syndrome. Seven patients were thought to have secondary PTCS with the following etiologic factors: 2 (5.9%) patients had Hashimoto’s thyroiditis, 1 (2.9%) had a history of all-trans retinoic acid intake due to a malignancy, 1 (2.9%) had choroid plexus granuloma, 2 (5.9%) had sinus venous thrombosis, and 1 (2.9%) had Familial Meditteranian Fever. Conclusion: Although PTCS was described many years ago, its physiopathology and exact treatment procedures are not clearly understood. The most important target of its treatment is to prevent loss of vision and improve symptoms. With a better understanding of its pathophysiology, effective treatment protocols will be develope

Clinical and demographic characteristics of Guillain-Barre syndrome

Objective: We aimed to assess the epidemiological, clinical, laboratory, electrophysiological findings in patients with Guillain-Barre´ syndrome Methods: We performed a retrospective analysis of 33 patients with GBS admitted to Dicle University Medical Faculty Hospital neurology clinic from January 2011 to March 2014. Were reviewed. Epidemiological, clinical, therapeutical and evolutionary data were collected. Results: Thirty-six patients with the diagnosis of GBS included 22 males and 14 females. The average age at diagnosis was 41.3±21.38years with a wide age range (11–82) and a peak between 36 and 55 years. Based on clinical and electrophysiological features, 61.1% of the patients had acute inflammatory demyelinating polyneuropathy (AIDP), 22.2% acute motor and sensory axonal neuropathy 11.1% had acute motor axonal neuropathy, and 5.6% had Miller Fisher Syndrome. In 28 of 36 patients (77.0%), potential trigger factors could be identified. Respiratory tract infection was the most common infection (36.1%), followed by gastrointestinal infection (27.8%), after surgery (11.1%), vaccination (2.8%) Conclusion: Our study showed that surgery may be triggered GBS and suggesting a geographical and environmental factor involved in GBS etiopathogenesis

Níveis de sortilina-1, lipocalina-2, autotaxina, decorina e interleucina-33 no líquido cefalorraquidiano em pacientes com hipertensão intracraniana idiopática]

Background Idiopathic intracranial hypertension (IIH) is characterized by increased cerebrospinal fluid (CSF) pressure of unknown cause. It has been suggested that the inflammatory process plays a role in the pathophysiology of the disease. Sortilin-1, lipocalin-2, autotaxin, decorin, and interleukin-33 (IL-33) are among the factors involved in inflammatory processes. Objective To investigate the CSF levels of sortilin-1, lipocalin-2, autotaxin, decorin, and IL-33 in patients with IIH. Methods A total of 24 IIH patients and 21 healthy controls were included in the study. Demographic characteristics of the patients and of the control group as well as CSF pressures were evaluated. Sortilin-1, lipocalin-2, autotaxin, decorin and IL-33 levels in the CSF were measured. Results The CSF levels lipocalin-2, sortilin-1, autotaxin, IL-33 and CSF pressure were significantly higher in the patients group compared with the control group (p < 0.001). Decorin levels were reduced in patients (p < 0.05). There was no correlation between the autotaxin and IL-33 levels and age, gender, CSF pressure, and body mass index. The results of our study showed that inflammatory activation plays an important role in the development of the pathophysiology of IIH. In addition, the fact that the markers used in our study have never been studied in the etiopathogenesis of IIH is important in explaining the molecular mechanism of this disease. Conclusion Studies are needed to evaluate the role of these cytokines in the pathophysiology of the disease. It is necessary to evaluate the effects of these molecules on this process. © 2022. Academia Brasileira de Neurologia. All rights reserved

Primary Sjögren’s Syndrome with Sensory Ganglionopathy and Painful Legs and Moving Toes Syndrome

Sjogren’s syndrome is characterized by the sicca syndrome, with dryness of the mouth (xerostomia) and the eyes (xerophthalmia). Sjogren's syndrome is the only connective tissue disease that has been associated with sensory neuronopathy. The syndrome of painful legs and moving toes consisting of pain in the lower limbs with spontaneous movements of the toes or feet. The association between Sjogren’s syndrome and painful legs and moving toes syndrome is a rare condition

Effect of Caffeic Acid Phenethyl Ester on Cerebellar Tissue Damage Secondary to Methanol Intoxication: Experimental Study

OBJECTIVE: Previous studies have shown the role of oxidative stress in methanol neurotoxicity. CAPE is noted to have an antioxidant property by many experimental studies. In this study, we aim to investigate whether CAPE has a protective effect against oxidative stress observed in the cerebellar tissue in methanol intoxication METHODS: In this study, a total of 40 rats were split into 5 groups: Control group (n=8), MTX-alone group (n=8), MTX+Methanol group (n=8), MTX+Methanol+Ethanol group (ie., ethanol group) (n=8), and MTX+Metanol+CAPE group (ie.,CAPE group) (n=8). All the rats except the control group were delivered methotrexate (MTX) therapy (0.3 mg/kg/day, via i.p. route) for 7 days in order to induce methanol toxicity. The control group received no drug therapy. Seven days later, 3 g/kg (i.p.) methanol was delivered in the ethanol and CAPE groups. Four hours after the delivery of methanol, ethanol group received 0.5 g/kg ethanol (i.p.) and CAPE group received 10 µmol/kg CAPE (i.p.), while the other groups were delivered only saline (i.p.). The rats were decapitated at 8 hours and the cerebellar tissues were removed. PON-1, TAS, and MDA levels were measured in the tissues. RESULTS: MTX-alone group demonstrated decreased TAS and PON-1 levels (p=0.001 and p=0.004, respectively) and increased MDA level (p=0.001), as compared to the Control group. When MTX+Methanol group was compared with the MTX-alone group, MTX+Methanol group was found to have decreased TAS and PON-1 activities (p=0.037 and p=0.046, respectively) and increased MDA level (p=0.022). The Ethanol group was found to show a significant decrease in MDA level (p=0.001), as compared with the MTX+Methanol group. The CAPE group exhibited increased TAS and PON-1 levels (p=0.001 and p=0.001, respectively) and decreased MDA level, as compared with the MTX+Methanol group. CONCLUSION: Cerebellum demonstrates oxidative stress secondary to methanol intoxication. CAPE therapy is more effective against cerebellar oxidative stress than ethanol therap

Investigation of Mean Platelet Volume in Patients with Multiple Sclerosis

OBJECTIVE: Alterations in platelet function have been observed in patient with multıple sclerosis (MS). Mean platelet volume (MPV) is a marker of the platelet activity and is reported to increase in vascular diseases. The aim of this retrospective study was to investigate the correlation between MPV and MS. METHODS: The patient group consisted of 46 MS patients who were presented to MS attacks (males/females: 10/36, mean age: 34.3±9.4). In the MS patients, during the attack MPV value compared with the value of MPV after attack. Also, their MPV values were compared with those of 38 age/sex-matched healthy individuals (males/females: 14/24, mean age: 36.4±10.4). RESULTS: No difference was found in terms of MPV values between during the attack of MS (8.0±1.2) and after MS attack (7.9±1.2), and no relation was found between MPV and EDSS parameters (p>0.05). No difference was found in terms of MPV values between the MS group (8.1±1.3) and control group (8.1±1.1) (p>0.05). CONCLUSION: As a result, no significant change in MPV was seen between the during the MS attack and after the MS attack. This finding support that platelet activation not an important role pathogenesis in MS. But, relation between MS and MPV should investigated with prospectively

Investigation of Total Oxidants/Antioxidants in Patients with Intracerebral Haemorrhage

OBJECTIVE: There are numerous study about oxidant and antioxidant status in patients with ischemic stroke however there are few study about this subject in patients with intracerebral hemorrhage (ICH). Malondialdehyde (MDA) is an oxidant parameter which was investigated in patients with ICH, although total oxidant status (TOS) has not been investigated so far. We aimed to investigate in blood samples respectively oxidant and antioxidant parameters MDA and TOS, total antioxidant status (TAS) in patients with ICH. METHODS: Total of 30 patients with ICH, admitted and treated Neurology Clinic in Dicle University Medical Faculty Hospital and 30 control, had no stroke or any systemic disorder have been included. Peripheral vein blood samples taken from patients and controls were included in the first 24 hours after stroke. Serum TAS, TOS values measured to the original, fully automatic and colorimetric method of Erel. Serum level of MDA was measured according to the method of Ohkawa et al. RESULTS: According to the control group, the serum levels of TAS, TOS and MDA were significantly higher in patient with ICH (p 0.05). CONCLUSION: These findings support that oxidative stress may play a significant role in the pathogenesis of the ICH. However, the increase of these parameters not associated with hematoma volume and GCS in patients with IC

The Increase of The Mean Platelet Volume in Patients With Intracerebral Haemorrhage

OBJECTIVE: The mean platelet volume (MPV) is a biomarker of platelet function and activity. The influence of platelet function disorders on the aetiology of intracerebral haemorrhages (ICH) and mortality is not clear yet. The purpose of this study is to investigate the change in the MPV values in patients with ICH and to observe its influence on mortality in a retrospective manner. METHODS: Sixty-six patients with intracerebral haemorrhage (32 males, 34 females; mean age: 61.9± 16.9) were enrolled in the study. Patients with ICH were divided into two groups as those who died within the first 10 days and those who survived. The MPV values and the haematoma volumes were compared between the groups. Also, the MPV values and platelet counts of the patients with ICH were compared with the values of healthy volunteers from similar age and sex groups (27 males, 17 females; mean age: 59.9 ±3.2). RESULTS: The MPV values of the patients with ICH measured within 24 hours following the intracerebral haemorrhage (8.33 ± 1.27 fl/mL) were statistically significantly higher than the MPV values of the control group (7.76 ± 1.14 fl/mL) (p=0.018). The platelet counts of the patients with ICH also measured within the first 24 hours (235.8±94.9 x103/mL) were statistically significantly lower than the platelet counts of the control group (279.1 ± 94.9 x103/mL) (p=0.022). No statistically significant difference in terms of the MPV values and platelet counts was observed between the patients with ICH who died within the first 10 days and those who survived (p>0.05). However, the difference observed in the haematoma volume between the patients with ICH who died within the first 10 days (31.1 ±33.7 ml) and those who survived (8.7± 13.4 ml) was statistically significant (p<0.001). No correlation was found between the haematoma volume and the MPV value in the patients with ICH. CONCLUSION: The increase observed in the mean platelet volume in patients with ICH may point to a disorder in the platelet function. No relationship was found between the increase in the MPV and the mortality rates