Examining the Etiology of Patients Diagnosed With Polyneuropathy According to Subtypes

DergiPark: 379019tmsjAims: In this study, the aim is to classify the patients who were diagnosed with polyneuropathy in Trakya University Health Services Research and Application Center Neurology Polyclinics EMG Lab between years 2014 and 2015, relevant to their subtypes (axonal, sensorial and sensorimotor), and to investigate the causes and their relation to each subtype.Methods: The reports of 144 patients diagnosed with polyneuropathy in between 2014 and 2015 were scannedretrospectively. The patients were represented with age, gender, polyneuropathy type and etiologic inference. The correlation between the diagnosis of polyneuropathy and its underlying etiology was analyzed with the SPSS software and presented statistically. Patients were categorized in accordance to their polyneuropathy types by chi-square test. As descriptive statistics, numbers and percentages, arithmetic mean ± standard deviation and median (minimum-maximum) values were provided.Results: It is seen that the patients whose application is related to diabetes, cancer, chemotherapy, dysproteinemia,AIDS, B12 vitamin insufficiency and pyridoxine intoxication have a higher rate of polyneuropathy. Meanwhile, no significant difference among the causes of the three polyneuropathy types was found.Conclusion: Thorough and attentive investigation on the etiology of patients who were diagnosed with polyneuropathy can lead to pre-diagnosi

A Fahr’S Disease Case Presenting With Dementia

DergiPark: 379009tmsjAims: Fahr’s disease is characterized by a bilateral striopallidodentate calcinosis, related to various neurologic and psychiatric disorders. It is a rare disease which can occur both sporadically or hereditarily. While the clinical symptoms related to calcifications include parkinsonism, dystonia, tremor, chorea, ataxia, dementia and mood disorders, some asymptomatic cases have also been reported. With this study, an overall view of Fahr’s disease is aimed, by investigating the 65-year-old patient considering her clinical, endocrinological and radiologic aspects, also utilizing the available literature Case report: A 65-year-old female patient with a six-year history of forgetfullness and 3-months history of walking difficulty, unbalance and general reduction of spontaneous movement complaints was hospitalized with parkinsonism pre-diagnosis. Laboratory results indicated primary hyperparathyroidism. CT scans also revealed diffuse bilateral intracranial calcifications. The diagnosis of Fahr’s disease was confirmed after clinical investigations and exclusion of other diseases which cause intracranial calcifications. Conclusion: This case implies the importance of keeping Fahr’s disease in consideration in cases with primary degenerative dementia in the foreground and indistinct motor dysfunctions adding subtly to the symptoms, and manifestation of hypocalcaemia

The Evaluation and Interpretation of the Most Common Intervertebral Discs in Cervical Hernias: a Retrospective Study

DergiPark: 379029tmsjAims: In this study it is aimed to determine the most common intervertebral discs in cervical hernias and to discuss the possible causes of prevalence.Methods:The data of 110 patients who were diagnosed with cervical disc hernia in Trakya University Health Center for Medical Research Neurology Clinics EMG lab in between 2012 and 2015 was analyzed retrospectively by looking at the age, gender and herniated intervertebral disc. Chi- Square test was used to determine the frequency of the cervical disc hernia in intervertebral discs in both genders. Independent Samples T Test was used to determine the correlation between prevalence of herniated intervertebral discs, age and gender. Arithmetic mean ± standard deviation, number and percentages, median (minimum-maximum) were used as descriptive analysis.Results: Out of 110 patients, there were 60 males (52.3%) and 50 females (48.7%) with the mean age of 50.43 ±12.67, the youngest patient was 26 and the oldest was 82. The most involved disc was found to be C5-C6 (15 males with a percentage of 25% and 23 females with a percentage of 46%). Conclusion:The most common intervertebral disc in cervical hernia was detected as C5-C6. It may be because of the maximal extension and flexion, functional overloading and micro traumas which affect C5-C6 segmen

Electrophysiological Correlation and Gradation of Patients Prediagnosed With Carpal Tunnel Syndrome

DergiPark: 378999tmsjAims: In this study, it is aimed to detect electrophysiological correlation of patients who were referred to TrakyaUniversity Medical Research Center Neurology Clinics Electromyography (EMG) lab in 2014 with Carpal Tunnel Syndrome (CTS) pre-diagnosis and grade them based on electrophysiological features.Methods: Electromyography (EMG) records of 174 patients who were sent to electromyography lab in 2014 withCarpal Tunnel Syndrome (CTS) pre diagnosis were scanned retrospectively. Patients were recorded with the data of gender and age. Correlation between pre diagnosis and electrophysiological diagnosis were reported statistically by using Kappa and McNemar tests. Patients were classified based on sex using Chi-square test. Number and percentages, arithmetic mean± standard deviation, median (minimum-maximum) were used as descriptive analysis. Results: Out of all electrophysiological diagnosis, 62 patients (35.6%) were consistent with pre diagnosis when 112(64.4%) were inconsistent. Out of patients who were diagnosed with Carpal Tunnel Syndrome (CTS) according to their electromyography (EMG) findings, 31 patients (48.4%) had mild syndrome.Conclusion: A big inconsistency between pre diagnosis and electromyography (EMG) results was detected. It isimportant to make a more careful and detailed examination to fix this proble

Lumbar opening pressure and radiologic scoring in idiopathic intracranial hypertension : is there any correlation?

Background: To investigate correlation between lumbar opening pressure (LOP) and radiological scores based on cranial MRI and contrast-enhanced MR venography in patients with idiopathic intracranial hypertension (IIH). Material/Methods: Patients with IIH who underwent brain MRI and contrast-enhanced MR venography before measurement of LOP between 2010-2014 were evaluated retrospectively. Three experienced radiologists (blinded to LOP values) evaluated a total of 51 patients. They reached a consensus on the presence or absence of 6 radiological findings identified in the literature as characteristic for IIH: empty sella, perioptic dilation, optical tortuosity, flattening of the posterior globe, swelling of the optic disc, and bilateral transverse sinus stenosis. The radiological score was obtained by giving 1 point for the presence of each finding, with the highest possible score of 6 points. The correlation between the calculated radiological scores and LOP was evaluated. Results: There was no significant correlation between LOP and radiological scores (r=0.095; p=0.525, Spearman's rank coefficient). Similarly, no significant correlation was detected between LOP and each of the radiological findings (partial empty sella [p=0.137], perioptic dilation [p=0.265], optical tortuosity [p=0.948], flattening of the posterior globe [p=0.491], swelling of the optic disc [p=0.881], and bilateral dural sinus stenosis [p=0.837], Mann-Whitney U test). Conclusions: There was no significant correlation between LOP and reliable radiological features of IIH

Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: A Rare Cause of Headache and Increased Intracranial Pressure: Primary Leptomeningeal Melanomatosis Sum mary Özet

Primary leptomeningeal melanomatosis is a rare central nervous system neoplasm originating from leptomeningeal melanocytes. The cases can be presented with focal neurologic deficit, seizure, neuropsychiatric symptoms or increased intracranial pressure symptoms along with encephalitis or meningitis. Diagnosis can be made upon imaging studies, cytopathologic examination of cerebrospinal fluid and biopsy. Biopsy can return false negative since the leptomeningeal involvement is not diffuse. In this study, a case is presented who admitted to hospital with leptomenengitis symptoms such as headache, fever and altered state of consciousness and developed additional neurologic signs after months. First biopsy came out as normal while the second one did as positive. This case has been found worth presenting since this is a tumor of rare existence and the diagnosis was made upon the second biopsy. (Turkish Journal of Neurology 2014; 20:138-140) Key Words: Primary leptomeningeal melanoma, headache, increased intracranial pressure, leptomenengitis Conflict of interest: The authors reported no conflict of interest related to this article. Primer leptomeningeal melanomatozis, leptomeningeal melanositlerden kaynaklanan merkezi sinir sisteminin oldukça nadir görülen bir neoplazmıdır. Ensefalit yada menenjit yanında fokal nörolojik defisit, nöbet, nöropsikiyatrik semptomlar veya kafa içi basınç artışı semptomları ile presente olabilmektedirler. Tanı, görüntüleme teknikleri, beyin omurilik sıvısının sitopatolojik incelemesi ve biyopsi ile konulabilmektedir. Leptomeningial tutulum diffüz olmadığı için biyopsi yanlış negatif çıkabilir. Bu çalışmada baş ağrısı, ateş ve bilinç bulanıklığı gibi genel leptomenenjit kliniği ile baş vuran ve aylar sonra nörolojik ek belirtiler eklenen bir hasta sunuldu. İlk biyopsi normal olarak yorumlanmış ve ikinci biyopsi pozitif olarak saptanmıştır. Oldukça nadir rastlanan bir tümör olduğu ve ikinci biyopsi ile tanı konulabildiği için bu olgu sunulmaya değer görülmüştür. (Türk Nöroloji Dergisi 2014; 20:138-140) Anah tar Ke li me ler: Primer leptomeningeal melanoma, baş ağrısı, intrakranial basınç artışı, leptomenenjit Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir

A Rare Cause of Headache and Increased Intracranial Pressure: Primary Leptomeningeal Melanomatosis

Primary leptomeningeal melanomatosis is a rare central nervous system neoplasm originating from leptomeningeal melanocytes. The cases can be presented with focal neurologic deficit, seizure, neuropsychiatric symptoms or increased intracranial pressure symptoms along with encephalitis or meningitis. Diagnosis can be made upon imaging studies, cytopathologic examination of cerebrospinal fluid and biopsy. Biopsy can return false negative since the leptomeningeal involvement is not diffuse. In this study, a case is presented who admitted to hospital with leptomenengitis symptoms such as headache, fever and altered state of consciousness and developed additional neurologic signs after months. First biopsy came out as normal while the second one did as positive. This case has been found worth presenting since this is a tumor of rare existence and the diagnosis was made upon the second biopsy