Unusual Combination of Reversible Splenial Lesion and Meningitis-Retention Syndrome in Aseptic Meningomyelitis

[No abstract available

Treatment of idiopathic opsoclonus-myoclonus syndrome with intravenous immunoglobulin

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Evaluation of silent cerebral lesions in patients with first ischemic stroke attack

Background: We aimed to evaluate the frequency of silent cerebral lesions (silent cerebral infarction (SCI) and leukoaraiosis (LA)) in first-ever ischemic stroke patients. We wanted to identify the risk factors related with silent cerebral lesions, and the impact of these lesions on the prognosis of patients. Materials and methods: A total of 114 (58 male/56 female) patients with first-ever ischemic stroke that underwent brain MRI were enrolled in this study. Clinical features, and laboratory results were compared in the patients with and without SCI. They were also compared with LA severity, and the risk factors were evaluated. Results: SCI was detected in 90 patients and the most common location was periventricular white matter (PWM) (33%). High body mass index (BMI), hypertension (HT), and hyperlipidemia (HL) were associated with SCI (p = 0.023, 0.012, and 0.019). No associations were detected with LA (p > 0.05). The cholesterol (p = 0.011) and LDL (p = 0.009) levels of the multiple-SCI group were higher than those of the single-SCI group. Lower ejection fraction (EF) was associated with SCI and the severity of LA (p = 0.029 and 0.036). Hemoglobin and hematocrit values were low in advanced-periventricular white matter hyperintensity (adv-PWMH).The presence of SCI had no effects, on stroke recurrence, mortality, or prognosis. Multiple logistic regression analysis showed that HL and the presence of adv-PWMH were independent risk factors for SCI. Conclusion: While some parameters are associated with presence of SCI and LA, other parameters are related only with presence of LA. Different factors may play a role in development of SCI and LA. Studies on larger populations are needed for further evaluation of this issue. © 2011 Elsevier GmbH. All rights reserved

NERVE CONDUCTION STUDY AND GASTROCNEMIUS H REFLEX RESPONSE IN RHEUMATOID ARTHRITIS

WOS: 000416395300006PubMed: 29870649Objectives - We aimed to evaluate nerve conduction studies and gastrocnemius H reflex responses in rheumatoid arthritis (RA) patients and compared to the healthy adult subjects. Materials and methods - Twenty-six RA patients and twenty-two healthy adult subjects were included in the study. The nerve conduction study (NCS) findings and bilateral gastrocnemius H reflex responses were evaluated in all the groups. Age, gender, subcutaneous nodules, joint deformities, laboratory parameters, duration of disease, anti-rheumatic drug and steroid usage were recorded. Activity of disease was assessed using a 28-joint disease activity score (DAS28). The functional status was measured using the health assessment questionnaire (HAQ), pain intensity measured using a visual analog scale (VAS). Results - The rate of electroneuromyographic (ENMG) abnormalities was 73% in RA patients. The most common diagnosis was carpal tunnel syndrome (61.4%). There were no significant correlations between ENMG findings and clinical and laboratory features evaluated. Right H reflex latencies were statistically longer in RA patients (p=0.03). According to calculated cut-off levels, there were more subjects with longer H reflex latencies in RA patients. Conclusions - In this study, entrapment neuropathies were found common as independent identity from duration and severity of disease in RA patients. For H reflex latencies, cutoff values were longer in RA patients. It may provide information about the early neuropathic involvement of long peripheral nerves in RA patients. But this findings are needed to be supported by larger population study

Radial Nerve Neuropathies: A Retrospective Study

WOS: 000421133400007Objective: Radial nerve neuropathy is a rare neuropathy between upper extremity entrapment neuropathies developed because of various etiological factors. This study aimed to retrospectively evaluate patients referred to our EMG laboratory with a diagnosis of radial nerve neuropathy. Methods: In the study, the files of 41 patients who referred to our electromyography (EMG) laboratory with the radial nerve lesion diagnosis between 2004 and 2013 were retrospectively investigated. Results: Forty-one patients were included in this study. Of the patients, 36 were male (87.8%), five were female (12.2%), and the mean age was 42.36 +/- 15.21. Of the patients, 39% were referred by Orthopedics, 34.1% by Neurology, 24.4% by Physical Therapy and Rehabilitation, and 2.4% by Plastic and Reconstructive Surgery departments to our laboratory. Studying the relationship between the shape of nerve injury for etiological reasons shows that the humerus and radius fractures occur most frequently after falling. Conclusion: Therefore, the variety of etiological factors leading to the radial nerve lesions is remarkable. The higher incidence in male patients may be associated with more common factors such as trauma and work accidents in this gender. The electrophysiological examinations can provide valuable contributions to the diagnosis and follow-up of radial nerve neuropathy. On examining the EMG results of patients, the findings consistent with axonal lesion of radial nerve in the spiral grove after the triceps muscle were the most common (34.1%). The average recovery time of the patients could not be recorded because of the referred patients from other centers and the lack of control visits of the patients. It was found that five of the 10 patients contacted by phone had complete recovery, and there was no recovery in the other five patients

Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study

Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms.Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis.Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received "effective" treatment [international normalization ratio >= 2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug.Conclusion: NoroTekTR revealed the high but expected frequency of AF in acute stroke in Turkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Turkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF