Rapid Recovery of Visual Acuity after Lumboperitoneal Shunt Operation in Malignant Idiopathic Intracranial Hypertension

Background. Idiopathic intracranial hypertension can cause rapid deterioration of visual acuity in some severe cases, and these cases are usually thought to have “malignant” form of this disease. Case. In this paper, we report on a 16-year-old girl who is a typical example for malignant idiopathic intracranial hypertension with a rapid recovery of visual acuity after lumboperitoneal shunt operation. Observations and Conclusions. Malignant form of idiopathic intracranial hypertension must be kept in mind in selected patients to avoid irreversible visual loss

Acute transverse myelitis at the conus medullaris level after rabies vaccination in a patient with Behçet's disease

Case report: A 25-year-old man with Behçet's disease was admitted because of weakness of the lower limbs and difficulty in urination. He had received a rabies vaccination 2 months previous because he had been bitten by a dog. Findings: Clinical and laboratory findings supported acute transverse myelitis. A hyperintense lesion and expansion at the level of conus medullaris was detected on spinal magnetic resonance imaging. Conclusion: Although neurologic involvement is one of the main causes of mortality and morbidity in Behçet's disease, the factors that aggravate the involvement of the nervous system are still unclear. Vaccination may have been the factor that had activated autoimmune mechanisms in this case. To our knowledge, involvement of the conus medullaris in Behçet's disease after rabies vaccination has not been reported.Indications:For prevention of rabies in a patient who was bitten by a dog. Coexisting diseases: Behcet's disease, relapsing aphthous stomatitis and genital ulcerations.Patients:One 25-year-old male patient.TypeofStudy:A case report describing acute transverse myelitis at the conus medullaris level after Rabipur vaccination in a patient with Behcet's disease.AdverseEffects:1 patient developed acute transverse myelitis at the conus medullaris characterized by weakness of lower limbs, urinary retention, severe backache, difficulty with urination and defecation, hypoesthesia below the level of L1, absence of lower extremities vibratory and position senses, absence of deep tendon reflexes in the lower extremities, detrusor atony, and atrophy and fasciculations of the left leg muscles.AuthorsConclusions:Involvement of the conus medullaris in Behcet's disease after rabies vaccination has not been reported previously in the literature. The possibility of an activating factor (eg, vaccination) other than infection has never been mentioned in Neuro-Behcet syndrome. Understanding the activating factors may be helpful for the prevention of neurological involvement and is important for planning follow up and understanding the prognosis. Further reports and investigations are needed.FreeText:Tests: cerebrospinal fluid (CSF) leukocyte and protein level; muscle strength using Medical Research Council grade scoring; spine magnetic resonance imaging (MRI); vibratory and position senses; and deep tendon reflexes. The active substance of the rabies vaccine was an inactivated rabies virus.Results:Two months after the administration of the rabies vaccine, the patient experienced weakness of lower limbs which was preceded by severe backache for 12 hours and urinary retention. The weakness progressively worsened, and he began experiencing difficulty with urination and defecation. Muscle strength score was 2/5 at proximal left lower limb, 1/5 at distal left lower limb, 3/-5 at proximal right lower limb, and 1/5 at distal right lower limb. Atrophy and fasciculations of the left leg muscles were noted. There was hypoesthesia below the level of lumbar 1 (L1), and lower extremities demonstrated absence of vibratory and position senses. Absence of deep tendon reflexes was noted in the lower extremities, and plantar responses were extensor bilaterally. CSF examination revealed 110 leukocytes/mm3 with no microorganisms and elevated protein level (114 mg/dL). Spine MRI showed hyperintense lesion and expansion at the level of the conus medullaris. The patient was treated with methylprednisolone, azathioprine, and physiotherapy. He also required intermittent catheterization for urinary retention. After a year, a complete resolution of symptoms was observed and spinal MRI became normal.DosageDuration:Dosage not stated; given on the day of the bite and on the 3rd and 7th days thereafter

Aseptic meningitis, venous sinus thrombosis, intracranial hypertension and callosal involvement contemporaneously in a young patient with Behçet's disease

Abstract Not Availabl

İzole baş ağrısı bulgusu veren serebral ven trombozları

OBJECTIVE: The aim of this study is to demonstrate the demogrophical specialities and clinical features among patients with cerebral venous thrombosis (CVT), who had admitted to our department between 2006 and 2012 and who had headache as the only presenting symptom. MATERIAL and METHODS: Thirty-two patients who had diagnosed as CVT between 2006-2012 were evaluated and 12 of them who had headache as the only presenting symptom were included to the study. RESULTS: Headache was only symptom of CVT in 12 patients (10 Female, 2 Male). 8 of these 12 patients had papilledema. 4 patients had only headache without additional sign. The lateral sinus was the most frequently involved sinus. CONCLUSION: The headache is usually progressive over a few days, but a few patients have sudden onset or even a thunderclap headache. The outcome of CVT patients with isolated headache diagnosed was favourable

Neurološki simptomi koji su česti u pacijenata s COVID-19: retrospektivna opservacijska studija

In December 2019, a novel coronavirus outbreak spread rapidly all over the world. The virus is known to be neuroinvasive, but much is still unknown. In this study, we aimed to present the main neurologic symptoms in patients who were diagnosed with coronavirus disease 2019 (COVID-19). The study was conducted retrospectively by phoning 156 patients in Turkey diagnosed with COVID-19 through real-time polymerase chain reaction; only 100 patients could be reached. Data about their demographics, initial symptoms, neurological symptoms, and sleeping habits were collected. During the disease process, 66% had at least one neurological symptom, 55% had central nervous system symptoms, 42% had peripheral nervous system symptoms, and 64% had sleep disturbances and myalgia. Impaired consciousness, smell and taste impairments, and sleep disturbances were significantly higher in patients with positive chest computed tomography imaging (p < 0.05). Neurological symptoms were observed in COVID-19, as in other coronaviruses. Headache in particular was the most common symptom in our population. In patients with respiratory system findings, the detection of certain neurological symptoms such as smell-taste impairments, impaired consciousness, and sleep disorders were more common. We concluded that COVID-19 patients should be approached in a more holistic way, taking the nervous system into account.U prosincu 2019. nova epidemija koronavirusa brzo se proširila cijelim svijetom. Poznato je da je virus neuroinvazivan, ali je pun nepoznanica. U ovoj studiji imali smo za cilj predstaviti glavne neurološke simptome kod pacijenata kojima je dijagnosticirana koronavirusna bolest 2019. (COVID-19). Studija je provedena retrospektivno telefoniranjem 156 pacijenata u Turskoj kojima je dijagnosticiran COVID-19 putem lančane reakcije polimeraze u stvarnom vremenu; moglo se doći do samo 100 bolesnika. Prikupljeni su podaci o njihovim demografskim podacima, početnim simptomima, neurološkim simptomima i navikama spavanja. U procesu bolesti, 66% je imalo barem jedan neurološki simptom, 55% je imalo simptome središnjeg živčanog sustava, 42% imalo je simptome perifernog živčanog sustava, a 64% imalo je poremećaje spavanja i mijalgiju. Poremećaji svijesti, mirisa i okusa te poremećaji spavanja bili su značajno veći u bolesnika s pozitivnim slikanjem računalne tomografije u prsima (p <0,05). Neurološki simptomi primijećeni su u COVID-19, kao što su ostali koronavirusi. Posebno je glavobolja najčešći simptom u našoj populaciji. U bolesnika s nalazima dišnog sustava češće je otkrivanje određenih neuroloških simptoma kao što su smetnje okusa mirisa, oslabljena svijest i spavanje. Zaključili smo da s pacijentima s COVID-19 treba postupati na cjelovitiji način, uzimajući u obzir živčani sustav

Decreased ocular pulse amplitude and retinal nerve fibre layer in multiple sclerosis

This study was conducted to assess ocular pulse amplitude and retinal nerve fibre layer in patients with multiple sclerosis and their correlation with disease duration and with severity. Retinal nerve fibre layer thickness was measured by Heidelberg Retinal Tomography II (HRT-II; Heidelberg Engineering, Dossenheim, Germany) and ocular pulse amplitude was measured by dynamic contour tonometry (Ziemer Ophthalmic Systems, Port, Switzerland) in 37 multiple sclerosis patients and 72 age- and gender-matched controls. Ocular pulse amplitude was significantly reduced and retinal nerve fibre layer was significantly thinner in temporal, superotemporal, and nasal sectors in patients with multiple sclerosis regardless of having an optic neuritis attack. The retinal nerve fibre layer was thinner in eyes with a previous optic neuritis attack compared with the eyes without an attack, but the difference was not significant. Ocular pulse amplitude showed a positive correlation with visual evoked potential amplitude and a negative correlation with visual evoked potential latency. Retinal nerve fibre layer thickness showed a significant negative correlation with the disease duration but not with visually evoked potential, disease severity, nor previous optic neuritis. These findings indicate that the process of degeneration starts in the early period of the disease, as our study group is composed of early-middle-stage multiple sclerosis patients, and is independent of relapses. © Informa Healthcare USA, Inc

Optic disc and retinal nerve fibre layer changes in parkinson's disease

This study was conducted to assess optic nerve and peripapillary retinal nerve fibre layer (RNFL) changes in patients with idiopathic Parkinson's disease (PD) and its correlation with disease duration and severity. Optic nerve parameters and RNFL thickness were measured in 24 PD patients and 25 age-gender-matched controls by Heidelberg Retinal Tomography II (Heidelberg Engineering, Dossenheim, Germany). Patients with visual acuity below 20/25 were excluded. The mean RNFL in the temporal sector was significantly thinner in the study group than the control group (p = 0.020). Additionally, disease severity and duration negatively correlated with optic disc parameters in some sectors. © 2013 Informa UK Ltd All rights reserved

Simultaneous ischemic optic neuropathy and third cranial nerve palsy in giant cell arteritis [5]

Abstract Not Availabl

Bilateral optic disc head drusen manifesting as unilateral episodic visual field obscuration: A case report

Optic nerve head drusen (ONHD) are formed within the substance of the optic disc due to the accumulation of calcified hyaline-like material. They are generally misdiagnosed as papilledema since they elevate the disc and blur the disc margins. In this report, we describe a 22-year-old female patient with unilateral, episodic, partial visual field obscuration diagnosed as bilateral ONHD, the and pathogenesis, diagnosis and possible complications of disc drusen are discussed

Documentation of clinical and laboratory features of patients with spinal isolated syndrome who have no cranial lesion

Abstract Not Availabl