Prevalence of Abnormalities in Vestibular Function and Balance among HIV-Seropositive and HIV-Seronegative Women and Men

BACKGROUND: Most HIV-seropositive subjects in western countries receive highly active antiretroviral therapy (HAART). Although many aspects of their health have been studied, little is known about their vestibular and balance function. The goals of this study were to determine the prevalences of vestibular and balance impairments among HIV-seropositive and comparable seronegative men and women and to determine if those groups differed. METHODS: Standard screening tests of vestibular and balance function, including head thrusts, Dix-Hallpike maneuvers, and Romberg balance tests on compliant foam were performed during semiannual study visits of participants who were enrolled in the Baltimore and Washington, D. C. sites of the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study. RESULTS: No significant differences by HIV status were found on most tests, but HIV-seropositive subjects who were using HAART had a lower frequency of abnormal Dix-Hallpike nystagmus than HIV-seronegative subjects. A significant number of nonclassical Dix-Hallpike responses were found. Age was associated with Romberg scores on foam with eyes closed. Sex was not associated with any of the test scores. CONCLUSION: These findings suggest that HAART-treated HIV infection has no harmful association with vestibular function in community-dwelling, ambulatory men and women. The association with age was expected, but the lack of association with sex was unexpected. The presence of nonclassical Dix-Hallpike responses might be consistent with central nervous system lesions

A case report of isolated distal upper extremity weakness due to cerebral metastasis involving the hand knob area

Unilateral weakness of an upper extremity is most frequently caused by traumatic nerve injury or compression neuropathy. In rare cases, lesion of the central nervous system may result in syndromes suggesting peripheral nerve damage by the initial examination. Pseudoperipheral hand palsy is the best known of these, most frequently caused by a small lesion in the contralateral motor cortex of the brain. The 'hand knob' area refers to a circumscribed region in the precentral gyrus of the posterior frontal lobe, the lesion of which leads to isolated weakness of the upper extremity mimicking peripheral nerve damage. The etiology of this rare syndrome is almost exclusively related to an embolic infarction.We present the case of a 70-year-old male patient with isolated left sided upper extremity weakness and clumsiness without sensory disturbance suggesting a lesion of the radial nerve. Nerve conduction studies had normal results excluding peripheral nerve damage. Neuroimaging (cranial CT and MRI) detected 3 space occupying lesions, one of them in the right precentral gyrus. An irregularly shaped tumor was found by CT in the left lung with multiple associated lymph node conglomerates. The metastasis from this mucinous tubular adenocarcinoma with solid anaplastic parts to the 'hand knob' area was responsible for the first clinical sign related to the pulmonary malignancy.Pseudoperipheral palsy of the upper extremity is not necessarily the consequence of an embolic stroke. If nerve conduction studies have normal results, neuroimaging - preferably MRI - should be performed, as lesion in the hand-knob area of the precentral gyrus can also be caused by a malignancy

Eye movements at an early stage of essential tremor

WOS: 00043163420220

Therapeutic plasma exchange for neurologic disorders: Single center experiences [Nörolojik hastalıklarda terapötik plazma değişimi deneyimlerimiz]

Introduction: Therapeutic plasma exchange (TPE), is a procedure that involves separating the blood, exchanging the plasma and returning the other components, primarily red blood cells, to the patient. TPE is an effective treatment in neurologic diseases with immune pathogenesis. We report our single center experience about TPE in patients with different kind of neurologic diseases. Material- Method: We reviewed the medical records of 37 patients who had been consecutively treated by TPE between 2010 and 2014 at Neurologic Intensive Care Unit and The Apheresis Center. Results: Neurologic indications included neuromyelitis optica (NMO) (17 patients), GuillainBarre syndrome (GBS) (4 patients), myastenia gravis (MG) (3 patients), multiple sclerosis (MS) (2 patients), paraneoplastic encephalopathy (5 patients), acute disseminated encephalomyelitis (ADEM) 1 patient, acute hemorrhagic leucoencephalopathy 1 patient, transverse myelitis (2 patients), chronic inflammatory demyelinating polyneuropathy (CIDP) (1) and multifocal acquired demyelinating sensory and motor neuropathy (MADSAM) 1 patient. The median TPE session number was 6 (range 1-25). Total number of TPE procedures in all cases was 236. Discussion: In neurological diseases with immune pathogenesis TPE must always be kept in mind as a treatment option. TPE is widely accepted as a first line treatment for GBS and MG. According to our experience NMO is the third disease in which TPE must be admitted as the first therapeutic option. © 2016, Ege University Press. All Rights Reserved

Vaproate associated reproductive and sexual dysfunctions: are epileptic men at greater risk than bipolar men?

4th Biennial Conference of the International-Society-for-Bipolar-Disorders -- MAR 17-20, 2010 -- Sao Paulo, BRAZILWOS: 000275344600006Int Soc Bipolar Disorder

MULTIDISCIPLINARY SECONDARY STROKE PREVENTION PROGRAM PROTOCOL IN TURKEY

WOS:000587365201581[No Abstract Available

Ischaemic preconditioning reduces spinal cord injury in transient ischaemia

WOS: 000177629400008PubMed ID: 12222697Objective - Paraplegia remains a devastating complication after thoracic and thoracoabdominal aortic surgery for coarctations, dissections or aneurysms. Since the advent of ischaemic preconditioning of the myocardium, attention has been directed to the nervous system. This study was designed to evaluate the acute protective effect of ischaemic preconditioning on the spinal cord. Methods and results - Thirty-six New Zealand white rabbits were randomly assigned to one of three groups. The preconditioning group had 5 minutes of aortic occlusion, 25 minutes reperfusion and 20 minutes of ischaemia, whereas the controls had only 20 minutes of ischaemia. The sham group was anaesthetized and subjected to laparotomy without aortic occlusion. Physiological parameters and somatosensory evoked potentials were monitored during the experiment. Neurological outcome was clinically evaluated up to 48 hour after ischaemia and motor function was scored. Then the animals were sacrificed. Their spinal cord, abdominal aorta and its branches were removed and processed for histopathological examination. Histhopathological changes of the gray matter in the lumbosacral segments were scored from 0 to 6 according to a semi-quantitative scala. The changes in amplitudes of evoked potentials during ischaemia and recovery periods were similar in preconditioning and control groups. The average motor function score was significantly higher in the preconditioning group than the control group at 24 and 48 hours after the ischaemic event (p < 0.05). Histological observations were consistent with the neurological findings. The histopathological scores in the control group and the preconditioning group were 3.2 (1.4-5.2) and 2.4 (0.8-4.4), respectively (p < 0.05). Conclusions - The results suggest that ischaemic preconditioning reduces the spinal cord injury and improves neurological outcome in transient ischaemia in rabbits. This protective mechanism is rapidly invoked within only 25 minutes interval between the preconditioning stimulus and the ischaemic insult