Retinal nerve fiber layer analysis in idiopathic intracranial hypertension

WOS: 000239211900011PubMed: 16804262Background: The chronic nature of idiopathic intracranial hypertension (IIH) represents a risk factor for progressive optic nerve damage and structural abnormalities of the retina. Aim: We measured the retinal nerve fiber layer (RNFL) thickness in patients followed with the diagnosis of IIH who had no or mild visual impairment to search for possible structural alterations in the retina for diagnostic and prognostic purposes. Settings and Design: Case-control prospective study. Materials and Methods: The study group consisted of 12 women followed and treated with the diagnosis of IIH in our clinic. The selection criteria were the, normal optic nerve, normal visual fields or mild visual field defects (Grade 1-3) by Humphrey perimeter. Randomly assigned, age-matched 12 healthy women were taken as the control group. Retinal nerve fiber layer thickness was evaluated with scanning laser polarimetry and both eyes were studied for each case in both groups. Statistical Analysis Used: Mann-Whitney U test. Results: The mean ages of the patient and the control groups were 34.58 +/- 4.2 and 34.42 +/- 5.7 years respectively (P=0.87). The mean duration of disease was 5.5 +/- 3 years. Some parameters related to RNFL thickness were found to differ significantly between patients with IIH and control subjects. Namely superior ratio (P=0.007), inferior ratio (P=0.039), superior-nasal ratio (P=0.025), maximum modulation (P=0.01) and symmetry (P=0.006) were lower in the patient group than controls. Conclusion: Scanning laser polarimetry might be a good adjunct for determining possible structural affects of IIH on the retina in patients with no or mild visual impairment

Is there an association between migraine and atopic disorders? The results of multicenter migraine attack study

WOS: 000259840600001We designed this multicenter study to evaluate the abnormalities related to the mast cell activation during attacks in a large group of migraineurs and to compare the findings both with episodic tension type headache (ETTH) and matched healthy control subjects. After the evaluation of diagnostic criteria, 213 subjects were included in this study after giving consent. Of all 146 subjects (67.8%) were migraineurs, 38 (19.4%) were ETTH patients and 29 others were healthy controls matched according to age and sex. Immunological screening showed significantly high ratios of IL-beta, IL-2, IL-6 and TNF-alpha in the migraine group compared to ETTH (16.6% vs 10.5%, 20.0% vs 5.3%, 13.8% vs 2.6% and 15.9% vs 5.3%, respectively) and to the healthy controls. Logistic regression analysis showed that only duration of headache has an important effect on having IL-2 abnormality (Exp-B: 0.322, 95% CI: 0.151-0.688, p=0.003) in patients with migraine. There was no important effect of clinical variables on serological abnormalitites or each other. In conclusion, our multicenter clinical and laboratory based study suggests that primary headache disorders (migraine and ETTH) are associated with atopic changes and they might share the inflammatory mechanism (pro-inflammatory as well as anti-inflammatory cytokine abnormalities) during headache attacks

Prevalence, etiology, and biopsychosocial risk factors of cervicogenic dizziness in patients with neck pain: A multi-center, cross-sectional study

Objectives: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain. Patients and methods: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0 +/- 13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety Depression Scale [HADS]) were recorded. Results: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001). Conclusion: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status