Remedies and the Supreme Court\u27s October 2007 Term

For this third annual review of Supreme Court decisions, I have identified three cases from very different areas all of which involve the remedies available for violations of federal law. These cases deal with the following issues: (a) federal remedies for state violations of federal labor policy (Chamber of Commerce); (b) state remedies for violations of the federal Bill of Rights (Danforth) and (c) federal common law standards for awarding punitive damages (Exxon Shipping)

ACTA NEUROLOGICA BELGICA

Restless legs syndrome (RLS) is a disease characterized by some type of dysesthesia, an indescribable abnormal sensation in the extremities. Our objective was to determine whether the visual evoked potentials (VEP) can be used as a quantitative monitoring method to evaluate demyelination-remyelination and neurodegeneration in the patients with RLS. The present study was carried out prospectively. It was planned to determine normal or pathological conditions in the form of increased latency or decreased amplitude of VEP and to evaluate possible pathologies in the visual and retinal pathways at early stages and at months 3 and 6 of follow-up in the patients with RLS (with or without iron deficiency anemia), in those without RLS (at the time of diagnosis prior to any medical therapy) without any visual symptoms. It was observed that latency of VEP improved but didn't return to normal limits following treatment with dopamin agonists, iron, or combination of both and that there was no significant difference between the post-treatment data and those of the control group. These results in combination with the fact that the latencies and amplitudes didn't return to normal levels despite the 6-month-treatment but showed a progressive course with partial regeneration suggests that there was incomplete remyelination. It should be kept in mind that this syndrome is likely to be a part of neurodegenerative process

NEUROLOGIA I NEUROCHIRURGIA POLSKA

Myasthenia gravis is a disease of neuromuscular junction due to auto-immune destruction of the acetylcholine receptors. Behcet's disease, on the other hand, is a multisystemic vascular-inflammatory disease. Both conditions are not common in the general population although their association has not been reported in the literature. We wanted to present our patient who developed clinical course of myasthenia gravis following discontinuation of medications due to complications of corticosteroid for Behcet's disease. It was observed that clinical findings of myasthenia gravis recovered following restarting steroid treatment and he did not experience attacks of both conditions. Although Myasthenia gravis and Behcet's disease are distinct entities clinically as well as in terms of pathogenesis, they share common physiopathological features and their treatment is based on their common features. (C) 2016 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved

JOURNAL OF MEDICAL AND SURGICAL INTENSIVE CARE MEDICINE

In this study, 15 patients who were being followed in a cerebrovascular diseases outpatient clinic with the diagnosis of cerebral venous thrombosis were retrospectively reviewed. The study aimed to assess and review their complaints at the time of presentation and during the clinical course as well as assess the etiological risk factors using new imaging modalities and new and old therapeutic modalities. Cerebral venous thrombosis was recognized as a rare and fatal condition when it was first defined; however, it currently presents with a better prognosis because of increased awareness, advanced neuroimaging techniques, and therapeutic methods. The use of dabigatran, which is a new therapeutic option, remains on the agenda particularly for avoiding drug interaction with warfarin in the patients with comorbidities and history of multiple medications. Dabigatran has a high rate of success with low incidence of side effects

DUSUNEN ADAM-JOURNAL OF PSYCHIATRY AND NEUROLOGICAL SCIENCES

Hashimoto's encephalopathy (HE) is a rare autoimmune disease with unclear pathophysiology, developing on the basis of Hashimoto's thyroiditis (HT), associated with antithyroid antibodies, that presents with autoimmune, neuroendocrine, and neuropsychiatric findings. The disease is characterized by generalized or focal slowing in the EEG, elevated antithyroid antibody titration in the serum, elevated cerebrospinal fluid protein level, and the presence of antithyroid antibodies. HE is known as an autoimmune disorder of the central nervous system. With this feature, it is differentiated from cognitive alterations observed in hypothyroidism or hyperthyroidism. The response to treatment with corticosteroids in line with the autoimmune nature of HE supports this diagnosis. This report shows a case presenting with neuropsychiatric symptoms, elevated antithyroid antibody titration in the serum, and complete response to steroid therapy. A clear indicator for the diagnosis of HE has not yet been found. Therefore, other potential causes need to be considered in the differential diagnosis of this clinical picture until they can be excluded after investigations. With this case report, we want to emphasize that in differential diagnosis of patients presenting with a variety of neuropsychiatric symptoms, Hashimoto's encephalopathy - though being seen quite rarely - should not be disregarded, given the dramatic improvement of patients receiving a correct diagnosis and appropriate treatment

EPILEPSI

Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterized by headache, changes in mental status, epileptic seizure, visual disturbances, and typically alterations in posterior circulation of the brain. Ictal findings of this type of epileptic seizures and their response to the treatment vary. It is observed that single and/ or combined anti-epileptic drugs have been used in treatment of the seizures. Radiological involvement doesn't always correlate with clinical findings. The same also applies for the relationship between epileptic-seizure activity and distribution of radiological involvement. Simple partial seizures rapidly and well responding to the isolated treatment as well as course of status epilepticus may occur. The present study discussed how the current approach to epileptic seizures was associated with posterior reversible encephalopathy syndrome by presenting a report whose prognosis was good although the condition involved both basal ganglia and cerebral deep structures, and whose seizures ceased with magnesium replacement

JOURNAL OF NEUROLOGICAL SCIENCES-TURKISH

Introduction: Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for development of atherosclerotic processes because it leads to hypertension, impaired glucose metabolism, obesity and metabolic syndrome, cardiac diseases, elevated blood pressure, and increased level of cholesterol, triglycerides, homocysteine, and coagulation. Materials and Methods: Our aim was to evaluate presence of subclinical atherosclerosis prior to CPAP treatment in the patients with OSAS without any history of previous diseases and any pathological finding in their investigations. After obtaining approval from the Ethics Board, we planned to compare the results of investigations for risk factors for atherosclerosis (fasting blood glucose [FBG], total cholesterol, Triglycerides, HDL- and LDL-cholesterol, thyroid function test, homocysteine, fibrinogen, high sensitivity C-reactive protein [hsCRP]) before and after CPAP treatment and to examine the effect of CPAP treatment on these parameters between July 2013 and July 2015. Findings: Findings obtained before CPAP treatment (homocysteine, hsCRP, HbA1c, subclinical hypothyroidism) suggested subclinical atherosclerosis. In comparative evaluation between the findings before and after CPAP treatment, no statistically significant difference was found in levels of triglycerides, HDL-cholesterol and fT4 (P = 0.346, 0.540, 0.060, respectively) whereas significant differences were found in leukocyte and platelet counts, hemoglobin level, fasting blood glucose, LDL-cholesterol, homocysteine, fibrinogen, fT3, TSH, CRP, and HbA1c (P = 0,003,-0,010,-0,000,-0,001,-0,008-0,004-0,000-0,000-0,0250,000- 0,000-0,000, respectively). Subclinical hypothyroidism was present in 12 (20%) patients before CPAP and in 5 (7%) patients after CPAP treatment. Conclusions: Improvement has been seen even in early markers of atherosclerosis with effective CPAP

INTERNATIONAL JOURNAL OF NEUROSCIENCE

Background: Idiopathic intracranial hypertension (IIH) is a clinical syndrome characterized by increased intracranial pressure in the absence of clinical, laboratory, or radiological findings of space-occupying lesion in the cranium. Papilledema is found in majority of the patients with IIH while it is absent in only about 5-6% of the patients. Methods: Our primary objective was to evaluate the patients with IIH with (n: 45) and without (n: 15) papilledema using cranial MRI and VEP analyses and to compare the obtained results. Diagnosis of IIH according to ICHD-3 criteria admitted to and followed in our clinic before receiving any treatment between 2008 and 2018 were reviewed retrospectively after obtaining approval from the Ethics Committee. Results: There was no statistically significant difference between both groups' ages (P: 0.494) while differences in lumbar puncture (LP) opening pressure and VAS were found to be statistically significant (p = 0.034, 0.001, respectively). In our VEP investigation, it was seen that latencies in the group without papilledema were seen to be closer to those in the control group (P latency: 0.706, P amplitude: 0.080). Increase in latency and decrease in amplitude were seen in the group with papilledema compared to the group without papilledema (p < 0.001). Conclusion: In conclusion, alterations in the optic nerve may be detected with VEP investigation before the detection of papilledema through ophthalmoscopic examination in these patients. Thus, VEP investigation may be considered to have predictive value. VEP examination may be recommended in diagnosis and treatment and during follow-up periods

Lesion patterns and etiology of ischemia in superior cerebellar artery territory infarcts: A diffusion magnetic resonance imaging study

PubMed ID: 15775708Background and Purpose: Infarcts in the territory of superior cerebellar artery (SCA) are uncommon. The clinical, and etiological mechanisms of different infarct patterns of SCA are not well known. Diffusion-weighted imaging (DWI) is superior to conventional magnetic resonance imaging for detecting acute small and multiple ischemic lesions. Methods: We studied 60 patients with lesions involving SCA territory proved by DWI, which have been selected from 3,800 patients with first ischemic stroke consecutively admitted to our stroke unit over a period of 5 years. Results: There are 7 distinctive SCA lesion patterns: (1) a lesion was found in the medial (m) branch territory of SCA (mSCA) in 14 patients; (2) a lesion in the lateral (I) branch territory of SCA (ISCA) was seen in 9 patients; (3) a coexisting lesion involving mSCA and ISCA was found in 9 patients; (4) a lesion in cortical borderzones between SCA and m/l branches of the posterior inferior cerebellar artery (PICA) was observed in 6 patients; (5) a lesion in deep borderzones between ISCA and mSCA, and IPICA and mPICA was present in 8 patients; (6) a lesion involving the medial rostral cerebellum between the right and left SCA was found in 4 patients; (7) multiple lesions involving SCA and other vertebrobasilar artery territories were present in 10 patients. The main cause was possible artery-to-artery embolism from atherosclerotic vertebrobasilar arteries to distal branches of SCA in 20 patients (33%). Fourteen patients had a source of cardioembolism (23%), and 6 patients (8%) had concomitant atherosclerotic vertebrobasilar artery disease and a source of cardioembolism. Conclusions: An acute ischemic lesion in the SCA territory is mainly multiple. The ISCA territory was the most involved area. Small territorial infarcts were frequently associated with large territorial SCA infarcts. Borderzone SCA infarcts occurred in one third of the patients with transient benign symptoms. Mass effects are unusual despite the large amount of SCA involvement. Our results supported the fact that embolism is the predominant stroke mechanism in the SCA territory infarction. Copyright © 2005 S. Karger AG