Migraine-like headache in cerebral venous sinus thrombosis

A 20-year-old female, university student presented with severe, throbbing, unilateral headache, nausea and vomiting that started 2 days ago. The pain was aggravated with physical activity and she had photophobia. She had been taking contraceptive pills due to polycystic ovary for 3 months. Cranial computed tomography was uninformative and she was considered to have the first attack of migraine. She did not benefit from triptan treatment and as the duration of pain exceeded 72h further imaging was done. Cranial MRI and MR venography revealed a central filling defect and lack of flow in the left sigmoid sinus caused by venous sinus thrombosis. In search for precipitating factors besides the use of contraceptive pills, plasma protein C activity was found to be depressed (42%, normal 70–140%), homocystein was minimally elevated (12.7μmol/L, normal 0–12μmol/L) and anti-cardiolipin IgM antibody was close to the upper limit

Evaluation of Short-term Memory, Working Memory, and Executive Functions in Patients with Relapsing-remitting Multiple Sclerosis

Objective: To compare patients with relapsing-remitting multiple sclerosis (RRMS) and healthy individuals in terms of short-term memory (STM), working memory (WM) and executive functions. Materials and Methods: The sample consisted of 33 patients with RRMS and 26 healthy participants. The groups were matched in terms of age, gender, level of education and hand dominance. The socio-demographic characteristics of the participants were recorded; and they were evaluated with Beck depression inventory and state/trait anxiety inventory. Visual aural digit span test B form, Wisconsin card sorting test, backward digit span task, stroop test T-BAG form, Wechsler memory scale: Revised form visual memory span subtest (WMS-R/VMS) and trail making test (TMT) for cognitive functions. Results: There was no statistically significant difference between groups in terms of depression and anxiety scores (p>0.05). Backward visual memory span calculated from WMS-R/VMS was significantly lower (p0.05). Conclusion: Results of this study indicate that patients with RRMS have lower visuo-spatial sketchpad capacity in their WM. However, there was no significant difference between patients with RRMS and healthy controls in terms of verbal and visuo-spatial STM capacity, phonological loop capacity in WM, perseveration, conceptualization, inhibition and set shifting skills

Dorsal Sural Nerve Conduction Study in Early Diabetic Polyneuropathy Patients and Relationship of Adiponectin and High Sensitive-C Reactive Protein Levels

WOS: 000273393300005Objective: In this study, we aimed to investigate the change in dorsal sural nerve (DSN) conduction studies in early diabetic neuropathic patients and to evaluate whether high sensitive C-reactive protein (hs-CRP), inflammatory marker, and adiponektin, important role in insulin resistance and diabetes, have any effect on DSN studies or not. Material and Method: Forty-six patients with early stages (Dyck classification N1)diabetic neuropathy and age-sex matched forty-four control subject were included in the study. Informed consent was obtained after approval of ethical committee. In all subject DSN conduction studies were performed with conventional electrophysiological studies. DSN electrophysiological parameters of diabetics were compared with controls. The relationship between plasma adiponectin and hs-CRP levels and DSN conduction study parameters were analyzed. Results: In diabetic patients, DSN parameters were significantly different than controls. The level of adiponectin was found to be lower in diabetic (p:0.01) but not statistically significant for hs-CRP levels (p:0.40). There was not any relationship between DSN parameters and the level of adiponectin or hs-CRP (p>0.05). Sixty-three % of diabetics, whom routine electrophysiological studies were in normal limits, had abnormal DSN parameters. Fifty% of diabetics had bilateral abnormalities. However, there was no difference in hs-CRP and adiponectin levels between patients with abnormal and normal DSN studies (p>0.05). Conclusion: DSN studies are useful methods to detect subclinical early diabetic polyneuropathy according to the results of our study. Although adiponectin level was found lower in early diabetic neuropathic patients, both adiponectin and hs-CRP do not have any relationship with DSN studies

A different look on the importance of lateralization and localization of figure 4 symptoms in epilepsy

Background Clinical seizure semiology provides valuable information in the evaluation of focal-onset bilateral tonic-clonic seizures. In the evaluation of these patients, long-term video-EEG monitoring (VEM) and neuroimaging studies are of great significance in determining lateralization together with clinical semiology. In this study, we examined the features of the figure 4 sign that we detected in patients with refractory epilepsy whom we followed up in the VEM unit. Methods In the study, 175 patients followed in the VEM unit were examined. Twenty-two patients for whom the figure 4 sign was detected were included in the study. Patients with the side indicated by the figure 4 sign comply with ictal EEG compatible were named as 1st group (G1), and those not were named as 2nd group (G2). Demographic characteristics, seizure type, number of seizures per month, duration of epilepsy, number of seizures during VEM, duration of figure 4 sign, medical history, and cranial MRI characteristics were compared between the two groups. Results When G1 and G2 were compared, it was observed that temporal lobe seizures were statistically significantly higher in G1. When the figure 4 sign durations were examined, this period was 16.3 +/- 8.2 s in frontal lobe seizures and 20.8 +/- 7.4 s in temporal lobe seizures. When the duration of the figure 4 sign was examined by gender, it was found that the duration was longer in males, which was statistically significant. Conclusion In conclusion, it is essential to evaluate ictal EEG findings together with brain imaging while performing semiological localization and lateralization in epileptic patients

Migraine-like headache in cerebral venous sinus thrombosis

WOS: 000349735500015PubMed: 25666780A 20-year-old female, university student presented with severe, throbbing, unilateral headache, nausea and vomiting that started 2 days ago. The pain was aggravated with physical activity and she had photophobia. She had been taking contraceptive pills due to polycystic ovary for 3 months. Cranial computed tomography was uninformative and she was considered to have the first attack of migraine. She did not benefit from triptan treatment and as the duration of pain exceeded 72 h further imaging was done. Cranial MRI and MR venography revealed a central filling defect and lack of flow in the left sigmoid sinus caused by venous sinus thrombosis. In search for precipitating factors besides the use of contraceptive pills, plasma protein C activity was found to be depressed (42%, normal 70-140%), homocystein was minimally elevated (12.7 mu mol/L, normal 0-12 mu mol/L) and anti-cardiolipin IgM antibody was close to the upper limit. (C) 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved

Comparison of Dementia Patients Admission Rates and Dementia Characteristics Before and During the COVID-19 Pandemic

Background The coronavirus disease 2019 (COVID-19) epidemic was recognized as a pandemic by the World Health Organization on March 2020. There have been significant changes in our lives due to the measures used to prevent the spread of the COVID-19 pandemic. Dementia patients are one of the most vulnerable groups who have difficulties in adapting to this situation. Our study aimed to compare the admission rate to the hospital and dementia characteristics of dementia patients in the COVID-19 pandemic and pre-pandemic periods. Methods Dementia patients admitted to the neurology outpatient clinic during the pandemic and pre-pandemic periods were included in the study. In these two periods, age, gender, dementia type, stage, age of onset, mini-mental state examination, reason for admission, vitamin B12, vitamin D, folk acid levels, brain imaging, electroencephalogram results were analysed retrospectively. Dementia characteristics and vitamin levels were compared. Results Two hundred and two dementia patients were included in the study. When the reasons for admission to the hospital were examined, the number of applications with the complaint of forgetfulness was highest in the pre-COVID period (53.1%); this rate was 37.8% in the COVID period. Also, 9.5% of patients were admitted for a drug prescription or medication report during the COVID period, while this rate was 1.6% in the pre-COVID period. Brain imaging was performed on 91 patients in the pre-COVID period, while 42 patients underwent imaging in the COVID period. Conclusions Although this study was performed with a limited population, it indicates that the COVID-19 pandemic indirectly affects the clinical conditions of people living with dementia