Evaluation of repetitive stimulation test (RST) in 30 patients with Myasthenia Gravis, who were previously confirmed by clinical sign and tensilon test 1996-99

est (RST) is the most commonly used electrodiagnostic test to asses the defect of neuromuscular transmission, which is reported to be positive in the diffuse and restricted ocular forms 60-95% and 14-50%, respectively. In a cross-sectional study, to determine the efficacy of repetitive stimulation test in myasthenia gravis, we evaluated the results in 30 cases who were hospitalized in Imam Khomeini Hospital during 1996-1999. Patients were first selected clinically and then confirmed by Tensilon test.Various clinical types including generalized and restricted ocular forms with different severity and duration were entered in this study. Considering the fact that the positiveness of the test is enhanced by assessment of more muscle groups, we evaluated decremental response in the facial, proximal and distal muscles of limbs. 90% of patients had the generalized form of the disease, whereas ocular myasthenia gravis was seen only in 10% of the cases. 74% of females and 73% of males showed positive response (overall: 73.3%). No significant association was found between the positive response, and age and sex. Peaks of incidences of the disease for the males were in fourth and sixth decades and for the females in thired decade

Altered expression of miR-326 in T cell-derived exosomes of patients with relapsing-remitting multiple sclerosis

Invasion of auto-reactive CD4+ T cells especially Th17 into central nervous system (CNS) is an underlying pathogenic mechanism in multiple sclerosis (MS). CD4+ T cells release exosomes which are enriched in microRNAs, reflective of cell�s physiological or pathological condition. Thus exosomes could be potent agents to provide quantitative and qualitative information about involved cells in MS. We investigated the expression of pathogenic microRNAs in T cells-derived exosomes of MS patients or healthy controls. Conventional T cells (Tconv) derived from relapsing-remitting (RR) MS patients (n=10) and healthy controls (n=10) were purified and cultured for 3 days by soluble anti-CD3/CD28. Exosomes were purified from cultured-T cells supernatants. The expression levels of exosomal miR-146a, miR-29a, miR-155, and miR-326 were quantified by real-time PCR. A statistically significant increased expression of miR-326 in Tconv-derived exosomes was observed in RRMS patients as compared with controls (7.5±1.88vs 2.51±0.9 p=0.03), On the contrary, no differences were found in the expression levels of miR-155, miR-146a, and miR-29a, in Tconv-derived exosomes of patients as compared with controls (p>0.05). Our results point to altered expression in exosome-derived microRNAs. MiR-326 was previously shown to play a role in the immunopathogenesis of MS by inducing TH17 differentiation and maturation. Therefore, miR-326 containing exosomes might also be a potential clinical target in course of MS. Moreover, the deregulation of this miRNA in exosomes may serve as a diagnostic and prognostic biomarker. Copyright© February 2019, Iran J Allergy Asthma Immunol. All rights reserved

The effect of action observation on weight distribution and dynamic balance index improvement in hemiparetic patients based on mirror neuron theory

Background and Objective: Cerebrovascular accident (CVA) is a severe debilitating neurological condition in adults. This study sought to assess the effect of observation and mimicking functional activities on weight distribution and dynamic balance index improvement in lower limbs of hemiparetic patients based on mirror neuron theory. Materials and Methods: This clinical trial was performed on 36 males and females aged 45-60 years who suffered ischemic CVA for the first time. Subjects were randomly divided into 3 groups as follows: viewers of functional film, viewers of non-functional (symbol) film and the control group (not watching any film). The physiotherapy treatments in all groups were similar. Results: Weight percentage distribution was not significant. The values prior to and after dynamic balance index were statistically significant in all 3 groups. Significant differences were found between group 1 and the other 2 groups in terms of balance index percentage change (level 6). Conclusion: Observation and imitation of action along with rehabilitation exercises and functional activities had a positive effect on the improvement of balance Index in post-stroke patients. © 2015, Zanjan University of Medical Sciences and Health Services. All Rights Reserved

ICTAL AND INTERICTAL EEG ABNORMALITIES IN 100 MIGRAINEURS WITH AND WITHOUT AURA

There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8) and 10-46 (mean: 23 ± 2.1) years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered from migraine with aura. Hemiplegic and basilar migraines were observed in one and two of our patients respectively. Gender and age had no effect on the type of migraine. Family history for first degree relatives was found in 64% of patients, without being influenced by gender or type of migraine. Male to female ratio was 1/1.6 (38/62). Abnormal EEG was found to be much more frequent in migraineurs than the control group (47% vs. 7%). Children had an overall somewhat more abnormal EEGs, compared with adult group (53% vs. 44% or 17/32 vs. 30/68), though slow discharges were detected more in adult group. The most common abnormality was slow high voltage waves, which was observed in 33/47 (70%) of abnormal recordings. The less common findings, in decreasing order of frequency were: focal (slow, sharps or mixed) discharges in 14/47 (29%), epileptiform (alone or associated with slow waves) in 4/47 (8.5%), diffuse beta and frontal intermittent delta, activity each being in 1/47 (2.1%) of abnormal recordings

SARS-CoV-2 and Stroke Characteristics: A Report from the Multinational COVID-19 Stroke Study Group

cited By 0BACKGROUND AND PURPOSE: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. METHODS: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2-infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries' health expenditure on outcomes. RESULTS: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were CONCLUSIONS: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.Peer reviewe