Evoked Potentials in Diagnosis of Demyelinating Diseases

Evocirani potencijali (EP) metoda su izbora u dijagnostici osjetnih poremećaja: vidnih, slušnih, somatosenzornih, kognitivnih. Služe za objektivan prikaz osjetnih funkcija. To je neinvazivna metoda koja se može učestalo ponavljati, a rezultati snimanja mogu se uspoređivati tijekom vremena. Demijelinizacijske bolesti prikazuju se širokim spektrom simptoma uz učestale ispade osjetnih funkcija. EP služi u objektivizaciji ispada osjeta koje bolesnici navode. Zbog različitosti osjetnih ispada, kao i nalaza EP-a, ovo je metoda koja pomaže u diferencijalnoj dijagnostici demijelinizacijskih bolesti.Evoked potentials (EPs) represent a method of choice in the diagnosis of sensory disturbances, namely vision, hearing, somatosensory and cognitive disorders. It provides an objective overview of sensory functions. This is a non-invasive method that can be repeated frequently, and the results of the recordings can be compared over a period of time. Demyelinating diseases show a wide range of symptoms with frequent sensory deficits. EPs are intended to objectify sensory deficits reported by patients. Given the diversity of sensory deficits and the EP findings, this method is valuable for the differential diagnosis of demyelinating diseases

Epidemiology and Socioeconomic Aspects of Migraine

Prema Međunarodnoj klasifikaciji glavobolja migrena spada u skupinu primarnih glavobolja. Postojeća istraživanja pokazuju da oko 15 % populacije ima migrene, žene češće u odnosu na muškarce – 3 : 1. Migrena može biti epizodična ili kronična. Kroničnu glavobolju ima svega 2 % bolesnika. Pod kroničnom migrenom podrazumijeva se glavobolja koja traje ≥ 15 dana mjesečno. Socioekonomski aspekti migrene čine značajni udio u troškovima pojedinca i šire zajednice. Ti troškovi mogu se podijeliti na direktne i indirektne. Sveukupni je trošak značajno veći za bolesnike s kroničnom migrenom u usporedbi s bolesnicima s epizodičnom migrenom, u omjeru 3 : 1.According to the International Classification of Headache Disorders (ICHD), migraine belongs to the group of primary headaches. According to existing research studies, about 15% of the population suffer from migraines, women significantly more than men: around 3:1. Migraines can be episodic and chronic. Chronic migraines are those that last 15 days or more. Only about 2% of patients suffer from chronic migraines. The socio-economic aspects of the migraine make up a significant part of the expenses incurred by both the patient and the wider society. These expenses may be divided into direct and indirect ones. Expenses incurred by patients suffering from chronic migraine are much greater than those suffering from episodic migraine, this ratio being 3:1

Epidemiology and Socioeconomic Aspects of Migraine

Prema Međunarodnoj klasifikaciji glavobolja migrena spada u skupinu primarnih glavobolja. Postojeća istraživanja pokazuju da oko 15 % populacije ima migrene, žene češće u odnosu na muškarce – 3 : 1. Migrena može biti epizodična ili kronična. Kroničnu glavobolju ima svega 2 % bolesnika. Pod kroničnom migrenom podrazumijeva se glavobolja koja traje ≥ 15 dana mjesečno. Socioekonomski aspekti migrene čine značajni udio u troškovima pojedinca i šire zajednice. Ti troškovi mogu se podijeliti na direktne i indirektne. Sveukupni je trošak značajno veći za bolesnike s kroničnom migrenom u usporedbi s bolesnicima s epizodičnom migrenom, u omjeru 3 : 1.According to the International Classification of Headache Disorders (ICHD), migraine belongs to the group of primary headaches. According to existing research studies, about 15% of the population suffer from migraines, women significantly more than men: around 3:1. Migraines can be episodic and chronic. Chronic migraines are those that last 15 days or more. Only about 2% of patients suffer from chronic migraines. The socio-economic aspects of the migraine make up a significant part of the expenses incurred by both the patient and the wider society. These expenses may be divided into direct and indirect ones. Expenses incurred by patients suffering from chronic migraine are much greater than those suffering from episodic migraine, this ratio being 3:1

Functional Changes of P300 Values among Young Football Players as a Measure of a Cognitive Function

Numerous studies have shown that evaluation of evoked potentials (EP) is an excellent estimation tool for a cognitive function. During daily practices footballers are exposed to headers that can leave mild head traumas. In this study, young footballers were examined, while the control group included their coevals who don’t practice contact sports. Results of the study have shown that footballers have longer latency value of the P300 wave when target stimulus is presented on N1, N2 and P3, but not on P2. Also, they have longer latency values when non-target stimulus is presented. Amplitude values of target stimulus are not different, but footballers have lower amplitudes of non-target stimulus. This study suggests that EP evaluation method can be used to detect first and mild changes of the brain function

Neurološke manifestacije hipereozinofilnog sindroma – pregled literature

Hypereosinophilic syndrome is a rare disorder of the hematopoietic system. The disease is characterized by continuously high number of eosinophils (>1.5x109/L) for more than six months. Other possible causes of hypereosinophilia, such as allergic and parasitic diseases, malignant disease, Churg-Strauss disease and infection should be eliminated. The most common manifestations of hypereosinophilic syndrome are pulmonary, skin, gastrointestinal, cardiac difficulties and neurologic lesions. Numerous neurologic lesions have been described, in particular of the central and peripheral nervous systems. Review of the literature revealed the following to have been recorded so far: mononeuritis multiplex, sensory polyneuropathy, radiculopathy, myalgia, myositis and perimyositis, neuropathy, ataxia, paraplegia, ophthalmologic abnormalities, optic neuritis, hemiplegia-hemiparesis, spasmodic quadriplegia, seizures, meningitis, cerebral infarction, organic psychosyndrome, other mental changes, stroke, temporal arteritis, leptomeningeal dissemination, memory deficits and dysarthria.Hipereozinofilni sindrom je rijetka bolest hematopoetskog sustava. Bolest je obilježena visokim brojem eozinofila (>1,5x109/L) duže od šest mjeseci, uz uvjet da su isključeni drugi mogući uzroci hipereozinofilije kao što su alergija i parazitne bolesti, maligne bolesti, Churg-Straussova bolest i druge infekcijske bolesti. Većina kliničkih manifestacija hipereozinofilnog sindroma obuhvaća oštećenja pluća, kože, probavnog sustava, srčane poremećaje i neurološka oštećenja. Opisana su brojna neurološka oštećenja središnjeg i perifernog živčanog sustava. Pretraživanjem literature nalaze se moguće neurološke manifestacije bolesti kao što su mononeuritis multiplex, senzorna polineuropatija, radikulopatija, mijalgija, miozitis i perimiozitis, neuropatija, ataksija, paraplegija, oftalmološki poremećaji, optički neuritis, hemiplegija-hemipareza, spastička tetraplegija, epileptični napadaji, meningitis, ishemijski moždani udar, psihoorganski sindrom i drugi mentalni poremećaji, temporalni arteritis, leptomeningealna diseminacija, poremećaji pamćenja i dizartrija

MTHFR C677T i protrombin G20210A mutacije u bolesnice iz Dalmacije s tihim moždanim udarom

A 55-year-old, previously healthy woman, presented with frequent headaches. She had no neurological disturbances, but had a positive family history; her father died from stroke. Magnetic resonance imaging showed brain infarction; therefore detailed diagnostic evaluation of thrombophilia markers and genetic testing were performed. The patient was found to be homozygous for the C677T mutation of the methylenetetrahydrofolate reductase gene and heterozygous for the mutation of the prothrombin G20210A gene. No other cause of cerebral infarction was found in the patient.Prikazuje se slučaj dotad zdrave 55-godišnje bolesnice koja se javlja s učestalim glavoboljama. Nije imala nikakve neurološke ispade, ali je imala pozitivnu obiteljsku anamnezu. Otac joj je umro od moždanog udara. Magnetna rezonanca je pokazala infarkt mozga zbog čega je napravljena detaljna dijagnostička evaluacija tromboembolijskih biljega te genetska ispitivanja. Utvrđeno je da je bolesnica homozigot za mutaciju C677T gena metilentetrahidrofolat reduktaze i heterozigot za mutaciju gena protrombina G20210A. Nije pronađen nijedan drugi uzrok moždanog udara

Functional Changes of P300 Values among Young Football Players as a Measure of a Cognitive Function

Numerous studies have shown that evaluation of evoked potentials (EP) is an excellent estimation tool for a cognitive function. During daily practices footballers are exposed to headers that can leave mild head traumas. In this study, young footballers were examined, while the control group included their coevals who don’t practice contact sports. Results of the study have shown that footballers have longer latency value of the P300 wave when target stimulus is presented on N1, N2 and P3, but not on P2. Also, they have longer latency values when non-target stimulus is presented. Amplitude values of target stimulus are not different, but footballers have lower amplitudes of non-target stimulus. This study suggests that EP evaluation method can be used to detect first and mild changes of the brain function

Blaži kognitivni poremećaj kao klinička manifestacija neurosarkoidoze lijevka hipofize: prikaz slučaja

A case is presented of a 59-year-old male patient with a 5-year history of sarcoidosis. In the last half a year, deterioration of his intellectual abilities was noticed. Psychological testing detected a mild cognitive disorder. Laboratory diagnostics found a decreased level of testosterone and magnetic resonance imaging showed pituitary stalk neurosarcoidosis without any other pathomorphological substrate of cognitive impairment. This case indicates that neurosarcoidosis should be considered as a possible cause of mild cognitive disorder and, consequently, included in the International Classification of Mental and Behavioural Disorders.Prikazuje se slučaj 59-godišnjeg bolesnika s 5-godišnjom poviješću bolesti sarkoidoze. U posljednjih pola godine primjetno je bilo slabljenje njegovih intelektualnih sposobnosti. Psihološkim testiranjem otkriven je blaži spoznajni poremećaj. Laboratorijskom dijagnostikom utvrđena je snižena razina testosterona, dok je magnetska rezonancija pokazala neurosarkoidozu lijevka hipofize bez ikakvog drugog patomorfološkog supstrata kognitivnog poremećaja. Ovaj slučaj pokazuje da neurosarkoidozu treba uzeti u obzir kao mogući uzrok blažeg spoznajnog poremećaja, pa bi je trebalo uvrstiti u Međunarodnu klasifikaciju psihičkih bolesti i bolesti ponašanja

Neurološke manifestacije hipereozinofilnog sindroma – pregled literature

Hypereosinophilic syndrome is a rare disorder of the hematopoietic system. The disease is characterized by continuously high number of eosinophils (>1.5x109/L) for more than six months. Other possible causes of hypereosinophilia, such as allergic and parasitic diseases, malignant disease, Churg-Strauss disease and infection should be eliminated. The most common manifestations of hypereosinophilic syndrome are pulmonary, skin, gastrointestinal, cardiac difficulties and neurologic lesions. Numerous neurologic lesions have been described, in particular of the central and peripheral nervous systems. Review of the literature revealed the following to have been recorded so far: mononeuritis multiplex, sensory polyneuropathy, radiculopathy, myalgia, myositis and perimyositis, neuropathy, ataxia, paraplegia, ophthalmologic abnormalities, optic neuritis, hemiplegia-hemiparesis, spasmodic quadriplegia, seizures, meningitis, cerebral infarction, organic psychosyndrome, other mental changes, stroke, temporal arteritis, leptomeningeal dissemination, memory deficits and dysarthria.Hipereozinofilni sindrom je rijetka bolest hematopoetskog sustava. Bolest je obilježena visokim brojem eozinofila (>1,5x109/L) duže od šest mjeseci, uz uvjet da su isključeni drugi mogući uzroci hipereozinofilije kao što su alergija i parazitne bolesti, maligne bolesti, Churg-Straussova bolest i druge infekcijske bolesti. Većina kliničkih manifestacija hipereozinofilnog sindroma obuhvaća oštećenja pluća, kože, probavnog sustava, srčane poremećaje i neurološka oštećenja. Opisana su brojna neurološka oštećenja središnjeg i perifernog živčanog sustava. Pretraživanjem literature nalaze se moguće neurološke manifestacije bolesti kao što su mononeuritis multiplex, senzorna polineuropatija, radikulopatija, mijalgija, miozitis i perimiozitis, neuropatija, ataksija, paraplegija, oftalmološki poremećaji, optički neuritis, hemiplegija-hemipareza, spastička tetraplegija, epileptični napadaji, meningitis, ishemijski moždani udar, psihoorganski sindrom i drugi mentalni poremećaji, temporalni arteritis, leptomeningealna diseminacija, poremećaji pamćenja i dizartrija

QUALITY OF LIFE AND HEALTH OF PATIENTS IN EARLY STAGES OF MULTIPLE SCLEROSIS

Background: Multiple sclerosis is a chronic neurologic condition with a variety of symptoms which have a great impact on quality of life even in the early stages. The aim of this study was to investigate, and to compare overall subjective quality of life with self-perceived health in patients with early stages of MS. Subjects and methods: Thirty patients with MS (22 women, 8 men; mean age 37.3±9.7years; relapsing-remitting MS; EDSS<2.5; all on immunomodulatory therapy: IFN, GA) were enrolled in the study. The QOL was assessed using the Personal well-being index (PWI) and health was measured by the Short Form 36-Item Health Survey (SF-36) questionnaire. Results: Results indicate that MS patients in early stage experience similar health and quality of life, comparing to the general adult population. Analysis of self-reported change in health by categories showed that 50% patients access their health about the same as a year before, 9 rate their health as worse as one year before and 5 rate their health even better. Correlation analysis revealed that SF-36 domain Mental health correlates with most PWI domains. Conclusion: This study demonstrates that MS patients in early stage experience similar quality of life as general adult population. Also, it was revealed that health domain Mental health is correlated with various quality of life domains, suggesting that mental health is of great significance for subjective quality of life perception. However, it is important to emphasize the distinction between the health and quality of life, due to the fact that one can perceive his/hers own health as impaired, but at the same time can have satisfactory quality of life