Headache as a sign of cerebral vein thrombosis

Zakrzepica żylna wewnątrzczaszkowa stanowi około 0,5% przypadków udaru mózgu. Jest to ważny problem kliniczny, nadal zbyt rzadko rozpoznawany. Przyczyny tego stanu patologicznego są różnorodne, obserwuje się także różnice w przebiegu schorzenia i rokowaniu. W niniejszym artykule zaprezentowano przypadek pacjentki, u której wykryto wewnątrzczaszkową zakrzepicę żylną i po leczeniu uzyskano regresję zmian zakrzepowych. W pracy przedstawiono podstawowe informacje dotyczące etiologii, objawów klinicznych i leczenia zakrzepicy. Dobre rokowanie w większości przypadków, przy odpowiednio przeprowadzonej diagnostyce i leczeniu, powinno umożliwiać coraz lepsze poznawanie tej patologii.Cerebral vein thrombosis accounts for an estimated 0.5% of all strokes. It remains a major clinical concern that is still too rarely diagnosed. The causes of CVT vary, with differences occurring in the history and prognosis of the condition. This article discusses the case of a female patient diagnosed with cerebral vein thrombosis, in which regression of thrombotic lesions was achieved during treatment. We will provide basic facts on the aetiology, clinical symptoms and treatment of thrombosis. In the majority of cases, good prognosis should — given the adequate diagnosis and treatment — allow us to improve our understanding of CVT

Zespół demielinizacji osmotycznej

Centralna mielinoliza mostu jest niezapalną, demielinizacyjną chorobą ośrodkowego układu nerwowego. To najczęstsza manifestacja zespołu demielinizacji osmotycznej, będącego zazwyczaj jatrogennym powikłaniem zbyt szybko wyrównywanej, ciężkiej, zagrażającej życiu hiponatremii. Wiąże się z wystąpieniem poważnych objawów neurologicznych, często prowadzących do niesprawności lub zgonu. Poniżej przedstawiono przypadek chorej z hiponatremią, nadużywającej alkoholu, u której na podstawie objawów klinicznych i wyniku badania rezonansu magnetycznego rozpoznano zespół demielinizacji osmotycznej z centralną mielinolizą mostu. Omówiono także etiopatogenezę oraz obraz kliniczny centralnej mielinolizy mostu

Sense of happiness in Polish patients with multiple sclerosis

Introduction. Happiness is crucial to patient well-being and their acceptance of their disease. The aim of this study was to assess the sense of happiness in persons with multiple sclerosis (PwMS), compare it to the level of happiness in patients with other neurological conditions, and determine which factors affect the sense of happiness in PwMS. Material and methods. Five hundred and eighty-nine PwMS and 145 control subjects (post-stroke patients with chronic pain syndromes and neuropathies) were included in the study. Due to the differences between the groups in terms of demographic variables, an adjusted group of PwMS (n = 145) was selected from the entire group of PwMS. All patients were assessed using the Oxford Happiness Questionnaire (OHQ), the Satisfaction with Life Scale (SLS), and the Family APGAR Questionnaire. Based on regression analysis, the study examined which variables affected the level of happiness in the groups. Results. Analysis of the OHQ scores showed that PwMS had a lower sense of happiness compared to the control group in the overall score [113.21 (25–42) vs. 119.88 (25–49), respectively; p = 0.031] and the subscales (OHQ subscale 1 — 54.52 vs. 57.84, respectively; p = 0.027; subscale 2 — 35.61 vs. 37.67; respectively; p = 0.044). Based on linear regression analysis, life satisfaction (β = 0.40; p < 0.001), positive orientation (β = 0.32; p < 0.001), and primary education (β = 0.08; p = 0.009) were the most significant predictors of a higher level of happiness in PwMS. Similar results were found in the control group. Conclusions. The sense of happiness in PwMS was lower than in patients with other conditions. The most important factors influencing happiness included life satisfaction and positive orientation. Influencing these predictors should be the aim of psychological interventions, especially in patients with a reduced sense of happiness

Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience

Introduction. The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited.Materials and methods. This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health.Results. There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used.Conclusions and clinical implications. Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs

Dysfunkcja kory czołowo-oczodołowej a ryzyko wystąpienia zaburzeń antyspołecznych

Cel. Celem pracy jest ustalenie zależności pomiędzy dysfunkcją kory czołowo-oczodołowej (OFC) a występowaniem zaburzeń antyspołecznych na podstawie o przeglądu aktualnej literatury. Metoda. Materiały odnoszące się do roli dysfunkcji w obrę- bie OFC w determinowaniu zaburzeń zachowania, w tym o charakterze antyspołecznym (dyssocjalnym), zostały zgromadzone metodą systematycznej kwerendy takich źródeł, jak MEDLINE, Google Scholar, czasopisma i biblioteki akademickie. Wyniki. Rezultaty wielu badań potwierdzają występowanie zaburzeń antyspołecznych u osób z uszkodzeniem płatów czołowych mózgu, szczególnie obejmującym struktury OFC. Przemawia to za występowaniem wyraźnej zależności pomię- dzy uszkodzeniem w obrębie OFC a zwiększonym ryzykiem zachowań agresywnych i antyspołecznych. Wniosek: Dane uzyskane w wyniku badań neuropsychologicznych i neuroobrazowania przeprowadzanych w obrębie różnych subdyscyplin neuronauki dostarczają dowodów potwierdzających ważną rolę dysfunkcji OFC jako predyktora zaburzeń antyspołecznych.Objective: This article is aimed to establish the relation between orbitofrontal cortex (OFC) dysfunction and antisocial behavior, based on a review of relevant literature. Method: Materials presenting the role of OFC dysfunction in human behavioral disorders, including antisocial behavior, were collected through systematic survey of various sources, including MEDLINE, Google Scholar, academic libraries. Results: Many studies showed prevalence of violent and antisocial behaviors in persons with frontal lobes damage, especially involving the OFC structures. The results support the assumption about association between focal orbitofrontal damage and increased risk of violent and aggressive behavior. Conclusion: Neuropsychological and neuroimaging data from various filds within neuroscience provide evidence about importance of the OFC dysfunction as a predictor of violent and antisocial behavior

Model of the Relationship of Religiosity and Happiness of Multiple Sclerosis Patients from Poland: The Role of Mediating and Moderating Variables

Religiosity and spirituality can be both beneficial and harmful to happiness. It depends on its operationalization and the measures of religiosity and sociodemographics used, together with cultural and psychosocial factors, still not comprehensively explored. This topic is especially important for religious-affiliated chronic patients such as those diagnosed with multiple sclerosis. Religion can deliver a sense of meaning, direction, and purpose in life and be an additional source of support to cope with the stress and limitations connected with the disease. The aim of the present study was to verify whether religiosity, directly and indirectly, through finding meaning in life, is related to one’s level of happiness and whether gender, the drinking of alcohol, financial status, and age are moderators in this relationship. In sum, 600 patients from Poland who suffered from multiple sclerosis were included in the study. Firstly, some gender differences were noticed. In women, religiosity was both directly and indirectly, through finding significance, positively related to happiness. Secondly, it was found that in women, the direct effect of age on happiness was generally negative but was positively affected by religiosity; however, among men, age was not correlated with happiness. In the group of women, religiosity and a lower propensity to drink alcohol in an interactive way explained happiness. Thirdly, both in men and women, financial status positively correlated with happiness, but in the group of wealthy men only, religiosity was negatively related to happiness. In conclusion, religion was found to show a positive correlation with the happiness of Roman Catholic multiple sclerosis patients from Poland. In this group of patients, religious involvement can be suggested and implemented as a factor positively related to happiness, with the one exception regarding wealthy men

Model of the Relationship of Religiosity and Happiness of Multiple Sclerosis Patients from Poland: The Role of Mediating and Moderating Variables

Religiosity and spirituality can be both beneficial and harmful to happiness. It depends on its operationalization and the measures of religiosity and sociodemographics used, together with cultural and psychosocial factors, still not comprehensively explored. This topic is especially important for religious-affiliated chronic patients such as those diagnosed with multiple sclerosis. Religion can deliver a sense of meaning, direction, and purpose in life and be an additional source of support to cope with the stress and limitations connected with the disease. The aim of the present study was to verify whether religiosity, directly and indirectly, through finding meaning in life, is related to one’s level of happiness and whether gender, the drinking of alcohol, financial status, and age are moderators in this relationship. In sum, 600 patients from Poland who suffered from multiple sclerosis were included in the study. Firstly, some gender differences were noticed. In women, religiosity was both directly and indirectly, through finding significance, positively related to happiness. Secondly, it was found that in women, the direct effect of age on happiness was generally negative but was positively affected by religiosity; however, among men, age was not correlated with happiness. In the group of women, religiosity and a lower propensity to drink alcohol in an interactive way explained happiness. Thirdly, both in men and women, financial status positively correlated with happiness, but in the group of wealthy men only, religiosity was negatively related to happiness. In conclusion, religion was found to show a positive correlation with the happiness of Roman Catholic multiple sclerosis patients from Poland. In this group of patients, religious involvement can be suggested and implemented as a factor positively related to happiness, with the one exception regarding wealthy men

Symptoms after COVID-19 infection in individuals with multiple sclerosis in Poland

(1) Background: To report and analyze the presence of residual symptoms after SARS-CoV-2 infection among Polish patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). (2) Methods: The study included 426 individuals with MS treated with DMTs and confirmed SARS-CoV-2 infection from 12 Polish MS centers. The data were collected through to 31 May 2021. The information included demographics, specific MS characteristics, course of SARS-CoV-2 infection, and residual (general and neurological) symptoms lasting more than four and 12 weeks after the initial infection. The results were obtained using maximum likelihood estimates for odds ratio and logistic regression. (3) Results: A total of 44.84% patients with MS reported symptoms lasting between four and 12 weeks after the initial infection; 24.41% people had symptoms that resolved up to 12 weeks, and 20.42% patients had symptoms that lasted over 12 weeks. The most common symptoms were: fatigue, disturbance of concentration, attention, and memory, cognitive complaints, and headache. None of the DMTs were predisposed to the development of residual symptoms after the initial infection. A total of 11.97% of patients had relapse three months prior or after SARS-CoV-2 infection. (4) Conclusion: Almost half of individuals with MS treated with different DMTs had residual symptoms after SARS-CoV-2 infection. None of the DMTs raised the probability of developing post-acute COVID symptoms