Early detection of mononeuritis multiplex & diagnosis of systemic diseases thru electrophysiological work out with polyneuropathy as preceeding symptom

22nd World Congress of Neurology (WCN) -- OCT 31-NOV 05, 2015 -- Santiago, CHILEWOS: 000384634802062Background: Mononeuritis multiplex (MNM) is a nervous system disorder that involves damage to at least two separate peripheral nerves. It is a syndrome not a disease, caused by certain systemic diseases like diabetes, vasculitis, rheumatic, infectious or paraneoplastic diseases. Objective: To evaluate the role of electrophysiological work out on patients presenting with polyneuropathy as preceding symptom that leads to early diagnosis of MNM and an underlying systemic disease. Patients: We retrospectively analyzed 12 MNM patients (4 females and 8 males from 19 to 62 years of age) presenting with patchily distributed weakness in all and pain at onset in nine, at our neuromuscular diseases clinic between 1993-2013. We have obtained Institutional Review Board (IRB) approval, as necessary. Methods: Neurophysiological evaluation, routine blood chemistry, vasculitis markers, serum and protein electrophoresis, HIV, Hepatitis markers were examined in all patients. Nerve and muscle biopsies were performed in 5 patients. Results: Neurophysiological evaluation revealed an asymmetrically distributed motor and sensory nerve involvement accompanied by neurogenic findings in all. Nerve and muscle biopsies were performed in five. The differential diagnostic work up of this patient group resulted in diagnosis of 2 Churg- Strauss syndrome, 2 rheumatoid arthritis, 2 non-necrotizing vasculitis, 2 PAN and 1 multiple myeloma, 1 CNS vasculitis related to p-ANCA, 1 Hepatitis C and 1 HIV. Conclusion: Detailed investigation of patients with polyneuropathy as preceding symptom thru electrophysiological work out can be a valuable tool that leads to early detection and treatment of MNM and the underlying systemic disease

Physical activity level of ambulatory stroke patients: Is it related to neuropsychological factors?

WOS: 000404296300011PubMed ID: 28680314Introduction: Physical inactivity is an important risk factor for stroke and stroke recurrence. There is insufficient knowledge about the physical activity (PA) level in stroke patients who are ambulatory in the subacute phase. Our aim was to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate neuropsychological factors that could affect the PA level in the same stroke group. Methods: Eighty-five subacute stroke patients and 58 healthy subjects were included. Patients' demographic features, disease-related features, and comorbidities were recorded. The PA level was assessed by the International Physical Activity Questionnaire-Short Version and a pedometer (OMRON Walking style II). The Apathy Rating Scale was applied to determine the apathy level. Depression level was investigated by the Geriatric Depression Scale. The standardized Mini-mental State Examination was performed to assess the cognitive status. Results: The PA level was significantly higher in the healthy group than in the stroke group (p 0.05). Conclusion: Subacute stroke patients have a lower PA level than healthy subjects. This is not related to neuropsychological factors. The reasons for minor deficits related to ambulation should be researched further while developing strategies for increasing the PA level of subacute stroke patients