Trigeminal Neuralgia Associated with Vagus Nerve Stimulation: A Case Presentation and Literature Review

Vagus nerve stimulation (VNS) is an effective therapeutic option that is widely used worldwide in drug-resistant epilepsy cases. Because it is a surgical procedure, some complications may develop with VNS implantation. Although VNS-related pain symptoms have been reported, VNS-related trigeminal neuralgia is an unexpected and rather rare side effect. This report presents a case of trigeminal pain as an adverse effect of VNS. A patient with drug-resistant epilepsy undergoing VNS treatment developed pain synchronously with stimulation in his left upper and lower jaw and teeth. Pain occurred on the day of stimulation’s current intensity (SCI) increase. The sudden disappearance of pain with decreasing SCI suggested that trigeminal pain was related to VNS. Because it is a rare side effect, trigeminal pain may not be regarded as a VNS-related side effect and may lead to unnecessary examinations. Being a rapidly reversible side effect, recognizing it and reducing SCI is crucial. VNS stimulation paradigms on nociception are still largely unknown, and it will be an important step to elucidate the important impact of VNS in pain modulation

Natalizumab, Fingolimod and Dimethyl Fumarate Use and Pregnancy-Related Relapse and Disability in Women With Multiple Sclerosis

To investigate pregnancy-related disease activity in a contemporary multiple sclerosis (MS) cohort

Transforme büyüme faktörü içeren farklı farmasötik dozaj formlarının hazırlanması ve etkinliklerinin hücre kültürü temelli olarak araştırılması

maç: Tez kapsamında; TGF-1 proteini kullanılarak farklı farmasötik formlar hazırlanması, etkinliklerinin ve protein 10,”stabilitesine katkısının yara iyileşme mekanizmasında rol alan hücrelerde gösterilmesi amaçlanmıştır.Gereç ve yöntem: TGF-β1 proteini için 3 farklı taşıyıcı sistem geliştirilmiştir. Bu formülasyonlar PLGA nanopartiküller, PVA/Kitozan hidrojeller ve PVA/PAMAM hidrojellerdir. PLGA nanopartiküller ikili emilsiyon çözücü buharlaştırma yöntemi ile elde edilmiştir. PVA/Kitozan ve PVA/PAMAM hidrojeller ise fiziksel jelleşme metodu olan dondur-çöz yöntemi ile hazırlanmıştır. Bulgular ve sonuçlar: Hazırlanan polimerik ilaç taşıyıcı sistemlerin karakterizasyon çalışmaları yapılmıştır. Daha sonra NIH-3T3 ve HaCaT hücre hatlarında test edilmiş ve özellikle serbest protein ile kıyaslandığında protein stabilitesinin yanısıra, hücrelerin canlılığını ve proliferasyonunu artırdığı bulunmuştur. Optimize edilen formülasyonlar ile migrasyon çalışması yapılmış ve artırdığı gözlemlenmiştir. Geliştirilen formülasyonlar arasında kombinasyon sistemler oluşturularak karakterizasyon analizleri yapılmış ve elde edilen sonuçların kıyaslaması hücre temelli olarak araştırılmıştır.--------------------Objective: Within the scope of the thesis; It is aimed to prepare different pharmaceutical forms using TGF-β1 protein and to demonstrate their efficacy and contribution to protein stability in cells involved in wound healing mechanism.Materials and Method: Three different delivery systems have been developed for TGF-β1 protein. These formulations are PLGA nanoparticles, PVA/Kitozan hydrogels and PVA/PAMAM hydrogels. PLGA nanoparticles were obtained by double emulsion solvent evaporation method. PVA/Kitozan and PVA/PAMAM hydrogels are prepared by the freeze-thaw method, which is the physical gelling method.Results and Conclusion: Characterization studies of prepared polymeric drug delivery systems have been carried out. It was then tested on NIH-3T3 and HaCaT cell lines and was found to increase cell viability and proliferation, as well as protein stability, especially when compared to free protein. Migration has been done with optimized formulations and it has been observed to increase. Characterization analyses were carried out by creating combination systems among the formulations developed and the comparison of the obtained results was investigated based on cells

Cortical excitability in patients with focal epilepsy: Letter to the Editor

Dear editor, we read with interest the article by Gilio et al.. Previous transcranial magnetic stimulation studies in focal epileptic patients brought to controversial results

Exploring self-efficacy beliefs of children experiencing social, emotional and behavioural difficulties : some insights from mainstream and special provision

Exploring children's self-efficacy beliefs is important as these beliefs tend to affect pupils' levels of cognitive, social and emotional engagement at school. This qualitative research study focuses on the self-efficacy beliefs and sources of self-efficacy for primary-aged children identified as experiencing social, emotional and behavioural difficulties (SEBO). A key aim of this study is to better understand the factors which might be having an impact on children's self-efficacy beliefs. Areas explored included self-efficacy beliefs in learning and behaviour management, and sources of self-efficacy beliefs, in particular perceived support from teachers. Semi-structured interviews were conducted with 14 boys (seven from mainstream school and seven from special provision) from Years 5 and 6. Pupils' teachers were also interviewed and school and pupil documentary evidence was collected to support the analysis. Each interview was transcribed and analysed using thematic analysis. The self-efficacy theoretical framework was also used for the analysis and interpretation of the data. Three main themes emerged from the analysis: perceptions of schooling, perceptions of learning and perceptions of behaviour management. Children reported various levels of self-efficacy depending on the self-efficacy domain under investigation. Where self-efficacy sources were concerned it was apparent that pupils were not always aware of their past accomplishments with regards to learning and behaviour management, implying they had -insufficient information to know how to improve. An interesting finding related to the availability of self-efficacy sources in the respective provisions. Whilst children in the special provision would seem to be advantaged by the greater availability of the self-efficacy sources, in particular teacher support, their reported levels of self-efficacy did not appear to be very different to the levels of their mainstream peers. This research highlights the need to support pupils in developing their selfefficacy beliefs. The implications of the study's findings are considered in relation to future practice of educational psychologists and school-based professionals.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Analyzing the Effect of Comorbidities and Drug Usage in Clopidogrel Unresponsive Patients

INTRODUCTION: OBJECTIVE: Clopidogrel is a widely used antiplatelet in vascular events. However multiple drug prescriptions increase the risk for drug-drug interactions. The purpose of the study is to rule out the factors leading to clopidogrel responsiveness including the comorbidities and drugs. METHODS: In this retrospective study, ischemic stroke patients who were being treated with clopidogrel for at least one year were eligible for enrollment.Clopidogrel resistance was measured with MEA. The comorbities and the medical treatment of the patients were noted. RESULTS: 92 patients were included the study. 49 % of them were male and the median age was 69,19±12,08. 44.6 % of the patients were unresponsive to clopidogrel. Hypertension, hyperlipidemia and diabetes mellitus were not associated with a decreased response to clopidogrel. Similarly, we did not observe any drug-drug interactions between clopidogrel and oral antidiabetics, insulin, antihypertensives, antilipidemics and proton pump inhibitors. Age and gender were also not associated with clopidogrel responsiveness. DISCUSSION AND CONCLUSION: CONCLUSION: Our study indicates that 45% of patients had a decrease response to clopidogrel. However we found no relation between clopidogrel resistance and the factors mentioned in previous studies. This could be attributed to other unknown factors leading to drug resistance

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

Quality of Life of Patients Under Anticoagulant Therapy Compared to Patients Treated with Antiplatelet Therapy

Introduction: Health-related quality of life (HRQoL) includes the physical, functional, social, and emotional well-being of an individual. The most important and frequently used generic HRQoL assessment is Short Form- 36 (SF-36). The objective of this study was to analyze the HRQoL of patients under chronic use of oral anticoagulants in a specialized stroke unit

An internal cerebral artery dissection presented with anterior choroidal artery infarction

Anterior choroidal artery (AchA) is a branch of internal carotid artery. AchA infarcts are frequently presented by lacunar syndromes. Hemiparesis is the most common presenting symptom. Horner syndrome and cranial nerve palsies are unusual findings for AChA infarcts. In case of presentation with these, etiopathogenesis should be reconsidered and reevaluated. A 42 year old man was admitted to our neurology clinic with right hemiparesis. He had Horner syndrom and hypoglossal nerve palsy. An acute AChA infarction was seen in cranial and diffusion-weighted magnetic resonance imaging (MRI). As there was a suspicious sign of carotid dissection in extracranial MR angiography, digital substraction angiography was performed and dissection of left carotid artery in the subpetrosal region was observed. The patient was diagnosed with left carotid artery dissection and was started on oral anticoagulan therapy. Presentation of an acute AChA infarction due to the dissection of ICA is rarely observed. ICA dissections can sometimes be presented by Horner syndrome and/or cranial nerve palsies. Especially in young stroke patients, dissection should be considered even if the patient does not mention headache