ON DIFFERENCES BETWEEN GILLES DE LA TOURETTE SYNDROME AND PSYCHOGENIC/FUNCTIONAL TICS: A NARRATIVE REVIEW

A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization. Motor and phonic tics in a course of over 1 year that first occured before 18 years are the main features of Gilles de la Tourette syndrome (GTS). Psychogenic/functional ( P/F) tics were considered as a diagnosis made per exlusionem in lack of agreement of diagnostic criteria. Recently, emphasis is in r ather highlighting positive signs when making diagnosis of P/F tics. Several features in clinical course are important to differentia te GTS from P/F tics. Some of them are acute onset in adulthood, precipitation by physical event, absent family history of tics, varia ble, complex and inconsistent phenomenology, suggestibiity, distractibility. Premonitory urge, feeling of excessive energy and being \u27wound up\u27 prior tic, is a usual feature of GTS unlike in P/F tics. If present, such premonitory urge have different qualitativ e and quantitative marks. Another possible diagnostics tool could be the beireitshaftspotential, an event-related electrical potentia l associated to initiation of movement which is divided in two phases, early (B1) and late (B2) phase. Early phase, whose occuren ce in some papers has been reported prior P/F tics, is absent prior performed tic in GTS. In everyday clinical practice differentiati ng GTS from P/F tics is often very challenging but taking proper medical history, paying more attention to positive signs and possibly using electroneurophysiology tests could contribute in making the right diagnosis

The effect of art therapy on the degree of depression and the outcomes of Parkinson’s disease treatment

According to various studies, depression occurs in a large percentage of patients diagnosed with Parkinson’s disease (PD). In some cases, it appears as the first symptom and significantly impairs the patient’s quality of life

Effects of various factors on sleep disorders and quality of life in Parkinson's disease

In Parkinson's disease (PD), sleep disorders (SD) occur as a result of the neurochemical changes in sleep centres, neurodegenerative changes in dopaminergic neurons, and other factors. The most common SD include excessive daytime sleepiness, insomnia, restless legs syndrome and nocturia. The aim of the study was to compare quality of sleep, as a factor that greatly impacts quality of life (QoL), between PD patients and a control group and to further examine SD in the PD group with focus on incidence and SD types as well as on effects various factors (age, sex, PD characteristics, medication usage) have on these disorders. The study included 110 patients who met the criteria for the diagnosis of PD and 110 age-matched healthy controls. We used the Pittsburgh Sleep Quality Index, PD Sleep Scale, Epworth Sleepiness Scale, PD QoL Questionnaire-8 and PD Questionnaire-39 (items 30 and 33). In the group with PD, we considered the duration of the disease, the stage of disease according to the Hoehn and Yahr scale, medications and their impact on the SD. The average duration of the disease was 6 years and the mean stage was 2.44. The result showed significant differences in the sleep quality between groups. In the PD group, SD differences were also found according to gender, duration of the disease and medication usage. The most common SD were fragmented sleep, insomnia and nocturia. To improve the QoL of PD patients, it is necessary to pay more attention to detecting and solving SD

Association between venous anomaly of the cerebellum and tremor

Tremor is an involuntary movement of a body part that often occurs due to damage to the extrapyramidal system. Action-intention tremor usually occurs in ipsilateral lesions of the cerebellum. Such lesions can be caused by changes in venous drainage created by venous anomalies

Symptomatic capillary telangiectasia of the pons and intracerebral developmental venous anomaly – a rare association [Simptomatska kapilarna teleangiektazija ponsa i intracerebralna razvojna venska anomalija: prikaz slučaja]

Various combinations of vascular malformations of the brain in one lesion have been reported, while others seem to be very rare. In this report, the authors discuss the case of a coexistence of an capillary telangiectasia of the pons and intracerebral venous anomaly. To our knowledge, this is the first report of coexistence of a capillary telangiectasia of the pons and intracerebral venous anomaly apparted from each other. These discrete vascular malformations of the brain raise attention on possible interrelations in the pathogenesis of these entities. We report a case of pontine capillary telangiectasia and intracerebral venous anomaly in a 42-year-old woman with a right side facial palsy. Hight field magnetic resonance imaging suggested presence of a capillary telangiectasia of the pons. Another lesion in the left frontal gyrus was attributable to the venous anomaly. Along with neuroradiological findings, results of the somatosensor evoked potentials, brain stem auditory potentials, laboratory analysis including blood, cerebrospinal fluid and urine investigation are demonstrated. Awareness of the magnetic resonance imaging finding of the capillary telangiectasias and of the venous anomalies may help in defining clinical correlates of this vascular malformations, while the follow up of these malformations might help to asses risk of vascular rupture. We and others previously selects capillary telangiectasia and venous anomaly in two discrete entities. Coexistence of these malformations in the brain apparted from each other appear to be very rare and raise attention on possible interactions in their natural history and pathogenesis

Symptomatic Capillary Telangiectasia of the Pons and Intracerebral Developmental Venous Anomaly – A Rare Association

Various combinations of vascular malformations of the brain in one lesion have been reported, while others seem to be very rare. In this report, the authors discuss the case of a coexistence of an capillary telangiectasia of the pons and intracerebral venous anomaly. To our knowledge, this is the first report of coexistence of a capillary telangiectasia of the pons and intracerebral venous anomaly apparted from each other. These discrete vascular malformations of the brain raise attention on possible interrelations in the pathogenesis of these entities. We report a case of pontine capillary telangiectasia and intracerebral venous anomaly in a 42-year-old woman with a right side facial palsy. Hight field magnetic resonance imaging suggested presence of a capillary telangiectasia of the pons. Another lesion in the left frontal gyrus was attributable to the venous anomaly. Along with neuroradiological findings, results of the somatosensor evoked potentials, brain stem auditory potentials, laboratory analysis including blood, cerebrospinal fluid and urine investigation are demonstrated. Awareness of the magnetic resonance imaging finding of the capillary telangiectasias and of the venous anomalies may help in defining clinical correlates of this vascular malformations, while the follow up of these malformations might help to asses risk of vascular rupture. We and others previously selects capillary telangiectasia and venous anomaly in two discrete entities. Coexistence of these malformations in the brain apparted from each other appear to be very rare and raise attention on possible interactions in their natural history and pathogenesis

Coexistence of Intradural Spinal Arteriovenous Malformation and Associated Developmental Anomalies – Report of Two Cases

Spinal arteriovenous malformations (AVM) have been devided into dural (Type I), intramedullary glomus (Type II), juvenile (Type III), and perimedullary direct arteriovenous fistulae (Type IV). AVMs are usually associated with subacute myelopathy in what has been known as Foix-Alajouanine syndrome.We presented two patients with two intradural spinal arteriovenous malformations associated in what we call Foix-Alajouanine syndrome. The both patient developed acute back pain and paresthesias, followed by paraplegia and incontinence. The clinical status of one patient has been improved after particle embolization for a 17 years when he deteriorated up to paraplegia after spinal angiography for follow up. Clinical status in another patient deteriorated, because particle emoblisation cannot be performed due to very descrete presentation of the feeding artery. Extensive neuroradiological examination in both patients revealed coexistence of numerous associated developmental anomalies in both patients.We conclude that arteriovenous malformations occasionally are associated with other vascular and nonvascular developmental anomalies elsewhere in the body. These findings rise attention about keep in mind the suspicion of mutual etiopathogenesis and congenital origin of these anomalies. Early timing of the diagnostic and therapeutic interventiosn are stressed to prevent or delay irreversible ishaemic myellopathy or haemorrhage. For the definitive diagnosis of spinal arteriovenous malformations and evaluation of its occlusion grade after the therapy spinal angiography is neede

Impact of war on central nervous system tumors incidence: a 15-year retrospective study in Istria County, Croatia

The aim of study was to analyze epidemiological features of central nervous system (CNS) tumors diagnosed in Istria County, Croatia, with a particular emphasis on incidence dynamics during the wartime (1991-1995). The data were extracted from the medical records of patients with CNS tumors admitted to the Department of Neurology of Pula General Hospital in the period from the 1st January 1986 to the 31st December 2000, N = 364. For calculation of rates, we used data from the 2001 Croatian consensus http://www.dzs.hr/Eng/Census/census2001.htm. Data are presented as counts and incidence rates (IRs) per 100,000 persons-years in the case of annual rates. Annual incidence rates are shown as "raw" incidence rates and smoothed 5-year rolling average rates. The examined patient-related variables were: sex, age, occupation, premorbidity and comorbidity, with a particular emphasis on psychosomatic disorders and negative habits. The analyzed tumor-related variables included clinical manifestation, localization, and applied diagnostic and therapeutic methods. Primary tumors were separated from the metastatic, and the latter were analysed with respect to their site of origin. The lowest incidence of CNS tumors (10 patients) was reported in 1990, and the highest (42 patients) in 1993. The incidence dynamics of CNS tumors showed a rapidly progressive increase over the 1991-1995 period, followed by the return to average values. The access to a better and more readily available diagnostics may only partially explain this phenomenon. Therefore, we analyzed other factors that may have contributed towards the rapid increase in the number of CNS tumors, such as its coincidence with the war or psychotrauma. The results confirm the observational clinical hypothesis of an extreme increase in the number of CNS tumors during the period under consideration