Aktualnosci Neurologiczne最新文献

{"title":"Tumefactive multiple sclerosis – a diagnostic and therapeutic challenge","authors":"Weronika Galus, Katarzyna Zawiślak-Fornagiel, E. Krzystanek","doi":"10.15557/an.2022.0017","DOIUrl":"https://doi.org/10.15557/an.2022.0017","url":null,"abstract":"Tumefactive multiple sclerosis with the presence of tumefactive demyelinating lesions (TDL) is an infrequent manifestation of multiple sclerosis. It poses a diagnostic challenge, especially in attempts to differentiate it from a central nervous system neoplasm or other demyelinating disorders, such as neuromyelitis optica spectrum disorder (NMOSD). The article reports a case of a 40-year-old female during chronic steroid therapy administered due to an episode of idiopathic transverse myelitis. The patient developed tumour-like brain lesions in the left hemispheric parietal-occipital region. The diagnostic process was hindered by extended steroid treatment and a lack of patient compliance. This case is an example of insufficient knowledge about rare forms of multiple sclerosis and the need for a holistic approach involving a through analysis of medical history and previous medical records.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CCL3 and CCL5 as potential markers of carotid atherosclerotic plaque stability – preliminary research","authors":"Maria Konarska-Król, Piotr Szpakowski, P. Kaźmierski, A. Głąbiński","doi":"10.15557/an.2022.0015","DOIUrl":"https://doi.org/10.15557/an.2022.0015","url":null,"abstract":"Introduction: Carotid atherosclerosis is one of the main causes of ischaemic stroke. The study verified the hypothesis on the relationship between the expression of selected inflammatory markers and the stability of atherosclerotic plaque in stroke patients. Aim: The aim of the study was to determine CCL3 and CCL5 levels in both plasma and carotid atherosclerotic plaques in relation to the history of ischaemic stroke, as well as to assess plaque morphology and stability. Materials and methods: The levels of CCL3 and CCL5 chemokines were determined by ELISA for both plasma and supernatants of atherosclerotic plaque homogenates from patients undergoing endarterectomy due to at least 70% carotid artery stenosis. Results: Both chemokines were found in atherosclerotic plaques, with elevated CCL3 in unstable plaques. Furthermore, patients with atherosclerosis showed significantly higher plasma CCL5 compared to healthy individuals. Conclusions: The chemokines CCL3 and CCL5 are likely to be involved in the inflammatory processes contributing to the development of atherosclerotic plaque, but this needs to be confirmed in further studies.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49065044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polish adaptation of the Mini-Cog","authors":"A. Barczak, Elwira Urban-Oleńska","doi":"10.15557/an.2022.0013","DOIUrl":"https://doi.org/10.15557/an.2022.0013","url":null,"abstract":"Early diagnosis of cognitive disorders, including dementia, is critical in the context of both pharmacological and non-pharmacological interventions. The diagnostic process for neurodegenerative diseases is usually challenging, and the objectification of symptoms reported by patients and/or their families should always be its first element. Screening tools can be usually used for this purpose, but the most available scales are time-consuming and sometimes problematic in assessing and interpreting the obtained results. Moreover, doctors, who are the first link in the diagnostic process, most often in primary care facilities, usually lack experience in the use and interpretation of the results of common diagnostic tools. Above all, they do not have time for it. Therefore, a fast, effective screening tool that requires no experience seems an optimal solution. Furthermore, it will allow for objectifying the patients’ symptoms and, if necessary, refer them to an appropriate dementia specialist. The Mini-Cog, which takes a maximum of five minutes to complete, offers simple and rapid assessment, and whose algorithm allows to decide how to proceed with the patient, is such a tool. Unfortunately, the scale has not been translated and standardised in Polish conditions. The article discusses the Mini-Cog and describes the course of linguistic and cultural adaptation of this tool.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47834099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological complications of SARS-CoV-2 infection","authors":"A. Sawicka, A. Acewicz","doi":"10.15557/an.2022.0010","DOIUrl":"https://doi.org/10.15557/an.2022.0010","url":null,"abstract":"SARS-CoV-2 virus was first identified in 2019 in Wuhan (China) and is responsible for the ongoing COVID-19 pandemic. Although the virus causes mild, transient symptoms of an upper respiratory tract infection in most cases, it can also lead to severe pneumonia, respiratory failure and/or death. Approximately 85% of patients experience central and peripheral neurological symptoms. In the acute phase of the disease, ischaemic strokes, intracranial haemorrhages, meningitis and encephalitis, acute demyelinating diseases and acute inflammatory polyneuropathies may occur. However, mild neurological symptoms that can persist for months and significantly affect daily functioning are much more common. These include headache and dizziness, olfactory and gustatory dysfunction, mild cognitive disturbances, as well as depressive, anxiety, and sleep disorders. Some of them are encompassed by popular terms “post-covid syndrome” and “brain fog.” The pathogenesis of neurological complications of SARS-CoV-2 infection is still not fully understood; overproduction of cytokines induced by viral infection may be of great importance. There is no causal treatment, while symptomatic treatment is of limited effectiveness. Primary prevention in the form of SARS-CoV-2 vaccinations is of great importance. In the following review, we would like to present the current knowledge on epidemiology, pathology, pathogenesis and treatment of neurological complications after SARS-CoV-2 infection. Further multi-centre, large-scale clinical studies are necessary to identify the exact pathogenetic mechanisms.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do increased serum IL-12 and IL-23 levels affect cognitive function in patients with multiple sclerosis? A preliminary study","authors":"Anna Nowaczewska-Kuchta, Paulina Mizera, Piotr Szpakowski, I. Bednarski, J. Lesman, K. Jastrzębski","doi":"10.15557/an.2022.0008","DOIUrl":"https://doi.org/10.15557/an.2022.0008","url":null,"abstract":"Aim of the study: To compare the serum levels of IL-12 and IL-23 between healthy volunteers and patients with multiple sclerosis with regard to their cognitive function. Materials and methods: A total of 21 patients with multiple sclerosis and 21 healthy individuals were enrolled into the study. The individuals were age- and sex-matched. Each participant was evaluated using the Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI). The enzyme-linked immunosorbent assay was performed to assess the serum levels of IL-12 and IL-23. Results: The concentration of IL-12 was 1.61 ± 4.61 pg/mL in the group of patients with multiple sclerosis and 1.78 ± 3.54 pg/mL in the control group, p = 0.5009. The concentration of IL-23 was 19.04 ± 75.50 pg/mL in the study group and 5.50 ± 14.4 pg/mL in the control group, p = 0.5170. A significant difference was found between the control and study groups in the MoCA cognitive test (28 vs. 24 points, respectively, p < 0.0001). There was no significant difference in the Beck Depression Inventory and PSQI between the control and study groups. No significant correlations were found between the IL-12/IL-23 serum levels and psychological evaluations. Conclusions and clinical implications: The results obtained indicate that IL-12 and IL-23 may not play a role in the development of cognitive impairment. The assessment of cognitive impairment in patients with multiple sclerosis may have a screening value in preventing their cognitive deterioration.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48921218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flammer syndrome – characteristics and prevalence among multiple sclerosis patients","authors":"Katarzyna Pikora, J. Jamiołkowska, P. Janosz, Joanna Betlejewska, Jędrzej Warpechowski, K. Kapica-Topczewska, A. Czarnowska, Anna Supronik, J. Kochanowicz, A. Kułakowska","doi":"10.15557/an.2022.0012","DOIUrl":"https://doi.org/10.15557/an.2022.0012","url":null,"abstract":"Flammer syndrome, which has been described in literature only recently, combines two basic components: primary vascular dysregulation and symptoms not directly related to vascular function (prolonged sleep onset time, low pain threshold or specific personality traits). Some health-protective effects, such as a reduced risk atherosclerosis and metabolic syndrome, have also been noted. Flammer syndrome most often coexists with ocular diseases, normal tension glaucoma in particular, as well as with neurological disorders, such as multiple sclerosis. Diagnosis is based on a detailed physical examination; however, standardised diagnostic methods are missing. A three-component therapeutic strategy, including appropriate lifestyle, proper nutrition and pharmacotherapy in the form of magnesium preparations or low-dose calcium channel blockers, is used for Flammer syndrome. Clinical studies in 2016 and 2019 showed that multiple sclerosis patients are significantly more likely to develop typical symptoms of Flammer syndrome compared to controls. These included dizziness, low body weight, non-migraine headaches, reduced feeling of thirst, prolonged sleep onset time, and a tendency towards perfectionism. Although the aetiology of Flammer syndrome and multiple sclerosis or the causes underlying the clinical correlations between them have not been clarified so far, expanded research may contribute to better care for those at increased risk of developing multiple sclerosis, as well as improved therapy and support for patients, with consideration given to challenges that may arise from the coexistence of both diseases.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new look at the clinical and molecular characteristics of SCN1A-related developmental and epileptic encephalopathies","authors":"Elżbieta Stawicka, P. Górka-Skoczylas, D. Hoffman-Zacharska","doi":"10.15557/an.2022.0011","DOIUrl":"https://doi.org/10.15557/an.2022.0011","url":null,"abstract":"SCN1A-related diseases are a heterogeneous group of disorders with an expanding spectrum of phenotypes. Until recently, mutations in this gene were associated with epileptic syndromes and epileptic and developmental encephalopathy – Dravet syndrome, which was contrasted with a new group of early-onset syndromes, non-Dravet developmental and epileptic encephalopathies (DEEs; OMIM: PS308350). The aim of this paper is to review published data on the phenotypic variability of SCN1A-related developmental and epileptic encephalopathies, particularly non-Dravet syndromes. These are disorders with very early onset, polymorphic, drug-resistant epileptic seizures, impaired psychomotor development and intellectual disability, as well as the presence of additional symptoms such as arthrogryposis, osteopenia, and hyperkinetic movement disorders. Unlike Dravet syndrome, epileptic seizures begin in the first few months of life and may have an epileptic spasm or tonic morphology. The ability to quickly recognise the non-Dravet developmental and epileptic encephalopathy is of significant clinical value, because the identification of pathogenic SCN1A variants and their functional evaluation have an impact on both treatment and prognosis. Studies on the aetiology of non-Dravet developmental and epileptic encephalopathies have shown that pathogenic variants of the gain of function (GOF) type are identified in these patients. Therefore, it is possible to treat such patients with medicaments from the group of sodium channel blockers, which were contraindicated in cases of loss of function (LOF) variants, occurring in Dravet syndrome.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conduction block and positive sharp waves/fibrillation potentials in entrapment neuropathies of the ulnar, radial, and peroneal nerves","authors":"Şencan Buturak, H. Fi̇danci, İlker Öztürk, Z. Arlıer","doi":"10.15557/an.2022.0007","DOIUrl":"https://doi.org/10.15557/an.2022.0007","url":null,"abstract":"Introduction: Entrapment mononeuropathies can cause motor conduction block, positive sharp waves, and fibrillation potentials. Aim: The study aims to find whether there is a relationship between positive sharp waves/fibrillation potentials and conduction block observed in entrapment mononeuropathies. Materials and methods: Patients with ulnar neuropathy at the elbow, radial neuropathy at the spiral groove, and peroneal neuropathy at the fibular head were included in this retrospective study. Nerve conduction study and needle electromyography results of the patients were analysed. Results: The study included a total of patients with 67 ulnar neuropathy, 8 radial neuropathy, and 27 peroneal neuropathy. All radial and peroneal neuropathy patients and 30 ulnar neuropathy patients had positive sharp waves/fibrillation potentials in at least one muscle. Twenty-three ulnar neuropathy patients with these potentials, 6 radial neuropathy patients, and 18 peroneal neuropathy patients had conduction block (p < 0.001). The reduction of compound muscle action potential amplitude in percentage recorded from the abductor digiti quinti/first dorsal interosseous across the elbow segment in ulnar neuropathy patients with and without positive sharp waves/fibrillation potentials was 41.9 ± 35.9/46.6 ± 36.1% and 7.6 ± 16.5/10.4 ± 16.5%, respectively (p < 0.001/p < 0.001). The distal compound muscle action potential amplitudes of ulnar neuropathy patients with these potentials were lower than those of ulnar neuropathy patients without these potentials (p = 0.029 – abductor digiti quinti, p = 0.017 – first dorsal interosseous). No correlation was found between the severity of positive sharp waves/fibrillation potentials and muscle strength in patients with these potentials (p > 0.05). Conclusions: Positive sharp waves/fibrillation potentials and motor conduction block can be seen together in patients with entrapment mononeuropathies. We concluded that there may be no relationship between the severity of these potentials and muscle strength.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47980765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manual therapy improves symptom severity and disability in patients with carpal tunnel syndrome","authors":"Przemysław Tadeusz Wielemborek, Katarzyna Kapica-Topczewska, R. Pogorzelski, Agata Bartoszuk, Rafał Kułakowski, Dagmara Mirowska-Guzel, J. Kochanowicz, A. Kułakowska","doi":"10.15557/an.2022.0009","DOIUrl":"https://doi.org/10.15557/an.2022.0009","url":null,"abstract":"Aim: The aim of the study was to assess early outcomes of manual therapy in patients with carpal tunnel syndrome. Materials and methods: In this study, patients diagnosed with electrophysiologically confirmed carpal tunnel syndrome received manual therapy. The therapy was used in 41 individuals who received one session in line with IFOMPT (International Federation of Orthopaedic Manipulative Physical Therapists) standards per week for 5 weeks. Grip strength was assessed using a dynamometer, disability was assessed using the DASH (Disability of Arm, Shoulder and Hand) questionnaire, and the quality of life was assessed using VASEQ5D5L (Visual Analog Scale of the 5-level EQ-5D). Data was collected before the first treatment and one week after the last treatment. Results: We observed significant change in DASH score and quality of life. Grip strength tended to improve, but the effect was statistically significant only in patients over 50 years of age. Symptom severity (Carpal Tunnel 6 score, Douleur Neuropathique 4 score and peripheral cutaneous threshold assessed with Semmes–Weinstein monofilament) improved significantly. There was no significant correlation between changes in DASH score and grip strength. Conclusion: Manual therapy significantly improves quality of life and reduces upper limb disability in patients with carpal tunnel syndrome.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48666894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological complications of varicella-zoster virus infection in children","authors":"J. Frąszczak, A. Mania, P. Kemnitz, Katarzyna Mazur-Melewska, M. Figlerowicz","doi":"10.15557/an.2021.0028","DOIUrl":"https://doi.org/10.15557/an.2021.0028","url":null,"abstract":"Varicella-zoster virus is an exclusively human α-herpesvirus, known as the aetiological factor of chickenpox which is usually linked with childhood. The disease occurs with a worldwide geographic distribution, and in temperate climates shows a seasonal pattern with epidemics occurring mostly during late winter and spring. The annual incidence is estimated at 80–90 million cases worldwide. Children usually acquire varicella during the first five to 10 years of life, and the highest risk of infection is related to household contacts without a history of vaccination. Although the disease is commonly considered benign, varicella-zoster virus bears the potential of causing a wide range of complications, including the most serious ones of central nervous system manifestations. The neuropathogenesis of varicella-zoster virus infections is not well understood. Based on a wide spectrum of clinical syndromes, multiple theories explaining the pathways of spread of the virus, and host immune response to the viral presence have been proposed, including direct retrograde trafficking of the virus and haematogenous spread as well as inflammatory response with vasculitis. Neurological complications related to varicella-zoster virus infection are the second most common indication for hospitalisation in immunocompetent children with varicella, following skin superinfections. In this paper, the neurological aspects of chickenpox in children are discussed. The characteristics of the clinical syndromes, pathogenesis, methods of diagnosis and treatment, as well as long-term consequences are presented.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}