Iranian Journal of Neurology最新文献

{"title":"Evaluation of glucose-6-phosphate dehydrogenase serum level in patients with multiple sclerosis and neuromyelitis optica.","authors":"Niloofar Chitsaz,&nbsp;Leila Dehghani,&nbsp;Amir Safi,&nbsp;Nazgol Esmalian-Afyouni,&nbsp;Vahid Shaygannejad,&nbsp;Majid Rezvani,&nbsp;Karim Sohrabi,&nbsp;Kaykhosro Moridi,&nbsp;Milad Moayednia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Background:</b> Multiple sclerosis (MS) and neuromyelitis optica (NMO) are both demyelinating disorders and oxidative stress is suggested to have a role in their pathogenesis. Glucose-6-phosphate dehydrogenase (G6PD) produces nicotinamide adenine dinucleotide phosphate (NADPH) via the pentose phosphate pathway. NADPH is not only involved in the synthesis of fatty acids necessary for myelination, but also it is involved in the defense against oxidative stress. Prescribing supplementary vitamin D as a part of the MS treatment plan can increase G6PD gene expression. The aim of this study was to determine the serum level of G6PD in patients with MS and NMO and its relationship with vitamin D, since it is yet to be explored thoroughly. <b>Methods:</b> In this case-control study, subjects were divided into three experimental and control groups. The experimental groups comprised 50 patients with relapsing-remitting MS (RRMS) who had a history of vitamin D consumption, 50 newly-diagnosed MS patients, and 50 patients with NMO. Control group included 65 healthy individuals. Serum level of G6PD was measured and compared among these groups. <b>Results:</b> No significant difference was seen between the G6PD level in patients with MS and NMO, but it should be noted that this level was significantly lower than the healthy group. G6PD serum level was significantly higher in patients with MS who had previously consumed supplementary vitamin D compared to those who had not. <b>Conclusion:</b> G6PD deficiency is observed in patients with MS and NMO. Also, supplementary vitamin D may induce favorable results on the G6PD level.</p>","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37692957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Disability Grief”: A patient’s allegorical expression of her disability","authors":"A. Moghadasi","doi":"10.18502/ijnl.v18i4.2194","DOIUrl":"https://doi.org/10.18502/ijnl.v18i4.2194","url":null,"abstract":"Multiple sclerosis (MS) is an autoimmune disabling disease of the central nervous system, and can lead to a wide range of symptoms. Although the most common form of MS is relapsing-remitting, most of the patients also will develop disability in the future due to the natural course of the disease.1,2 The disease onset mostly occurs in 27 years of age.3 Therefore, considering the symptoms and complications of the disease, it can virtually affect the whole life of the patient. Unfortunately, there is not any accurate study of the opinions of patients with MS regarding their illness. However, in the daily work of treatment, one of the well-known cases of severe discomfort expressed by patients is the fear of future disability. This issue is aggravated when a person starts to lose abilities. When the patient experiences disability in walking and a decrease in his/her daily activities, thinking about the future becomes one of his/her major concerns. \u0000Most patients express these concerns in their visits. However, a patient who has other abilities such as poetry, writing a story, or painting, can more effectively portray concerns. \u0000The painting reported here is the allegorical view of a patient about her disability. \u0000The patient is a 37-year-old woman who has had MS for 15 years. Her illness started with the right eye optic neuritis. She has had six attacks during this period and, after 9 years, her disease entered the secondary progressive phase. Her symptom in this stage was the weakness of the right lower extremity, which was gradually deteriorating such as difficulty in walking. Now, she is unable to walk without help. This disability has affected all aspects of her life, and has greatly diminished her quality of life. She has been interested in drawing since childhood, and has drawn as a non-professional artist. One of her paintings reported here (Figure 1), according to the patient herself, reflects her perception and grief over her progressive disability. She believes that she should say goodbye to her ability and good days of the past. She painted herself as someone (when she could walk unrestrictedly) moving away along with a balloon","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44280725","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":"Ptosis following botulinum toxin injection in hemifacial spasm","authors":"M. Jamshidian-Tehrani, Hadi Z. Mehrjardi, Abolfazl Kasaee, S. Yadegari","doi":"10.18502/ijnl.v18i4.2192","DOIUrl":"https://doi.org/10.18502/ijnl.v18i4.2192","url":null,"abstract":"Hemifacial spasm (HFS) is characterized by irregular involuntary tonic or clonic contractions of muscles innervated by the seventh cranial nerve. Patients usually need long-term treatment, as spontaneous remission is infrequent. \u0000Repeated botulinum toxin injection has been shown as a safe and successful treatment for symptomatic relief in patients with HFS.1 Side effects are usually mild and transient. Ptosis has been reported in about 24% of patients with HFS probably due to diffusion of toxin to levator palpebrae superioris muscle.2 However, the frequency of ptosis in patients with HFS has not been addressed yet, due to causes other than botulinum toxin side effect. \u0000Herein, we present a case of HFS who presented to our clinic with complaint of complete ptosis and progressive pain early after botulinum toxin injection. Despite initial negative evaluations, further work up revealed a compressive lesion. \u0000A 75-year-old man presented with left severe ptosis since 3 weeks ago (Figure 1). He was known case of left HFS since 4 years ago, and botulinum toxin had been regularly injected for his symptom relief in orbicularis oculi, corrugator, and procerus muscles. \u0000  \u0000Figure 1. Left Blepharoptosis one week after botulinum toxin injection \u0000  \u0000The patient stated that this new ptosis had begun within a week after his last Dysport (Ipsen, Ltd., Slough, Berkshire, UK) injection while he had no ptosis in his previous injections. In past medical history, he had ischemic heart disease, hypertension, cataract extraction of both eyes, and glaucoma surgery on his right eye. He had been admitted to the neurology ward of a general hospital.","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46033696","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":"Posterior reversible encephalopathy syndrome with spinal cord involvement as the first presentation of lupus nephritis.","authors":"Ali Asghar Okhovat,&nbsp;Siamak Abdi,&nbsp;Farzad Fatehi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37693431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and side effects of dimethyl fumarate in multiple sclerosis after 12 months of follow up: An Iranian clinical trial","authors":"M. Foroughipour, S. Gazeran","doi":"10.18502/ijnl.v18i4.2186","DOIUrl":"https://doi.org/10.18502/ijnl.v18i4.2186","url":null,"abstract":"Background: Multiple sclerosis (MS) is a neurologic disorder with a considerable global burden. During the last decades, some pharmaceutical treatments have been approved for patients with MS. Dimethyl fumarate (DMF) is one of these drugs which has been reported to have early promising results in recent studies, but the efficacy of this drug in patients with MS is still being studied in different parts of the world. In the present study, we evaluated the effectiveness of DMF therapy on reducing relapses, lesions, and disability in Iranian patients with MS. Methods: The present single-arm before-after study was approved by the Ethics Committee of Mashhad University of Medical Sciences, Mashhad, Iran [Iranian Registry of Clinical Trial (IRCT) code: IRCT20190121042439N1]. Every patient who was diagnosed with relapsing MS was considered eligible to enroll in the present clinical trial. Before receiving DMF therapy, the baseline liver function tests and complete blood count were obtained from all individuals. Also, a baseline brain magnetic resonance imaging (MRI) was obtained and Expanded Disability Status Scale (EDSS) was documented from all patients. After receiving 240 mg DMF twice daily for 12 months, the laboratory and imaging measurements as well as EDSS were repeated. Furthermore, the total number of relapses within the study period was recorded. Satisfaction with DMF treatment was determined by answering a yes-no question. Results: A total number of 50 patients enrolled in the study and most of them were female (80%). There was a significant decrease in EDSS score and gadolinium (GD)-enhancing lesions after the study period (P < 0.001 for each). Moreover, the attacks significantly dropped after the study period (P < 0.001) and 86% of patients were satisfied with their treatment. Conclusion: The findings of this study showed that 240 mg DMF administered twice daily can effectively reduce disability and provide satisfaction within the first year of therapy in patients with MS.","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48246774","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":"Ptosis following botulinum toxin injection in hemifacial spasm.","authors":"Mansooreh Jamshidian-Tehrani,&nbsp;Hadi Z Mehrjardi,&nbsp;Abolfazl Kasaee,&nbsp;Samira Yadegari","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37693433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of glucose-6-phosphate dehydrogenase serum level in patients with multiple sclerosis and neuromyelitis optica","authors":"N. Chitsaz, L. Dehghani, Amir Safi, Nazgol Esmalian-Afyouni, V. Shaygannejad, M. Rezvani, K. Sohrabi, Kaykhosro Moridi, Milad Moayednia","doi":"10.18502/ijnl.v18i4.2185","DOIUrl":"https://doi.org/10.18502/ijnl.v18i4.2185","url":null,"abstract":"Background: Multiple sclerosis (MS) and neuromyelitis optica (NMO) are both demyelinating disorders and oxidative stress is suggested to have a role in their pathogenesis. Glucose-6-phosphate dehydrogenase (G6PD) produces nicotinamide adenine dinucleotide phosphate (NADPH) via the pentose phosphate pathway. NADPH is not only involved in the synthesis of fatty acids necessary for myelination, but also it is involved in the defense against oxidative stress. Prescribing supplementary vitamin D as a part of the MS treatment plan can increase G6PD gene expression. The aim of this study was to determine the serum level of G6PD in patients with MS and NMO and its relationship with vitamin D, since it is yet to be explored thoroughly. Methods: In this case-control study, subjects were divided into three experimental and control groups. The experimental groups comprised 50 patients with relapsing-remitting MS (RRMS) who had a history of vitamin D consumption, 50 newly-diagnosed MS patients, and 50 patients with NMO. Control group included 65 healthy individuals. Serum level of G6PD was measured and compared among these groups. Results: No significant difference was seen between the G6PD level in patients with MS and NMO, but it should be noted that this level was significantly lower than the healthy group. G6PD serum level was significantly higher in patients with MS who had previously consumed supplementary vitamin D compared to those who had not. Conclusion: G6PD deficiency is observed in patients with MS and NMO. Also, supplementary vitamin D may induce favorable results on the G6PD level.","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43896576","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":"Fitness to drive in seizure and epilepsy: A protocol for Iranian clinicians.","authors":"Nasim Tabrizi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Driving restriction is a well-known undesirable consequence of epilepsy and causes significant problems regarding independence and employment for epileptic patients. Many countries all over the world have provided comprehensive protocols in this regard with the aim of providing the possibility of less restricted, but safe driving for epileptic patients and also providing the opportunity for uniform decision-making for clinicians. However, the available fitness to drive protocol in Iran still lacks sufficient details and clinicians might encounter serious problems in terms of the driving issue in epileptic patients. In order to provide a uniform protocol containing adequate practical data, a systematic review of literature addressing guidelines about driving and epilepsy and driving laws of different countries for epileptic patients was performed and, after consideration of cultural issues, a practical protocol for Iranian neurologists was suggested.</p>","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37693429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bullous pemphigoid as an injection site reaction of glatiramer acetate.","authors":"Seyed Mohammad Baghbanian,&nbsp;Maryam Ghasemi,&nbsp;Somayeh Sheidaei,&nbsp;Zohreh Hajheydari","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37693434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Disability Grief\": A patient's allegorical expression of her disability.","authors":"Abdorreza Naser Moghadasi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45759,"journal":{"name":"Iranian Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37693435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}