Neurological Sciences and Neurophysiology最新文献

{"title":"Significance of pure sensory manifestations in estimating electromyography results in cervical radiculopathy","authors":"M. Ercan, H. Kuruoğlu","doi":"10.4103/nsn.nsn_10_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_10_22","url":null,"abstract":"Background: The sensitivity of electromyography (EMG) in cervical radiculopathy (CR) is reportedly higher in patients with objective neurological findings, but many patients are sent to the EMG laboratory with only pain and paresthesias. Aims: We aimed to assess the diagnostic contribution of EMG in patients with sensory manifestations without objective neurological deficits. Settings and Design: The files of patients with neck pain radiating to the shoulder and arm on the same side referred to the EMG Laboratory were retrospectively evaluated. EMG findings of those with pure sensory manifestations were compared with the results obtained from patients with objective neurological deficits. Subjects and Methods: Patients with subjective sensory manifestations were separated into two groups according to the specificity of the presenting symptoms, who were compared with subjects with neurological findings in the upper extremity. Clinical diagnoses of the patients were compared with the electrodiagnostic testing results. Statistical Analysis: Categorical variables were analyzed with multi-span Chi-square test, while individual groups were compared utilizing Fisher's exact test. One-way analysis of variance was employed to assess the significance of group differences for quantitative values. Results: EMG rarely confirmed CR in patients with purely sensory symptoms. Some of these patients were found to have unexpected peripheral neuropathy syndromes. Both paraspinal and limb muscle EMG abnormalities indicative of CR were not only more common, but also helpful in localization in patients with objective clinical findings. Conclusions: CR patients presenting only with pain and paresthesias even in a specific dermatomal distribution usually demonstrate no abnormalities in EMG examination. However, some of these patients harbor unsuspected entrapment neuropathies.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"132 - 137"},"PeriodicalIF":0.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49349302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axonal excitability findings in acute inflammatory demyelinating polyneuropathy related to SARS-CoV-2","authors":"A. Alaamel, R. Sahin, Merve Hashan, T. Taşkınoğlu, T. Özel, N. Erdem, H. Uysal","doi":"10.4103/nsn.nsn_111_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_111_21","url":null,"abstract":"Guillain–Barré syndrome (GBS) is a disorder of the peripheral nervous system characterized by acute-onset ascendance paresis. We present a patient who was diagnosed as having facial-onset acute inflammatory demyelinating polyneuropathy after being infected with SARS-CoV-2. A 51-year-old man presented to the emergency department with facial diplegia. He then developed bilateral ascendance paralysis. He had noticed that for 1 month, he had smell and taste disturbances. SARS-CoV-2 infection was suspected. Nasopharyngeal swab polymerase chain reaction test was negative, but anti-SARS-CoV-2 antibody was found to be positive. A nerve conduction study showed prolonged motor distal and F wave latencies with decreased motor and sensory compound muscle action potential amplitudes. Lumbar puncture revealed albuminocytologic dissociation. According to the neurologic examination and laboratory findings, the patient was diagnosed as having acute inflammatory demyelinating polyneuropathy. An axonal excitability study revealed fanning in pattern with prolonged refractoriness, which indicates nodal sodium channel disturbances. Facial-onset SARS-CoV-2–related GBS has been rarely reported; however, facial involvement seems to be one of the features of the neurologic findings.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"158 - 160"},"PeriodicalIF":0.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42694815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rituximab-induced leukocytoclastic vasculitis","authors":"D. Tezer, I. Dogan, C. Arican, S. Demir, M. Tutuncu","doi":"10.4103/nsn.nsn_153_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_153_21","url":null,"abstract":"","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"161 - 163"},"PeriodicalIF":0.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44883365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria","authors":"B. Ormeci, Handan Uyanik, N. Taşdelen, E. Keles, T. Erdoğru, A. Öge","doi":"10.4103/nsn.nsn_239_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_239_21","url":null,"abstract":"Aim: Pudendal neuropathy (PN) is a common cause of chronic perineal pain and usually diagnosed long after the onset of symptoms. Diagnostic work-up of PN mainly includes radiologic and neurophysiological studies. However, there is no established diagnostic test to confirm the clinical diagnosis. This study aims to evaluate the correlation between the dynamic pudendal somatosensory evoked potential (SEP) and pudendal magnetic resonance imaging (MRI) in patients with PN diagnosed clinically based on Nantes criteria as the gold standard for comparison. Methods: Forty-three patients (25 females, 18 males) were included in the study. Dynamic pudendal SEP as a novel method, which includes both provocative positioning and stimulation of each side separately, and pudendal MRI were performed in each patient. Results: Dynamic pudendal SEPs were found to be abnormal in 42, normal in 12 of the 54 clinically symptomatic nerves and abnormal in 2, normal in 30 of the 32 clinically asymptomatic nerves. Pudendal MRI was abnormal in 19, normal in 35 of the 54 clinically symptomatic nerves and abnormal in 8 and normal in 24 of the 32 clinically asymptomatic nerves. There was 84% agreement between clinical diagnosis and dynamic pudendal SEP (high sensitivity and specificity), 49% agreement between clinical diagnosis and pudendal MRI (low sensitivity and acceptable specificity), 53% agreement between dynamic pudendal SEP and pudendal MRI. Conclusions: The novel dynamic pudendal SEP method seems to be useful in supporting the clinical diagnosis of PN, while pudendal MRI lacks sufficient sensitivity to be used alone in diagnosis of PN.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"119 - 125"},"PeriodicalIF":0.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43568419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical course and outcomes of complicated mild traumatic brain injury in children: A single-center series of 124 cases","authors":"Ş. Hanalioğlu, D. Hanalioğlu, Ç. Elbir, O. Sahin, Balkan Sahin, M. Turkoglu, H. Kertmen","doi":"10.4103/nsn.nsn_35_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_35_22","url":null,"abstract":"Objective: Mild traumatic brain injury (mTBI) constitutes majority of TBI cases. A considerable portion of mTBI cases has intracranial imaging abnormalities (complicated mTBI), which pose challenges in the diagnosis and management to clinicians. Here, we aimed to evaluate the early clinical course and outcomes of pediatric complicated mTBI cases treated at a large-volume tertiary referral center. Materials and Methods: A single-center retrospective cohort study was conducted at a large-volume tertiary trauma referral center for 12-month period between 2017 and 2018. Pediatric mTBI cases with at least one of the following computed tomography (CT) findings were included a depressed skull fracture, pneumocephalus, intracranial hemorrhage, edema, or contusion. Demographic, clinical, and radiological data were collected and analyzed. Results: One hundred and twenty-four patients with complicated mTBI were identified. Falls were the leading mechanisms of trauma (71.8%). Most patients (90.3%) had a Glasgow coma score (GCS) of 15 at initial evaluation. Most frequent radiological findings on initial CT scan were epidural hematoma (EDH) (34.7%) and pneumocephalus (31.5%), followed by subdural hematoma (SDH) (19.4%), subarachnoid hemorrhage (16.9%), contusion (14.5%), and depressed skull fracture (8.1%). Radiological findings in the routine repeat CT scan were stable in 55.6% of the patients, whereas the findings progressed in 15.3% and improved in 29% of patients during this interval period (median 7 h). Neurosurgical operation was performed in 7 (5.6%) patients. Thirty-six (29%) patients were identified as having clinically important TBI (ciTBI). Average length of stay at emergency department was 9.7 ± 4.9 h, and the average length of hospital stay was 3.6 ± 2.3 days. Multivariate analysis revealed that age, GCS, pneumocephalus, depressed skull fracture, EDH, and SDH were independent predictors of ciTBI. Conclusion: Pediatric complicated mTBI is associated with higher rates of hospitalization and therefore ciTBI but relatively lower rates of need for neurosurgery. Effective decision-making tools and algorithms are needed to guide optimal management strategies of these patients.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"151 - 157"},"PeriodicalIF":0.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49523356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding pathophysiology of cluster headache: Heart rate variability and parasympathetic activation","authors":"Erdi Şahin, E. Ekizoğlu, E. Orhan, A. Bilge, B. Baykan","doi":"10.4103/nsn.nsn_154_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_154_21","url":null,"abstract":"Aim: The underlying mechanisms of cluster headache (CH) have not been fully understood yet. The cranial autonomic activation suggests that both sympathetic and parasympathetic systems are impaired in the clinical presentation; however, the systemic autonomic involvement during pain-free episodes is not well-known. Methods: Thirty-five subjects were included in 24 h Holter monitoring and electrophysiological studies in this controlled study. Results: In Holter monitoring, heart rate variability parameters, RMSSD (P = 0.001), and pNN50 (P = 0.024) were significantly higher in patients compared to age and gender-matched controls. The R-R variations during breathing and deep breathing and sympathetic skin responses of all patients were normal. Conclusions: High RMSSD and pNN50 levels are the two indicators of increased parasympathetic activity in CH patients. Considering the intense stress because of severe pain of the CH patients, who are mostly adult men and smokers, there is an urgent need for broader studies with prospective follow-up in terms of cardiac health.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"146 - 150"},"PeriodicalIF":0.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45754468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodic legs movements in sleep persisting after positive airway pressure titration is significantly associated with cardiovascular diseases","authors":"Aygul Mahmudova, H. Kurucu, G. Şenel, D. Karadeniz","doi":"10.4103/nsn.nsn_149_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_149_21","url":null,"abstract":"Purpose: Obstructive sleep apnea syndrome (OSAS) and periodic limb movement disorder in sleep (PLMS) are highly prevalent diseases of sleep and both are associated with a negative cardiovascular outcome. The purpose of this study was to investigate the presence of PLMS in patients with OSAS in positive airway pressure (PAP) titration and examine its relation to cardiovascular diseases. Materials and Methods: All patients who were diagnosed as having OSAS after one-night polysomnographic (PSG) recording during a 1-year period and were been treated successfully through PAP titration PSG were investigated retrospectively. Results: Out of 460 medical files investigated, 300 patients were included in the study (204 males, 68%) with a mean age of 54.2 ± 10.6 years. A comparison between patients with a PLMS index >15/h and PLMS index <15/h revealed that cardiac diseases (P = 0.040), hypertension (HT) (P = 0.006), and hyperlipidemia (P = 0.019) were all more common if patients had a PLMS index >15/h. Furthermore, a significant correlation was detected between the PLMS index and cardiac diseases (ß = 39.908, P = 0.012) and HT (ß = 32.884, P = 0.021). Conclusions: The risk of cardiovascular diseases is markedly increased in patients with OSAS with PLMS, and this was positively correlated with the PLMS index. Physicians should be aware that PLMS persisting after PAP titration might prevent the efficiency of PAP therapy in OSAS, especially in preventing cardiovascular complications.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"35 - 39"},"PeriodicalIF":0.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42861513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of circadian locomotor output cycles kaput rs1801260 and hypocretin receptor 1 rs2271933 polymorphisms in patients with chronic migraine and sleep disorder","authors":"Genc Hamit, OzdemirAsena Ayca, BarlasIbrahim Omer, Oksuz Nevra, Ozge Aynur","doi":"10.4103/nsn.nsn_195_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_195_21","url":null,"abstract":"","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70838577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis","authors":"D. Burke","doi":"10.4103/nsn.nsn_199_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_199_21","url":null,"abstract":"Neurophysiological testing plays a very important role in the diagnosis of amyotrophic lateral sclerosis (known in the British world as motor neuron disease). As specified in the Awaji criteria, electromyography is critical for defining the neurogenic changes due to involvement of the lower motor neuron (LMN), and it can do so for muscles that are not involved clinically or are so only minimally. Demonstrating LMN involvement can be enhanced by the judicious use of neuromuscular ultrasound and imaging, particularly whole-body magnetic resonance imaging. There is a gap with involvement of the upper motor neuron (UMN), with promising procedures yet to be adopted widely. Reflex function can be used to demonstrate hyperreflexia and sometimes that paresis is at least partly of UMN origin. Protocols using transcranial magnetic stimulation can demonstrate enhanced excitability of interneuronal circuits in motor cortex and thereby pathology involving the UMN. The motivation behind studies using these and other techniques is to be able to make the diagnosis before the disease has spread significantly from its site of onset, when the clinical deficit is still minor.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"1 - 7"},"PeriodicalIF":0.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42279651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why electrophysiological reassessment is needed? The experience of our laboratory – A cross-sectional study","authors":"I. Gençdal, Ayşe Nur Özdağ Acarlı, AyşeDeniz Elmalı, A. Emekli, A. Öge, M. Baslo, E. Orhan","doi":"10.4103/nsn.nsn_233_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_233_21","url":null,"abstract":"","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"13 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70838728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}