The Egyptian journal of neurology, psychiatry and neurosurgery最新文献

{"title":"Focal finger palsy and wrist pain due to cortical infarction: a case report","authors":"Shiyu Hu, Yang Wang, Lijie Ren","doi":"10.1186/s41983-024-00807-x","DOIUrl":"https://doi.org/10.1186/s41983-024-00807-x","url":null,"abstract":"Hand knob infarction induced focal weakness of contralateral hand or distal arm, only accounts for less than 1% of all ischemic strokes. To date, there is no case with pain during sleep as the onset symptoms being reported. The atypical symptoms of hand knob infarction might increase the risk of delaying treatment especially in the hyperacute phase of stroke. A 70-year-old man awoke from sleep due to sudden pain of his right medial wrist and presented to the emergency department with difficulty extending his right index and middle fingers within the time window of intravenous thrombolysis. But the intravenous thrombolysis was not given based on the NIHSS score (0) and atypical symptoms. MRI showed multiple DWI hyperintense lesions, including partial left hand knob area and left posterior central gyrus. CTA showed a severe focal stenosis of proximal left internal carotid artery. The hand knob infarction might onset with unusual pain and should be carefully inspected in patients combined with acute onset of focal hand paresis.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925909","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":"New-onset seizures misdiagnosed as psychogenic non-epileptic seizures: a case of paraneoplastic limbic encephalitis with primary testicular cancer","authors":"Axel Rivas, Daniel Levine, Cory Nichols, Mckenzie Merritt, Paul Janda, Aroucha Vickers","doi":"10.1186/s41983-024-00804-0","DOIUrl":"https://doi.org/10.1186/s41983-024-00804-0","url":null,"abstract":"Behavioral psychiatric symptoms can be the only warning signs of more serious conditions such as paraneoplastic limbic encephalitis. Differentiating between primary psychiatric disorders and paraneoplastic neurological syndromes is crucial as they require distinct treatment approaches. In this case report, we provide an overview of paraneoplastic encephalitis and introduce a unique case that showcases a misdiagnosis of psychogenic non-epileptic seizures (PNES) in a male as the primary symptom of paraneoplastic encephalitis due to pure seminoma. This case highlights the underlying pathophysiology of antibody-mediated paraneoplastic encephalitis and its significance. A 31-year-old male with no known past medical history presented due to recurrent seizures. There was no prior history of epilepsy or exposure to seizure-triggering agents. Imaging and electroencephalogram findings during his initial hospitalizations pointed to a potential diagnosis of PNES. The patient continued to experience seizures following discharge, leading to repeat hospitalizations. During the fourth hospitalization, the patient received mood-stabilizing anti-seizure medications and benzodiazepines, but he deteriorated and required intubation. It was during this time that the patient was transferred to our facility. Magnetic resonance imaging of the brain revealed multifocal areas of hyperintensity and restricted diffusion with avid enhancement. Immunotherapy was initiated with improvement of non-epileptic spells and encephalopathy. Outpatient workup uncovered malignant pure seminoma with metastases to the retroperitoneum. The authors theorize that paraneoplastic neurological disorders stemming from testicular cancer led to the neurological symptoms seen in this case. This report highlights a rare occurrence of paraneoplastic limbic encephalitis associated with pure testicular seminoma, clinically manifested as PNES. The diagnostic challenge posed by variability of presenting symptoms in paraneoplastic encephalitis emphasizes the importance of accurate differentiation from conditions such as autoimmune encephalitis. Current diagnostic approaches for paraneoplastic and autoimmune etiologies involve detection of known antibodies, as well as brain imaging. Notable antibodies associated with psychogenic non-epileptic seizures symptoms include anti-GAD-65, anti-Ma2, KLH11-antibodies, anti-Hu, and NMDA receptor antibodies. Recognizing paraneoplastic limbic encephalitis symptoms is challenging and often leads to misdiagnosis or overlooking of malignancies highlighting the need for awareness, comprehensive evaluation and timely treatment. Through this comprehensive case analysis, we enhance the understanding of underlying mechanisms, associated symptoms, and treatment options.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925975","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":"Electrophysiological studies versus high-resolution nerve ultrasound in diagnosis of Guillain–Barré syndrome","authors":"Ahmed Abou Hagar, Mohamed Negm, Samer Elshamly, Osama Shehab, Walid Mosallam, Reda Abd El-Razek","doi":"10.1186/s41983-024-00799-8","DOIUrl":"https://doi.org/10.1186/s41983-024-00799-8","url":null,"abstract":"Guillain–Barré syndrome (GBS) is polyneuropathy characterized by inflammation and immune-mediated processes that is classified into many subtypes based on electrophysiological and pathological criteria. The diagnosis of GBS can be confirmed using electrophysiological studies. However, electrophysiological studies may be normal when carried out early within 1 week in the course of the disease (Berciano et al. in J Neurol 264:221–236, 2017). One of the most useful imaging modalities for peripheral nerve diseases is ultrasonography (US). Nerve US in combination with electrophysiological studies provides an appropriate method in evaluating diseased peripheral nerves. This study aimed to enhance the reliability of early GBS diagnosis by correlating the findings of electrophysiological studies and nerve ultrasound. The nerve conduction studies (NCSs) in 37 GBS patients and 37 controls combined with cross-sectional area (CSA) assessment with US within the first 3 days of onset of symptoms and on day 14 after disease onset were evaluated. At presentation, patients and controls did not differ significantly in NCS parameters (p ≥ 0.05) except for a significantly longer F-wave minimum latency in the median, ulnar, and tibial nerves in patients (p < 0.001). While on day 14 all NCS parameters differed significantly in patients in comparison to controls (p < 0.001) with exception of the sural nerve parameters (p ≥ 0.05). Except for the sural nerve (p ≥ 0.05), all the examined nerves' CSAs were considerably higher in patients at presentation and on day 14 in comparison to the controls (p < 0.001). The subtypes of Guillain–Barré syndrome either demyelinating, axonal or mixed axonal and demyelinating did not significantly differ regarding the CSAs of all the examined nerves either at presentation or on day 14 (p > 0.05). Electrophysiological results in GBS are crucial in diagnosing the disease and understanding its pathophysiology, but serial NCSs are required. Ultrasound shows structural aspects of the nerve, so ultrasonography is a reliable tool which can be used in diagnosis and follow-up of early GBS. As a result, combining the two investigations has a complementary effect in the diagnosis and prognosis of GBS.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925799","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":"Using 6-CIT, P300 encephalography, and pro-inflammation assessments for screening age-related cognitive decline and exploring associated risk factors in Egyptian elderly","authors":"Mai S. Saleh, Asmaa F. Galal, Sara F. Sallam, Noha A. Mowaad, Hala M. Zeidan, Adel Hashish, Hala R. Elhabashy, Ola A. Heikal","doi":"10.1186/s41983-024-00806-y","DOIUrl":"https://doi.org/10.1186/s41983-024-00806-y","url":null,"abstract":"The elderly population is suffering from many mental health problems that are aggravated as a matter of age and cognitive decline is a serious one of them. The aim of the present work is to screen the cognitive performance among a sample of Egyptian elderly volunteers and to investigate the associated risk factors. A sample of 88 elderly volunteers from both genders was enrolled in the study according to the specified eligibility criteria after signing the approval consent. Medical history and socio-demographic data were collected from all participants in addition to basic clinical examination. Cognitive performance was assessed using the 6-Item Cognitive Impairment Test (6-CIT) while the endogenous event-related potentials (ERP) was measured using P300. The inflammatory biomarkers; TNF-α and COX-2 levels were assessed in serum using ELISA technique in addition to gene expression of TNF-α, PPAR-γ and CD-36 exploration using qRT-PCR. About half (51%) of the sample under investigation showed cognitive problems with scores on the 6-CIT exceeding the normal level. TNF-α serum levels showed positive correlation with P300 latency and correlated negatively with P300 reaction time. Furthermore, serum COX-2 levels correlated positively with P300 reaction time and negatively with P300 amplitude. The study population is showing early signs of cognitive decline that invites attention to the importance of spreading preventive measures against further deterioration. Inflammatory biomarkers under investigation and 6-CIT are suggested to be used in prediction of early stages of cognitive decline among the elderly population.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925872","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":"The reliability and validity of the Timed Up and Go test in patients ongoing or following lumbar spine surgery: a systematic review and meta-analysis","authors":"Fatih Özden","doi":"10.1186/s41983-024-00805-z","DOIUrl":"https://doi.org/10.1186/s41983-024-00805-z","url":null,"abstract":"No other systematic review examined the measurement properties of the TUG in LSS. The present systematic review and meta-analysis aimed to investigate the measurement properties of the Timed Up and Go (TUG) in patients with Lumbar Spine Surgery (LSS). A literature search yielded 906 studies [PubMed:71, Web of Science (WoS):80, Scopus:214, ScienceDirect:471 and Cochrane Library:70]. Included 10 studies were assessed for risk of bias and quality using the “four-point COSMIN tool” and “COSMIN quality criteria tool”. Criterion validity and responsiveness results were pooled with “correlation coefficient” and “Hedges’ g” based effect size, respectively. The correlation coefficient pooling between TUG and VAS back and leg pain was 0.26 (moderate) (95% CI 0.19–0.34) and 0.28 (moderate) (95% CI 0.20–0.36). The pooled coefficient of TUG with ODI and RMDI was 0.33 (moderate) (95% CI 0.27–0.39) and 0.33 (moderate) (95% CI 0.24–0.42), respectively. Besides, TUG has correlated with the quality-of-life PROMs with a coefficient of − 0.22 to − 0.26 (moderate) (EQ5D Index 95% CI − 0.35 to − 0.16), (SF12-PCS 95% CI − 0.33 to − 0.15) and (SF12-MCS 95% CI − 0.32 to − 0.13). The pooled coefficient of TUG with COMI, ZCQ-PF and ZCQ-SS was 0.46 (moderate) (95% CI 0.30–0.59), 0.43 (moderate) (95% CI 0.26–0.56), and 0.38 (moderate) (95% CI 0.21–0.52), respectively. TUG’s 3-day and 6-week responsiveness results were 0.14 (low) (95% CI − 0.02 to 0.29) and 0.74 (moderate to strong) (95% CI 0.60–0.89), respectively. TUG was responsive at the mid-term (6 weeks) follow-up. In clinical practice, the TUG can be used as a reliable, valid and responsive tool to assess LSS patients’ general status, especially in mid-term.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925871","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":"Evaluation of smartphone-assisted infrared thermal imaging efficiency in carpal tunnel syndrome","authors":"Kaya Turan, Osman Görkem Muratoğlu, Tuğrul Ergün, Haluk Çabuk","doi":"10.1186/s41983-024-00801-3","DOIUrl":"https://doi.org/10.1186/s41983-024-00801-3","url":null,"abstract":"Thermography is an industrial method for surface temperature measurements, and although it is medically safe and non-invasive, its place in daily practice has been limited. With the development of technology, thermal cameras have become more accessible and practical via adaptation to mobile phones. Among patients evaluated with bilateral nerve conduction studies (NCS) for suspected carpal tunnel syndrome (CTS), those with electrophysiological findings consistent with mild-to-moderate unilateral CTS were accepted for this prospective study. The hands with positive NCS findings were the study group, and the unaffected hands were the control group. The images were evaluated with the thermal analysis software (FLIR Tools ver. 6.4, Windows 10) and compared with NCS for statistical significance. In addition, thermal images were examined by three orthopaedic surgeons, and interobserver correlation was analyzed. Our study aims to evaluate the mobile phone-assisted thermal camera (FLIR One Pro, FLIR Systems, Wilsonville, OR, USA) as a suitable tool to diagnose CTS. 48 patients, 35 women and 13 men were included in the study. Bilaterally, a total of 96 hands were evaluated. 18 patients had mild, and 30 patients had moderate NCS stages unilaterally. The mean temperature difference at the region of interest in the palm, first and third fingers were statistically significant between the study and control groups (p < 0.05). NCS values and stages were correlated with the temperature difference in the third finger (p = 0.002). The inter-observer reliability was high (ICC = 0.858) while detecting temperature differences. Since smartphone-assisted thermal cameras are easy and convenient to use, we think they are helpful in the daily practice of diagnosing mild-to-moderate carpal tunnel syndrome.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139928242","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":"Return-to-work after interlaminar endoscopic sequestrectomy: case series","authors":"Ismail Bozkurt, Cagri Canbolat, Kemal Paksoy, Salim Senturk, Onur Yaman","doi":"10.1186/s41983-024-00803-1","DOIUrl":"https://doi.org/10.1186/s41983-024-00803-1","url":null,"abstract":"Considering the epidemiology of single-level lumbar disc herniations (LDH) in the young and active patients, the impact on working capacity is highly relevant. The timing of return-to-work after lumbar surgery through various modalities differs greatly. This may be partly due diverse disparate surgical approaches along with differences in patient and surgeon. The purpose of this paper is to provide evidence for a return-to-work policy after endoscopic sequestrectomy and discuss possible clues to a faster recovery of patients that did not receive a sick-leave report via a case series. The sample comprises fourteen cases of single-level LDH that underwent endoscopic interlaminar sequestrectomy and did not receive a sick-leave report and were advised to return-to-work whenever they felt fit so. Time until return-to-work, pre- and post-operative leg VAS pain scores and amount of analgesic used post-operatively were retrospectively analyzed. Fourteen patients were operated on using the same technique and on average returned to work after 6.6 ± 1.8 days, used 3.7 ± 2.5 analgesic tablets before returning to work and had a postoperative leg VAS pain score of 1.4 ± 1.2. No patient requested a sick-leave report during the follow-up period of 1 month. The patients in this case series had a remarkably short period of sick-leave and a low number of analgesic usage. These findings may be due to selection of patients who were operated on specifically for leg pain with the absence of lower back pain suggesting integrity of annulus fibrosus. We can postulate that intraoperative preservation of lamina, facet joint and annulus fibrosus along with reassurance of the surgeon suggesting to return-to-work whenever fell fit so were the key factors in the swifter recovery of the patients.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"178 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139762856","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":"Bulbar-onset amyotrophic lateral sclerosis in a patient with genetically confirmed Huntington’s disease: a case study","authors":"Ivo Bozovic, Sanja Gluscevic, Ivana Kezic, Vukan Ivanovic, Aleksa Palibrk, Stojan Peric, Ivana Basta, Zorica Stevic","doi":"10.1186/s41983-024-00800-4","DOIUrl":"https://doi.org/10.1186/s41983-024-00800-4","url":null,"abstract":"The rationale for this paper is a description of a patient from Southeast Europe with genetically confirmed Huntington’s disease (HD), coexisting with sporadic, bulbar-onset amyotrophic lateral sclerosis (ALS). To the best of our knowledge, the total number of reported cases with confirmed coexistence of HD and ALS is less than 20. Thus, it is an extremely rare condition speculated to be in a range from 2 to 6 per billion, and data from this part of the World are completely missing. Here we report a 72-year-old female with a family history of HD who had generalized chorea and hyperreflexia. Using the PCR-based test for the detection of the CAG triplet repeat expansion, the presence of HD was confirmed. After several months, our patient had progressively developed dysarthria and dysphagia, followed by spastic quadriparesis, generalized muscle wasting, spontaneous fasciculations and sialorrhea. The diagnosis of definite ALS was established based on the patient’s neurological status, electromyography findings and current El Escorial criteria. Our study emphasizes the need for the recognition of the co-occurrence of clinically distinct and rare genetic disorders, such as HD and ALS. New insights from the studies dealing with these rare topics could significantly contribute to the contest of new gene therapy trials.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139762854","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":"Value of MUNE versus compound muscle action potential in assessing motor unit loss in patients with carpal tunnel syndrome","authors":"Safa Dheaa Al-Den Abdul-Muneem, Hussein Ghani Kaddoori","doi":"10.1186/s41983-024-00796-x","DOIUrl":"https://doi.org/10.1186/s41983-024-00796-x","url":null,"abstract":"The most prevalent nerve entrapment disorder, known as carpal tunnel syndrome (CTS), is brought on by wrist-based median nerve compression. Focal demyelination progresses to axonal dysfunction as the condition worsens. In order to detect motor unit (MU) loos, this study compares two motor unit number estimation (MUNE) techniques with compound muscle action potential (CMAP) amplitude. The CMAP amplitude and MUNE of the median nerve in 137 hands of 70 neurophysiologically approved CTS patients, aged 40.27 ± 10.06 years were examined. Another 90 hands from 56 healthy volunteers who are age- and gender-matched serve the control group. In contrast to 192.5 and 248.5 in controls, the median nerve values of incremental and adapted multipoint stimulation (aMPS) MUNE in CTS patients were, respectively, 111 and 133 (p < 0.0001). Patients with severe CTS compared to those with mild CTS using both methods had significantly lower MUNE. MUNE values are the same regardless of gender or hand dominance. In comparison to MUNE methods (cutoff values of 106.5 and 203, respectively), CMAP amplitude had a sensitivity and specificity of more than 60% in detecting MU loss (cutoff value of 6.85 mV). The CTS grading had no effect on the CMAP amplitude. MUNE values had positive with CMAP amplitude and negative with CTS grading and Phalen test positivity. When identifying motor nerve involvement in CTS patients, the MUNE technique is more accurate than a standard motor nerve conduction study (NCS). It was emphasized that MUNE evaluation in determining MU loss in the early stages of CTS may be helpful in diagnosis and treatment. There was no correlation between handedness and the number of MUs as determined by MUNE techniques. Both methods almost equally identify MU loss and have the same sensitivity and specificity.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139762940","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":"The effect of transcranial direct current stimulation paired with neuromuscular electrical stimulation on swallowing function in post stroke dysphagia","authors":"Nevine El Nahas, Hossam Shokri, Ahmed Refaat, Hanaa Mousa, Aya Hamid, Amr Abdel Monem, Eman AbuShady","doi":"10.1186/s41983-023-00767-8","DOIUrl":"https://doi.org/10.1186/s41983-023-00767-8","url":null,"abstract":"Transcranial direct current stimulation (tDCS) and neuromuscular electrical stimulation (NMES) are noninvasive neuromodulation techniques that have shown positive effects in a variety of neurological disorders. Most protocols apply one modality at a time. Here we tested the effect of tDCS applied together with NMES on patients with dysphagia after acute stroke. To assess the efficacy of combined tDCS and NMES on improvement of dysphagia after acute stroke, guided by Fiber-optic endoscopic evaluation of swallowing (FEES). This study is a double-blinded randomized case-controlled study conducted in a University hospital. This study enrolled 48 patients diagnosed by FEES and assigned to 3 groups of 16 patients each. The first group received both tDCS and NMES, the second group received NMES only and the third group received sham NMES. Gugging Swallowing Screen (GUSS) test was done before and after intervention. Significant improvement was seen in all tested materials on GUSS test in tDCS/NMES group. While in the other two groups, there was only improvement for safety of liquid swallowing. This study shows that the combined application of tDCS and NMES has an advantage in improvement of PSD over active NMES and sham NMES groups in all materials tested by GUSS.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139762865","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}