Open access journal of neurology & neurosurgery最新文献

{"title":"Stiff Person Syndrome Mimicking as Atypical Parkinson’s Disease - A Diagnostic Dilemma","authors":"Aakash Kodikoppa Somappa","doi":"10.19080/oajnn.2023.18.555992","DOIUrl":"https://doi.org/10.19080/oajnn.2023.18.555992","url":null,"abstract":"Stiff person syndrome (SPS) is a rare neurological disorder characterized by stiffness and spasm of the truncal muscles and subsequent postural deformities. In this report, we present a case of a woman in her early 60s who presented to us with muscle stiffness, back pain, and frequent falls. On examination, she was found to have increased muscle tone and mild tremors. Given her age and presentation, a provisional diagnosis of Atypical Parkinson’s was made. Patient was treated with Diazepam. Because of presence of autoimmune co-morbid conditions, anti-glutamic acid decarboxylase (GAD) antibodies were tested, which were positive, and thus, diagnosis of SPS was made. Treatment with Diazepam was continued, and her symptoms significantly improved. Even though SPS is a rare disorder, our case report highlights the need to keep it in differential diagnoses when an elderly patient presents with stiffness and postural instability, as treatment for SPS and atypical Parkinson’s vary considerably.","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786538","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":"Single Photon Computed Tomography (SPECT) Findings in Cases with Japanese Adult- Attention-Deficit/Hyperactivity Disorder (ADHD): Special Attention to Cerebellar Posterior Lobe Hypoperfusion on Iodoamphetamine (IMP) SPECT using 3 Dimensional Stereotactic Surface Projection (3D-SSP) Analysis","authors":"Nobuhiko Miyazawa","doi":"10.19080/oajnn.2023.18.555991","DOIUrl":"https://doi.org/10.19080/oajnn.2023.18.555991","url":null,"abstract":"Although a number of case with adult ADHD has been increasing in Japan , helpful diagnostic method of it has yet not existed. Recently, effective and supportive findings on cerebral SPECT with statistical methods have been fund in cases with Japanese adult ADHD. During 2 years, 15 cases with Japanese ADHD diagnosed by DSM-5 were examined with IMP-SPECT using statistical methods. ROIs were placed on anterior and posterior lobe of cerebellum on IMP SPEC with vbSEE level 2 software and other regions with that level 5 software. Significant decrease was observed on cerebellum in 8 cases (bilateral in 6 cases, unilateral in 2 cases), upper posterior lobe, thalamus in 4 cases, middle posterior lobe, lower posterior lobe, pons in 2 cases, cuneus, lingualis gyrus in 1 case. In total 15 cases, there were significant decrease in posterior lobe of cerebellum compared with anterior lobe (left side: p=2.24E-05, right side: p=2.63E-05). Those results were in accordance with those of studies with SPECT with statistical methods. Hypoperfusion on posterior lobe of cerebellum on SPECT with statistical methods might facilitate the diagnosis of adult ADHD in Japan.","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363421","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":"Tumor-Related Epilepsy and Post-Surgical Outcomes: Tertiary Hospital Experience in Saudi Arabia","authors":"Alawi A Al Attas","doi":"10.19080/oajnn.2021.16.555939","DOIUrl":"https://doi.org/10.19080/oajnn.2021.16.555939","url":null,"abstract":"Objectives: Recent studies reported that tumor histopathology plays a significant role in predicting freedom from seizures after epilepsy surgery; however, no consensus among researchers regarding this issue exists. This study retrospectively examined different types of tumor-related epilepsy and post-epilepsy surgical outcomes and the relationship between various tumor Histopathology and these outcomes. Methods: In this hospital-based retrospective study, patients with brain tumors and drug-resistant epilepsy, which is defined as the failure of two tolerated and appropriately chosen antiepileptic drugs (whether as monotherapies or in combination) to achieve and alleviate sustained seizure freedom, were recruited. These patients underwent a thorough pre-surgical evaluation in an Epilepsy Monitoring Unit (EMU) before deciding to undergo surgical intervention according to an epilepsy case management conference. Results: One-hundred patients (including 45 children) with brain tumors were included in this study (male: female = 3:2). Most of the patients (93) had G/GNT. No significant differences in outcome were observed among sex, age, or histopathological categories. However, during the first year after epilepsy surgery, most of the low-grade G/GNT cases showed favorable outcomes based on ILAE classes 1 and 2 (61.3% and 9.7%, respectively), whereas high-grade gliomas and meningothelial tumors showed outcomes of ILAE class 1 (40% and 100%, respectively). Conclusion: Post-epilepsy surgical outcomes of different brain tumors have been achieved with favorable outcomes in children and adults with low-grade gliomas and meningiomas. Thus, pre-surgical evaluation in EMU is highly recommended to enhance better post-epilepsy surgical outcomes.","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48885560","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 Utility of Concentric Needle Single Fiber Electromyography in Diagnosing Myasthenia Gravis","authors":"A. Nadeem, K. Al-Salmi, A. Al-Salti","doi":"10.19080/OAJNN.2021.15.555907","DOIUrl":"https://doi.org/10.19080/OAJNN.2021.15.555907","url":null,"abstract":"Introduction: Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular disorder, characterized by varying degrees of fluctuating muscular weakness and fatigability. The diagnosis of MG can be difficult and, therefore, bed-side clinical testing, electrophysiological investigations; as well as serum antibodies tests are often used to establish the diagnosis. Objective: The aim of this study was to define the diagnostic accuracy of concentric needle electrode single fiber electromyography (CNE- SFEMG) jitter test in MG patients and to determine its’ diagnostic value by calculating the sensitivity, specificity, predictive values and accuracy of the test. Methods: Retrospective analysis of 74 Omani MG patients’ data was carried out to determine the diagnostic sensitivity, specificity and predictive values of CNE-SFEMG test; against a reference standard of MG by virtue of clinical features, antibody assay and response to treatment. Receiver Operating Characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was also calculated to measure the accuracy of the test. A comparison of the frequency of CNE-SFEMG abnormality between ocular (OMG) and generalized (GMG) myasthenia gravis patients was done. Results: Abnormal CNE-SFEMG results were detected in 79.1%, 77% and 82.4% of all MG, GMG and OMG patients respectively. Based on the reference standard used, the sensitivity, specificity and predictive values were determined, and the test accuracy was measured in all MG, GMG and OMG included patients. CNE-SFEMG had a sensitivity of 79.1 % and specificity of 51.6 % in all MG patients with 67.6% test accuracy. In GMG, CNE-SFEMG had a sensitivity of 76.9%, specificity of 35.7% and 62.5% accuracy of the test; while CNE-SFEMG for OMG cases showed a sensitivity of 82.4% and specificity of 64.7% with 73.5% test accuracy. The CNE-SFEMG abnormality was more frequent in the ocular than the generalized MG patients but with insignificant statistical difference. Conclusion: Our findings indicate that CNE-SFEMG is a very useful and valid test for MG and our results were comparable, but lower than previously published values. Significance: The sensitivities, specificity, predictive values and test accuracy of CNE-SFEMG jitter in the diagnosis of MG cases attending the neuromuscular unit at a tertiary care hospital in Muscat-Oman were documented.","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68375670","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":"Normobaric Oxygen Therapy for Pneumocephalus; Simple, Cheap, Available and Effective","authors":"S. Fosmark","doi":"10.19080/OAJNN.2021.15.555908","DOIUrl":"https://doi.org/10.19080/OAJNN.2021.15.555908","url":null,"abstract":"Background: Pneumocephalus is quite often seen after traumatic brain injury and neurosurgical procedures. Though the majority of patients are asymptomatic, lethargy, headache, dizziness, decreased level of consciousness and neurological symptoms may all be signs of the condition. A suggested treatment is supplemental normobaric oxygen, a simple, cheap, available and effective treatment. As a reminder of this often-forgotten treatment, we here present four cases with pneumocephalus treated with normobaric oxygen supplement. A short review of the theoretical basis for this treatment modality is also presented. Methods: In this retrospective case series, we present four cases of pneumocephalus, all treated with normobaric oxygen supplement. Serial imaging using CT was applied for evaluation, and air volumes pre- and post-treatment were calculated. Results: All cases showed decreased volumes of intracranial air after receiving supplemental 100% O2 for 18-71 hours with a volume reduction of the intracranial air ranging from 51.5%-98.2%. In the three awake patients, radiographical volume reduction of the pneumocephalus was paralleled by clinical improvement. In one case the patient was on a ventilator during the normobaric oxygen treatment and clinical evaluation was not possible. Conclusions: Our findings support the treatment of pneumocephalus with supplemental oxygen therapy.","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45850448","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":"Sphenoid Wall Dehiscence: A Preventable Cause of Iatrogenic Internal Carotid Artery Rupture","authors":"Prashant Punia","doi":"10.19080/OAJNN.2020.14.555885","DOIUrl":"https://doi.org/10.19080/OAJNN.2020.14.555885","url":null,"abstract":"Minimally Invasive approaches to pituitary tumor have become gold standard not just for pituitary surgery but also for pathologies of ventral skull base [1]. It is due to the fantastic view it offers and the ease of doing surgery. The same, however, are not without complications and rupture of Internal Carotid Artery (ICA) is potentially the most catastrophic and thus, most feared [2].","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43243982","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 the COVID-19 Pandemic: what is Known, what has Ensued and what the Pandemic Portend?","authors":"D. Menkes","doi":"10.19080/oajnn.2020.13.555867","DOIUrl":"https://doi.org/10.19080/oajnn.2020.13.555867","url":null,"abstract":"","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45616354","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 Refractory Status Epilepticus in an Adult Patient with Autoimmune Encephalitis Responding to Vitamin B6 Pyridoxine","authors":"A. Nadeem","doi":"10.19080/OAJNN.2020.13.555865","DOIUrl":"https://doi.org/10.19080/OAJNN.2020.13.555865","url":null,"abstract":"New onset refractory status epilepticus is a difficult to treat neurological emergency. We report here a 39 years old male admitted to our hospital with new onset seizures presented as status epilepticus. Clinical evaluation and extensive investigations revealed an underlying autoimmune-mediated etiology with positivity for anti-NMDAR autoimmune encephalitis. His seizures could not be controlled, and he remained in a super-refractory status epilepticus, despite treatment with multiple anti-epileptic drugs in their proper doses, use of IV anesthetics in addition to a high dose corticosteroid and IVIG courses for treating his underlying disease. The patient had no previous significant past medical history, no family history of a seizure disorder and no comorbidities. Remarkably, the patient’s seizures responded successfully to treatment with vitamin B6 (Pyridoxine). He was discharged, after 117 days staying in hospital, with almost complete neurologic recovery and without recurrence of seizures after achieving control with Pyridoxine. We highlight here the possible role of Pyridoxine to terminate refractory seizures in patients with autoimmune encephalitis and to ensure neuroprotection, while the underlying etiology addressed with immune-modulating therapy. Moreover, we encourage clinicians to consider Pyridoxine deficiency as a potential etiology of new onset refractory status epilepticus and seizures, even in adult patients who suffer from other underlying diseases which can cause seizures.","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42502106","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":"Current Trends in Biomarkers for Traumatic Brain Injury.","authors":"Tejas R. Mehta, Muniba Fayyaz, Gema E Giler, Harleen Kaur, S. Raikwar, D. Kempuraj, G. P. Selvakumar, M. E. Ahmed, R. Thangavel, Smita A. Zaheer, S. Iyer, R. Govindarajan, A. Zaheer","doi":"10.19080/oajnn.2020.12.555842","DOIUrl":"https://doi.org/10.19080/oajnn.2020.12.555842","url":null,"abstract":"Neurotrauma, especially Traumatic Brain Injury (TBI) is a major health concern not only for the civilian population but also for the military personnel. Currently there are no precision and regenerative therapies available for the successful treatment of TBI patients. Hence, early detection and treatment options may prevent the severity and untoward harmful effects of TBI. However, currently there are no effective biomarkers available for the rapid and robust diagnosis as well as prognosis of TBI. Several biomarkers in blood, cerebrospinal fluid (CSF), saliva and urine have been explored to assess the onset, progression, severity and prognosis of TBI recently. Present knowledge on the blood biomarkers including cytokines and chemokines and in vivo imaging modalities are useful to some extent to detect and treat TBI patients. Here, we review S100B, Glial Fibrillary Acidic Protein (GFAP), Neuron Specific Enolase (NSE), Myelin Basic Protein (MBP), Ubiquitin C-terminal Hydrolase L1 (UCHL1), tau protein, and alpha spectrin II break down products regarding their usefulness as a set of reliable biomarkers for the robust diagnosis of TBI. We suggest that these biomarkers may prove very useful for the diagnosis and prognosis of TBI.","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":"12 4 1","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2020-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46082651","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":"Current Trends in Biomarkers for Traumatic Brain Injury.","authors":"Tejas Mehta,&nbsp;Muniba Fayyaz,&nbsp;Gema E Giler,&nbsp;Harleen Kaur,&nbsp;Sudhanshu P Raikwar,&nbsp;Duraisamy Kempuraj,&nbsp;Govindhasamy Pushpavathi Selvakumar,&nbsp;Mohammad Ejaz Ahmed,&nbsp;Ramasamy Thangavel,&nbsp;Smita Zaheer,&nbsp;Shankar Iyer,&nbsp;Raghav Govindarajan,&nbsp;Asgar Zaheer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neurotrauma, especially Traumatic Brain Injury (TBI) is a major health concern not only for the civilian population but also for the military personnel. Currently there are no precision and regenerative therapies available for the successful treatment of TBI patients. Hence, early detection and treatment options may prevent the severity and untoward harmful effects of TBI. However, currently there are no effective biomarkers available for the rapid and robust diagnosis as well as prognosis of TBI. Several biomarkers in blood, cerebrospinal fluid (CSF), saliva and urine have been explored to assess the onset, progression, severity and prognosis of TBI recently. Present knowledge on the blood biomarkers including cytokines and chemokines and in vivo imaging modalities are useful to some extent to detect and treat TBI patients. Here, we review S100B, Glial Fibrillary Acidic Protein (GFAP), Neuron Specific Enolase (NSE), Myelin Basic Protein (MBP), Ubiquitin C-terminal Hydrolase L1 (UCHL1), tau protein, and alpha spectrin II break down products regarding their usefulness as a set of reliable biomarkers for the robust diagnosis of TBI. We suggest that these biomarkers may prove very useful for the diagnosis and prognosis of TBI.</p>","PeriodicalId":93038,"journal":{"name":"Open access journal of neurology & neurosurgery","volume":"12 4","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410004/pdf/nihms-1614104.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38256942","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}