Neurology International

655 KiB

Open AccessCase Report

Chiari Type I Malformation with Cervicothoracic Syringomyelia Subterfuge as Flail Arm Syndrome

by Zhi Gang Lan, Seidu A. Richard, Jiagang Liu and Chao You

Neurol. Int. 2017, 9(3), 7336; https://doi.org/10.4081/ni.2017.7336 - 02 Oct 2017

Cited by 3 | Viewed by 360

Chiari type I malformation with cervicothoracic syringomyelia although very common in clinical practice usually in children can progress slowly and mimic muscular dystrophies in adulthood. We present a rare adult case of Chiari type I malformation with cervicothoracic syringomyelia subterfuge as Flail arm syndrome. A 44- year-old man was diagnosed with congenital type I Chiari malformation with cervicothoracic syringomyelia about 21 years ago without surgery. His health status deteriorated over the years until 21 days prior to presentation when he had severe pain in the right knee. In his upper limbs, he had bilateral corresponding severe weakness of 0/5 proximal strength and 0/5 strength in his distal muscles. Magnetic resonance imaging (MRI) revealed an enlargement of the spinal cord from C1-C4 level with a mass that appeared hypo-dense on T1 and hyperdense on T2. Syringomyelia is a potentially serious neurologic condition that can mimic other neuromuscular disorders. Early detection and diagnosis with MRI is crucial to avoid irreversible neurological complications. We suggest that whether asymptomatic or symptomatic, decompressive surgery should be carried out to allow for free flow of cerebrospinal fluid thereby improving the quality of life for the patient. Full article

535 KiB

Open AccessBrief Report

Migraine Headache in Patients with Idiopathic Intracranial Hypertension

by Farzad Sina, Saeed Razmeh, Neda Habibzadeh, Arefeh Zavari and Mona Nabovvati

Neurol. Int. 2017, 9(3), 7280; https://doi.org/10.4081/ni.2017.7280 - 02 Oct 2017

Cited by 15 | Viewed by 489

Abstract

Migraine is a neurological disorder that afflicts many people in the world and can cause severe disability during the attacks. The pathophysiology of migraine is complex and not fully understood. It seems that migraine is common in idiopathic intracranial hypertension (IIH). However, the association between migraine headache and IIH is still unclear. The present study was conducted to assess the prevalence of migraine headache and associated factors in IIH patients. In this cross-sectional study, a total of 68 patients diagnosed with IIH underwent a medical history interview and a neurological examination. The diagnosis of migraine was based on the four diagnostic criteria of the International Classification of Headache Disorders 3rd edition. Forty-five patients (63.2%) met the diagnostic criteria of migraine headache. There was no significant difference between patients with and without migraine headache in respect of their age, gender, body mass. This study revealed high prevalence of migraine headache in IIH patients; appropriate treatment can reduce their headache and prevent unnecessary treatments for IIH. Full article

682 KiB

Open AccessReview

Risk Factors Associated with Post-Stroke Dementia: A Systematic Review and Meta-Analysis

by Jesada Surawan, Suchat Areemit, Somsak Tiamkao, Theparak Sirithanawuthichai and Suprawita Saensak

Neurol. Int. 2017, 9(3), 7216; https://doi.org/10.4081/ni.2017.7216 - 29 Sep 2017

Cited by 28 | Viewed by 646

Abstract

This study aimed to evaluate the risk factors for prognostic of post-stroke dementia (PSD). A systematic review included case-control and/or cohort studies, we searched both published and unpublished literatures between 2000 to July 31, 2016. Two authors independently screened and selected research articles. If another one disagreed, the third author would be just along with his/her professionally. Moreover, Critical appraisal was measured by the quality (GRADE). Data collection was in the data extraction form. The Rev-Man 5.3 was used to estimate pooled data. The fixed-effect model will be used when the heterogeneity I²>50%. Result eight publications were pooled for measuring an association between risk factors and PSD by meta-analysis. There were 6 strongly PSD risk factors. The pooled relative ratio (RR) of atrial fibrillation was 1.68, previous stroke 1.59, myocardial infarction 1.40, hypertension 1.36, diabetes mellitus 1.25 and previous transient ischemic attack 1.25 respectively. Un-pooled data from 13 publications reported that the risk factors for dementia in stroke patients were i) demographic factors, ii) vascular risk factors, iii) stroke factors, iv) stroke complications, and v) abnormalities on brain imaging. Strongly risk factors associated with increasing PSD risk were atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes mellitus, and previous transient ischemic attack. Further studies, strongly risk factors need to investigate and develop the risk score for the prediction of dementia in stroke patients. Full article

564 KiB

Open AccessBrief Report

Body Mass Index and Severity of Parkinsonism in Multiple System Atrophy

by Ai Suzuki, Hitoshi Mochizuki, Yuka Ebihara, Kazutaka Shiomi and Masamitsu Nakazato

Neurol. Int. 2017, 9(3), 7276; https://doi.org/10.4081/ni.2017.7276 - 28 Sep 2017

Cited by 2 | Viewed by 401

Abstract

Patients with neurodegenerative disorders lose body weight as their diseases progress. In Parkinson’s disease (PD), however, autonomic dysfunction is associated with increased body mass index (BMI). We investigated the correlation between BMI, clinical features, and autonomic dysfunction in patients with multiple system atrophy with predominant parkinsonism (MSAP). BMI, clinical features, cardiac 123Imetaiodobenzylguanidine scintigraphy (MIBG), Hoehn and Yahr (H-Y) stage, and the coefficient of variation of the R-R interval (CVRR) were analyzed in 50 patients with MSA-P. BMI showed no significant correlation with MIBG parameters or CVRR. On the other hand, the H-Y stage was significantly negatively correlated with BMI. Higher H-Y stage indicates a more severe neuromuscular state in MSA-P and is considered to be related to higher energy expenditure and decrease of BMI. Patients with MSA-P lose weight as the disease progresses. This is the first report indicating a significant correlation between disease severity and BMI decrease in MSA. Full article

1059 KiB

Open AccessCase Report

Miller Fisher Syndrome with Sinus Arrest

by Nobuko Shiraiwa, Mitsumasa Umesawa, Sachiko Hoshino, Tsuyoshi Enomoto, Susumu Kusunoki, Akira Tamaoka and Norio Ohkoshi

Neurol. Int. 2017, 9(3), 7312; https://doi.org/10.4081/ni.2017.7312 - 29 Aug 2017

Cited by 3 | Viewed by 374

Abstract

Dysautonomia in Guillain-Barre syndrome (GBS) rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS) is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS. Full article

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Neurol. Int., Volume 9, Issue 3 (August 2017) – 5 articles

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