Seyed Amir Hassan Habibi; Luigi Romito; Oldooz Aloosh; Mohammad Rohani; Fatemeh Moghadas; Mansour Parvaresh; Gholamali Shahidi; Mehdi Moghaddasi; Ehsan Ziayi; Maziar Emamikhah
Abstract
Background: Nowadays, many neurological conditions, including Parkinson’s disease (PD), are treated with deep brain stimulation (DBS). Life-threatening consequences can occur from DBS hardware failure or sudden implantable pulse generator (IPG) battery depletion. This issue may potentially worsen ...
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Background: Nowadays, many neurological conditions, including Parkinson’s disease (PD), are treated with deep brain stimulation (DBS). Life-threatening consequences can occur from DBS hardware failure or sudden implantable pulse generator (IPG) battery depletion. This issue may potentially worsen in concomitance with medical or infectious conditions, requiring stronger emergency management. Methods: We present here a 58 year-old PD patient with DBS, whose IPG replacement surgery was complicated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and we report management of this patient along with recommendations for patients with similar situation. Results: As the newly-emerged coronavirus disease 2019 (COVID-19) is now announced to be pandemic, new protocols and specific measures for each individual group of patients with chronic diseases seem obligatory. Regarding our recent experience with a patient suffering from PD, on DBS treatment, who needed hospitalization, we felt useful to share our experience as a recommended protocol for similar patients in the time of current pandemic. Conclusion: Close monitoring of laboratory and clinical signs should be warranted in patients with PD awaiting IPG replacement in order to be prepared in these novel conditions that may precipitate an akinetic crisis/dystonic storm and to prevent life-threatening complications during the current pandemic.
Mansour Parvaresh-Rizi; Alireza Tabibkhoei; Gholamali Shahidi; Janardan Vaidyanathan; Amirreza Tabibkhoei; Mohammad Rohani
Volume 15, Issue 1 , January 2016, , Pages 34-45
Abstract
Background: Subthalamic nucleus (STN) stimulation is the reatment of choice for carefully chosen patients with idiopathic Parkinson's disease (PD) and refractory motor fluctuations. We evaluated the value of intraoperative electrophysiology during STN deep brain stimulation (DBS) procedures in refining ...
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Background: Subthalamic nucleus (STN) stimulation is the reatment of choice for carefully chosen patients with idiopathic Parkinson's disease (PD) and refractory motor fluctuations. We evaluated the value of intraoperative electrophysiology during STN deep brain stimulation (DBS) procedures in refining the anatomically-defined target.Methods: We determined the spatial distance between the anatomical and physiological targets along x, y and z axes in 50 patients with PD who underwent bilateral subthalamic nucleus DBS surgery.Results: The mean spatial distance between anatomical and functional targets was 1.84 ± 0.88 mm and the least distances in different methods were 0.66 mm [standard error (SE): 0.07], 1.07 mm (SE: 0.08) and 1.01 mm (SE: 0.08) on x, y and z axes, respectively, for the combined method.Conclusion: The most physiologically-accurate anatomical targeting was achieved via a combination of multiple independent methods. There was a statistically significant difference between the anatomical and functional targets in all methods (even the combined) on the y coordinate, emphasizing the need for intra- operative electrophysiological monitoring to refine the anatomico-radiologically-defined target.
Mohammad Rohani; Gholamali Shahidi
Volume 14, Issue 1 , March 2015
Mitra Ansari Dezfouli; Elham Jaberi; Afagh Alavi; Mohammad Rezvani; Gholamali Shahidi; Elahe Elahi; Mohammad Rohani
Volume 11, Issue 4 , December 2012, , Pages 155-158
Abstract
Background: Pantothenate kinase associated neurodegeneration (PKAN) is the most prevalent type of neurodegeneration with brain iron accumulation (NBIA) disorders characterized by extrapyramidal signs, and 'eye-of-the-tiger' on T2 brain magnetic resonance imaging (MRI) characterized by hypointensity in ...
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Background: Pantothenate kinase associated neurodegeneration (PKAN) is the most prevalent type of neurodegeneration with brain iron accumulation (NBIA) disorders characterized by extrapyramidal signs, and 'eye-of-the-tiger' on T2 brain magnetic resonance imaging (MRI) characterized by hypointensity in globus pallidus and a hyperintensity in its core. All PKAN patients have homozygous or compound heterozygous mutation in PANK2 gene.Methods:Three sibling patients were diagnosed based on clinical presentations especially extrapyramidal signs and brain MRI. The exons and flanking intronic sequences of PANK2 were sequenced from DNA of leukocytes of the affected individuals.Results:All patients were homozygous for c.C1069T, p.R357W in PANK2 gene. This mutation is well conserved in the homologous protein of distally related spices.Conclusion:In the current study we identified three siblings affected with PKAN, all of them have mutations in PANK2 gene. In MRI of all patients with PANK2 mutation eye-of-the-tiger sign was apparent.
