Ali Noureddine; Kavian Ghandehari; Mohammad Taghi Shakeri
Volume 13, Issue 3 , September 2014, , Pages 127-130
Abstract
Background: Previous literatures have shown a transient ischemic attack (TIA) mimic rate of 9-31%. We aimed to ascertain the proportion of stroke mimics amongst suspected TIA patients. Methods: A prospective observational study was performed in Ghaem Hospital, Mashhad, Iran ...
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Background: Previous literatures have shown a transient ischemic attack (TIA) mimic rate of 9-31%. We aimed to ascertain the proportion of stroke mimics amongst suspected TIA patients. Methods: A prospective observational study was performed in Ghaem Hospital, Mashhad, Iran during 2012-2013. Consecutive TIA patients were identified in a stroke center. The initial diagnosis of TIA was made by the resident of neurology and final diagnosis of true TIA versus TIA mimics was made after 3 months follow-up by stroke subspecialist. Results: A total of 310 patients were assessed during a 3- month period of which 182 (58.7%) subjects were male and 128 (41.3%) were female. Ten percent of the patients was categorized as a TIA mimic. The presence of hypertension, aphasia, duration of symptoms, and increased age was the strongest predictor of a true TIA. Migraine was the most common etiology of stroke mimic in our study. Conclusion: It seems that many signs and symptoms have low diagno tic usefulness for discrimination of true TIA from non-cerebrovascular events and predictive usefulness of any sign or symptom should be interpreted by a stroke neurologist.
Seyed-Ali Javad Mousavi; Babak Zamani; Shahab Shahabi Shahmiri; Mohammad Rohani; Gholam Ali Shahidi; Elyas Mostafapour; Helia Hemasian; Hanieh Raji
Volume 13, Issue 3 , September 2014, , Pages 131-137
Abstract
Background: The rapidity of progression of amyotrophic lateral sclerosis (ALS) to death or respiratory failure impacts patients, clinicians, and clinical investigators. The aim of this study is to evaluate of the pulmonary function tests (PFTs) in patients with ALS and the association between these PFTs ...
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Background: The rapidity of progression of amyotrophic lateral sclerosis (ALS) to death or respiratory failure impacts patients, clinicians, and clinical investigators. The aim of this study is to evaluate of the pulmonary function tests (PFTs) in patients with ALS and the association between these PFTs and survival Methods: A total of 36 ALS patients who PFTs, including vital capacity (VC), maximum mid-expiratory flow rate (MMEFR), forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1), were available from the time of diagnosis were included in this study. Nonpulmonary characteristics assessed at the time of PFTs. Data were analyzed using chi-square, Student’s independent t-test, Kaplan-Meier, correlation, and receiver operating characteristic (ROC) curve.Results: The mean age of subjects was 55.36 (SD = 12.24) year, and the male to female ratio was 2.6. Twenty-Cve (69.4%) were died in 5 years period of our study. The mean and median survival time (In months) was calculated as 42.51 (95% co Cdence interval [CI] 33.64- 51.39) and 38 (95% CI 27.23-48.77) months, respectively. The rate of ALS survival was 74% at 1st year, 41% at 3rd year and 10% at 5th year of starting symptoms. The results of Kaplan-Meier test showed survival was significantly longer in the group with PFTs closer to normal. In addition, ROC analysis showed that FVC < 50% could potentially be a predictor of death in ALS patients (P = 0.003, area under curve = 0.649). Conclusion: We found single measures of upright FVC, FEV1 to be significantly associated with survival, even after controlling for relevant non-pulmonary patient characteristics. Our study demonstrated that upright FVC, FEV1, VC, and MMEFR are useful non-invasive measures in the prediction of survival in ALS.
Samira Yadegari; Shahriar Nafissi; Neda Kazemi
Volume 13, Issue 3 , September 2014, , Pages 138-143
Abstract
Background: Incidence and predominant subtype of Guillain-Barre syndrome (GBS) differs geographically. Electrophysiology has an important role in early diagnosis and prediction of prognosis. This study is conducted to determine the frequent subtype of GBS in a large group of patients ...
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Background: Incidence and predominant subtype of Guillain-Barre syndrome (GBS) differs geographically. Electrophysiology has an important role in early diagnosis and prediction of prognosis. This study is conducted to determine the frequent subtype of GBS in a large group of patients in Iran and compare nerve conduction studies in axonal and demyelinating forms of GBS.Methods: We retrospectively evaluated the medical records and electrodiagnostic study (EDS) of 121 GBS patients who were managed in our hospital during 11 years. After regarding the exclusion criteria, patients classified as three groups: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), and acute motor sensory axonal neuropathy (AMSAN). The most frequent subtype and then electrophysiological characteristic based on the time of EDS and their cerebrospinal fluid (CSF) profile were assessed.Results: Among 70 patients :nally included in the study, 67% w re men. About 63%, 23%, and 14% had AIDP, AMAN, and AMSAN, respectively.AIDP patients represented a wider range of ages compared with other groups. Higher levels of CSF protein, abnormal late responses and sural sparing were more frequent in AIDP subtype. Five AMSAN patients also revealed sural sparing. Conduction block (CB) was observed in one AMAN patient. Prolonged F-wave latency was observed only in AIDP cases. CB and inexcitable sensory nerves were more frequent after 2 weeks, but reduced F-wave persistency was more prominent in the early phase.Conclusion: AIDP was the most frequent subtype. Although the electrophysiology and CSF are important diagnostic tools, classification should not be made based on a distinct finding.
Hanieh Moshayedi; Reza Ahrabi; Afshin Mardani; Saieed Sadigetegad; Mehdi Farhudi
Volume 13, Issue 3 , September 2014, , Pages 144-148
Abstract
Background: Some studies in recent years showed that carotid intima-media thickness (IMT), indicator of the presence of atherosclerosis, was higher in non-alcoholic fatty liver disease (NAFLD) in comparison with normal subjects. They concluded that NAFLD patients ...
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Background: Some studies in recent years showed that carotid intima-media thickness (IMT), indicator of the presence of atherosclerosis, was higher in non-alcoholic fatty liver disease (NAFLD) in comparison with normal subjects. They concluded that NAFLD patients may be resulted in more cardiovascular events. Hence, we aimed to study the association of NAFLD and ischemic stroke.Methods: For this reason, 110 brain magnetic resonance imaging confirmed ischemic stroke patients and 110 patients age and sex matched controls went through liver ultrasound to detect NAFLD and common carotid ultrasound to measure IMT. Demographic and vascular risk factors were detailed for all subjects.Results: NAFLD was found in 47 (42.7%) of ischemic stroke patients and 25 (22.7%) of controls. By adjusting sex and age in table 2, odds ratio (OR) for NAFLD was 2.15 (95% con<dence interval [CI]: 1.25-3.71) that was statistically significant (P = 0.006). However, after adjusting for other confounding risk factors (waist circumference, hypertension, diabetes mellitus, low-density lipoprotein, triglyceride, alanine aminotransferase, aspartate aminotransferase, creatine, body mass index, cigarette smoking, and ischemic heart disease), the OR decrease to 1.68 (95% CI: 0.42-6.76) that was not statistically signi<cant (P = 0.460). The OR for IMT of right and left common carotid was 1.23 (95% CI: 0.48-3.15) and 1.24 (95% CI: 0.57-2.69), respectively that none of them were statistically significant.Conclusion: Although the risk of occurrence of ischemic stroke is higher in NAFLD patients, but NAFLD is not associated independently with ischemic stroke.
Behnaz Sedighi; Abbas Pardakhty; Hoda Kamali; Kaveh Shafiee; Bahar Naz Hasani
Volume 13, Issue 3 , September 2014, , Pages 149-153
Abstract
Background: Cognitive impairment is one of the most crucial disorders among multiple sclerosis (MS) patients. Since MS is an inflammatory disease and Boswellia papyrifera has anti-inflammatory effects, the influence of B. papyrifera on cognitive impairment in MS ...
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Background: Cognitive impairment is one of the most crucial disorders among multiple sclerosis (MS) patients. Since MS is an inflammatory disease and Boswellia papyrifera has anti-inflammatory effects, the influence of B. papyrifera on cognitive impairment in MS patients has been investigated in the present study.Methods: In this clinical trial, 80 MS patients who referred to the clinic of Shafa Hospital, Kerman, Iran were selected. Having completed a written consent form, patients with relapsing remitting MS, with no occurrence of a new attack throughout 1 month before the study, with no pregnancy or breastfeeding entered the study. The patients were randomly divided into two groups; then Brief International Cognitive Assessment for MS (BICAMS) test was carried out. One group received B. papyrifera (capsule 300 mg, twice a day) while the other group received placebo with the same dose for 2 months. After 2 months of treatment, BICAMS was redone and changes were analyze .The significant change value on the before-after BICAMS points were considered to be 8, 13, and 7 points for the symbol digit modality test (SDMT), the California verbal learning test (CVLT), and the brief visual-spatial memory test revised (BVMT-R), respectively.Results: The patients’ mean age was 36.58 8.50 years. The mean duration of disease was 7.41 4.13 years. About 84.2% (n = 64) of the patients was female. In the BVMT-R, 13 patients (34.2%), who had already taken B. papyrifera, were shown to have significant improvement compared to the placebo group with no improvement (P < 0. 001). About 12 and 8 patients in the treatment and placebo groups in the SDMT, respectively (P = 0.200) and 17 and 12 patients in the treatment and placebo groups in the CVLT, respectively (P = 0.170) had signi@cant change values.Conclusion: B. papyrifera showed significant improvement in visuospatial memory, but had no effect on verbal memory and information processing speed.
Aliasghar Molana; Masoud Mehrpour; Nasim Vousooghi; Mahmoud Reza Hajighasem; Mohammad Taghi Joghataei
Volume 13, Issue 3 , September 2014, , Pages 154-159
Abstract
Background: Migraine is a chronic neurological disorder, characterized by recurrent moderate to severe headaches. Worldwide migraine a=ects nearly 15%. Studies suggest that genes involved in the production of nitric oxide (NO) may act as genetic factors for migraine. NO synthase 3 (NOS3) ...
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Background: Migraine is a chronic neurological disorder, characterized by recurrent moderate to severe headaches. Worldwide migraine a=ects nearly 15%. Studies suggest that genes involved in the production of nitric oxide (NO) may act as genetic factors for migraine. NO synthase 3 (NOS3) by expressing enzyme NOS regulates endothelial derived NO. One class of medications used as first-line treatment in migraine prophylaxis is tricyclic antidepressants (TCAs). The aim of this study was to determine e=ects of NOS3 gene Glu298Asp polymorphism in the production of NO and response of patients to TCAs in migraine attacks.Methods: A total of 80 migraine patients were invited to participate in the study. Patients recorded the characteristics of their migraine attacks such as frequency of attacks and intensity of headaches for the 1st month of the study. Then peripheral blood samples were taken from all subjects in order to determine patients’ genotype distribution, mRNA expression level of NOS3 and NO content of plasma. Patients were then instructed to use 25 mg nortriptyline at night before bed for 3 months. At the end of 3rd month of the treatment patients again recorded the migraine characteristics for 1 month and blood sampling was performed in order to determine the level of plasma NO.Results: The patients’ genotype distribution for TT, GT, and GG was 9, 24, and 47 subjects, respectively. Mean NO level in patients with TT genotype was less in comparison to GT and GG genotypes before and after use of TCAs (P < 0.05). Mean intensity of headaches in patients with TT genotype was lower in comparison to GT and GG genotypes before and after use of TCAs (based on verbal numerical rating scale). Mean frequency of migraine attacks after use of TCAs was significantly decreased in all genotypes of NOS3 Glu298Asp polymorphism particularly in TT genotype (P < 0.05).Conclusion: Presence of T allele of the Glu298Asp polymorphism may be a factor for TT genotype patients to produce less NO and is a favorable factor for better response to TCAs in reducing migraine attacks in comparison to GT and GG genotypes.
Roya Abolfazli; Azam Elyasi; Mohammad Reza Javadi; Kheirollah Gholami; Hassan Torkamandi; Mohammad Amir-Shahkarami; Masoud Etemadifar; Zahra Nasr
Volume 13, Issue 3 , September 2014, , Pages 160-167
Abstract
Background: Multiple sclerosis (MS) patients permanently confronted with serious challenges from treatment regimen. Developing a new questionnaire in MS management, through evaluation of patients’ perspectives and knowledge regarding treatment will help to identify ...
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Background: Multiple sclerosis (MS) patients permanently confronted with serious challenges from treatment regimen. Developing a new questionnaire in MS management, through evaluation of patients’ perspectives and knowledge regarding treatment will help to identify the sources of tension, and to build a therapeutic alliance. We purposed to describe MS patients’ understanding of their treatments.Methods: About 425 completed and returned questionnaire were assessed of a total of 500 recruited MS patients. The knowledge of correct using interferon-beta (IFN-β) and attitude toward medical care were assessed using self- reported questionnaires consisted of 25 items with validity of multidisciplinary panel and pre-testing on 20 patients.Results: Knowledge about IFN-β therapy was very low; however, attitude was at a high level. Female patients, self- injection ability, higher educational level, normal functional status, delay from the start of diagnostic workup to definite diagnosis, and being younger were related to a higher level of knowledge. Attitude was associated with functional status, family history of disease and the summary of knowledge variable.Conclusion: Developing educational interventions are needed for MS patients regarding to their low levels of knowledge.
Mahshid Hosseini Behbahani; Hamid Galehdari; Maryam Mohaghegh
Volume 13, Issue 3 , September 2014, , Pages 168-171
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of central nervous system with unknown causes. Etiology of MS involves both genetic and environment factors. The interleukin 7 receptor (IL7R) gene ...
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Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of central nervous system with unknown causes. Etiology of MS involves both genetic and environment factors. The interleukin 7 receptor (IL7R) gene is a promising candidate for MS, because its involvement in the autoimmunity, regulation of the T-cell homeostasis, proliferation, and anti-apoptotic signaling.Methods: We investigated the association of the IL7R gene polymorphism rs6897932 in MS patients in a case and control study. In this case and control study participating, 127 relapsing-remitting MS (RRMS) patients (mean age: 32.25, age range: 16-57) selected according McDonald criteria, and 109 ethnically, sex and age matched healthy control (mean age: 27.44, age range: 14-63) with no personal or family history of autoimmune diseases were studied. DNA was extracted from whole blood using high pure polymerase chain reaction template preparatio kit from Roch Company. Amplification refractory mutation system method was applied to define the genotyping C/T within exon 6 of the IL7R gene among individuals.Results: Evaluation of the IL7R gene polymorphism revealed that the T allele and the C/T and T/T genotypes are present in 53.5%, 42.5%, 4.0%, and 68.8%, 26.6%, 4.6% in MS patients and controls, respectively. Comparison between alleles and genotypes in the MS patients and healthy controls show significant differences (P = 0.038).Conclusion: The distribution of the rs6897932 polymorphism is significantly different in our case/control study in Khuzestan Province. This single nucleotide polymorphism causes alternative splicing in exon 6 of the IL7R gene with possible influence of the autoimmunity.
Samia Younes; Yousra Cherif; Mouna Aissi; Wafa Alaya; Olfa Berriche; Amel Boughammoura; Mahbouba Frih-Ayed; Baha Zantour; Mohamed Habib Sfar
Volume 13, Issue 3 , September 2014, , Pages 172-176
Abstract
Background: Non-ketotic hyperglycemia (NKHG) may increase the probability of seizures and movement disorders. Methods: We describe a series of 14 elders admitted for seizures and movement disorders linked to NKHG.Results: Twelve patients developed motor seizures and two others movement disorders. ...
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Background: Non-ketotic hyperglycemia (NKHG) may increase the probability of seizures and movement disorders. Methods: We describe a series of 14 elders admitted for seizures and movement disorders linked to NKHG.Results: Twelve patients developed motor seizures and two others movement disorders. Glucose levels varied 9.28 to 32 mmol/l, while osmolarity values varied from 302.28 to 328 mosmol/l. All patients responded well to insulin therapy and four of them needed anti-epileptic drugs.Conclusion: Seizures or movement disorders in elderly with NKHG could be misdiagnosed as neurological diseases. Blood glucose must be audited whenever patients with seizures or movement disorders are encountered, as the condition may quickly resolve when NKHG is controlled.Introduction: Seizures and movement disorders related to non- ketotic hyperglycemia (NKHG) have been reported with increasing frequency since the first case documented in 1965.1,2 The clinical spectr m of this syndrome is various with a severe course in elderly. It develops more quickly than other disorders of diabetes mellitus with hyperglycemia, but usually without evidence of ketosis.2,3 Since the syndrome often ensues during the course of any illness and yet has not been reported in diverse medical fields, doctors must become familiar with this preventable condition, especially in elders. Thus, only the prompt institution of appropriate insulin therapy will improve prognosis and hasten recovery.2,3
Anahid Safari; Esmail Jafari; Afshin Borhani-Haghighi
Volume 13, Issue 3 , September 2014, , Pages 177-180
Abstract
Morning glory syndrome (MGS) is a rare congenital optic disc anomaly characterized by a funnel-shaped, excavated optic disc surrounded by chorioretinal pigmentary disturbance. The main ophthalomoscopic feature of the MGS is enlarged optic disc with a funnel shaped scleral defect; elevated peripapillary ...
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Morning glory syndrome (MGS) is a rare congenital optic disc anomaly characterized by a funnel-shaped, excavated optic disc surrounded by chorioretinal pigmentary disturbance. The main ophthalomoscopic feature of the MGS is enlarged optic disc with a funnel shaped scleral defect; elevated peripapillary chorioretinal pigmentation; and pale fluffy tissue of glial hyperplasia overlying the optic disc. Although most of the reported cases were isolated ocular abnormality, but it may occurs in association with other ophthalmic abnormalities such as cyst of the optic nerve atrophy, congenital cataract, microophthalmos, and aniridia. Craniofacial deformities such as cleft lip and palate, hypertelorism, dysplatic ears; renal abnormalities; and cardiac defects have also been reported with MGS. Herein, we present a case of MGS associated with multiple sclerosis - a rather unusual concurrence.
Alireza Khoshnevisan; Askar Ghorbani; Narges Sistany Allahabadi; Farshid Farzaneh; Sina Abdollahzadeh; Sepehr Soleymani; Vahidreza Ostovan
Volume 13, Issue 3 , September 2014, , Pages 181-184
Abstract
Central nervous system infection is a rare complication of endovascular procedures. We report a 21-year-old woman presented with headache, nausea, vomiting, and right-sided hemiparesis 4 months after endovascular embolization of cerebral arteriovenous malformation. Investigations led to the diagnosis ...
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Central nervous system infection is a rare complication of endovascular procedures. We report a 21-year-old woman presented with headache, nausea, vomiting, and right-sided hemiparesis 4 months after endovascular embolization of cerebral arteriovenous malformation. Investigations led to the diagnosis of multiple brain abscesses. This is the sixth case report of brain abscess following endovascular interventions.
Mohammad Taher Rajabi; Seyed Ziaeddin Tabatabaie; Mohammad Bagher Rajabi; Yalda Abrishami; Seyedeh Simindokht Hosseini; James Oestreicher
Volume 13, Issue 3 , September 2014, , Pages 185-187
Anahita Sadeghi; Behrouz Navabakhsh; Leila Aghaghazvini
Volume 13, Issue 3 , September 2014, , Pages 188-190
Abdorreza Naser Moghadasi
Volume 13, Issue 3 , September 2014, , Pages 191-192
Mehdi Farhoudi; Kaveh Mehrvar; Hadiseh Kavandi; Arash Aslanabadi
Volume 13, Issue 3 , September 2014, , Pages 193-194
Bahaadin Siroos; Mohammad Hossein Harirchian
Volume 13, Issue 2 , June 2014, , Pages 57-63
Abstract
Multiple sclerosis (MS) is the most common chronic autoimmune demyelinating disorder of the central nervous system (CNS) which preferentially involves young women in early child bearing age. Opposite to traditional view emphasized on discouraging female patients from enduring pregnancy, recent investigations ...
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Multiple sclerosis (MS) is the most common chronic autoimmune demyelinating disorder of the central nervous system (CNS) which preferentially involves young women in early child bearing age. Opposite to traditional view emphasized on discouraging female patients from enduring pregnancy, recent investigations showed that pregnancy-related physiological alterations, especially during the third trimester, reduce the annual relapse rate of multiple sclerosis up to 80% which is comparable with conventional disease modifying drugs. Nowadays, expert's viewpoint is that female patients should not be discouraged from having children. Nonetheless, who and when should be allowed to endure gestational period is a complex decision which should be taken for every patient individually. It necessitates that neurologists be aware of updated information regarding pregnancy-related fetal and maternal considerations in patients with MS. In this brief review, it was tried to discuss this topic according to available data and guideline-based recommendations.
Fahimeh Abdollahi; Seyed Aidin Sajedi
Volume 13, Issue 2 , June 2014, , Pages 64-49
Abstract
Background:Recently, we introduced solar related geomagnetic disturbances (GMD) as a potential environmental risk factor for multiple sclerosis (MS). The aim of this study was to test probable correlation between solar activities and GMD with long-term variations of MS incidence.Methods:After a systematic ...
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Background:Recently, we introduced solar related geomagnetic disturbances (GMD) as a potential environmental risk factor for multiple sclerosis (MS). The aim of this study was to test probable correlation between solar activities and GMD with long-term variations of MS incidence.Methods:After a systematic review, we studied the association betwee n alterations in the solar wind velocity (VSW) and planetary A index (AP, a GMD index) with MS incidence in Tehran and western Greece, during the 23(rd) solar cycle (1996-2008), by an ecological-correlational study.Results:We found moderate to strong correlations among MS incidence of Tehran with VSW (rS = 0.665, P = 0.013), with 1 year delay, and also with AP (rS = 0.864, P = 0.001) with 2 year delay. There were very strong correlations among MS incidence data of Greece with VSW (r = 0.906, P < 0.001) and with AP (r = 0.844, P = 0.001), both with 1 year lag.Conclusion:It is the first time that a hypothesis has introduced an environmental factor that may describe MS incidence alterations; however, it should be reminded that correlation does not mean necessarily the existence of a causal relationship. Important message of these findings for researchers is to provide MS incidence reports with higher resolution for consecutive years, based on the time of disease onset and relapses, not just the time of diagnosis. Then, it would be possible to further investigate the validity of GMD hypothesis or any other probable environmental risk factors.
Sheyda Shaafi; Ehsan Sharifipour; Rouhollah Rahmanifar; SeyedShamseddin Hejazi; Sasan Andalib; Masoud Nikanfar; Behzad Baradarn; Robab Mehdizadeh
Volume 13, Issue 2 , June 2014, , Pages 70-76
Abstract
Background: Interleukin-6 (IL-6) is one of the inflammatory mediators characterized by elevated levels in ischemic stroke (IS) patients. The present study set out to assess the role of IL-6, as a marker for inflammation, in the severity and prognosis of acute IS.Methods:In a cross-sectional descriptive ...
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Background: Interleukin-6 (IL-6) is one of the inflammatory mediators characterized by elevated levels in ischemic stroke (IS) patients. The present study set out to assess the role of IL-6, as a marker for inflammation, in the severity and prognosis of acute IS.Methods:In a cross-sectional descriptive study, 45 patients with acute IS were selected. Patients with their first day of stroke were included in the study. National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) for stroke severity were evaluated on Days 1, 5, 90, and 365. Serum IL-6 level was measured by enzyme-linked immunosorbent assay (ELISA) on days 1 and 5.Results:In the present study, 45 patients with a mean age of 77.6 ± 4.9 including 32 (71%) men and 13 (28.9%) women were studied. Death occurred in 2 (4.4%) patients before discharge from the hospital; the others, be that as it may, followed the study until Day 365 with a mortality rate of 6 (13.3%). A positive significant correlation was found between IL-6, and NIHSS and mRS of the patients from the time of admission to the end of the follow-up period (P < 0.001, r = 0.6). Moreover, there was a significant correlation between IL-6 and infarction size in brain magnetic resonance imaging (MRI) scan (P < 0.001, r = 0.7).Conclusion:The evidence from the present study suggests that IL-6 contributes to determination of severity of ischemic stroke. In addition, IL-6 concentrations affect clinical outcomes in ischemic stroke.
Fariba Yadegari; Mojtaba Azimian; Mahdi Rahgozar; Babak Shekarchi
Volume 13, Issue 2 , June 2014, , Pages 77-82
Abstract
Background: As both oral and verbal apraxia are related to vocal orofacial musculature, this study aimed at identifying brain regions impaired in cases with oral and verbal apraxia.Methods: In this non-experimental study, 46 left brain damaged subjects (17 females) aged 23–84 years, ...
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Background: As both oral and verbal apraxia are related to vocal orofacial musculature, this study aimed at identifying brain regions impaired in cases with oral and verbal apraxia.Methods: In this non-experimental study, 46 left brain damaged subjects (17 females) aged 23–84 years, were examined by oral and verbal apraxia tasks. Impaired and spared Broca’s area, insula, and middle frontal gyrus in the left hemisphere were checked from magnetic resonance imaging and computed tomography scans utilizing Talairach Atlas. Data were analyzed using chi-square test.Results: Insula was significantly impaired in both forms of oral and verbal apraxia and different severities and prominent forms of both apraxias (P < 0.05). Broca’s area was slightly less involved than insula in two forms of apraxia.Conclusion: As the damage of insula was more prominent in both forms of apraxias, it seems that oral and verbal apraxia may have commonalities regardin their underlying brain lesions.
Davood Sobhani-Rad; Askar Ghorbani; Hassan Ashayeri; Shohereh Jalaei; Behrooz Mahmoodi-Bakhtiari
Volume 13, Issue 2 , June 2014, , Pages 83-87
Abstract
Background: Pragmatics is appropriate use of language across a variety of social contexts that provides accurate interpretation of intentions. The occurrence of the right hemisphere lesions can interfere with pragmatic abilities, and particularly with the processing of nonliteral ...
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Background: Pragmatics is appropriate use of language across a variety of social contexts that provides accurate interpretation of intentions. The occurrence of the right hemisphere lesions can interfere with pragmatic abilities, and particularly with the processing of nonliteral speech acts.Methods: Since the objective of this study was to assess different aspects of pragmatic competence in the right hemisphere damage (RHD) patients, 20 Iranian patients with right hemisphere lesions were examined by adult pragmatic profile (APP) and a novel checklist was introduced for Persian language speaking individuals. Meanwhile, 40 healthy adult individuals, who were age and gender matched with RHD patients, were considered as the control group. After obtaining video records, all subjects were evaluated for 35 pragmatic skills, including 24 verbal, 5 paralinguistic, and 6 nonverbal aspects, by a two-point scale system.Results: Studying RHD patients and their healthy counterparts revealed that the performance by participants with right hemisphere lesions exhibited a high degree of inappropriate pragmatic abilities compared with controls in all domains. Furthermore, RHD patients showed a trend of increasing difficulty in understanding and producing different pragmatic phenomena, including standard communication acts.Conclusion: Present results indicated that the right hemisphere lesions significantly affected pragmatic abilities in verbal, paralinguistic and nonverbal aspects. Such a pattern of performance, which is in line with deficits previously reported for RHD, proved the unquestioned role of the right hemisphere in processing nonliteral language.
Masoud Etemadifar; Farshid Afshar; Zahra Nasr; Mohsen Kheradmand
Volume 13, Issue 2 , June 2014, , Pages 88-93
Abstract
Background: Multiple sclerosis (MS) is an autoimmune inflammatory disease that affects the central nervous system. Except tremor, other movement disorders such as Parkinsonism are less frequent in MS. However, some investigations have shown inflammatory and autoimmune aspects of Parkinson’s ...
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Background: Multiple sclerosis (MS) is an autoimmune inflammatory disease that affects the central nervous system. Except tremor, other movement disorders such as Parkinsonism are less frequent in MS. However, some investigations have shown inflammatory and autoimmune aspects of Parkinson’s disease. In this study, we report eight new cases of MS who present Parkinson’s disease.Methods: This retrospective population-based study was carried out on Isfahan MS society between April 2003 and July 2012. A total of 3792 patients with MS were surveyed for Parkinson’s disease. Parkinson’s disease was approved according to “UK Parkinson disease Brain Bank” criteria. Eligible cases were invited to have an interview with a neurologist. MRI was carried out according to the baseline.Results: We identified eight patients (three men and five women) who present MS and Parkinson’s disease. The mean (±SD) age of onset was 33.3 ± 6.5 (range: 24–42) years for MS and 39.5 ± 8. (range: 30–55) years for Parkinson’s disease patients. In all patients, MS was preceded Parkinson’s disease. Parkinson’s disease was developed within mean duration of 6.1 ± 3.4 (range 2–13) years after MS. Focal lesions was shown in six cases, lesions of basal ganglia (BG) in four, lesions of the thalamus in two and lesions of mid-brain in five of cases. In four cases, Parkinsonism occurred before age 40 that is considered as Young-Onset Parkinson’s disease.Conclusion: We reported eight patients with MS and Parkinson’s disease. To the best of our knowledge, 34 cases of Parkinsonism associating with MS are reported so far. Parkinsonism is a movement disorder, defines as deep gray matter disorder which lead to dopamine deficiency in BG.Investigations have shown that MS could affect deep gray matter structures. Demyelinated lesions in MS and consequence axonal loss in BG and/or nigrostriatal pathway may be responsible for Parki sonism manifestations in such cases.
Nahid Ashjazadeh; Golnaz Yadollahikhales; Anaheed Ayoobzadehshirazi; Nazanin Sadraii; Negin Hadi
Volume 13, Issue 2 , June 2014, , Pages 94-100
Abstract
Background: Epilepsy is defined as recurrent unprovoked febrile seizures, which cause disability in patients. This study aims to assess the health-related quality-of-life (QOL) in epileptic patients in Fars Province, southern Iran.Methods: One-hundred epileptic patients, above ...
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Background: Epilepsy is defined as recurrent unprovoked febrile seizures, which cause disability in patients. This study aims to assess the health-related quality-of-life (QOL) in epileptic patients in Fars Province, southern Iran.Methods: One-hundred epileptic patients, above 18 years, referred to Shiraz University of Medical Sciences affiliated clinics, were included. The QOL of patients with generalized and partial seizure were assessed using the Iranian valid and reliable Sf-36 questionnaire. Patients’ socio-demographic and their disease features were also compared with each other using a questionnaire.Results: In partial epilepsy group (n = 24), the married patients in social functioning (SF) aspect of QOL (64.42 ± 14.29) (P = 0.024), the patients on antiepileptic drugs (AEDs) monotherapy in both physical functioning (PF) (88.75 ± 11.57) (P = 0.030) and SF (75.00 ± 6.68) (P = 0.022) aspects, the employed patients in PF aspect of QOL ( = 0.023) (91.87 ± 8.83) and those with high income in mental health aspect of QOL (P = 0.036 and correlation coeDcient = 0.413) got better scores compared with the partial epileptic patients who were single, on polytherapy, unemployed and had low to moderate income. In generalized epilepsy group (n = 76), patients on AEDs monotherapy in PFaspect of QOL (P = 0.025) (78.33 ± 24.36) and employed patients in vitality aspect (P = 0.023) (57.00 ± 28.25) had better scores.Data were analyzed using SPSS for windows.Conclusion: Epilepsy can affect patient’s life in a number of ways such as their lives, marriage, occupation, and education. We can encourage patients to find a partner, continue higher education and try to find a job.
Humain Baharvahdat; Hamid Etemadrezaie; Samira Zabyhian; Zahra Valipour; Babak Ganjeifar; Seyed Mohammad Mousavi Mirzaye; Payam Sasannejad; Kavian Ghandehari
Volume 13, Issue 2 , June 2014, , Pages 101-104
Abstract
Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved treatment for acute ischemic stroke within 4.5 h of symptoms onset. Decompressive craniectomy (DC) has been shown as an effective therapeutic modality in malignant middle cerebral artery (MCA) ...
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Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved treatment for acute ischemic stroke within 4.5 h of symptoms onset. Decompressive craniectomy (DC) has been shown as an effective therapeutic modality in malignant middle cerebral artery (MCA) infarction. As rt-PA could result in hemorrhagic complication during or after any surgery DC may be associated with severe bleeding after intravenous thrombolysis.Case Description: A 57-year-old woman was presented 90 min after the sudden onset of left hemiplegia. Despite intravenous thrombolytic therapy, she lost consciousness within 48 h and brain CT scan showed a right malignant MCA infarction associated with a small bleeding. DC was performed without any complication. The patient improved dramatically.Conclusion: DC could be done safety for malignant MCA infarction after unsuccessful intravenous thrombolytic therapy even the later was complicated with intra- infarction hemorrhage.
Mojtaba Azimian; Azam Shahvarughi-Farahani; Mahdi Rahgozar; Masoud Etemadifar; Zahra Nasr
Volume 13, Issue 2 , June 2014, , Pages 105-107
Abstract
Background: Fatigue, depression, and physical impairment are common among multiple sclerosis (MS) patients. The aim of this study was to determine the relationship between depression, physical impairment, and fatigue in an Iranian MS cohort.Methods: Fifty consecutive relapsing-remitting ...
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Background: Fatigue, depression, and physical impairment are common among multiple sclerosis (MS) patients. The aim of this study was to determine the relationship between depression, physical impairment, and fatigue in an Iranian MS cohort.Methods: Fifty consecutive relapsing-remitting MS patients and 50 age- and sex-matched healthy controls (HCs) were recruited from Sina Rehabilitation Clinic,Tehran, ran. The depression substance of Hospital Anxiety and Depression Scale (HADS), Expended Disability Status Scale, and Fatigue Severity Scale questionnaires were used to assess depression, physical impairment, and fatigue, respectively.Results: This study included 38 (76%) females and 12 (24%) males in both patients and HC groups. The depression substance of the HADS in MS and HCs showed a mean value of 1.92 ± 0.80 and 1.17 ± 0.38, respectively (P < 0.001). Pearson’s correlation analyses showed that in the MS group depression was associatedwith fatigue (r = 0.54, P = 0.01), but not with physical impairment (r = 0.16, p = 0.01),while fatigue was associated with both depression (r = 0.54, P = 0.01) and physical impairment (r = 0.36, P = 0.01). Depression in HCs group was also associated with fatigue (r -0.64, P = 0.01).Conclusion: Fatigue is associated with both depression and physical impairment, and an intervention in one of these conditions might improve others.
Fahmi Nasrallah; Joseph Vamecq; Ichraf Kraoua; Marie Joncquel-Chevalier Curt; Moncef Feki; Souheil Omar; Gilbert Briand; Ilhem Turki Ben Youssef; Naziha Kaabachi
Volume 13, Issue 2 , June 2014, , Pages 108-109
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