Acta Neurologica Taiwanica[JOURNAL]
Sun
200 papers
Molecular, biochemical and histological assessment in paraquat induced neurotoxicity: restoring role of nano-curcumin in an experimental study.
Mohammadi M, Tajedini SS, Sadeghian Z … +4 more , Asl SS, Kheiripour N, Sabahi M, Ranjbar A
Acta Neurol Taiwan · 2024 Sep · PMID 37848242
BACKGROUND: Paraquat is known to cause damage to various organs, including the brain. Although curcumin have anti-inflammatory and anti-oxidant properties, it is not yet clear how they relate to PQ-induced neurotoxicity....
BACKGROUND: Paraquat is known to cause damage to various organs, including the brain. Although curcumin have anti-inflammatory and anti-oxidant properties, it is not yet clear how they relate to PQ-induced neurotoxicity. This study's objective was to compare the effects of curcumin and nanocurcumin on PQ-induced neurotoxicity in male rats. CONCLUSIONS: Treatment with curcumin and nano-curcumin improves brain function in PQ toxicity and nanocurcumin was more advantageous than ordinary curcumin.
Non-Hodgkin's Lymphoma of the Central Nervous System with N-Methyl-D-Aspartate Receptor Antibody Positivity - A Case Report.
Tunc H, Camkiran E, Gemici A … +5 more , Irmak S, Ismayilzade H, Aliyev R, Bozkurt S, Midi I
Acta Neurol Taiwan · 2024 Jun · PMID 37848241
PURPOSE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, among the paraneoplastic syndromes, is a recently characterized autoimmune encephalitis most commonly associated with antibodies against subunits of the N...
PURPOSE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, among the paraneoplastic syndromes, is a recently characterized autoimmune encephalitis most commonly associated with antibodies against subunits of the NMDAR in the central nervous system. As a paraneoplastic syndrome, anti-NMDAR encephalitis is commonly associated with ovarian teratomas, small cell lung carcinomas and testicular germ cell tumors. To our knowledge, there have been no cases with primary central nervous system lymphoma (PCNSL), a rare type of extranodal non-Hodgkin's lymphoma, without lymph node involvement associated with anti-NMDAR encephalitis. CASE REPORT: A 58-year-old right-handed male patient with complaints of instability in walking for two months, progressively smaller handwriting, hallucinations when falling asleep or waking up, decreased memory, inability to maintain attention was admitted to our hospital for further diagnosis and treatment. Lumbar puncture was performed with the diagnosis of possible encephalitis after many further examinations and CSF studies revealed NMDAR antibody positivity, leading to the initial diagnosis of anti - NMDAR encephalitis. He was treated with high dose methylprednisolone and intravenous immunoglobulin. Due to the continuation of the patient's presenting symptoms and cranial magnetic resonance imaging findings, a stereotactic brain biopsy was performed from the area with contrast enhancement and the diagnosis was revised as PCNSL associated with NMDAR antibody positivity. CONCLUSION: This report emphasizes the importance of anti-NMDAR encephalitis as a paraneoplastic syndrome in previously undiagnosed PCNSL. Therefore, it is crucial to be aware of anti-NMDAR encephalitis as a paraneoplastic neurological syndrome that can present with non-Hodgkin's lymphoma. It is necessary to continually observe the evolution of the disease and perform further diagnostic tests for early identification.
Steroid-responsive multifocal motor neuropathy with cranial manifestations - a case report.
Chen YH, Wei YC, Weng WC … +2 more , Chien YY, Wu CL
Acta Neurol Taiwan · 2024 Mar · PMID 37848240
The typical presentation of multifocal motor neuropathy (MMN) is progressive asymmetric limb weakness. Cranial neuropathy is rare. We report a 28-year-old woman with cranial and bulbar palsies but with typical electrophy...
The typical presentation of multifocal motor neuropathy (MMN) is progressive asymmetric limb weakness. Cranial neuropathy is rare. We report a 28-year-old woman with cranial and bulbar palsies but with typical electrophysiological features of MMN by multifocal motor conduction blocks and serological markers of anti-ganglioside GM1 antibodies. The previous consensus on the treatment of MMN is intravenous immunoglobulins, but our patient responded to oral steroids and had clinical and electrophysiological improvement under continuous low-dose prednisolone treatment. In summary, MMN is a treatable chronic inflammatory disease of peripheral nerves. Cranial neuropathies can be its initial presentations. Electromyography studies are crucial for MMN diagnosis and helpful in monitoring disease activity and treatment responses. Although the previous guideline did not suggest using steroids for MMN, with careful patient selection, low-dose oral steroids can be an effective treatment in patients with relatively minor symptoms. Keywords: Multifocal motor neuropathy, conduction block, bulbar palsy, cranial nerve, cranial neuropathy.
Antioxidant and Apoptotic Effect of Edaravone on Cisplatin-Induced Brain Injury in Rats.
Kara O, Kilitci A
Acta Neurol Taiwan · 2024 Mar · PMID 37848239
PURPOSE: This study aims to investigate the effect of edaravone in preventing cisplatin-induced brain damage. METHODS: Forty female Wistar albino rats were included in the study. 4 groups were created. In group 1 (contro...
PURPOSE: This study aims to investigate the effect of edaravone in preventing cisplatin-induced brain damage. METHODS: Forty female Wistar albino rats were included in the study. 4 groups were created. In group 1 (control group) (n=10), neither any drugs were given nor anything was performed. Group 2 (cisplatin group) (n=10), single dose 7.5 mg/kg cisplatin was given. In group 3 (edaravone group) (n=10), single dose 1 mg/kg edaravone was administered. Group 4 (cisplatin+ edaravone group) (n=10), single dose 7.5 mg/kg cisplatin and 1 mg/kg edaravone were given. Brain tissue was removed in all rats after 3 days. Blood samples taken from heart tissue were examined for malondialdehyde (MDA) and nitric oxide (NO) levels. Brain tissue was evaluated for damage with p53, GFAP and Ki 67. RESULTS: Edaravone reduced cisplatin-induced brain damage. MDA and NO levels in the cisplatin group were significantly higher than the other groups (p less than 0.05). Likewise, tissue damage in the cisplatin group was significantly higher than in the other groups (p less than 0.05). The immunohistochemical staining which was done by using p53, GFAP and Ki 67 was shown that tissue damage was higher in cisplatin group than cisplatin+ edaravone group and this difference was found to be statistically significant (p less than 0.05). CONCLUSION: The findings of our study suggest that edaravone therapy may be effective in the prevention and treatment of cisplatin-induced brain injury.
Millard-Gubler Syndrome due to Parenchymal Neuro-Behcet's Syndrome Lesion: a Rare Case Report.
Tosunoğlu B, Çokal BG, Güneş HN … +1 more , Yoldaş TK
Acta Neurol Taiwan · 2024 Mar · PMID 37848238
Behcet's disease; it is a vascular-inflammatory chronic recurrent disease that can affect many systems in the body. Millard Gubler syndrome is one of the brainstem syndromes that occurs due to lesions involving the ventr...
Behcet's disease; it is a vascular-inflammatory chronic recurrent disease that can affect many systems in the body. Millard Gubler syndrome is one of the brainstem syndromes that occurs due to lesions involving the ventral part of the caudal pons. We wanted to present a case of Millard Gubler syndrome, which developed due to Behçet's syndrome lesion in the pons ventral region in a patient who presented with limitation of outward gaze on the left, inability to close the left eye completely, inability to completely wrinkle the left side of the forehead, and loss of contralateral muscle strength. Keywords: Behcet's syndrome, parenchymal, abducens, facial, lesion.
Bilateral Medial Medullary Infarct with Unique Radiological Presentation.
Çakmakci G, Çetiner M, Uysal N … +2 more , Arikan FA, Kabay SC
Acta Neurol Taiwan · 2024 Mar · PMID 37848233 · Publisher ↗
Bilateral medial medullary infarction is a rare subtype of stroke.The typical heart-shaped appearance on magnetic resonance imaging is pathognomonic for bilateral medial medullary syndrome. Vertebrobasilar dolichoectasia...
Bilateral medial medullary infarction is a rare subtype of stroke.The typical heart-shaped appearance on magnetic resonance imaging is pathognomonic for bilateral medial medullary syndrome. Vertebrobasilar dolichoectasia is a condition characterized by tortuous dilatation and marked enlargement of the basilar and vertebral arteries, and it may cause posterior circulation infarction. We present the case of a 55-year-old female patient with complaints of speech disorder, regression in consciousness, and difficulty breathing. Diffusion-weighted imaging examination was normal on arrival. In the cranial imaging after 24 hours, acute infarction was observed in the bilateral medial medullary area. Time-of-flight magnetic resonance angiography revealed vertebrobasilar dolichoectasia. In this report, a case of bilateral medial medullary infarction with a unique radiological appearance accompanied by vertebrobasilar dolichoectasia, which is rarely reported in the literature, is presented. Keywords: Stroke, infarct, bilateral medial medullary infarction, heart appearance.
Fulminant Vaccine-Induced Immune Thrombotic Thrombocytopenia After ChAdOx1 nCoV-19 (AZD1222) Vaccine Administration in a Woman With Obesity: A Case Report.
Chou YL, Ling WS, Chiou YH
Acta Neurol Taiwan · 2024 Jun · PMID 37848232
Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare complication of ChAdOx1 nCoV-19 (AZD1222) vaccine administration. The overall incidence of VIT...
Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare complication of ChAdOx1 nCoV-19 (AZD1222) vaccine administration. The overall incidence of VITT worldwide is one case per 100 000 exposures. Because of the high mortality rate from VITT, thorough monitoring is crucial to predict the risk of occurrence. The underlying risk factors for VITT are not fully understood. Potential risk factors include sex (female) and young age (less than 50 years), but further research must be conducted to confirm these assumptions. We report the case of a woman with obesity, which is a risk factor for deep vein thrombosis in the legs and for pulmonary embolism, who experienced fulminant VITT after AZD1222 vaccine administration. Keywords: Vaccine-induced immune thrombotic thrombocytopenia, AZ vaccine, Obesity, Risk factor.
Clinico- Radiological Profile and Outcome of Isolated Paramedian Hemipontine Infarcts.
Basu E, Javali M, Haskar K … +4 more , Gogineni S, R P, Mehta A, T AP
Acta Neurol Taiwan · 2024 Jun · PMID 37848229
OBJECTIVE: To study the clinico- radiological profile and outcome of isolated paramedian hemipontine infarcts. MATERIALS AND METHODS: This is a prospective cross- sectional study. 50 consecutive patients admitted between...
OBJECTIVE: To study the clinico- radiological profile and outcome of isolated paramedian hemipontine infarcts. MATERIALS AND METHODS: This is a prospective cross- sectional study. 50 consecutive patients admitted between January 2019 and December 2020 with a diagnosis of isolated paramedian hemipontine stroke were included. The locations of the infarcts were classified as follows- caudal; middle; rostral; dorsomedian; caudal and middle; and middle and rostral pons. The clinico- radiological profiles were studied and the outcomes were assessed using NIHSS (National Institutes of Health Stroke Scale) and mRS (modified Rankin score). Data was analysed using SPSS 22 version software. Paired t-test was used as a test of significance to identify the mean differences between the two quantitative variables. RESULTS: Majority of the subjects were 51- 60 years (34 percent). The most common risk factors were hypertension and type 2 diabetes mellitus. The most common clinical features were hemiparesis and speech disturbances. Pure motor hemiparesis (PMH) is the common syndrome seen in paramedian hemipontine strokes with infarcts located in caudal; middle; caudal and middle; and middle and rostral pons. In ataxic hemiparesis, infarcts were located in dorsomedian pons. In dysarthria clumsy hand syndrome, infarcts were located at rostral pons. 44 percent of the subjects had left vertebral artery abnormality. There was a statistically significant difference in the mean NIHSS and mRS when compared at admission/ discharge and at 3 months. CONCLUSION: Isolated paramedian hemipontine stroke syndromes have good topographical correlation with patients usually having a good functional outcome at the end of three months.
Cytotoxic lesion of corpus callosum after COVID-19 vaccination: case report.
Chang WL, Cheng CF, Lin SK
Acta Neurol Taiwan · 2024 Jun · PMID 37848228
PURPOSE: Cytotoxic lesions of corpus callosum (CLOCCs) are associated with many disease entities. Serious neurological complications after coronavirus disease 2019 (COVID-19) vaccination are rare. CASE REPORT: A 20-year-...
PURPOSE: Cytotoxic lesions of corpus callosum (CLOCCs) are associated with many disease entities. Serious neurological complications after coronavirus disease 2019 (COVID-19) vaccination are rare. CASE REPORT: A 20-year-old man presented with severe headache for 2 days. He had received the first dose of ChAdOx1nCoV-19 COVID-19 vaccine 5 days ago. Persistent dull headache occurred on the third day after vaccination and intensified gradually to awaken him from sleep at night. No neck stiffness was observed. Brain magnetic resonance angiography (MRA) 9 days after vaccination revealed an oval-shaped diffusion-weighted restriction lesion at the splenium of corpus callosum with a mildly high signal intensity on T2-weighted images (T2WI) and low signal intensity on apparent diffusion coefficient (ADC) imaging but without enhancement after contrast injection. A COVID-19 polymerase chain reaction test was negative. A blood test revealed slight leukocytopenia, thrombocytopenia, and hyponatremia. Further autoimmune and hematological studies were normal. A cerebrospinal fluid study revealed normal intracranial pressure. The patient's headache improved gradually. Follow-up brain MRA 5 weeks after vaccination revealed complete disappearance of the diffusion-weighted restriction lesion of the splenium. CONCLUSION: CLOCCs are rare transient adverse effect of COVID-19 vaccination possibly related to a cytokine storm. The splenic lesion might disappear spontaneously with a good prognosis.
Isolated Bilateral Triceps Weakness in Myasthenia Gravis.
Özenç B, Işık K, Odabaşı Z
Acta Neurol Taiwan · 2024 Jun · PMID 37848221
PURPOSE: Myasthenia gravis (MG) is the most common autoimmune disease that affects the neuromuscular junction and can cause weakness in various muscle groups. The most commonly affected muscles are the eye, facial, and n...
PURPOSE: Myasthenia gravis (MG) is the most common autoimmune disease that affects the neuromuscular junction and can cause weakness in various muscle groups. The most commonly affected muscles are the eye, facial, and neck flexors. Focal or dominant weakness of the triceps muscle is rare. In this case, we aimed to describe a rare form of MG consisting of selective or dominant triceps muscle weakness. CASE REPORT: We present a 45-year-old male patient whose initial complaints were diplopia and ptosis. Acetylcholine receptor antibody was positive. After 10 years of well-being following thymectomy, bilateral triceps weakness was added to his ocular symptoms despite regular medication (pyridostigmine and prednisone). Repetitive nerve stimulation (RNS) showed decremental responses in the right triceps muscles. CONCLUSION: It is important to recognize this type of myasthenia gravis to facilitate diagnosis and appropriate treatment and to avoid unnecessary investigations and treatments.
Effects of Crocin on brain neurotrophins, cognition, balance and pain in toxic-induced demyelination model.
Fatemi R, Moghaddam HF, Farbod Y … +1 more , Beygtashkhani R
Acta Neurol Taiwan · 2024 Jun · PMID 37848220
OBJECTIVE: The purpose of this study was to investigate the effects of Crocin on brain neuroterophins, cognition, sensory and motor dysfunction and compare to fingolimod effects in toxic-induced demyelination with Ethidi...
OBJECTIVE: The purpose of this study was to investigate the effects of Crocin on brain neuroterophins, cognition, sensory and motor dysfunction and compare to fingolimod effects in toxic-induced demyelination with Ethidium Bromide EB in female Wistar rats. METHODS: Animals were assigned in to 8 groups; Sham, Sham operated (ShOp), EAE, crocin treated, Vehicle, Fingolompd (Fing) and fingolimod + crocin (Cr+Fing). Demyelination was induced by single dose injection of 10 μl of EB 0.1 percent into the fourth ventricle of the brain. Crocin and fingolimod were administered for 21 days, daily, oral gavage. BDNF, NGF1, tail flake latency, balance and behavioral variables were sampled and analyzed by paired t-test and ANOVA test with repeated post hoc measurements. RESULTS: The results showed that crocin improves all studied factors, but remarkable improvements were observed in dosage of 10 mg/kg. Crocin (10mg/kg) and fingolimod (1mg/kg) significantly improved cognition variables in open field test, sensory and motor nerve conduction velocity, tail flick latency and clinical scores (p less than 005). In addition, applying of crocin co-administered with fingolimod led to significant increases in all assessed factors, greater than crocin or fingolimod intervention alone. CONCLUSION: Based on the current findings, crocin can improve the level of brain neurotrophins, exploratory behavior, balance and pain after toxin-demyelination as close as fingolimod results.
Guillain-Barré Syndrome Following the mRNA COVID-19 Vaccination: Comment.
Mungmunpuntipantip R, Wiwanitkit V
Acta Neurol Taiwan · 2023 Dec · PMID 37781729
Dear Editor, we would like to share ideas on the publication "Guillain-Barré Syndrome Following the BNT162b2 mRNA COVID-19 Vaccine [1]." In order to advance our understanding of this consequence, Algahtani et al. describ...
Dear Editor, we would like to share ideas on the publication "Guillain-Barré Syndrome Following the BNT162b2 mRNA COVID-19 Vaccine [1]." In order to advance our understanding of this consequence, Algahtani et al. describe a case of Guillain-Barré syndrome following the first dose of the BNT162b2 mRNA COVID-19 vaccination [1]. Guillain-Barré syndrome following COVID-19 vaccination is treatable, according to Algahtani et al. [1]. The advantages of providing the vaccination exceed the dangers, according to Algahtani et al. [1]. Algahtani and co. mentioned Given the detrimental effects of COVID-19, it is crucial to be aware of the emergence of any potential neurological side effects after immunization, such as Guillain-Barré syndrome [1]. We can all agree that COVID-19 prevention is essential and that additional research is required to address the underlying clinical problem. The outcome of a vaccination test and the development of a clinical condition may be related. Prior to treating the clinical issues caused by COVID-19 vaccination, a few crucial aspects need to be taken into account Comorbidities should be taken into account first. For instance, when the sickness and the clinical state co-occur, dengue vaccinations may be employed. Early detection of asymptomatic COVID-19 individuals is crucial [2]. It's likely that prior COVID-19 epidemics affected the effectiveness and outcomes of the immunization. Infection with COVID-19 may have an impact on clinical outcomes. Without the necessary laboratory testing, it can be difficult to completely rule out an illness that was previously asymptomatic. A significant auxiliary influence is genetics [3]. The immune system's reaction to specific hereditary features may have an impact on how it reacts to the negative side effects of vaccination. Understanding how underlying genetic variables affect vaccine efficacy in clinical settings would be highly beneficial. In fact, more research is required to find a solution to this problem. The volume of clinical information needed will aid in researchers' knowledge.
Giant Internal Carotid Artery Aneurysm of the Cavernous Segment.
Rossi UG, Valdata A, Castaldi A
Acta Neurol Taiwan · 2023 Dec · PMID 37723917
A 70-year-old woman with a history of hypertension developed acute onset of severe tightness headache accompanied by vomiting. Patient reported having right diplopia and occasional and temporary right peripheral facial p...
A 70-year-old woman with a history of hypertension developed acute onset of severe tightness headache accompanied by vomiting. Patient reported having right diplopia and occasional and temporary right peripheral facial paralysis for two weeks. Neurological examination revealed only a right squint. Cerebral multi-detector computed tomographic angiography (MD-CTA) and Magnetic Resonance Imaging (MRI) revealed a giant right internal carotid aneurysm (2.7 cm) at the cavenous segment (Figure 1A, 1B). No abnormalities were noted in subarachnoid spaces and white - grey matter. A selective digital subtraction angiography (DSA) of the right internal carotid artery confirmed the giant aneurysm at the cavenous segment (Figure 2A, 2B). Subsequently endovascular flow-diverting stent was deployed at the cavernous segment of the right internal carotid artery to treat over time the giant aneurysm. Her clinical course has no neurological symptoms and she was discharged after two days with established over time clinical and imaging follow-up. Giant intracranial aneurysms and vascular anomalies of the internal carotid are rare, and are defined "giant" those greater than 2.5 cm in diameter (1-4). Conservative treatment of giant intracranial aneurysms have a mortality rates of 65-100% in 2-5 years (4). Clinical presentation of internal carotid aneurysms at the petrous segment can manifest from no-symptom to headache, cranial nerve disturbs and epistaxis (1- 4). MD-CTA and MRI are the two gold standard methods for diagnosis in patients with suspected internal carotid artery and intracranial artery aneurysm (1,5). Internal carotid aneurysms at the cavenous segment are located in a surgically difficult accessible area, therefore endovascular percutaneous techniques are considered the first lines treatments (6).
VISUAL SNOW SYNDROME IN A PEDIATRIC CASE.
Ozyurek H, Ozer PA, Oztepeli R … +1 more , Uysal GS
Acta Neurol Taiwan · 2023 Dec · PMID 37723916
INTRODUCTION Visual snow (VS) is a rare condition that is characterized by continuous dynamically flickering dots in the entire visual field that imitate the 'static' or 'snow' of an analogue television set that is not c...
INTRODUCTION Visual snow (VS) is a rare condition that is characterized by continuous dynamically flickering dots in the entire visual field that imitate the 'static' or 'snow' of an analogue television set that is not connected to the antenna (1). VS was first described in 3 of 10 migraineurs patients who presented with a spectrum of positive visual symptoms (2). The symptoms of VS can persist for many years. Although VS might be expressed in patients with migraine as visual aura, persistent VS has been accepted as a distinct clinical entity and termed as visual snow syndrome (VSS) independently from migraine. Schankin et al. proposed that the criteria for diagnosis of VSS consisted of visual snow as the main criterion, with some additional criteria (3). A few cases with childhood VSS have been described in literature (4-6). Herein, the case of a teenager was presented to emphasize the importance of differential diagnosis in persistent positive visual phenomena.
The Clinical Course of New-Onset Ocular Myasthenia Gravis Caused by Pfizer-BioNTech COVID-19 Vaccine.
Su WY, Lu CJ
Acta Neurol Taiwan · 2023 Dec · PMID 37723915
PURPOSE: Myasthenia gravis (MG) caused by COVID-19 vaccine had been reported, but the clinical course of new-onset ocular MG had never been described. We would like to document the clinical course of a patient with new-o...
PURPOSE: Myasthenia gravis (MG) caused by COVID-19 vaccine had been reported, but the clinical course of new-onset ocular MG had never been described. We would like to document the clinical course of a patient with new-onset ocular MG which was caused by Pfizer-BioNTech COVID-19 vaccine. CASE REPORT: A 39-year-old woman noticed diplopia one week after she accepted the first dose of Pfizer- BioNTech COVID-19 vaccine. Diagnosis of ocular MG was made after investigation. Despite intravenous immunoglobulins, pyridostigmine and prednisolone therapy, she had no improvement until 10 days after treatment. She then rapidly improved, and almost fully recovered in the following 10 days. We had observed this patient for 8 months. After tapering off steroid, she remained stable to date, though she still suffered from transient diplopia on awakening. CONCLUSION: No matter the symptoms at onset, the clinical course or the response to steroid therapy was identical to ocular MG that we had ever known. Ocular MG caused by COVID-19 vaccine could probably be an iatrogenic life-long disease.
Anti-SRP Myopathy with Sensorimotor Polyneuropathy: A Case Report.
Huang LY, Peng YJ, Sung YF
Acta Neurol Taiwan · 2023 Dec · PMID 37723914
PURPOSE: Anti-signal recognition particle (SRP) myopathy is a subtype of immune-mediated necrotizing myopathy. It rarely presents with extramuscular features, involving the skin, lung, and heart. This paper presents a ca...
PURPOSE: Anti-signal recognition particle (SRP) myopathy is a subtype of immune-mediated necrotizing myopathy. It rarely presents with extramuscular features, involving the skin, lung, and heart. This paper presents a case of anti-SRP myopathy associated with sensorimotor polyneuropathy. CASE REPORT: A 33-year-old woman with no history of systemic disease presented to our hospital with weakness and numbness of the lower limbs for 1 year. Electromyography and nerve conduction study (NCS) revealed combined myopathy and axonal sensorimotor polyneuropathy. Blood examination revealed increased levels of serum muscle enzymes and anti-SRP antibodies. T1-weighted magnetic resonance imaging revealed diffuse muscular hyperintensities in the thighs, indicative of fatty replacement. She was administered methylprednisolone pulse therapy, followed by oral prednisolone and azathioprine. Muscle power increased, and serum muscle enzyme levels decreased significantly. Subsequent NCS performed 2 years later revealed persistent axonal degeneration in the lower limbs. CONCLUSION: Anti-SRP myopathy can present with sensorimotor polyneuropathy. Thus, the possibility that the same pathological process affected the skeletal muscles and peripheral nerves should be considered.
A Case Report of Guillain-Barré Syndrome In Association with SARS-CoV-2 Vaccination in Malaysia.
Sii HL, Ng SH, Wong VF … +1 more , Law WC
Acta Neurol Taiwan · 2023 Dec · PMID 37723913
PURPOSE: Guillain-Barré Syndrome (GBS) associated with SARS-CoV-2 vaccine administration is very rare. Early recognition of GBS at early stage could prevent extensive nerve damage with potential respiratory and autonomic...
PURPOSE: Guillain-Barré Syndrome (GBS) associated with SARS-CoV-2 vaccine administration is very rare. Early recognition of GBS at early stage could prevent extensive nerve damage with potential respiratory and autonomic failure. CASE REPORT: We report a case of paraparetic spectrum of GBS in a 53-year-old lady who presented with rapidly progressive acute flaccid paralysis involving both lower extremities with areflexia eight days after the first dose of Sinovac vaccine for SARS-CoV-2 in Malaysia. Cerebrospinal fluid (CSF) albuminocytological dissociation was seen and nerve conduction study (NCS) revealed sensory neuropathy. The diagnosis of GBS was made based on the Brighton criteria. Patient responded well to intravenous immunoglobulin (IVIG). CONCLUSION: Though there is currently no convincing evidence of any causation between GBS and SARS- CoV-2 vaccination, clinicians should remain vigilant and consider GBS in the differential diagnosis for patient who presents with weakness with reduced or absent deep tendon reflex after vaccination against SARS-CoV-2.
Pure Sensory Lacunar Infarction in the Thalamus Presented as Bilateral Hypogeusia: A Case Report.
Wang YC, Chen IH, Huang P
Acta Neurol Taiwan · 2023 Dec · PMID 37723912
PURPOSE: While the gustatory pathway of animals has been well-researched, that of humans is still a mystery. Several theories have been established, and some earlier reports hypothesized the relation to laterality. Howev...
PURPOSE: While the gustatory pathway of animals has been well-researched, that of humans is still a mystery. Several theories have been established, and some earlier reports hypothesized the relation to laterality. However, some cases could not be fully explained by the laterality theory (1). To clarify the gustatory pathway, we reported a case with bilateral hypogeusia after right thalamic infarction. CASE: This 55-year-old, right-handed man suffered from sudden decreased sensitivity of taste. He was unable to differentiate sweetness and saltiness at bilateral anterior parts of tongue. Additionally, there was numbness at the upper palate and the lips. Neurological examination revealed decreased taste sense at both sides of his anterior tongue and decreased pin-prick sensation of the left part of his lips. Brain magnetic resonance imaging (MRI) revealed acute ischemic stroke at the right ventral posteromedial nucleus (VPM). Thus, single antiplatelet therapy was administered. Two weeks later, the symptoms improved significantly and completely recovered without sequelae. CONCLUSION: The exact gustatory pathway in humans remains uncertain nowadays. First, there were few reports about dysgeusia, which might be related to clinical neglect of taste deficits. Second, our knowledge of the human gustatory pathway depends solely on sporadic cases of taste-involved brain lesions. We reported a case of bilateral hypogeusia after right thalamic infarction. This finding indicates that, although there might be laterality of gustatory fibers to the left hemisphere, anatomical variations may exist in the human gustatory system. More research is needed to elucidate the understanding of the gustatory pathway in humans.
First-Ever Ischemic Stroke In Covid-19: How Is It Different? - A Stroke Registry-Based Study From South India.
Y MR, Murthy JM, Y SR … +7 more , Gattu AK, Jaiswal SK, Pidaparthi L, Parida S, B SK, Osman S, Kamatam SN
Acta Neurol Taiwan · 2023 Dec · PMID 37723911
Stroke associated with COVID-19 has been characterised in several multicentre retrospective studies and meta-analyses. However, they did not distinguish first-ever ischemic strokes (F-AIS). Therefore, we aimed to study t...
Stroke associated with COVID-19 has been characterised in several multicentre retrospective studies and meta-analyses. However, they did not distinguish first-ever ischemic strokes (F-AIS). Therefore, we aimed to study the incidence, clinical characteristics, and outcomes of a cohort of F-AIS associated with COVID-19 during the first wave of the pandemic and compare this cohort with those of F-AIS without COVID-19, COVID-19 without stroke. We also sought to compare the stroke admissions and mechanisms during the pandemic and immediate prepandemic periods.
A Morphological Study Of The Sensory Innervation Of Hand In South India With Its Clinical Implications.
Palimar V, Gupta C, M I … +1 more , Kalthur SG
Acta Neurol Taiwan · 2023 Dec · PMID 37723910
INTRODUCTION: The sensory innervation of the hand is getting a lot of attention because of the quick surge in the usage of local anesthesia and the progress of plastic surgeries. It is significant to know the likely disp...
INTRODUCTION: The sensory innervation of the hand is getting a lot of attention because of the quick surge in the usage of local anesthesia and the progress of plastic surgeries. It is significant to know the likely disparities in the sensory innervation of the hand to prevent mistakes while analyzing the symptoms or misdiagnosing the nerve pathology. So this study aims to assess the sensory innervation of the hand. MATERIALS AND METHOD: The study was carried out on 54 upper limbs. All the branches of the median, ulnar and radial nerve were traced. Variations in the distribution and anastomoses were noted. RESULTS: Anastomosis between the median and ulnar nerve was found in 12.95% of cases. In all cadavers, 3 1⁄2 digits are supplied by the median nerve and 1 1⁄2 digits by the ulnar nerve bilaterally in the palms. In all cadavers 2 1⁄2 digits, each is supplied by radial and ulnar nerve bilaterally on the dorsum of hands. CONCLUSION: These anatomic conclusions will aid hand surgeons in identifying differences in sensory losses after either dorsal or palmar injuries.
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