[Survey of various post stroke pain syndromes and the related risk factors]

Stroke is the most common cause of disability among neurologic disorders. Post stroke pain is a common and often neglected complication with prevalence in several studies ranging from 18.6% to 49%. Different types of pain occur following stroke that including central, nociceptive, and spastic, headache, and others. It is also important to differentiate between various causes of pain because of their different clinical pictures, risk factors and treatments. To evaluate the relative frequency of post stroke pain syndromes and respective related risk factors. In this cross -sectional descriptive study 389 consecutive patients with stroke during the last 3 months, who visited in spring 2011 at the neurology clinic of Poursina Hospital for their routine follow up, were interviewed and examined for the presence and classification of post stroke pains. Demographic data and stroke characteristics were also registered. Collected data were analyzed using SPSS 16 software version. Among the 389 patients, 142 [36.5%] complained about post stroke pain. The most common types of pain were spastic pains and headaches [12.9% and 11.1%, respectively] and the most common locations of pain were upper limbs, and head [18.5% and 11.3%, respectively]. Nociceptive and central pains were significantly more common in deep gray nuclei and internal capsule infarcts [P=0.002 and P=0.001, respectively] and headache was more common in brainstem infarcts [p=0.022]. There were no associations between other types of pain and location of lesion. Post stroke pain is a common complication of stroke. As pain syndromes adversely affect the quality of life, and are potentially treatable, it is important to consider the occurrence of pain in all stroke patients in any outpatient visit. Pattern of correlated risk factors such as location of the lesion can help predict certain types of post stroke pain syndromes

[Fatigue in multiple sclerosis and its relationship to clinical status]

Multiple Sclerosis [MS] is the leading cause of permanent disability in young adults. Iran is considered a high risk zone for MS and its incidence has risen in recent years. Fatigue is a common and disabling symptom in MS and its timely diagnosis and treatment can markedly improve the quality of life in the affected patients. There is a considerable heterogeneity in the results of most reported studies on the prevalence of fatigue in MS and its contributing factors. Most of them did not pay attention specifically to the role of clinical parameters in the prevalence and severity of fatigue. To determine the relative frequency of fatigue in MS patients and the link between fatigue and clinical status. In this cross-sectional study, 167 patients with definite relapsing MS, according to McDonald 2005 criteria, filled the questionnaires containing items on demographic data and main clinical symptoms of MS [visual, sensory, motor, balance, and sphincteric] and Fatigue Severity Scale [FSS]. Then, they were examined to determine Expanded Disability Status Scale [EDSS] score. In 167 patients, 43 [25.7%] were male and 124 [74.3%] were female. Mean age, fatigue severity according to FSS and EDSS score were 32.34, 39.49, and 1.96, respectively. Relative frequency of fatigue was 60.5%. In univariate analysis, a significant correlation was found between fatigue severity and age, EDSS score, pyramidal involvement, imbalance, visual and sphincter involvement, however, in multivariate analysis a significant correlation was only found with EDSS score and age. Fatigue is a frequent symptom in the patients with MS. It is a heterogenous symptom with numerous etiologies; however, the clinical status of the patients can greatly help predict its occurrence. It seems that EDSS score is an efficient and sufficient clinical indicator of fatigue severity

[Effect of donepezil on improvement of consciousness in patients with strock]

Strock is the common cause of death after cardiovascular diseases and cancer. Middle cerebral artery occlusion is the most common disease and because of its high extension in brain, the loss of consciousness is more. Donepezil protected neurologic cells. Effect of donepezil on improvement of consciousness in patients with strock. In this double blind clinical trial study 59 patients were selected according to inclusion criteria and filling out the consent form. They randomly divided to two groups: 28 patients who received donepezil 5mg daily till 4 weeks the 10 mg daily till 3 months [cases group] and 31 patients who received placebo [control group]. Patients' consciousnesses were registered before and after intervention. Change of consciousness was compared between two groups using spss 10. Improvement, no change and deterioration of consciousness was 26.9%, 46.2% and 26.9% in Donepezil group and 3.6%, 32.1% and 64.3% in placebo group, respectively. [p=0.008]. There was a significant difference between two groups, so Donepezil is significantly effective in improvement of consciousness, reduction of mortality and hospitalization in patients with strock

[Survey the correlation between f wave persistence and level of consciousness in stroke patients]

Level of consciousness is an important factor in management of critically ill patients and predicting outcome. However there is no quantitative, reproducible measure for evaluation of consciousness. F wave persistence can be influenced by level of consciousness according to some studies. Survey the correlation between F wave persistence and level of consciousness in stroke patients. In this cross sectional study, 114 patients within 72 hours of stroke onset were divided according to their level of consciousness either with GCS and qualitative method. F wave persistence were obtained in each Tibial nerves. Effects of background variables including side of study, side of hemiparesis, type of stroke, and sex were evaluated. Data were analyzed by SPSS 14.0 and ANCOVA statistic model. A significant correlation were found between F wave persistence and level of consciousness, either with GCS or qualitative method [P0.001]. These results were independent of the side of study, side of hemiparesis, type of stroke, and sex. F wave persistence can be influenced by level of consciousness. F wave study may be a useful objective and quantitative measure in documenting the severity of consciousness impairment