ABSTRACT
Objective: to investigate the frequency of white matter abnormalities [WMAs] in patients with migraine and their relationship to type, duration, and frequency of migraine attacks
Methods: eighty four patients with migraine whose ages ranged between 16 and 50 years were evaluated. Twenty four patients had migraine with aura and 60 had migraine without aura, according to the diagnostic criteria of the International Headache Society. Patients with known vascular risk factors were excluded. Twenty age and sex matched healthy subjects were used as a control group. MRI brain was done in all patients and control group and evaluated for the presence of white matter lesions
Results: in 15 [17.9%] of 84 patients, white matter abnormalities were present on magnetic resonance imaging. Ten of these patients [66.7%] had migraine with aura, and 5 patients [33.3%] had migraine without aura. The presence of white matter foci was significantly higher in patients with aura than in those without aura [p<0.001]. Patients with WMAs were significantly older than those without [p<0.05]. Frequency of WMAs was significantly higher in those with history of more than two attacks per month [P<0.05]. The presence of WMAs was not significantly related to sex, disease duration or ergotamine consumption
We conclude that patients with migraine may have non-specific WMAs. Detection of white matter foci should be interpreted with particular caution before diagnosing other conditions since these lesions could be ischemic in origin and related to age, migraine with aura and attack frequency
ABSTRACT
Objective: To evaluate the diagnostic value of ultrasonography in patients with clinically and electrophysiologically confirmed carpal tunnel syndrome [CTS]
Methodology: Seventy three wrists of 48 patients with clinically and electrophysiologically confirmed CTS and 60 wrists of 40 asymptomatic controls were included in the study. All of them underwent high resolution ultrasonography of the wrists. Cross sectional area and flattening ratio at the proximal carpal tunnel were measured in both groups
Results: There was a high degree of correlation between median nerve conduction abnormalities and the measurement of cross sectional area as measured by ultrasound [p<0.001]. The ultrasonographic measurements of median nerves were found to be increased significantly in patients with carpal tunnel syndrome when compared with controls, particularly in terms of cross sectional area [mean, 10.6 mm2 versus 6.1 mm2 p <0.001] and the flattening ratio [p<0.001]. A cut off value of cross sectional area larger than 9 mm2 at the level of proximal carpal tunnel provided a diagnostic sensitivity of 75.3% and specificity of 95 % and in 20.5 % of wrists, morphological changes suggested secondary causes
Conclusion: Additional diagnostic confirmation can be provided by ultrasonography, which is a sensitive, specific and useful non-invasive method for diagnosis of CTS and evaluation of the morphologic changes of the median nerve in CTS patients