ABSTRACT
Objective Through an analysis of three cases of ocular flutter-opsoclonus in adults and a review of the relevant literature,we summarized its characteritics to improve the clinical awareness of this sign.Methods Three cases of adult-onset ocular flutter-opsoclonus from July 2014 to July 2017 were retrospectively analyzed in terms of clinical features,cerebrospinal fluid (CSF) analysis,brain imaging,etiologies and treatment,and followed up through telephone calls.Results Case 1:A 68-year-old man presented with ocular flutter,vertigo,myoclonus,ataxia and conscious disturbance.CSF analysis demonstrated pleocytosis and mildly elevated protein level.Brain MR imaging revealed ischemia,and SPECT showed hypoperfusion involving left frontal and occipital lobes.Paraneoplastic syndrome was considered as the etiology.The symptoms subsided without any specific treatment.He died from lung cancer within one year.Case 2:A 66-year-old man presented with ocular flutter,vertigo,ataxia,conscious disturbance and fever.CSF protein level was severely elevated.Brain MR imaging revealed ischemia.Epstein-Barr virus infection was considered as the etiology.The symptoms improved with the administration of antiviral drugs and steroid.Relapse was not observed in the two-year follow-up.Case 3:A 34-year-old woman presented with opsoclonus,oscillopsia,vertigo,ataxia,conscious disturbance and fever.MR imaging showed midbrain lesions.Viral brainstem encephalitis was considered as the etiology.The symptoms improved with the administration of antiviral drugs,steroid,intravenous immunoglobulin and clonazepam.Relapse was not observed in the two-year follow-up.Conclusions Infection and tumors are common etiologies of ocular flutter-opsoclonus.Treatment includes etiological management for infection or tumors and immunosuppressive therapy.The clinical outcomes vary with the underlying etiologies.
ABSTRACT
Objective To study the influence of nitric oxide synthase (NOS) inhibitor in a rat model of Parkinson’s disease. Methods Hemi-Parkinsonism rat model was established by stereotaxic 6-hydroxydopamine (6-OHDA) lesions in striatum in which nitric oxide synthase (NOS) was inhibited by L-Nitro-Arginine (L-NNA) and apomorphin-induced rotational behavior was measured. The immunohistochemical staining method was used to observe the change of striatal nNOS-positive neurons and nigral tyrosine hydroxylase(TH)-positive neurons. Results L-NNA dramatically protected 6-OHDA-injected rats against indices of severe injury to the nigrostriatal dopaminergic pathway, including decreases in numbers of TH-positive nigral neurons and rotational behavior. The nNOS-positive neurons showed no changes in numbers. Conclusions These results indicate that NO might mediate, in part, 6-OHDA-induced neurotoxicity and nNOS-positive neurons might resist the 6-OHDA neurotoxicity. NOS inhibitor may play a role in the protection of 6-OHDA neurons.
ABSTRACT
Objective To evaluate the effect of bilateral subthalamic nuclei deep brain stimulation (STN-DBS) on anxiety and depression of patients with Parkinson's disease(PD).Methods Forty-one consecutive patients with refractory motor fluctuations and dyskinesia were assessed with Hoehn & Yahr scale, Unified Parkinson’s Disease Rating Scale Ⅲ (UPDRSⅢ), HADS, PD Questionnaire Chinese version (PDQ-39) a week before surgery and 12 months after the surgical procedure. Results The scores of UPDRSⅢ, HADS and PDQ-39 significantly increased after STN-DBS treatment (all P