Diabetes mellitus and bell's palsy in Iranian population

During last decades many researchers have focused on the conditions associated with Bell's palsy including diabetes mellitus, hypertension, and viral infections. This study was performed to evaluate correlation of diabetes mellitus and Bell's palsy and some relevant features not discussed in the literature in an Iranian population. The presence of diabetes mellitus was evaluated in a total number of 275 subjects [75 patients with Bell's palsy and 200 control subjects]. Diabetes mellitus was noted in 10 [13.3%] patients with Bell's palsy among which 6 case were diagnosed as new cases of diabetes. Previous history of Bell's palsy was present in 10.67% of the subjects with Bell's palsy. This study confirms the correlation of diabetes mellitus and Bell's palsy for the first time in an Iranian population. We suggest screening tests for diabetes mellitus to be a routine part in the management of patients with Bell's palsy, especially in developing countries

Cerebral venous thrombosis in a patient with clinically isolated syndrome suggestive of multiple sclerosis

Cerebral venous thrombosis [CVT] may occur at any age and may be idiopathic or secondary to various causes. It has been described in patients with multiple sclerosis [MS] as well. On the other hand, because of the variations of MS per presentations, coincidence of other neurological disorders in MS patients could be ignored. Therefore, more clinical and paraclinical evaluations should be considered in MS patients with any new atypical symptom. We report a rare case with symptoms and signs of inflammatory demyelinating disease as clinically isolated syndrome [CIS] suggestive of MS onset. This case developed CVT after lumbar puncture and during high-dose methylprednisolone pulse therapy

Herpes simplex virus in saliva of patients with Bell's palsy

Acute idiopathic peripheral facial paralysis [Bell's palsy] is the most common disorder of the facial nerve. Most patients recover completely, although some have permanent disfiguring facial weakness. Many studies have attempted to identify an infectious etiology for this disease. Although the cause of Bell's palsy remains unknown, recent studies suggest a possible association with Herpes Simplex Virus-1[HSV-1] infection. In this case-control study we investigated the presence of DNA of HSV in the saliva of 26 patients with Bells palsy in first and second weeks of disorder compared to normal population who were matched in sex, age, as well as history of diabetes mellitus, hypertension and labial herpes. In the case group 3 and 7 patients had positive polymerase chain reaction [PCR] for HSV in first and second weeks of disease respectively compared to 4 in controls. It means that there was not any relationship between Bell's palsy and HSV in saliva either in first or in second week. Two and 6 of positive results from the sample of first and second weeks were from patients with severe [grade 4-6] Bell's palsy. Although the positive results were more in second week in patient group and more in severe palsies, but a significant relationship between Bell's palsy or its severity and positive PCR for HSV was not detected [P >0.05]

relation of hyperhomocysteinemia to cognitive function and brain atrophy in patients with multiple sclerosis

Cognitive impairment may be a common even at the onset of multiple sclerosis [MS] In this case-control study, we tried to find out the probable relationship between homocysteine levels and cerebral atrophy or cognitive impairment in patients with multiple sclerosis. One hundred fifty six patients who had MS according to McDonald diagnostic criteria were included in this study. Patients' age, gender, and educational level, MS duration and clinical type, disability, cognitive function state based on minimental state examination [MMSE], presence of hyperhomocysteinemia, and brain atrophy were evaluated. There was no statistically significant relationship between hyperhomocysteinemia and cognitive status. Total homocysteine levels had a significant correlation with MMSE score only in those patients with elementary level of education. Also total homocysteine levels and overall cerebral atrophy did not indicate significant relationship according to those independent variables mentioned above except in the patients with EDSS less than 6. "When mteicaudate ratio > 0.10 was applied as a criterion for cerebral atrophy, we found that hyperhomocysteinemia related significantly to intercaudate ratio > 0.10 in females, aged between 21 and 30 years, MS duration