ABSTRACT
BACKGROUND: The study on transcranial sonocraphy (TCS) as a diagnostic test for Parkinson's disease (PD) has been neglected in some hospitals. The current study was conducted as the first study to investigate the utility of TCS for diagnosis of PD and its ability to distinguish PD from essential tremor (ET) in an Iranian population. MATERIALS AND METHODS: TCS of substantia nigra (SN) was performed on 50 PD, 48 ET, and 50 healthy controls by two blinded investigators. RESULTS: Bilateral SN margin over 0.20 cm(2) was found in 39 (90%) and 7 (15%) in PD and ET patients, respectively. Furthermore, 4 (8%) of healthy control displayed this particular echo feature as well (false positives). SN hyperechogenicity ≥0.20 cm(2) was considered as a cut-off point to detected PD. Accordingly, TCS proved 90% (95% confidence interval [CI]: 77.85-97.35) sensitive and 92% (95% CI: 80.75-97.73)specific for the detection of PD by visualizing the SN. CONCLUSION: SN hyperechogenicity ≥20 cm(2) is a specific feature of PD. Since, the symptoms of PD and ET might be overlapping; this method seems to be reliable to confirm PD diagnosis in doubtful clinical cases. Further studies in years to come are warranted to shed light on standardized data for Iranian to enhance the validity of TCS.
ABSTRACT
BACKGROUND: One of the frequent symptoms of Multiple Sclerosis (MS) is tremor which can severely cause disability. Treatment of tremor in MS patients is still very challenging to manage. In this study, we sought to determine the efficacy of Levetiracetam on treatment of MS-related tremor. MATERIALS AND METHODS: This clinical trial study was conducted among 22 patients from July 2012 to April 2012 in Alzahra-Hospital, Isfahan, Iran. Patients were given 500 mg Levetiracetam twice a day for 1 week. The drug dosage increased 1000 mg per week until reaching the peak dose of 50 mg/kg. After a 2 week period of washout, first phase was repeated. The subjects were assessed at baseline, after first intervention, after wash-out period, and after second intervention. RESULTS: A total of 20 patients (17 females and 3 males) were enrolled in our study. There was a significant difference among tremor rate before and after intervention (P = 0.001). The drug was well tolerated and without any serious side effect during follow-up. CONCLUSION: Our findings suggest that although Levetiracetam caused a decrease tremor rate in MS it surged again after washout period.
ABSTRACT
Pulmonary arteriovenous fistula (PAVF) is a venous malformation that permits right to left shunting of blood, bypassing the pulmonary capillary bed. Often PAVFs are seen in association with hereditary conditions. On the other hand, isolated PAVFs are rare and asymptomatic. There have been few reports of isolated PAVF related complications. A patient was referred to us with dysarthria and diplopia and history of surgically-treated PAVF. Further evaluations revealed a stroke in thalamic region. We found an open PAVF in a case of thalamic stroke.
ABSTRACT
Head injury is a common occurrence in motor vehicle accidents. There are numerous causes for cranial nerve injury that include head trauma or other lesions. Few studies regarding cranial nerve injury following mild head trauma (GCS: 14 - 15) exist in the literature. The oculomotor nerve is a somatic and visceral motor nerve. When it is completely injured the result is ptosis, pupils that are non-reactive to light and a lack of eye movement. We report the case of a completely isolated oculomotor nerve palsy associated with minor head injury.
