Valvular heart disease in patients with Parkinson's disease treated with pergolide, levodopa or both.

Cardiac valvulopathy has been reported in patients with Parkinson's disease treated with pergolide. The aim of this study was to clarify the frequency and severity of valvular heart disease (VHD) in patients treated with pergolide, levodopa or both. We evaluated VHD by transthoracic echocardiography in 25 patients who were taking pergolide, 29 patients taking levodopa and 20 patients taking both levodopa and pergolide. All groups were compared with two separate age-matched control groups. There was no increase in the frequency of any type of echocardiographically-significant valvulopathy in the pergolide groups. Echocardiographically significant aortic regurgitation was found in 8% of the patients in the pergolide group and in 37.9% of the patients in the levodopa group. There was no correlation between VHD and pergolide dose, cumulative dose or duration of therapy. The mean pergolide dose was 2.6+/-1.4 mg/day in the pergolide monotherapy group. We did not find any unequivocal evidence that pergolide causes significant valvular regurgitation. However, the mean pergolide dosage in our study was lower than in previous studies.

Reduced P50 auditory sensory gating response in professional musicians.

Evoked potential studies have demonstrated that musicians have the ability to distinguish musical sounds preattentively and automatically at the temporal, spectral, and spatial levels in more detail. It is however not known whether there is a difference in the early processes of auditory data processing of musicians. The most emphasized and studied early process, especially for neuropsychiatric purposes, is sensory gating. The suppression percentage of the midlatency auditory evoked potential P50, and rarely the N100, wave is used for sensory gating studies. Our aim in this study was to investigate whether there was a difference in the auditory P50 and N100 suppression of control subjects who were professional musicians with no psychiatric problems. 34 professional musicians and 19 non-musicians (the control group) were included in this study. P50 and N100 measurements were taken, the suppression percentage of P50 and N100 was calculated and the results compared. Musicians showed significantly less P50 suppression when compared to non-musicians. There was no significant difference for N100 suppression. What the decreased P50 suppression in musicians when compared to non-musician subjects means, when we also take into account that N100 suppression is not decreased, and how it may contribute to the music perception and production processes of these persons is discussed.

Cerebral artery hemodynamics in polycystic ovary syndrome.

OBJECTIVE: The aim of the present study was to investigate hemodynamic changes in the medial cerebral artery and also the internal carotid artery in young women with polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO). METHODS: Twenty-eight patients with PCOS, 16 patients with PCO and 24 healthy control subjects were included in the study. Blood flow rate, pulsatility index and back pressure of both the medial cerebral artery and the internal carotid artery were determined by transcranial Doppler ultrasonography and the results compared between groups. RESULTS: There were no significant differences between the groups in bilateral medial cerebral artery and internal carotid artery blood flow rate, pulsatility index and back pressure. CONCLUSION: Our results do not indicate whether the risk of cerebrovascular events will increase for PCOS patients in middle and advanced age, but do show that changes in cerebral hemodynamics are not likely in PCOS at an early stage.

Crocodile tears syndrome: botulinum toxin treatment under EMG guidance.

Crocodile tears syndrome is one of the rare complications of facial paralysis. There have been several reports of cases in which botulinum toxin was found to be useful in the treatment of crocodile tears syndrome. The adverse effects, due to the paralytic action of botulinum toxin, have been reported to involve the palpebral muscle, lateral rectus and superior rectus. Therefore, we considered that it might be more appropriate to carry out the injection procedure under electromyographic guidance in order to inject botulinum toxin selectively into the lacrimal gland and protect the above-mentioned muscles. In conclusion, we recommend EMG guidance in the treatment of crocodile tears syndrome with botulinum toxin.

Sympathetic skin response in premenstrual syndrome.

Premenstrual syndrome is a term which includes a broad group of emotional, behavioral and physical symptoms that occur for several days before menses and subside following the menstrual period. Many women experience premenstrual syndrome symptoms, particularly physical ones such as breast tenderness and swelling. Approximately 5-10% women suffer from severe premenstrual syndrome and another 30-40% have moderate symptoms. Premenstrual syndrome continues to be an unsolved problem. In this study, we evaluated 24 premenstrual syndrome patients and 20 healthy women in the control group. The ages of the women were 22-34 years (mean +/- SD: 25+/-3) for the premenstrual syndrome group and 23-34 (25+/-3) for the control group. The sympathetic skin response was recorded from the palms, soles and genital regions by using electrical stimuli to the median nerve at the wrist. The sympathetic skin response was recorded twice, in the follicular and late luteal phases of menstruation. The follicular and late luteal phase sympathetic skin response of the two groups were compared. The amplitudes and latency values of the late luteal and follicular phase sympathetic skin response from the premenstrual syndrome group and control group women were statistically similar. We also did not find any latency or amplitude difference in the sympathetic skin response obtained from the three regions of the premenstrual syndrome patients and the control group. We checked sympathetic skin response in the symptomatic (late luteal phase) and asymptomatic (follicular phase) periods of patients with premenstrual syndrome, a disorder known to have many autonomic symptoms, to determine whether there was sudomotor sympathetic involvement. The results of our PMS patients indicate at the very least that there is no difference with the control subjects as regards peripheral sudomotor functions.

Cognitive event-related potential and neuropsychological findings in Behcet's disease without neurological manifestations.

Behcet's disease (BD) is a multisystem inflammatory disorder characterized by recurrent oral and genital ulcers and uveitis. BD patients without neurological involvement frequently have mild neurological symptoms. The aim of this study was to evaluate whether BD patients without neurological involvement have any changes in cognitive functions. Twenty BD patients without neurological involvement and 13 control subjects were included in the study and were analyzed by neurophysiological and neuropsychological examinations. The cognitive event-related potentials (P300) were recorded from the frontal, central and parietal areas of the right and left hemispheres of the patients and control subjects. Likewise, all individuals were evaluated with neuropsychological tests. In contrast to a study with similar design, we did not find any difference between the cognitive event-related potentials values of BD patients without neurological involvement and the control subjects. All BD patients without neurological involvement exhibit normal results of the neuropsychological test. In conclusion, the results of neuropsychological tests and cognitive event-related potentials values in BD patients without neurological involvement are indistinguishable from those in control subjects and no alteration of cognitive functions is present.

Isolated intracranial hypertension: a rare presentation of neurobrucellosis.

Brucella melitensis infection is endemic in the eastern and south-eastern Anatolia regions of Turkey. We report an unusual case of brucella meningitis presenting with bilateral papilla stasis, diplopia and absence of other neurological involvement. Diagnosis was made by positive culture of Brucella spp. with a BACTEC 9120 system with inoculation of the patient's cerebrospinal fluid (CSF). This is the first report of isolation of Brucella spp. from CSF on a BACTEC 9120 system for diagnosis of meningitis. This case demonstrated that brucella meningitis may present with very slight symptoms, and inoculation of CSF into BACTEC bottle besides conventional cultures improves the detection of Brucella in endemic areas such as Turkey.

Topographic abnormalities in event-related potentials in children with monosymptomatic nocturnal enuresis.

AIMS: A functional maturational delay in the central nervous system is dwelled upon in the pathogenesis of monosymptomatic nocturnal enuresis (MNE). In this study we studied whether according to controls N200 and P300, components of the event-related potential (ERP), which is related to aspects of cognitive processing, showed any difference in its topographic distribution in children within the age group 10-13 with monosymptomatic nocturnal enuresis and discussed its relation to the pathogenesis of MNE. METHODS: We performed P300 in 18 patients with MNE and in 16 age-matched healthy subjects. P300 were evoked by an auditory oddball paradigm consisting of 150 tone bursts (80% 1 kHz; 20% 2 kHz). The latencies of the N200 and the P300 waves and the amplitude of the P300 wave were measured. RESULTS: There was no statistical difference between the enuretic group and the controls in N200 and P300 latency and amplitude in the midline frontal (Fz), central (Cz), and parietal (Pz) recording site of the 10-20 International System. In the enuretic group while P300 amplitude in the Fz site was significantly less than the P300 amplitude in the Cz site, there was no statistical difference between the Fz and Pz P300 amplitude values. CONCLUSIONS: When different levels of maturational delay are considered in MNE, it may be claimed that maturational delay in children whose enuresis lasts until older ages will be different from those whose enuresis ends at an early age. The determination of P300 amplitude in parietal records being less in enuretics when compared to the controls may show that there are regional differences in stimuli processing rate/quality.