The relationship between sarcopenia-related measurements and osteoporosis: The SARCOP study.

As muscle and bone are closely-related, we have explored the association between sarcopenia-related measurements and bone mineral density (BMD) (and osteoporosis) in postmenopausal women. Grip strength, anterior thigh muscle thickness and chair stand test were found to be related with BMD. Additionally, grip strength < 22 kg increased the odds ratio of osteoporosis 1.6 times. INTRODUCTION: As muscle and bone are two closely related tissues, we aimed to investigate the association between sarcopenia-related measurements (i.e., sonographic anterior thigh muscle thickness, grip strength, chair stand test (CST), gait speed) and clinical factors, lumbar/femoral BMD, and the presence of osteoporosis (OP) in postmenopausal women. METHODS: Community dwelling postmenopausal women from two physical and rehabilitation medicine outpatient clinics were consecutively included in this cross-sectional study. Demographic data, age, weight, height, education/exercise status, smoking, and comorbidities were registered. BMD measurements were performed from lumbar vertebrae (L1-4) and femoral neck using dual energy X-ray absorptiometry (DXA). A T-score of ≤ -2.5 SD in the lumbar vertebrae (L1-L4) and/or femoral neck was accepted as OP. Anterior thigh muscle thickness (MT) at the midthigh level was measured sonographically using a linear probe. Grip strength was measured from the dominant side. Physical performance was assessed by CST and gait speed. RESULTS: Among 546 postmenopausal women, 222 (40.7%) had OP. Among sarcopenia-related parameters, grip strength and anterior thigh MT were positively associated with lumbar vertebral BMD. CST performance was positively associated with femoral neck BMD. After adjusting for confounding factors, low grip strength (< 22 kg) increased 1.6 times the risk of OP. CONCLUSION: Loss of muscle mass/function (i.e., sarcopenia) can coexist with loss of trabecular and cortical bone. To this end, grip strength and anterior thigh MT seem to be associated with the lumbar vertebral BMD, while CST is associated with the femoral neck BMD. Lastly, low grip strength might have an association with postmenopausal OP.

Periodic electroclinical seizures following an ischemic stroke revealed by continuous-EEG.

BACKGROUND: Periodic EEG patterns are mostly associated with critical illnesses and acute disruptions of the central nervous system. Periodic or cyclic seizures are extremely rare phenomena, most of which are nonconvulsive, only reported in critically ill patients. Here we report a patient with periodic focal impaired awareness seizures following a minor stroke and address possible pathophysiological mechanisms. CASE: A 49 years old male patient presented with periodic seizures, associated with an acute stroke in the left occipital and parietal regions. These focal seizures, recorded during long-term video-EEG monitoring in the scalp EEG, appeared every 9-11 min, and responded to iv valproic acid treatment but not to iv treatments of diazepam, phenytoin, and levetiracetam. DISCUSSION: We believe that the blood-brain barrier disruption due to stroke, in conjunction with hyperglycemia and antiphospholipid antibodies have led to an imbalance of the surrounding tissue and sustained hyperexcitability to a point of pacemaker potentials. It is tempting to speculate that repetitive cycles of cortical spreading depression due to tissue injury have aided the periodicity of the seizures. CONCLUSION: Continuous EEG monitoring is crucial, not only to diagnose and appropriately treat accompanying subtle seizures but also to further understand the underlying intriguing pathophysiological processes like periodicity.