Tuberculosis is primarily characterized by pulmonary involvement, however, one third of the cases exhibit extrapulmonary tuberculosis. In this report, a case of epidural abscess due to Mycobacterium ...tuberculosis with primary resistance to isoniazid and ethambutol was presented. A 57-year-old male patient was admitted to emergency service with ten days history of weakness in legs, disability of walking and fever. Neurological examination revealed paraplegia of lower extremities, numbness distal to T2 disc level and hyperactivity of deep tendon reflexes indicating transverse myelitis. Laboratory findings were as follows; ESR: 74 mm/hour, CRP: 22 g/L, ALT: 42 IU/L, AST: 45 IU/L and white blood cell count 23.000/mm3 (45% polymorphonuclear leukocyte, 45% lymphocyte, 10% monocyte). Spinal magnetic resonance imaging showed a fusiform abscess localized at anterior epidural space and extending along levels of C5-6 and C6-7. The longitudinal dimension of the abscess was 3 cm. The lesion was hypointense on T1 and hyperintense on T2 weighted MRI images with prominent rim shaped contrast enhancement on contrast-enhanced T1-weighted images. At fourth day of hospitalization the patient underwent neurosurgical management. M.tuberculosis was isolated from the cultures of operation material by Mycobacteria Growth Incubator Tube system (MGIT, BBL; BD, USA) on the 12th day. The isolate was found susceptible to streptomycin and rifampisin, but resistant to isoniazid and ethambutol. The treatment was initiated with rifampicin 600 mg/day, pyrazinamid 2 g/day, ethambutol 1.5 g/day and levofloxacin 500 mg/day. At the end of second month levofloxacin 500 mg/day and rifampisin 600 mg/day combination was sustained and total treatment period was planned as nine months. As far as the national literature was considered, this was the first case of extrapulmonary tuberculosis with primary resistance to isoniazid and ethambutol.
Amaç: Bu çalışmanın amacı Botulinum toksin enjeksiyonu uygulanan hastaların sosyodemografik özellikleri ve hastalık özelliklerinin belirlenmesi, ve Botulinum toksin uygulama aralıkları ile etki ve ...yan etki profillerini dokümante ederek klinik deneyimimizin sunulmasıdır.Gereç ve Yöntemler: Hastaların sosyodemografik özellikleri ve Botulinum toksin tedavisinin karakteristik özellikleri kaydedilmiştir. Botulinum toksin enjeksiyonu yapılan hastaların hastalık tanıları, hastalık süreleri ve Botulinum toksin tedavisine başlama süreleri incelenmiştir. Olası yan etkiler kaydedilmiştir.Bulgular: Çeşitli hareket hastalıkları tanısı almış otuz iki hasta (20 erkek, 12 kadın) çalışmaya dahil edilmiştir. Hastaların yaş ortalaması 60.65±14.40 yaştır (aralık= 22-83 yaş). Botulinum toksin enjeksiyonu uygulanan hastaların tanıları servikal distoni, blefarospazm, klonik hemifasiyal spazm, fokal el distonisi/yazıcı krampı, oromandibular distoni ve distonik tremordur. Tüm hastalara tekrarlayan Botulinum nörotoksin enjeksiyonları yapılmıştır. İki blefarospazm hastasında enjeksiyon bölgesinde izlenen hafif morluklar dışında, hastalarda belirgin yan etki görülmemiştir.Sonuç: Botulinum toksin fokal distonili hastalarda önemli bir tedavi seçeneğidir. Clostridium botulinum bakterisinin nörotoksini olan Botulinum nörotoksin, sinaptik aralığa asetilkolin salınımını engelleyerek kas kasılmasını baskılamak üzere çalışır. Geri dönüşümlü olan bir etki ile nöronal filizlenmenin süresiyle ilişkili olarak yaklaşık üç ila dört ay kadar sürmektedir. Özellikle fokal distoni gibi hareket bozuklukları hastalarında Botulinum toksin etkinliğine ilişkin farkındalığı arttırmak amacıyla ve hareket hastalıkları perspektifinden Botulinum toksin poliklinik veya kliniklerinin klinik deneyimlerini ve verilerini paylaşmak önem arz etmektedir.
Sodium valproate is a well-known antiepileptic agent with multiple mechanisms of action such as sodium channel blockage and gamma-aminobutyric acid activity induction. Despite its well-described ...anxiolytic and mood stabilization effects, its mechanism of action in pathological gambling is not clear. However, it has been reported as an effective treatment option in pathological gambling for patients without Parkinson's disease (PD). We presented a male patient with a diagnosis of PD suffering from pathological gambling as an impulse control disorder due to antiparkinsonian drugs who did not respond to drug adjustments but showed complete improvement with sodium valproate, without any worsening in PD symptoms.
Cognitive impairment in patients with Parkinson’s disease (PD) is one of the commonest and most disabling non-motor manifestations during the course of the disease. The clinical spectrum of ...PD-related cognitive impairment includes subjective cognitive decline (SCD), mild cognitive impairment (MCI) and PD dementia (PDD). As the disease progresses, cognitive decline creates a significant burden for the family members and/or caregivers of patients with PD, and has a great impact on quality of life. Current pharmacological treatments have demonstrated partial efficacy and failed to halt disease progression, and novel, effective, and safe therapeutic strategies are required. Accumulating preclinical and clinical evidence shows that several agents may provide beneficial effects on patients with PD and cognitive impairment, including ceftriaxone, ambroxol, intranasal insulin, nilotinib, atomoxetine, mevidalen, blarcamesine, prasinezumab, SYN120, ENT-01, NYX-458, GRF6021, fosgonimeton, INT-777, Neuropeptide S, silibinin, osmotin, cordycepin, huperzine A, fibroblast growth factor 21, Poloxamer 188, ginsenoside Rb1, thioredoxin-1, tangeretin, istradefylline and Eugenia uniflora. Potential underlying mechanisms include the inhibition of a-synuclein aggregation, the improvement of mitochondrial function, the regulation of synaptic plasticity, an impact on the gut–brain axis, the modulation of neuroinflammation and the upregulation of neurotrophic factors, as well as cholinergic, dopaminergic, serotoninergic and norepinephrine neurotransmission. In this updated overview, we aim to cover the clinical aspects of the spectrum of PD-related cognitive impairment and discuss recent evidence on emerging treatment approaches that are under investigation at a preclinical and clinical level. Finally, we aim to provide additional insights and propose new ideas for investigation that may be feasible and effective for the spectrum of PD-related cognitive impairment.
The future of e-learning in neurology Tettenborn, Barbara; Degirmenci, Yildiz
Journal of the neurological sciences,
12/2023, Letnik:
455
Journal Article
The aim of this study was to investigate the frequency of epilepsy among students of the Canakkale Onsekiz Mart University. This cross sectional epidemiological study was performed on 4762 of 19,988 ...Canakkale Onsekiz Mart University students in the academic year 2007-2008. Participants that answered "epilepsy" to the question "Do you have any disease diagnosed by a doctor?" in a questionnaire including 4 subgroups were identified. Data were transferred to the Epi-Info Version 6.0 statistics program and controlled data were analyzed in the SPSS 15.0 statistics program. There were 53.1% of female and 46.9% of male students, mean age 20.4 ± 2.1 (range 17-43) years. Twelve (0.25%) students had epilepsy diagnosis, eight (66.7%) female and four (33.3%) male, mean age 20.8 ± 1.8 years. In our study, epilepsy was detected in 0.25% of students (n = 12). Age specific prevalence studies related to epilepsy epidemiology are extremely rare, especially in university students with average intelligence. Thus, we considered that it would be epidemiologically significant to share the results of our cross sectional study with all those involved in epilepsy epidemiology and management.
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