Isolated Unilateral Hypoglossal Nerve Palsy Caused by Internal Carotid Artery Loop.

Isolated unilateral hypoglossal nerve (HN) palsy caused by vascular compression is a rare condition. We report a case of a 42-year-old male, presenting with tongue paresis and unilateral atrophy of the tongue due to an internal carotid artery (ICA) loop. The compression of HN by ICA loop and concomitant wall irregularities of the loop segment were observed in magnetic resonance imaging and digital subtraction angiography (DSA).

Acute thrombosis of the carotid artery associated with positional nystagmus at multiple planes.

Objective: An acute onset central pathology without any clear neurological symptoms may mimic peripheral vestibular problem in an emergency setting. A 54-year-old man suddenly developed dizziness without any cranial nerve symptoms, paresis, cerebellar signs or sensory disturbances except upbeat positional nystagmus at multiple provoked positions which alerted for a possible acute central pathology.

Findings: An instantaneous magnetic resonance imaging and angiography studies further showed obstruction of the left internal carotid artery above the bifurcation.

Transcallosal conduction in paroxysmal kinesigenic dyskinesia.

Objectives: Detecting whether a possible disequilibrium between the excitatory and inhibitory interhemispheric interactions in paroxysmal kinesigenic dyskinesia (PKD) exists.

Methods: This study assessed measures of motor threshold, motor evoked potential latency, the cortical silent period, the ipsilateral silent period and the transcallosal conduction time (TCT) in PKD patients. Data were compared between the clinically affected hemisphere (aH) and the fellow hemisphere (fH).

Decreased cerebral vasomotor reactivity in patients with obstructive sleep apnea syndrome.

Objective: In obstructive sleep apnea syndrome (OSAS), any of the activated neural, vascular, hemodynamic, metabolic, inflammatory, and thrombotic mechanisms may be related to increased cerebrovascular disease and risk of death; however, the possible pathophysiological process between obstructive sleep apnea syndrome and stroke has not been clearly explained. We hypothesize that alterations in vasomotor reactivity in patients may be responsible for their altered cerebral blood flow, and may contribute to the increased risk of ischemic stroke.

Methods: A total of 30 untreated patients with severe obstructive sleep apnea and 26 control subjects were included in the study.

Vestibular Evoked Myogenic Potentials in a Female Population with Migraine.

The objective is to analyze the vestibular system by vestibular evoked myogenic potential (VEMP) in 30 female patients with migraine and balance problem in a controlled study. Thirty female patients with migraine and vestibular problems were enrolled in the study (2009-2012). Fifteen age-matched healthy subjects were selected as the controls.

The efficacy of botulinum toxin in patients with cervicogenic headache: a placebo-controlled clinical trial.

Objective: Botulinum toxin type-A (BoNTA) has been considered a treatment option for CH. The aim of this study was to assess the effectiveness of BoNTA treatment in patients with medically resistant CH.

Materials And Methods: Forty patients with CH were included in the study.

[Botulinum neuro-toxin aype-A in the treatment of chronic tension type headache associated with pericranial tenderness].

Objectives: Both peripheral and central nociceptive mechanisms are responsible in chronic TTH. Analgegics are used in the acute treatment of chronic TTH and antidepressants are used in prophylactic treatment. However, further studies are needed to bring out new treatment options.

Effect of pramipexole on cutaneous-silent-period parameters in patients with restless legs syndrome.

Objective: The aim of this study was to investigate cutaneous-silent-period (CSP) parameters in patients with restless legs syndrome (RLS) and examine the effects of treatment on CSP which, to our knowledge, have not been investigated till date.

Methods: A total of 25 patients with RLS and 25 healthy volunteers were studied. CSP latency and duration in the upper and lower extremities were examined in the two groups.

Electrophysiological assessment of the autonomic nervous system in male patients with acromegaly.

Background/aims: We aimed to electrophysiologically evaluate the autonomic function in acromegalic patients using sympathetic skin response (SSR) as a reflection of the sympathetic sudomotor activity and RR interval variation (RRIV) as an indicator of the cardiovagal autonomic function.

Methods: The study group consisted of 18 male acromegalics, and the control group was composed of 18 age- and sex-matched healthy subjects. Participants underwent SSR and RRIV tests.

Parkinsonism caused by chronic usage of intravenous potassium permanganate.

Introduction: Chronic overexposure to manganese (Mn) may cause neuronal degeneration. Manganese intoxication is well known to induce parkinsonism. Manganese intoxication may be associated with abnormal magnetic resonance (MR) imaging (abnormal signal hyperintensity in the globus pallidus and substantia nigra on T1-weighted images).

In restless legs syndrome, during changes in vigilance, the forced EEG shifts from alpha activity to delta or high alpha may lead to the altered states of dopamine receptor function and the symptoms.

RLS cases may carry a genetic vulnerability called EEG alpha activity gate dyscontrols which appear during changes in vigilance and generally during sleep. It is triggered by forced EEG shifts either from alpha activity to delta or high alpha. Expressions of alpha activity gate dyscontrols may have a gate effect that trigger a second vulnerability-dopamine receptor specific individual sensitivity (DRSIS) and this leads to a deficiency in dopamine transmissions at diencephalospinal dopamine system (DSDS).

Cognitive dysfunction in beta-thalassemia minor.

Beta-thalassemia minor is a common, hereditary, and mostly symptomless disease. Previous studies have shown that lower hemoglobin values are associated with poorer cognitive functions. We aimed to evaluate the cognitive function in patients with beta-thalassemia minor.

Evaluation of event-related potentials in Klinefelter syndrome and idiopathic hypogonadotrophic hypogonadism.

Background: Many studies have evaluated patients with idiopathic hypogonadothropic hypogonadotropism (IHH), but few of these studies utilize event-related potentials (P300).

Aims: To assess the cognitive functions of hypergonadotropic vs. hypogonadotropic patients.

Evaluation of periodic leg movements and associated transcranial magnetic stimulation parameters in restless legs syndrome.

Restless legs syndrome (RLS), a sensorimotor disorder characterized by unpleasant sensations commonly localized in the legs, is frequently associated with periodic limb movements (PLMs) during sleep. We investigated the role of transcranial magnetic stimulation (TMS) and cortical silent period (CSP) duration as diagnostic and monitoring tools in 20 patients with primary RLS before and after 1 month of treatment and also studied 15 normal age- and gender-matched subjects. Polysomnographic assessment was undertaken and the PLM index determined in 17 of the 20 patients.

Median nerve somatosensory evoked potentials recorded with cephalic and noncephalic references in central and peripheral nervous system lesions.

Somatosensory evoked potentials (SSEP) to electrical stimulation of the median nerve by using cephalic and noncephalic references were studied to detect the generator sources of short latency evoked potentials in 29 patients with cerebral, brainstem, spinal and peripheral nerve lesions. Patients were divided into six groups according to the localization of their lesions: group 1: cortical and subcortical lesions, group 2: basal ganglion lesions, group 3: pons and mesencephalon lesions, group 4: diffuse cerebral lesions, group 5: cervical cord lesions, group 6: brachial plexus lesions. Potentials were recorded using cephalic and noncephalic references after median nerve stimulation.

Migrainous stroke causing bilateral anterior cerebral artery territory infarction.

A 38-year-old man developed bilateral anterior cerebral artery territory infarction during the course of a migraine. Magnetic resonance imaging showed bilateral ischemic lesions involving the cortex of the paramedian region of the frontal and parietal lobes, more prominent on the right. Cerebral angiography was normal.

Acetyl salicylic acid improves somatosensory evoked potentials in streptozotocin-diabetic rats.

The effects of acetyl salicyclic acid (ASA) on somatosensory evoked potentials (SEP) and neural levels of thiobarbituric acid reactive substances (TBARS), products of lipid peroxidation, were studied in streptozotocin-diabetic rats. ASA (100 mg/kg, in rat chow) was given to diabetic rats (n = 8) after the induction of diabetes for 16 weeks. ASA-treated normal control rats (n = 8), untreated diabetic rats (n = 8) and normal control rats (n = 8) were used for comparison.

Unusual late responses in a patient with an Arnold-Chiari malformation.

We studied a young man with spastic right hemiparesis, in whom supramaximal stimulation of the left posterior tibial nerve produced toe movements of the both feet and associated late responses in the flexor hallucis brevis muscle bilaterally. These findings indicate that, in this patient, there are central connections between peripheral afferents and contralateral alpha-motor neurons. It may be that such connections are normally present but that they are too weak in normal subjects to produce firing of the alpha-motor neurons by themselves.

Order effects in response times of parkinsonian patients and normal controls.

Response latencies were measured in 6 parkinsonian patients and 6 normal subjects in a choice reaction task requiring the discrimination of two different tones with different probabilities of occurrence (frequent and rare). Response latency was measured from stimulus onset to onset of electromyographic activity in the responding muscle. Rare-tone responses were separated on the basis of the number of frequent tones intervening between the rare tone of interest and the immediately preceding rare tone (defined as rare-tone position).

Simple and choice reaction time in Parkinson's disease.

Reaction-times were evaluated in 6 parkinsonian patients and 6 normal control subjects using a simple reaction task and 3 choice reaction tasks of differing complexity. Reaction-times were measured as the time from stimulus onset to the onset of electromyographic activity in the responding muscle. Reaction-time was significantly delayed in patients compared to controls in all tasks, but to a greater extent in the more difficult tasks.

Cerebral accompaniments to simple and choice reaction tasks in Parkinson's disease.

In order to clarify the nature and basis of the delayed reaction time that occurs in Parkinson's disease, we measured reaction times and cerebral responses in six parkinsonian patients and six normal age-matched control subjects. Each participated in one simple reaction task and three choice reaction tasks of different complexity. The reaction times were delayed in the parkinsonian patients in all conditions but especially in the more difficult choice tasks.

Mirror movements associated with cervical meningocele: case report.

A patient with mirror movements associated with cervical meningocele has been presented in this report. The MRI showed normal cerebrum and cervical meningocele, and an anomaly at the posterior to the cervical spinal cord-medulla junction. Unilateral transcranial magnetic stimulation evoked bilateral responses at similar latencies on the thenar muscles which are quite different from those observed in normal subjects.