The impact of the comorbid seizure/epilepsy on the health related quality of life in people with multiple sclerosis: an international multicentric study.

Introduction: The health-related quality of life (HRQoL) of people with (Pw) multiple sclerosis (MS) is usually deteriorated. It has been recently suggested that comorbidities may have the negative influence on the quality of life of the PwMS, but according to the best of our knowledge, only one study investigated, although in a very small cohort, the impact of individual comorbidity on the quality of life of PwMS. The aim of our investigation was to assess, in an international, multicentric study, the impact of comorbid seizure/epilepsy on the HRQoL in PwMS.

Localised neuropathic pain in the primary care setting: a cross-sectional study of prevalence, clinical characteristics, treatment patterns, quality of life and sleep performance.

Background: Localised Neuropathic Pain (LNP) is challenging to diagnose and manage in primary care.

Objective: To describe clinical characteristics, treatment patterns, quality of life and sleep performance of patients with LNP and estimate its prevalence in primary care.

Methods: Cross-sectional study in 4 European countries.

Levodopa-carbidopa intestinal gel in advanced Parkinson's: Final results of the GLORIA registry.

Introduction: This registry evaluated the 24-month safety and efficacy of levodopa-carbidopa intestinal gel (LCIG) treatment in advanced Parkinson's disease (PD) patients under routine clinical care.

Methods: Motor fluctuations, dyskinesia, non-motor symptoms, quality of life, and safety were evaluated. Observations were fully prospective for treatment-naïve patients (60% of patients) and partially retrospective for patients with ≤12 months of pre-treatment with LCIG (40% of patients).

The 5% Lidocaine-Medicated Plaster: Its Inclusion in International Treatment Guidelines for Treating Localized Neuropathic Pain, and Clinical Evidence Supporting its Use.

When peripheral neuropathic pain affects a specific, clearly demarcated area of the body, it may be described as localized neuropathic pain (LNP). Examples include postherpetic neuralgia and painful diabetic neuropathy, as well as post-surgical and post-traumatic pain. These conditions may respond to topical treatment, i.

A pharmacological treatment algorithm for localized neuropathic pain.

Neuropathic pain is caused by a lesion or disease affecting the somatosensory system and is difficult to manage, often proving refractory to existing treatments. In more than half of cases, it is localized and affects a specific, clearly circumscribed area of the body (localized neuropathic pain, or LNP). A recently developed screening tool enables patients with probable neuropathic pain/LNP to be identified quickly and easily.

Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus.

Quantitative sensory testing (QST) is a psychophysical method used to quantify somatosensory function in response to controlled stimuli in healthy subjects and patients. Although QST shares similarities with the quantitative assessment of hearing or vision, which is extensively used in clinical practice and research, it has not gained a large acceptance among clinicians for many reasons, and in significant part because of the lack of information about standards for performing QST, its potential utility, and interpretation of results. A consensus meeting was convened by the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG) to formulate recommendations for conducting QST in clinical practice and research.

Pedicle-Screw-Based Dynamic Systems and Degenerative Lumbar Diseases: Biomechanical and Clinical Experiences of Dynamic Fusion with Isobar TTL.

Dynamic systems in the lumbar spine are believed to reduce main fusion drawbacks such as pseudarthrosis, bone rarefaction, and mechanical failure. Compared to fusion achieved with rigid constructs, biomechanical studies underlined some advantages of dynamic instrumentation including increased load sharing between the instrumentation and interbody bone graft and stresses reduction at bone-to-screw interface. These advantages may result in increased fusion rates, limitation of bone rarefaction, and reduction of mechanical complications with the ultimate objective to reduce reoperations rates.

Topical pain management with the 5% lidocaine medicated plaster--a review.

Background: The topical 5% lidocaine medicated plaster is recommended as first-line treatment for localized peripheral neuropathic pain.

Scope: In order to provide an overview of the efficacy and safety of the lidocaine plaster in the treatment of different neuropathic pain conditions, all efficacy and safety studies (randomized, controlled, or open-label with well described methodology), case reports, and pharmacological studies on the lidocaine plaster retrieved from a PubMed literature research (1960-March 2012) plus additional references identified from retrieved articles were included.

Findings: The lidocaine plaster is efficacious in the treatment of neuropathic pain symptoms associated with previous herpes zoster infection.

Contralateral hemi-parkinsonism and atypical tremor after stroke (a case report).

Extrapyraramidal parkinsonian-like syndromes have been observed as manifestations of different central nervous system lesions. A 45-year-old-man gradually developed tremor and slowing of movements 2 years after a stroke. Neurological examination revealed slight hemiparesis, muscle rigidity and bradykinesia in the left limbs.

Clinical and electromyographic characteristics of tremor in patients with generalized anxiety disorder.

The tremor in patients with anxiety was supposed to be an enhanced physiological tremor. However no detailed clinical and electromyographic examination of tremor in patients with anxiety has been published. It has been also supposed that propranolol or benzodiazepines may influence the tremor The aim of this investigation was to establish the clinical and electromyographic pattern of tremor in patients with anxiety and to compare the effects of propranolol and alprazolam treatment.

Clinical and electromyographic assessment of essential tremor treatment.

It is a matter of debate whether beta-blockers or primidone have a better influence on essential tremor. It is also controversial whether essential tremor with synchronous electromyographic activity is influenced by the administration beta-blockers, while tremor with alternating electromyographic activity is influenced by primidone. The aim of this study was to reevaluate the effects of beta-blockers and primidone on essential tremor.

Temporal pole MRI abnormalities in temporal lobe epilepsy.

Magnetic resonance imaging (MRI) demonstrates an abnormal aspect of the temporo-polar region in 1/3 to 2/3 of patients suffering from cryptogenic temporal lobe epilepsy. This abnormal aspect is described as a white matter increased T2 signal, resulting in a loss of gray-white matter demarcation, often associated with atrophy, as recently confirmed by quantitative volumetric measurements. These temporo-polar MRI findings appear to correctly lateralize the epileptogenic temporal lobe with a very high specificity, and have never been reported in extra-temporal lobe epilepsy nor in control subjects.

The role of the temporal pole in auditory processing.

Experiments in animals have shown that the temporal pole and the amygdala are involved in auditory processing. Comparable data are scarce in humans. It is only known that after temporal lobectomy, hearing may be impaired and dichotic listening scores reduced on the ear contralateral to the operated temporal lobe.

Direct electrical stimulations of the temporal pole in human.

We report the results of 105 intracortical electrical stimulations of the temporo-polar cortex performed in 30 patients during stereo-electroencephalography (SEEG) investigation of drug-resistant temporal lobe epilepsy. Clinical responses were elicited in 50% of the patients during 26 of the 105 stimulations. Responses are coherent with data found in the literature with mostly psychic, viscero-sensitive, autonomic and viscero-motor phenomena being elicited.

Clinical and electromyographic examinations of patients with psychogenic tremor.

The diagnosis of psychogenic tremor is difficult, as it is based on exclusion of all possible causes for organic tremor. The aim of this examination was to evaluate some typical clinical and electromyographic features of the psychogenic tremor. Twenty-nine patients with psychogenic tremor were examined and followed up for more than 36 months.

Correlation between tremor parameters.

The relationship between clinically scored tremor and electromyographic measurements of tremor amplitude is not clear and few reports have examined correlations between different tremor parameters. The aim of this study was to evaluate the correlations between different tremor parameters, clinical tremor scoring, age and disease duration. A total of 525 patients with different types of tremor were included in this study.

Clinical and electromyographic examinations of patients with midbrain and cerebellar tremor.

The aim of this study was to re-evaluate the controversial clinical and electromyographic findings of cerebellar and midbrain tremors. Neurological examination and surface electromyographic tremor recordings were performed on 46 patients (24 with midbrain and 22 with cerebellar tremor). Our results revealed that the midbrain tremor has involved the hand, sometimes the ipsilateral leg and regions outside the limbs.

Motoneuron activity in patients with different types of tremor.

The aim of this work was to examine the segmental motoneuron activity as a possible mechanism of tremor generation. Eighty-three patients with different types of tremor (25 with Parkinsonian, 29 with essential, and 30 with enhanced physiological tremor due to anxiety), 25 Parkinsonian patients without tremor and 30 healthy volunteers were examined. The tremor was studied clinically and by electromyography in all limb positions.

Electromyographic differentiation of tremors.

Objective: The aim of this study was to explore the opportunity for differentiation of tremors on the basis of the electromyographic examination.

Methods: We report data from 525 patients with different types of tremor included in this study. Two hundred and twenty patients with essential tremor, 110 patients with Parkinson's disease, 24 patients with midbrain tremor, 22 patients with cerebellar tremor, 120 patients with enhanced physiological tremor due to anxiety, and 29 patients with psychogenic tremor participated in the study.

The trigemino-cervical reflex in normal subjects.

There are only few reports on the trigemino-cervical reflex in humans and there is debate over the best method of reflex examination. The aim of this study was, comparing different methods, to provide a reproducible method for evaluating the trigemino-cervical reflex. The trigemino-cervical reflex was studied in 32 healthy volunteers.

Prevalence of Parkinson's disease in Bulgaria.

Despite some publications on Parkinson's disease prevalence in Bulgaria, its frequency in the country still remains uncertain. Earlier studies in Bulgaria were carried out on large population groups and were based on medical records without further diagnostic confirmation. The aim of the present study was to perform an epidemiological investigation on Parkinson's disease in Bulgaria, using strict diagnostic criteria in an attempt to obtain a more accurate estimate of its frequency in this country.

A cross-over clinical and electromyographic assessment of treatment for parkinsonian tremor.

Background: Whether dopaminergic and anticholinergic drugs exert influence on parkinsonian rest and postural tremor is a subject of debate. Different types of tremor may be influenced differently by the drugs. The aim of this study was to reevaluate the differential effects of levodopa and anticholinergic drugs on parkinsonian tremor in different limb positions and on different types of postural tremor.

Clinical and electromyographic examinations of patients with tremor after chronic occupational lead exposure.

Tremor is considered to be a clinical sign of patients with chronic lead exposure. However, the type of tremor and its pathophysiological mechanisms are controversial. The aim of this study was to examine the clinical and electromyographic characteristics of tremor in patients with chronic lead exposure.

Antiphospholipid syndrome and dystonia-parkinsonism. A case report.

Background: Although clinically evident and MRI confirmed, basal ganglia involvement, is usual in primary antiphospholipid syndrome, extrapyramidal disorders such as parkinsonism and dystonia are very rare. We were unable to find any report in the literature on dystonia-parkinsonism in patients with primary antiphospholipid syndrome. Here we report an adult patient with dystonia-parkinsonism and primary antiphospholipid syndrome.

Evaluation of the presynaptic inhibition by comparing the amplitudes of H reflexes and F waves. Is it possible?

The H reflexes depend on presynaptic inhibition, but not the F waves. The aim of this study was to explore the possibility for using the comparison of F wave and H reflex amplitudes (F/H ratio) for indirect evaluation of the presynaptic inhibition. An examination of 130 patients with old spastic hemiparesis was performed.