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1.
Introduction
Gliomas are commonly associated with the development of epilepsy; in some cases the two conditions share common pathogenic mechanisms and may influence each other. Brain tumor related-epilepsy (BTRE) complicates the clinical management of gliomas and can substantially affect daily life.State of the art
The incidence of seizures is high in patients with slow growing tumors located in the frontotemporal regions. However, recent studies suggest that epileptogenesis may be more associated with tumor molecular genetic markers than tumor grade or location. Although the exact mechanism of epileptogenesis in glioma is incompletely understood, glutamate-induced excitotoxicity and disruption of intracellular communication have garnered the most attention.Clinical management
Management of BTRE requires a multidisciplinary approach involving the use of antiepileptic drugs (AEDs), surgery aided by electrocorticography, and adjuvant chemoradiation.Future directions
Insight into the mechanisms of glioma growth and epileptogenesis is essential to identify new treatment targets and to develop effective treatment for both conditions. Selecting AEDs tailored to act against known tumor molecular markers involved in the epileptogenesis could enhance treatment value and help inform individualized medicine in BRTE. 相似文献2.
Paweł Daszkiewicz Paweł Kowalczyk Marcin Roszkowski 《Neurologia i neurochirurgia polska》2018,52(1):2-8
Background
Neuronal-glial tumors (ganglioglioma and dysembryoplastic neuroepithelial tumor) are a frequent cause of focal, drug-resistant and epilepsy in children and young adults, that is amenable for surgical treatment.Aim of paper
Assessment of late outcome of surgical treatment and degree of seizure control, as well as prognostic significance of selected clinical factors.Material and method
52 Pediatric patients presenting with epilepsy, lesion of mesio-basal temporal lobe and histologically verified neuronal-glial tumor treated at our facility since 2000–2011.Results
After the mean follow-up of 2.94 years, satisfactory treatment outcome (Engel classes I and II) was obtained in 92% of the patients (n = 48). Poor outcome (Engel class III) was seen in 8% of patients (n = 4). New neurological deficits appeared in 28% of the patients (n = 20) but in most of them resolved over time.Conclusions
In patients with drug-resistant epilepsy and a lesion of mesial-basal part of temporal lobe suggestive of a glial-neuronal tumor, surgical treatment is strongly recommended, aiming at excision of tumor and elimination of seizures. Histological verification of the lesion is a pre-requisite for optimal treatment planning. In most patients, both treatment goals may be reached. Short duration of epilepsy prior to surgery and young age are favorable prognostic factors. Histological diagnosis of GG, co-existence of cortical dysplasia and location of tumor extending beyond mesial-basal temporal structures are associated with a higher risk of postoperative complications. These may out-weight expected benefits of surgery. 相似文献3.
Rumyana Kuzmanova Irina Stefanova Katerina Stambolieva 《Neurologia i neurochirurgia polska》2018,52(2):215-221
Introduction
The absence of patient's cooperation when it comes to his/her treatment (“noncompliance”) is typical to chronic diseases and it is significant problem in medical practice. The term “compliance” means patient's capability of strictly adhering to the recommendations concerning the prescribed treatment. The noncompliance with drug regime is frequent case in patients with epilepsy, it is related to increased risk of epileptic seizures’ occurrence and other undesired consequences, including increased costs in the healthcare area.Objective
The objective of our research is assessing the interconnection between compliance with the treatment and social-demographic and clinical factors in patients with epilepsy.Contingent and methods
The research covers 131 consecutively included patients with epilepsy of various social-demographic and clinical characteristics. We have utilized analysis of the medical documentation, anamnesis, study of the somatic and neurological status, self-assessment scales and statistical methods.Results
We established statistically significant positive correlations between the number of patients with poor compliance and the absence of professional/educational occupation, frequency of epileptic seizures, number of the antiepileptic drugs taken during the present and past treatment, the simultaneous presence of poor control of epileptic seizures and adverse drug events being the reason behind the modification of the previous treatment.Conclusion
Patient's poor compliance, the great frequency of seizures, the higher number of antiepileptic drugs and the adverse drug reactions have negative impact on the course of the epileptic disease. The improved compliance results in optimizing the antiepileptic treatment, improving patients’ condition and significantly cutting down costs incurred in the healthcare area. 相似文献4.
Carlos Salavera Pablo Usán José Luis Antoñanzas Pilar Teruel Orosia Lucha 《Annales médico-psychologiques》2017,175(4):353-357
Objective
Analyze the relation between both these variables (affects and personality).Method
To evaluate the relation between affects and personality, 652 university students were evaluated, through questionnaires PANAS (affects) and ZKPQ-50-CC (personality).Results
The results showed how males presented higher levels of impulsiveness, activity, sociability and aggressiveness, and no differences in handling affects were found. Those people who used positive affects more showed higher levels of activity, sociability and impulsiveness. Personality influenced affects for three of its factors, Anxiety, Activity and Aggressiveness, and was a good predictor of affects. Anxiety also strongly influenced the prognosis of negative affects.Conclusions
We conclude that our research data provide evidence for a relation between both these study variables. 相似文献5.
Julien Puntonet Volodia Dangouloff-Ros Raphaël Saffroy Mélanie Pagès Felipe Andreiuolo Jacques Grill Stéphanie Puget Nathalie Boddaert Pascale Varlet 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(5):316-322
Background and purpose
Molecular alterations were recently added to the World Health Organization (WHO) 2016 classification of central nervous system (CNS) tumors. We correlated the histological and radiological features of G34R mutant high-grade gliomas, a recently described hemispheric and supratentorial glioma of children and young adults.Materials and methods
We performed a retrospective multicenter study on the histopathological and MRI results of 12 patients.Results
All tumors were supratentorial. Several radiological aspects were observed. Height over 12 were bulky and well delineated tumors, without visible peritumoral infiltration on MRI and pathologically characterized by highly cellular tissue associated with a moderate peritumoral infiltrative component. Two tumors were ill-defined and hyperintense on T2 sequences and pathologically characterized by diffuse tumoral infiltration. Two tumors were bulky and well delineated with an infiltrative component, both radiologically and histopathologically.Conclusions
These different patterns may correspond to different pathological mechanisms and a potential link with prognosis should be assessed in further studies. 相似文献6.
Vladimir Rendevski Boris Aleksovski Dragan Stojanov Vasko Aleksovski Ana Mihajlovska Rendevska Milena Kolevska Kiro Stojanoski Icko Gjorgoski 《Neurologia i neurochirurgia polska》2018,52(2):207-214
Objective
We aimed to evaluate the prognostic values, contribution and interactions of the peripheral blood plasma glutamate and tumor-necrosis factor-α (TNF-α) levels toward the formation of the perifocal edema in patients with intracerebral hemorrhage (ICH).Methods
Fifty patients with ICH and fifty healthy controls were included in the study. The peripheral markers were detected by high-sensitivity ELISA.Results
A highly significant differences in plasma glutamate and TNF-α levels with good separation of their values was detected between patients and healthy controls. The two variables correlated with the severity of the symptoms and the initial volume of the ICH at admission. Both peripheral glutamate and TNF-α levels at admission were estimated as significant predictors for the formation of the perifocal edema five days after ICH; nevertheless, it was shown that they independently contribute to the development of the edema, without effects of interaction and regardless the localization of the ICH.Conclusions
Our results support the idea for the significance of glutamate and TNF-α as peripheral markers for excitotoxicity and inflammation in ICH patients. The developed multiple regression model for prediction of the development of the edema could be beneficial in decision making between conservative treatment and surgical intervention in the clinical practice. 相似文献7.
Żanna Pastuszak Renata Piusińska-Macoch Adam Stępień Zbigniew Czernicki 《Neurologia i neurochirurgia polska》2018,52(2):281-284
Background
Post polio syndrome is a rare disease that occurs decades after polio virus infection. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option with proved effectiveness in drug resistant depression. Possibly it can be helpful in therapy of other neurological diseases including post polio syndrome.Objective
To describe a case of patient diagnosed with post polio syndrome who was treated with rTMS stimulation with a good effect.Methods
Patient had rTMS stimulation of left prefrontal cortex twice a week for an eight weeks. Patient's health status was evaluated before treatment, after last rTMS session and after three months from the end of the treatment.Results
Improvement of fatigue score, mood disturbances and motor functions was observed after treatment.Conclusion
rTMS can be an effective method in treatment of post polio syndrome but further studies with larger group need to be done to confirm that data. 相似文献8.
Kyriakos Paraskeva Dimitrios Giakoumettis Ioannis Nikas George Georgoulis George Sfakianos Marios S. Themistocleous 《Neurologia i neurochirurgia polska》2018,52(4):534-542
Introduction
Neck pain and torticollis are common symptoms in the pediatric population that rarely requires further investigation. However, in case symptoms persist, then a more meticulously approach should be considered. Underlying conditions such as infections, neck injury, autoimmune disorders or even cervical spine cancer should be excluded from diagnosis. Cervical spine cancer is a rare neurosurgical entity in the pediatric population and even rarer is atlantoaxial Ewing's sarcoma. In this report, we present a rare case of primary Ewing's sarcoma of the axis.Case report
A 3.5-year-old female with progressive neck pain and intermittent episodes of torticollis was referred to our outpatient clinic. Imaging studies revealed a malignant tumor located on C2 vertebra. Diagnosis of Ewing's Sarcoma was confirmed via open biopsy and the patient was treated with Euro-EWING 99 chemotherapy.Conclusion
Pediatric neck pain and/or torticollis should raise high suspicion for malignancy of cervical spine. Modern diagnostic means and techniques can assist in the screening and diagnosis of these tumors. 相似文献9.
Felipe Padovani Trivelato Marco Túlio Salles Rezende Alexandre Cordeiro Ulhoa Guilherme Seizem Nakiri Daniel Giansante Abud 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(2):142-146
Purpose
Spinal dural arteriovenous fistulas (sDAVF) are the most common spinal vascular lesions. The arterialization of the recipient vein results in venous hypertension and chronic ischemia. Intravascular injection of acrylic glue in order to occlude the draining vein is the principle of endovascular treatment, but a significant portion of embolization procedures do not succeed. We present our initial experience of endovascular balloon augmented embolization of sDAVF using a dual-lumen balloon.Clinical presentation
Three patients harboring sDAVF were submitted to endovascular treatment by onyx injection assisted by a double-lumen balloon as the sole therapy. Control angiography demonstrated complete obliteration of the fistula in all cases with clinical improvement.Conclusion
Dual-lumen balloon onyx embolization of spinal dural arteriovenous fistulas appears to be an acceptable and feasible alternative. 相似文献10.
Izabela Monika Rozmilowska Monika Helena Adamczyk-Sowa Damian Czyzewski 《Neurologia i neurochirurgia polska》2018,52(3):368-373
Introduction
The Myasthenia Gravis-Activities of Daily Living scale (MG-ADL) is a short, and easy to use disease-specific quality of life during daily routine tool in myasthenia gravis.Objectives
The purpose of our work was to evaluate neurological condition patients with myasthenia gravis using the form MG-ADL in order to enable the introduction in common use of an instrument which allows for the assessment of patients with myasthenia gravis.Patients and Methods
The total number of 50 patients with MG were qualified for the examination. Each patient underwent neurological examination and completed the quality of life evaluation questionnaire MQ-ADL. Additionally, each patient was asked to evaluate the quality of his/her life by means of questionnaire MG-QOL 15 and MG Composite in Polish language version.Results
Our analysis showed a positive correlation with other scales used - MG-QOL 15, MGFA, MG Composite. The intensification of neurological symptoms showed significant relation with obtained higher number of points in MG-ADL questionnaire. The MG-ADL was found to have high internal consistency, test–retest reliability, and concurrent validity.Conclusion
We confirmed reliability and dependability of the questionnaire in the the test-retest assessment. The MG-ADL is accepted to be a reliable and valuable tool for measuring disease-specific QOL in Polish patients with MG. 相似文献11.
Andżelina Wolan-Nieroda Andrzej Maciejczak Grzegorz Przysada Adrian Kużdżał Grzegorz Magoń Michlina Czarnota Mariusz Drużbicki Agnieszka Guzik 《Neurologia i neurochirurgia polska》2018,52(3):334-340
Background
Surgical treatment of odontoid fractures with posterior C1/C2 fusion always leads to severe limitations in mobility of the cervical spine and head.Purpose
To assess the mobility of the cervical spine in patients treated with various surgical methods after an axis body fracture.Material and methods
A group of 61 subjects receiving surgical treatment in a group of 214 subjects treated for odontoid fractures at one ward of neurosurgery at a regional hospital. Studies also included odontoid peg and Hangman fractures. The range of motion of the head was compared to standards by the International Standard Orthopedic Measurements (ISOM) and to head mobility in a control group of 80 healthy subjects without any pathologies or complaints associated with the cervical spine. Ranges of motion were measured with the CROM goniometre with regard to flexion, extension, right and left lateral flexion and right and left rotation. The functional status was evaluated with Neck Disability Index (NDI) standard questionnaires indicated for patients with cervical spine pain.Results
Except for flexion and extension, patients after odontoid fractures had a statistically significantly smaller range of motion of the cervical spine in all planes compared to the control group and ISOM standards.Conclusions
Odontoid fractures lead to limitations in mobility of the cervical spine even after treatment with methods that in theory should preserve the C1/C2 mobility. 相似文献12.
Żanna Pastuszak Ewa Koźniewska Adam Stępień Anna Piusińska-Macoch Zbigniew Czernicki Waldemar Koszewski 《Neurologia i neurochirurgia polska》2018,52(1):88-93
Introduction
The European population is aging and the number of elderly patients suffering from ischemic brain stroke increases. A better knowledge of the correlation between the risk factors and the course of the disease in old people may be useful for planning medical care and prophylactic strategies.Aim
This prospective study aimed to perform a demographic and clinical analysis of the etiology of ischemic stroke, survival rate and severity of post-stroke disability in patients who developed ischemic stroke at the age of over 85 years in the Polish population.Method
The study group consisted of 159 patients over 85 years old with ischemic stroke. The prevalence of risk factors such as sex, hypertension, hyperlipidemia, atrial fibrillation, heart failure and diabetes was evaluated. The outcome was assessed using the Barthel scale and the National Institutes of Health Stroke Scale.Results
The most common risk factors of ischemic stroke were hypertension and atrial fibrillation. Patients with atrial fibrillation had a more severe course of ischemic stroke.Conclusion
The course of brain stroke in the Polish population is more severe in patients over 85 years old than in younger ones. The key risk factor in this group is atrial fibrillation. 相似文献13.
Mauro Dobran Davide Nasi Maurizio Gladi Mattia Marinelli Fabrizio Mancini Maurizio Iacoangeli Massimo Scerrati 《Neurologia i neurochirurgia polska》2018,52(1):70-74
Background
The identification of psychological risk factors is important for the selection of patients before spinal surgery. Moreover, the effect of surgical decompression in lumbar spinal stenosis (LSS) on psychological outcome is not previously well analyzed.Aim of paper
to investigate clinical and psychological outcome after surgery for LSS and the effect of depressive symptoms and anxiety on the clinical outcome.Materials and methods
A total of 25 patients with symptomatic LSS underwent decompressive surgery with or without spinal stabilization were prospectively enrolled in this observational surgery. The Symptom Checklist-90-Revised (SCL-90-R) was used to assess global psychological distress with a summary score termed Global Severity Index (GSI) and single psychological disorders including depression (DEP) and anxiety (ANX). The clinical outcome of surgery was evaluated with the Oswestry Disability Index (ODI) and visual analogue scale (VAS) pain assessment.Results
Compared with baseline, there was a statistically significant improvement in VAS, ODI and GSI after surgery (p < 0.05) in all patients. Univariate analysis revealed that patients with high GSI and anxiety and depression scores had significantly higher ODI and VAS scores in the follow-up with a bad outcome.Conclusions
Surgery for spinal stenosis was effective to treat pain and disability. In this prospective study baseline global psychological distress, depression and anxiety were associated with poorer clinical outcome. 相似文献14.
E.D. Goldstein N. Ertekin-Taner A. Stephens M.M. Carrasquillo B. Boeve W.O. Tatum A.M. Feyissa 《Neurologia i neurochirurgia polska》2018,52(6):690-694
Aim of the study
The aim of this study is to evaluate standard scalp EEG findings in patients with posterior cortical atrophy (PCA), an atypical variant of Alzheimer's disease (AD).Clinical rationale
PCA is a topographically selective variant of AD. Patients with typical AD have an increased likelihood of seizures, which may negatively impact overall functional performance and cognition. It is currently unknown what the typical EEG findings are for patients with PCA.Materials and methods
A retrospective chart review was performed on patients identified either with autopsy confirmed (n = 13) or clinically (n = 126) as PCA.Results
139 patients were included though only 23 (16.5%) had undergone EEG recording. The EEG was normal in 6 (26%), while an abnormal EEG was present in 17 (74%). Interictal epileptic discharges (IEDs) were found in 2 of the 23 patients (9%).Conclusions
This study of limited sample size suggests that there may be an increased predilection to find IEDs within PCA when compared to typical AD. Larger cohorts are required to determine frequency of abnormal EEGs in PCA, roles of AEDs in therapy, and in the selection of preferred AED.Clinical implications
Patients with PCA would potentially benefit from an EEG for assessment of IEDs which may provide the clinician with a therapeutic opportunity. 相似文献15.
R. Terziev G. Petrirena Y. Marie W.C. Mueller F. Bielle J.-Y. Delattre 《Revue neurologique》2018,174(10):705-710
Objective/Background
Posterior fossa (PF) recurrences of supratentorial (ST) World Health Organization (WHO) grade II and III gliomas are thought to be rare and to have grim prognoses.Methods
This study entailed searching through our database and reviewing the records of patients with grade II and III ST gliomas who developed PF recurrence with no overt secondary gliomatosis or leptomeningeal spread.Results
Of 2266 grade II and III gliomas, 14 fulfilled the inclusion criteria: 5 oligodendrogliomas (O; 1 OII, 4 OIII); 7 astrocytomas (A; 4 AII, 3 AIII); and 2 oligoastrocytomas (OA; both OAIII). The male/female gender ratio was 10/4, and median age at recurrence was 43 years. Two groups were identified. In one group (n = 8; 1 AII, 3 AIII, 2 OAIII, 2 OIII), a rapidly growing contrast-enhancing PF mass (6/8) was associated with ST progression, and median survival time after detection was only 6.5 months despite radiotherapy and/or chemotherapy. In the second group (n = 6; 3 AII, 1 OII, and 2 OIII), a non-contrast-enhancing (5/6), asymptomatic (5/6), slow-growing PF mass remained isolated, and treatment with radio- or chemotherapy produced objective responses in three patients and durable stabilization in the remaining three. After a median follow-up of 63 months, only one patient died due to delayed recurrence of the ST lesion, while the remaining five patients are still alive.Conclusion
Non-contiguous PF relapses of ST grade II and III gliomas are rare. A high-grade ST tumor that is concomitantly progressing appears to be a predictor of poor survival. Conversely, the tumor course may be indolent if the ST lesion is low-grade and non-progressive at the time of PF involvement. The possible mechanism(s) behind this tropism are also discussed. 相似文献16.
Guo-Qing Sun Shi-Gang Jin Ting-Kai Fu Xiang-Tao Chen Zhen Xu 《Neurologia i neurochirurgia polska》2018,52(1):25-28
Objective
Pericallosal artery aneurysms are not common clinically. The microsurgery and endovascular therapy are surgically challenging operations. The objective of the study is to summarize their clinical symptoms and optimal treatment strategies of pericallosal artery aneurysms.Methods
Nine cases of pericallosal artery aneurysms detected by digital subtraction angiography (DSA) were reviewed. The clinical manifestation, brain imaging characteristics, and optimal treatment methods were summarized.Results
Patients with spontaneous aneurysm had good clinical outcomes after endovascular coiling or microsurgical clipping treatment. There were no any neurological function deficits in five patients. One patient suffered from permanent neurological function deficits. Patients with traumatic aneurysm pericallosal had relatively poor outcomes, including two patients showing disturbed consciousness and the paralysis of the lower limbs with slow recovery, and one patient was dead after the surgery.Conclusion
Spontaneous subarachnoid hemorrhage and interhemispheric fissure hematoma suggest spontaneously pericallosal aneurysm, while traumatic corpus callosum hematoma as well the accompanying embryo of intraventricular hemorrhage suggest traumatic pericallosal aneurysm. Endovascular embolization is the primary surgical treatment for pericallosal aneurysm, while patients with pericallosal aneurysm are not suitable for surgical treatment. Microsurgical clipping treatment may be a choice. However, both of these treatment strategies have high risk. 相似文献17.
Background/aims
This report shares and discusses the collected personal preferences of patients attending a memory clinic for disclosure of a potential Alzheimer's disease (AD) diagnosis.Methods
In this prospective study of outpatients attending a single memory clinic over a 6-year period (March 2004–October 2010), doctors collected their patients’ wishes (willingness to be informed, motivation, presence of the family) through a standardized procedure.Results
Of the 1005 patients questioned throughout the study period—with a final diagnosis of dementia for 480 of them—858 (85.3%) wished to be informed of an AD diagnosis, whereas 72 (7.2%) did not and 75 (7.5%) were not sure. Older age and reduced cognitive functioning were independently associated with a preference to not be informed of a potential AD diagnosis.Conclusion
Our study provides evidence of the willingness of most patients to know the truth vis-à-vis AD and also offers some insight into their motivations. 相似文献18.
A.R. Alruwaili K. Pannek A. Coulthard R. Henderson N.D. Kurniawan P. McCombe 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(1):41-48
Background and purpose
This study aims to compare the cortical and subcortical deep gray matter (GM) and white matter (WM) of ALS subjects and controls and to compare ALS subjects with (ALScog) and without (ALSnon-cog) cognitive impairment.Materials and methods
The study was performed in 30 ALS subjects, and 19 healthy controls. Structural T1- and diffusion-weighted MRI data were analyzed using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS).Results
All DTI measures and GM volume differed significantly between ALS subjects and controls. Compared to controls, greater DTI changes were present in ALScog than ALSnon-cog subjects. GM results showed reduction in the caudate nucleus volume in ALScog subjects compared to ALSnon-cog. and comparing all ALS with controls, there were changes on the right side and in a small region in the left middle frontal gyrus.Conclusion
This combined DTI and VBM study showed changes in motor and extra-motor regions. The DTI changes were more extensive in ALScog than ALSnon-cog subjects. It is likely that the inclusion of ALS subjects with cognitive impairment in previous studies resulted in extra-motor WM abnormalities being reported in ALS subjects. 相似文献19.
Ewa Sobieszczuk Justyna Kubiszewska Marta Lipowska Piotr Szczudlik Beata Szyluk Małgorzata Dutkiewicz Anna Kostera-Pruszczyk 《Neurologia i neurochirurgia polska》2018,52(3):364-367
Aim
To assess interleukin 15 (IL-15) serum levels in patients with seropositive myasthenia gravis (MG); searching for potential relationship between IL-15 levels and clinical features such as gender, age at onset, clinical presentation or treatment received.Background
IL-15 plays pivotal role in T-cell dependent autoimmunity. Increased IL-15 serum levels have been reported in several autoimmune diseases including MG patients from Japan.Patients and methods
Sera of 42 seropositive MG patients (66.7% women), mean age 50.6 ± 23.7 years) have been tested by ELISA for IL-15 levels.Results
There were no statistically significant differences between IL-15 serum levels in MG patients in comparison with controls as well as between subgroups of MG patients (early vs. late onset and thymoma MG). Mean/median IL-15 serum levels were similar in MG patients treated with corticosteroids (CS) and CS naïve. Outliers (very high values) were seen only in untreated generalized MG patients.Conclusions
Serum interleukin 15 levels in patients with seropositive myasthenia gravis do not correlate with disease severity. 相似文献20.
Indre Bakaniene Gintare Urbonaviciene Kristina Janaviciute Audrone Prasauskiene 《Neurologia i neurochirurgia polska》2018,52(5):581-586