Charakter zaburzeń mowy w chorobie Parkinsona

The aim of the study was to discuss physiology and pathology of speech and review of the literature on speech disorders in Parkinson disease. Additionally, the most effective methods to diagnose the speech disorders in Parkinson disease were also stressed. Afterward, articulatory, respiratory, acoustic and pragmatic factors contributing to the exacerbation of the speech disorders were discussed. Furthermore, the study dealt with the most important types of speech treatment techniques available (pharmacological and behavioral) and a significance of Lee Silverman Voice Treatment was highlighted.     

Znaczenie cyklooksygenaz w neurotoksyczności peptydów amyloidu β w chorobie Alzheimera

In the course of Alzheimer's disease (AD), chronic inflammation is initiated by amyloid β (Aβ) peptide aggregates that extensively participate in neurodegeneration. Epidemiological studies have shown that long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) reduces the risk of developing AD. NSAIDs are inhibitors of cyclooxygenases (COXs), enzymes involved in synthesis of eicosanoids, a major component of the inflammatory process. Recent studies have brought two new findings: 1) the toxic form of Aβ is its intra- and extracellular oligomers, rather than aggregates; 2) COX-2 activation is an early event in AD, preceding plaque formation and microglia activation. This finding suggests that COX might participate in Aβ toxicity in neurons in the early stage of AD independently of its role in the inflammatory reaction in glial cells in the advanced stage of AD. However, further studies on the role of COXs in the pathogenesis/pathomechanism of AD are needed.     

Czy wskaźnik masy ciała i stężenie lipidów w surowicy wpływają na częstość występowania i przebieg migreny?

Migraine is a well-known condition for many medical specializations. Some authors evaluate the potential impact of the abnormal body mass index (BMI) and abnormal lipid profile on the vulnerability to migraine and its severity. Regarding the fact that these factors have the inseparable connection with the risk of cardiovascular diseases, some papers bring the hypotheses of the probable role of migraine in the progression of such conditions. Some research suggests a link between abnormal BMI and a risk of migraine and its more severe course. When it comes to a lipid panel in migraine, the most frequent abnormalities are elevated levels of total cholesterol and low-density lipoprotein cholesterol which may contribute to the increased risk of migraine. High-density lipoprotein and triglycerides levels were not contributory in most of the papers. We present the latest views on the mentioned problems focusing on differences in results of the particular works.     

Choroba Wilsona – czynniki wpływające na obraz kliniczny

Wilson disease (WD) is a genetic disorder with copper metabolism disturbances leading to copper accumulation in many organs with their secondary damage. It is caused by mutation in the ATP7B gene on chromosome 13, which encodes ATP-ase 7B involved in copper transport. The age of neurologic symptom onset in WD is 20–30 years, but there is a wide spectrum of disease including: age at onset, clinical signs and treatment efficacy. More than 500 mutations of ATP7B have been described so far, but the WD genotype does not explain the disease variability. Several other factors are suspected to influence WD presentation, including polymorphisms in the genes encoding: apolipoprotein E, prion-related protein, methyltenetetrahydrofolate reductase, Murr1, antioxidant-1, X-linked inhibitor of apoptosis as well as iron metabolism disturbances, gender impact, inflammatory reactions and oxidative stress. The explanation of their significance can change the therapy of WD. The aim of our study was to review and assess the clinical significance of the factors affecting WD presentation.     

Rola czynników neurotroficznych w procesach regeneracji układu nerwowego

Neurotrophic factors regulate survival, development, and function of nervous tissue. They act via two different classes of receptors and activation of various signaling pathways in the target cells. Illumination of their physiological role in the maintenance of central nervous system homeostasis as well as regeneration of damaged tissue have ignited expectations to heal neurodegenerative diseases, including amyotrophic lateral sclerosis and Parkinson disease. Advances in pharmacotherapy, gene therapy, and stem cell biology have enabled development of novel therapies with application of regenerating cell transplantation. In the foreseeable future, it may lead to the establishment of safe and effective ways of treatment of these severe and currently incurable diseases.     

Czy wszystkie preparaty toksyny botulinowej typu A są takie same? Porównanie trzech preparatów toksyny botulinowej typu A w zarejestrowanych wskazaniach w neurologii

Recendy the list of clinical applications of botulinum toxin type A (BTX-A) enlarged. This medication is used not only by neurologists, but also by medical rehabilitation specialists, urologists, proctologists, and migraine and aesthetic medicine specialists. Currently, there are three commercially available BTX-A preparations available: Botox, Dysport and Xeomin. They have similar mechanisms of action but their chemical formulation, clinical potency, migration and diffusion as well as safety profile seem to be different. This may result in problems of bioequivalence, not only clinical but also economic ones. The authors reviewed the available clinical and laboratory studies on neurological indications labelled in Poland. Each BTX-A formulation should be treated as a different medication and used cautiously according to the individual range of dosages established in clinical trials.     

Zespół post-polio: Część I. „Dziedzictwo” zapomnianej choroby,wyzwanie dla lekarzy i pacjentów

The outcome of paralytic polio was believed to be a stable neurological state. Now, it is established that polio has an additional, slowly progressive phase, called post-polio syndrome (PPS) that develops 30–40 years after the acute poliomyelitis in 25–80% of paralytic and about 40% of nonparalytic polio survivors. The clinical symptoms are nonspecific and usually include muscle weakness, fatigue and muscle or joint pain. Some patients suffer from muscular atrophy, respiratory insufficiency, dysphagia, sleep disturbances or cold intolerance. The etiopathogenesis of PPS is unclear and many factors, such as dysfunction of the surviving motor units, aging, defects of neuromuscular transmission, persistence of viral infection and immunological mechanisms, are considered. This article reviews the epidemiology, pathophysiology, clinical characteristics and diagnosis of PPS patients.     

Postępowanie w udarze mózgu – wytyczne Grupy Ekspertów Sekcji Chorób Naczyniowych Polskiego Towarzystwa Neurologicznego. Aktualizacja 2013: leczenie trombolityczne

Thrombolysis is the most effective therapy for ischaemic stroke. The current guidelines and approvals have limited its use to patients available for treatment within 4.5 hours of onset and those aged 80 or less. There are also a number of other limitations derived from clinical trial protocols, i.e. minor and major strokes. The available evidence has indicated its possible efficacy in patients treated within 6 hours of onset and not fulfilling other limitations.Last year, the results of the IST-3 (Third International Stroke Trial: Thrombolysis) and a meta-analysis of all available trials including IST-3 were published. They point out the possible benefit of thrombolysis in patients not meeting the current criteria, which has been acknowledged in the Polish guidelines for management of stroke.     

Evaluación del trofismo del músculo temporal posquirúrgico en relación con el tiempo de manipulación y la infiltración transoperatoria de bupivacaína isobárica al 0,5% en pacientes sometidos a craneotomía pterional

IntroductionThere are different techniques for the reconstruction of the temporal muscle (TM) in the pterional approach (PA) in order to avoid and reduce atrophy, it has not been able to avoid it in its entirety.The administration of bupivacaine generates regeneration of muscle fibres. There are no studies in the medical literature that evaluate the time of TM manipulation and the use of bupivacaine for the treatment of atrophy after pterional approach, the present investigation aim is to describe the effects of these variables.Patient and methodsLongitudinal study, including patients from 18-80 years old with pterional approach at 2016-2017. We evaluated the effects of the TM manipulation times and the administration of 0.5% bupivacaine on the trophism and function of TM.ResultsTwenty-nine patients underwent a PA; 16(55.17%) count with criteria for 0.5% bupivacain infiltration.We found a negative correlation between manipulation times and trophism, with no statistically significance (p>.05).We evaluated presurgical and postsurgical index of Helkimo and Fonseca's index, finding an increase of disfunction with statistically significance (p<.05).In patients who were infiltrated with 0.5% bupivacaine we observed a mean difference in the TM's trophism of 0.275±1.18 mm, in contrast with no infiltrated which was 2.39±1.30mm (t[27] = -5.118, p=.0001).ConclusionsThe manipulation of the TM during a pterional approach conditioned an impact on the quality of life according to the disfunction indexes, due to atrophy. This investigation exhibits that de administration of 0.5% bupivacaine during surgery offers a decrease in the TM atrophy.