Isolated polio-like syndrome after tick-borne encephalitis presenting with acute hyperckemia

Tick borne encephalitis virus infection usually shows a biphasic course. In the first stage of illness symptoms are similar to a flu-like syndrome, then after a defervescence period, fever may represent with neurological manifestations ranging from mild meningitis to severe encephalomyelitis. We report the clinical case of an adult man presented with an acute proximal hyposthenia, severe hyperckemia, clinical and laboratoristic evidence of acute tick borne virus infection. This virus has a favourite tropism for the anterior horn cells of the cervical spine segment. Polio-like syndrome, usually affecting the upper limbs, is the clinical phenotype of an infection of the cervical motoneurons. Usually myelitis is associated to severe encephalitis and a complete diagnosis may be difficult in comatose patients. Rarely, an isolated polio-like syndrome may be the sole neurological complication of tick-borne encephalitis.     

The Effect of Graded Postischemic Spinal Cord Hypothermia on Neurological Outcome and Histopathology after Transient Spinal Ischemia in Rat

Background: Previous data have shown that postischemic brain hypothermia is protective. The authors evaluated the effect of postischemic spinal hypothermia on neurologic function and spinal histopathologic indices after aortic occlusion in the rat.

Methods: Spinal ischemia was induced by aortic occlusion lasting 10 min. After ischemia, spinal hypothermia was induced using a subcutaneous heat exchanger. Three studies were conducted. In the first study, the intrathecal temperature was decreased to 34, 30, or 27 [degree sign]C for 2 h beginning with initial reperfusion. In the second study, hypothermia (target intrathecal temperature 27 [degree sign]C) was initiated with reflow and maintained for 15 or 120 min. In the third study, the intrathecal temperature was decreased to 27 [degree sign]C for 2 h starting 5, 60, or 120 min after normothermic reperfusion. Animals survived for 2 or 3 days, at which time they were examined and perfusion fixed with 4% paraformaldehyde.

Results: Normothermic ischemia followed by normothermic reflow resulted in spastic paraplegia and spinal neuronal degeneration. Immediate postischemic hypothermia (27 [degree sign]C for 2 h) resulted in decreasing motor dysfunction. Incomplete protection was noted at 34 [degree sign]C. Fifteen minutes of immediate cooling (27 [degree sign]C) also provided significant protection. Delay of onset of post-reflow hypothermia (27 [degree sign]C) by 5 min or more failed to provide protection. Histopathologic analysis revealed temperature-dependent suppression of spinal neurodegeneration, with no effect of delayed cooling.     

Primary central nervous system lymphoma in an immunocompetent patient: an unusual case of prolonged response to steroids

Neurological Sciences -     

Chronic bilateral electrical stimulation of the subthalamic nucleus for the treatment of advanced Parkinson's disease

Preliminary reports in patients with Parkinson's disease (PD) showed that subthalamic nucleus (STN) stimulation was able to reverse parkinsoniam state. Since 1998 we evaluated the safety and the efficacy of STN stimulation in 7 patients affected by advanced PD. All patients were included using CAPIT protocol. Motor functions and quality of life were evaluated, before and after surgery, with UPDRS and PDQ38, respectively. At the 6-month follow-up, the off medication/on stimulation UPDRS motor score improved by 50.6% and the on medication/on stimulation by 20.3%. Motor fluctuations were reduced by 57.2% and dyskinesias by 73.5%. The total D-dopa equivalent daily dose was reduced by 40.7%. PDQ38 ameliorated by 49.9%. We did not observe any perioperatory complication and only mild and tolerable side effects after stimulation.     

Postischemic hypoxia improves metabolic and functional recovery of the spinal cord

We studied the effect of graded postischemic reoxygenation on the tissue concentrations of adenylates, glucose, and lactate in the rabbit lumbar spinal cord after 10, 20, and 30 minutes of ischemia. In comparison with recirculation without manipulated PaO2, a decrease of PaO2 to 40 to 45 mm Hg upon reestablishment of blood circulation after ischemia led to an amelioration of the energy metabolism in the spinal cord tissue as determined by measuring the ATP concentration and energy charge. The protective effect of postischemic hypoxia was also reflected by the improvement of neurologic functions in animals after 10 and 20 minutes of ischemia.     

Sports training and adaptive changes

Purpose

Sports training and professional experience lead to changes in the human motor cortex and on the autonomic nervous system. This experimental study aims to investigate as sport activities can lead changes on the human motor cortex and on the autonomic nervous system (ANS), analyzing the Heart Rate changes and spontaneous Galvanic Skin Response (GSR) fluctuations in relation to the adaptive changes on the human motor cortex.

Methods

Three neurophysiologic parameters (rMT, MEP latency and MEP amplitude) were investigated using transcranial magnetic stimulation (TMS). TMS was applied to the primary motor cortex (M1) of 30 right-handed young karate athletes recruited. To evaluate ANS, HR (at rest and during exercise) and GSR (at rest and post-exercise) were measured. All data were matched with the records obtained by 30 non-athletes. All statistical analyses were performed using R.

Results

Statistical significant differences were detected analyzing the data refers to neurophysiologic parameters. The HR and GSR values showed significant differences comparing athletes group with non-athletes group.

Conclusions

Our data suggest that there are significant differences analyzing the cortical excitability in athletes, compared to non-athletes. Furthermore, this data confirmed that the exercise training influences the parasympathetic tone, reducing HR. Moreover, a significant reduction in GSR parameters was reported in the athletes group, which is an indicator of stress level. The HR training helps to restore the autonomic balance and improves autonomic control that supports emotional regulation and performance coordination, so the training represents an advantage in reducing anxiety in athletes. Future studies could be used to investigate the differences of these adaptive changes respect to athletes’ level (for example, amateur vs professional).