- Email: [email protected]
16. A diagnostic challenge: Nonconvulsive status epilepticus in elderly
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Society Proceedings / Clinical Neurophysiology 120 (2009) e127–e132
Methods: Male Wistar rats (n = 48) were divided into following groups: (1) control, saline-treated group (n = 16), (2) dimethylsulfoxide-treated group (n = 16), (3) group that received lindane, dissolved in dimethylsulfoxide, in a dose of 8 mg/kg intraperitoneally (n = 16). Eight animals from each group were sacrificed 0.5 and 4 h after treatment and brain samples were prepared for further analysis. Acetylcholinesterase activity (mitochondrial and synaptosomal fraction) was determined in cerebral cortex, thalamus, hippocampus and nc. caudatus spectrophotometrically. Results: A significant rise in mitochondrial acetylcholinesterase activity was detected in cortex and nucleus caudatus of lindane-treated animals 0.5 h after administration (p < 0.05). This rise was sustained in nucleus caudatus within 4 h after treatment (p < 0.05). In contrast, activity of synaptosomal acetylcholinesterase fraction was significantly increased only in thalamus 4 h after lindane administration (p < 0.05). Conclusion: An increase in acetylcholinesterase activity may be involved in mediating acute neurotoxic effects of lindane, at least in some brain structures in rats.
METHODS: We have used classical electrophysiology to measure number of waves of depolarization per minute, wave amplitude, and number of spikes per wave during nickel induced oscillatory epileptiform activity of Retzius nerve cells of the leech Haemopis sanguisuga prior to and during application of 2% (435 mmol/l) ethanol in Ringer solution. All data represented as average ± SEM. Each trial was performed on five cells and averages calculated from at least 10 waves per cell. Results: Application of 3 mM nickel induces oscillatory epileptiform activity in leech Retzius nerve cells, which is shown as waves of depolarization, accompanied with repetitive firing of action potentials. Addition of 2% ethanol solution suppresses the number of waves of depolarization per minute from 8.20 ± 0.78 to 4.30 ± 1.05 (p < 0.05, t-test), diminishes wave amplitude from 11.40 ± 0.51 to 6.75 ± 0.53 mV (p < 0.001, t-test), and decreases number of spikes per wave from 3.00 ± 0.00 to 0.57 ± 0.30 (p < 0.001, t-test). Conclusions: Ethanol inhibits epileptiform activity induced by calcium channel blocker nickel on Retzius nerve cells of the leech. doi:10.1016/j.clinph.2008.12.018
doi:10.1016/j.clinph.2008.12.016
13. Effect of 2,4-diaminobutyric acid on Retzius cells of the leech—S. Lopicˇic´ 1, D. Pathak 1, M. Stanojevic´ 1, A. Nedeljkov 1, ˇ emerikic´ 1, V. Nedeljkov 1 (1 InstiA. Popovic´ 1, D. Pavlovic´ 2, D. C tute for Pathological Physiology, Medical Faculty Belgrade, Serbia, 2 Ernst Moritz Arndt University, Greifswald, Germany) Purpose: The aim of this study was to examine the effect of 2,4diaminobutyric acid (DABA) on Retzius cell of the leech in presence of 20 mmol/l bicarbonate since this amino acid is present in mammalian brain as well as in several Lathyrus species, it is shown to produce convulsions and neuropathologic changes in rats, and that bicarbonate increases its effect. Methods: We used classical electrophysiology to measure the resting membrane potential of Retzius nerve cells of the leech Haemopis sanguisuga upon application of 10 2 mol/l DABA in presence of 20 mmol/l bicarbonate. Results: Bath application of 10 2 mol/l DABA with 20 mmol/l bicarbonate for 3 min. depolarized resting membrane potential by 5.33 ± 1.25 mV (n = 5, p = 0.01, t-test). Since the solution of DABA is acidic (pH 6.8), we have also tested the effect of Ringer solution with pH adjusted to 6.8 by HCl. This acidic Ringer had no effect on the cell (depolarization of 1.67 ± 0.48 mV, n = 3, p > 0.05). Therefore the depolarization observed upon administration of DABA cannot be attributed to change in pH. Conclusions: We conclude that DABA in presence of bicarbonate has depolarizing effect on Retzius cell of the leech, and may contribute to the pathogenesis of neurolathyrism and other neurodegenerative diseases.
Purpose: To analyze factors associated with incomplete seizure control in children with cerebral palsy (CP). Methods: The group of 30 children with CP and epilepsy, age 3–17 years, was studied retrospectively. CP types, mental retardation and age of seizure onset were also analyzed. To determine prognosis of seizures, children were divided in two subgroups according to the level of seizure control. Results: Fifty-seven percentage of patients were on AED monotherapy, while 43% were treated with two or three AEDs. Twenty-three patients (77%) became seizure-free. Complete seizure control was achieved in the majority of children with spastic hemiplegia (7/9), diplegia (6/8) and spastic quadriplegia (7/10). All children with mixed type of CP belonged to the subgroup with complete seizure control (3/3). Associated mental retardation was seen in all patients without complete seizure control and in 83% of seizure-free patients. Seizure onset in the first year of life occurred in 35% of seizure-free children as compared to 86% of children without complete control of seizures. Conclusions: Severity of neurological condition (spastic quadriplegia), mental retardation and earlier age of seizure onset are factors mainly associated with incomplete seizure control. doi:10.1016/j.clinph.2008.12.019
16. A diagnostic challenge: Nonconvulsive status epilepticus in elderly—S. Kostic, R. Sujic, Z. Milojevic, V. Cvijanovic, V. Nikolic, D. Vranjes (Department of Neurology, Clinical Hospital Centre Zvezdara, Belgrade, Serbia)
doi:10.1016/j.clinph.2008.12.017
14. Effect of ethanol on epileptiform activity induced by nickel on Retzius nerve cells of the leech—D. Pathak 1, S. Lopicˇic´ 1, M. Stanojevic´ 1, A. Nedeljkov 1, A. Popovic´ 1, D. Pavlovic´ 2, ˇ emerikic´ 1, V. Nedeljkov 1 (1 Institute for Pathological physiD. C ology, Medical faculty Belgrade, Serbia, University, Greifswald, Germany)
15. Factors associated with incomplete seizure control in children with cerebral palsy—Predrag Ignjatovic (Clinic of Neurology and Psychiatry for Children and Youth, Belgrade, Serbia)
2
Ernst Moritz Arndt
Purpose: The purpose of the present study was to investigate the effect of ethanol in epileptiform activity evoked by blocking calcium channels with nickel, since ethanol exposure affects many neuronal functions, including pacemaker activity of individual nerve cells.
Purpose: To point out a differential diagnosis of non-convulsive status epilepticus (NCSE) in elderly. Method: We describe a case of acute confusional state and right hemiparesis due to nonconvulsive status epilepticus, not caused by an ischemic or hemorrhagic stroke as it usually is presumed. Results: This 67-year-old man presented acute confusional state and right hemiparesis that suddenly appeared, without headache or vomitus. CT and MRI of the brain revealed neither ischemic nor hemorrhagic stroke. NCSE lasted up to 5 days, when it was diagnosed by EEG recording discharges originating from the left temporo-parietal
Society Proceedings / Clinical Neurophysiology 120 (2009) e127–e132
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region, and their response to intravenous benzodiazepines. Following the initiation of antiepileptic treatment, neurological examination normalized concomitantly with resolution of the NCSE. The patient became alert without right hemiparesis. Blood examinations revealed leukocytosis 25.0 with lymphocyte count 17.0 (68.0%). Haematologist diagnosed chronic lymphocytic leukaemia, clinical stage 0 (CLL Rai 0). Conclusions: We recommend considering an early EEG in the evaluation of patients with an acute confusional state. NCSE can have unusual clinical manifestations, and a high index of suspicion is necessary to correctly diagnose these patients.
FSHD in 5 (12.19%) patients. In 32 (78%) patients, EMG diagnostics was carried out. In KMD group of 12 patients in 11 (92%) EMG was myopathic. In 6 out of 7 KMD biopsy was in accordance with EMG findings. In 3 out of 9 MD myotonic discharge was not detected, 1 out of 3 belonged to congenital type MD. EMG in FSHD group was myopathic in 3 out of 4 (75%), in LGMD in 6 out of 7 (5.71%) cases. Conclusions. Sensitivity of EMG test is greatest in KMD group, the least in the MD group. In MD the phenotype specificity and availability of genetic diagnostics transcended low sensitivity of EMG test.
doi:10.1016/j.clinph.2008.12.020
doi:10.1016/j.clinph.2008.12.022
17. West syndrome: Our clinical experience in 36 cases—M. Borkovic´ (Clinic of Neurology and Psychiatry for Children and Youth, Belgrade, Serbia)
19. Anterior interosseous nerve lesion – Case report—Z. Vukojevic´ 1, A. Dominovic´-Kovacˇevic´ 1, S. Grgic´ 1, D. Racˇic´ 1, S. C´ato 2 (1 Banja Luka, Neurological Clinic, Bosnia and Herzegovina, 2 General Hospital Prijedor)
Purpose: To analyze some clinical aspects of patients with West syndrome (WS). Methods: Thirty-six patients were enrolled in retrospective study. Mean onset of epileptic spasms was 6.5 months. All children were followed from one to four years (mean 2.8). Results: Aetiology of epileptic spasms was symptomatic 28 (77.7%). Idiopathic WS was concluded in 8 (22.2%). Family history for epileptic spasms was reported in two girls. Neuroimaging studies showed morphological abnormalities in 77.7%. Steroid therapy was administered in 80.5% of patients, with 75.0% receiving it as initial treatment. Complete or nearly complete control of spasms after one-month treatment was achieved in 25 (75% of patients treated with steroids and in 25.0% receiving vigabatrin). In addition, complete seizure control after one-year follow-up was noted in 11 (30.5%). Significant, favourable decrease in seizure frequency was seen in 26 (72.0%). Normal or slightly delayed psychomotor development was observed in only 9 (25.0%). During the follow-up, (at least one month after the introduction of therapy) focal EEG abnormalities were recorded in 17 (47.2%), modified hypsarrhythmic pattern in 9 (25.0%) and non-specific abnormalities in 10 (27.7%). Conclusion: The majority of our patients have a poor prognosis. Aetiology of WS seemed to have greatest impact on clinical course and long-term outcome.
Introduction: Compression of the anterior interosseous nerve, the biggest branch of the median nerve, in the forearm area is extremely rare in clinical practice (much rarer than carpal tunnel syndrome). It frequently occurs because of compression of the nerve between the two heads of the pronator teres; it may be posttraumatic or idiopathic. Case report: A 45-year-old patient came for the EMG testing due to pains in the right forearm, hand weakness and hyperextension of the index finger. One month before, he had performed an intensive physical work all day long (carrying heavy crates on his forearms). The following days he had felt pains, paresthesia in the front part of the forearm, reduced hand ability, hyperextension of the index finger. The EMG test showed moderately strong signs of the current and chronic neurogenic lesion in the M. Flexor pollicis longus, M. Flexor digitorum profundus and m. pronator quadratus. The patient underwent physical therapy. After three months, subjective complaints have been less expressed, while the EMG finding was improved. Conclusion: Lesions of the anterior interosseous nerve are rare in clinic practice and can cause considerable hand weakness. The EMG is a key diagnostic method, while medical treatment is most often conservative. doi:10.1016/j.clinph.2008.12.023
doi:10.1016/j.clinph.2008.12.021
18. Non-dystrophinopathy muscular dystrophies at childhood age—B. Vukadinovic´-Pajovic´ 1, V. Milic´-Rašic´ 2, S. Todorovic´ 2 (1 Kovin Special Neuropsychiatric Hospital, Kovin, Serbia, 2 Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia) Introduction: Muscular dystrophies are the most common hereditary myopathies related to children,and include: Dystrophinopathies, Limb-Girdle Muscular Dystrophy (LGMD), Congenital (KMD), Facioscapularohumeral (FSHD), Emery-Dreifuss Muscular Dystrohies, Distal and Myotonic Dystrophies (MD). Purpose: To define frequency of certain non-dystrophinopathy muscular dystrophy entities in childhood, and to identify significance of certain diagnostic procedures, primarily EMG and muscular biopsies. Methods: Registers of hospitalised patients and outpatients from 1997 to 2007 were used. Results: Out of 41 patients, dystrophy diagnosis was differentiated as: KMD 16 (39.02%), MD 12 (29.27%), LGMD 8 (19.51%) and
20. Correlation of EMNG findings in patients taking peroral antidiabetics and insulin—A. Dominovic´-Kovacˇevic´, Z. Vukojevic´, S. Grgic´. D. Racˇic´ (Banja Luka Neurological Clinic, Bosnia and Herzegovina) Diabetic neuropathies represent the most common and the most important complication of diabetes. Goal: To compare EMNG findings in patients taking peroral antidiabetics and insulin. Material and methods: EMNG examination encompassed 48 diabetics (24 taking oral and 24 insulin therapy since the beginning of disease). The average lifetime is 58.9, while the duration of diabetes is 13.9 years. 31 men (64.58%) and 17 women (35.42%) were examined. The following comparisons were made: motor and sensitive conduction velocity, amplitudes of the examined nerves and degree of muscle weakness. Results: The average motor conduction velocity of n. peroneus in patients taking insulin therapy was 40.29 m/s (±4.2), while in patients taking oral therapy 32.83 m/s (±4.7); for N. tibialis it was 40.91 m/s (±2.3) taking insulin, and 34.16 m/s (±2.1) taking oral
Society Proceedings / Clinical Neurophysiology 120 (2009) e127–e132
Methods: Male Wistar rats (n = 48) were divided into following groups: (1) control, saline-treated group (n = 16), (2) dimethylsulfoxide-treated group (n = 16), (3) group that received lindane, dissolved in dimethylsulfoxide, in a dose of 8 mg/kg intraperitoneally (n = 16). Eight animals from each group were sacrificed 0.5 and 4 h after treatment and brain samples were prepared for further analysis. Acetylcholinesterase activity (mitochondrial and synaptosomal fraction) was determined in cerebral cortex, thalamus, hippocampus and nc. caudatus spectrophotometrically. Results: A significant rise in mitochondrial acetylcholinesterase activity was detected in cortex and nucleus caudatus of lindane-treated animals 0.5 h after administration (p < 0.05). This rise was sustained in nucleus caudatus within 4 h after treatment (p < 0.05). In contrast, activity of synaptosomal acetylcholinesterase fraction was significantly increased only in thalamus 4 h after lindane administration (p < 0.05). Conclusion: An increase in acetylcholinesterase activity may be involved in mediating acute neurotoxic effects of lindane, at least in some brain structures in rats.
METHODS: We have used classical electrophysiology to measure number of waves of depolarization per minute, wave amplitude, and number of spikes per wave during nickel induced oscillatory epileptiform activity of Retzius nerve cells of the leech Haemopis sanguisuga prior to and during application of 2% (435 mmol/l) ethanol in Ringer solution. All data represented as average ± SEM. Each trial was performed on five cells and averages calculated from at least 10 waves per cell. Results: Application of 3 mM nickel induces oscillatory epileptiform activity in leech Retzius nerve cells, which is shown as waves of depolarization, accompanied with repetitive firing of action potentials. Addition of 2% ethanol solution suppresses the number of waves of depolarization per minute from 8.20 ± 0.78 to 4.30 ± 1.05 (p < 0.05, t-test), diminishes wave amplitude from 11.40 ± 0.51 to 6.75 ± 0.53 mV (p < 0.001, t-test), and decreases number of spikes per wave from 3.00 ± 0.00 to 0.57 ± 0.30 (p < 0.001, t-test). Conclusions: Ethanol inhibits epileptiform activity induced by calcium channel blocker nickel on Retzius nerve cells of the leech. doi:10.1016/j.clinph.2008.12.018
doi:10.1016/j.clinph.2008.12.016
13. Effect of 2,4-diaminobutyric acid on Retzius cells of the leech—S. Lopicˇic´ 1, D. Pathak 1, M. Stanojevic´ 1, A. Nedeljkov 1, ˇ emerikic´ 1, V. Nedeljkov 1 (1 InstiA. Popovic´ 1, D. Pavlovic´ 2, D. C tute for Pathological Physiology, Medical Faculty Belgrade, Serbia, 2 Ernst Moritz Arndt University, Greifswald, Germany) Purpose: The aim of this study was to examine the effect of 2,4diaminobutyric acid (DABA) on Retzius cell of the leech in presence of 20 mmol/l bicarbonate since this amino acid is present in mammalian brain as well as in several Lathyrus species, it is shown to produce convulsions and neuropathologic changes in rats, and that bicarbonate increases its effect. Methods: We used classical electrophysiology to measure the resting membrane potential of Retzius nerve cells of the leech Haemopis sanguisuga upon application of 10 2 mol/l DABA in presence of 20 mmol/l bicarbonate. Results: Bath application of 10 2 mol/l DABA with 20 mmol/l bicarbonate for 3 min. depolarized resting membrane potential by 5.33 ± 1.25 mV (n = 5, p = 0.01, t-test). Since the solution of DABA is acidic (pH 6.8), we have also tested the effect of Ringer solution with pH adjusted to 6.8 by HCl. This acidic Ringer had no effect on the cell (depolarization of 1.67 ± 0.48 mV, n = 3, p > 0.05). Therefore the depolarization observed upon administration of DABA cannot be attributed to change in pH. Conclusions: We conclude that DABA in presence of bicarbonate has depolarizing effect on Retzius cell of the leech, and may contribute to the pathogenesis of neurolathyrism and other neurodegenerative diseases.
Purpose: To analyze factors associated with incomplete seizure control in children with cerebral palsy (CP). Methods: The group of 30 children with CP and epilepsy, age 3–17 years, was studied retrospectively. CP types, mental retardation and age of seizure onset were also analyzed. To determine prognosis of seizures, children were divided in two subgroups according to the level of seizure control. Results: Fifty-seven percentage of patients were on AED monotherapy, while 43% were treated with two or three AEDs. Twenty-three patients (77%) became seizure-free. Complete seizure control was achieved in the majority of children with spastic hemiplegia (7/9), diplegia (6/8) and spastic quadriplegia (7/10). All children with mixed type of CP belonged to the subgroup with complete seizure control (3/3). Associated mental retardation was seen in all patients without complete seizure control and in 83% of seizure-free patients. Seizure onset in the first year of life occurred in 35% of seizure-free children as compared to 86% of children without complete control of seizures. Conclusions: Severity of neurological condition (spastic quadriplegia), mental retardation and earlier age of seizure onset are factors mainly associated with incomplete seizure control. doi:10.1016/j.clinph.2008.12.019
16. A diagnostic challenge: Nonconvulsive status epilepticus in elderly—S. Kostic, R. Sujic, Z. Milojevic, V. Cvijanovic, V. Nikolic, D. Vranjes (Department of Neurology, Clinical Hospital Centre Zvezdara, Belgrade, Serbia)
doi:10.1016/j.clinph.2008.12.017
14. Effect of ethanol on epileptiform activity induced by nickel on Retzius nerve cells of the leech—D. Pathak 1, S. Lopicˇic´ 1, M. Stanojevic´ 1, A. Nedeljkov 1, A. Popovic´ 1, D. Pavlovic´ 2, ˇ emerikic´ 1, V. Nedeljkov 1 (1 Institute for Pathological physiD. C ology, Medical faculty Belgrade, Serbia, University, Greifswald, Germany)
15. Factors associated with incomplete seizure control in children with cerebral palsy—Predrag Ignjatovic (Clinic of Neurology and Psychiatry for Children and Youth, Belgrade, Serbia)
2
Ernst Moritz Arndt
Purpose: The purpose of the present study was to investigate the effect of ethanol in epileptiform activity evoked by blocking calcium channels with nickel, since ethanol exposure affects many neuronal functions, including pacemaker activity of individual nerve cells.
Purpose: To point out a differential diagnosis of non-convulsive status epilepticus (NCSE) in elderly. Method: We describe a case of acute confusional state and right hemiparesis due to nonconvulsive status epilepticus, not caused by an ischemic or hemorrhagic stroke as it usually is presumed. Results: This 67-year-old man presented acute confusional state and right hemiparesis that suddenly appeared, without headache or vomitus. CT and MRI of the brain revealed neither ischemic nor hemorrhagic stroke. NCSE lasted up to 5 days, when it was diagnosed by EEG recording discharges originating from the left temporo-parietal
Society Proceedings / Clinical Neurophysiology 120 (2009) e127–e132
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region, and their response to intravenous benzodiazepines. Following the initiation of antiepileptic treatment, neurological examination normalized concomitantly with resolution of the NCSE. The patient became alert without right hemiparesis. Blood examinations revealed leukocytosis 25.0 with lymphocyte count 17.0 (68.0%). Haematologist diagnosed chronic lymphocytic leukaemia, clinical stage 0 (CLL Rai 0). Conclusions: We recommend considering an early EEG in the evaluation of patients with an acute confusional state. NCSE can have unusual clinical manifestations, and a high index of suspicion is necessary to correctly diagnose these patients.
FSHD in 5 (12.19%) patients. In 32 (78%) patients, EMG diagnostics was carried out. In KMD group of 12 patients in 11 (92%) EMG was myopathic. In 6 out of 7 KMD biopsy was in accordance with EMG findings. In 3 out of 9 MD myotonic discharge was not detected, 1 out of 3 belonged to congenital type MD. EMG in FSHD group was myopathic in 3 out of 4 (75%), in LGMD in 6 out of 7 (5.71%) cases. Conclusions. Sensitivity of EMG test is greatest in KMD group, the least in the MD group. In MD the phenotype specificity and availability of genetic diagnostics transcended low sensitivity of EMG test.
doi:10.1016/j.clinph.2008.12.020
doi:10.1016/j.clinph.2008.12.022
17. West syndrome: Our clinical experience in 36 cases—M. Borkovic´ (Clinic of Neurology and Psychiatry for Children and Youth, Belgrade, Serbia)
19. Anterior interosseous nerve lesion – Case report—Z. Vukojevic´ 1, A. Dominovic´-Kovacˇevic´ 1, S. Grgic´ 1, D. Racˇic´ 1, S. C´ato 2 (1 Banja Luka, Neurological Clinic, Bosnia and Herzegovina, 2 General Hospital Prijedor)
Purpose: To analyze some clinical aspects of patients with West syndrome (WS). Methods: Thirty-six patients were enrolled in retrospective study. Mean onset of epileptic spasms was 6.5 months. All children were followed from one to four years (mean 2.8). Results: Aetiology of epileptic spasms was symptomatic 28 (77.7%). Idiopathic WS was concluded in 8 (22.2%). Family history for epileptic spasms was reported in two girls. Neuroimaging studies showed morphological abnormalities in 77.7%. Steroid therapy was administered in 80.5% of patients, with 75.0% receiving it as initial treatment. Complete or nearly complete control of spasms after one-month treatment was achieved in 25 (75% of patients treated with steroids and in 25.0% receiving vigabatrin). In addition, complete seizure control after one-year follow-up was noted in 11 (30.5%). Significant, favourable decrease in seizure frequency was seen in 26 (72.0%). Normal or slightly delayed psychomotor development was observed in only 9 (25.0%). During the follow-up, (at least one month after the introduction of therapy) focal EEG abnormalities were recorded in 17 (47.2%), modified hypsarrhythmic pattern in 9 (25.0%) and non-specific abnormalities in 10 (27.7%). Conclusion: The majority of our patients have a poor prognosis. Aetiology of WS seemed to have greatest impact on clinical course and long-term outcome.
Introduction: Compression of the anterior interosseous nerve, the biggest branch of the median nerve, in the forearm area is extremely rare in clinical practice (much rarer than carpal tunnel syndrome). It frequently occurs because of compression of the nerve between the two heads of the pronator teres; it may be posttraumatic or idiopathic. Case report: A 45-year-old patient came for the EMG testing due to pains in the right forearm, hand weakness and hyperextension of the index finger. One month before, he had performed an intensive physical work all day long (carrying heavy crates on his forearms). The following days he had felt pains, paresthesia in the front part of the forearm, reduced hand ability, hyperextension of the index finger. The EMG test showed moderately strong signs of the current and chronic neurogenic lesion in the M. Flexor pollicis longus, M. Flexor digitorum profundus and m. pronator quadratus. The patient underwent physical therapy. After three months, subjective complaints have been less expressed, while the EMG finding was improved. Conclusion: Lesions of the anterior interosseous nerve are rare in clinic practice and can cause considerable hand weakness. The EMG is a key diagnostic method, while medical treatment is most often conservative. doi:10.1016/j.clinph.2008.12.023
doi:10.1016/j.clinph.2008.12.021
18. Non-dystrophinopathy muscular dystrophies at childhood age—B. Vukadinovic´-Pajovic´ 1, V. Milic´-Rašic´ 2, S. Todorovic´ 2 (1 Kovin Special Neuropsychiatric Hospital, Kovin, Serbia, 2 Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia) Introduction: Muscular dystrophies are the most common hereditary myopathies related to children,and include: Dystrophinopathies, Limb-Girdle Muscular Dystrophy (LGMD), Congenital (KMD), Facioscapularohumeral (FSHD), Emery-Dreifuss Muscular Dystrohies, Distal and Myotonic Dystrophies (MD). Purpose: To define frequency of certain non-dystrophinopathy muscular dystrophy entities in childhood, and to identify significance of certain diagnostic procedures, primarily EMG and muscular biopsies. Methods: Registers of hospitalised patients and outpatients from 1997 to 2007 were used. Results: Out of 41 patients, dystrophy diagnosis was differentiated as: KMD 16 (39.02%), MD 12 (29.27%), LGMD 8 (19.51%) and
20. Correlation of EMNG findings in patients taking peroral antidiabetics and insulin—A. Dominovic´-Kovacˇevic´, Z. Vukojevic´, S. Grgic´. D. Racˇic´ (Banja Luka Neurological Clinic, Bosnia and Herzegovina) Diabetic neuropathies represent the most common and the most important complication of diabetes. Goal: To compare EMNG findings in patients taking peroral antidiabetics and insulin. Material and methods: EMNG examination encompassed 48 diabetics (24 taking oral and 24 insulin therapy since the beginning of disease). The average lifetime is 58.9, while the duration of diabetes is 13.9 years. 31 men (64.58%) and 17 women (35.42%) were examined. The following comparisons were made: motor and sensitive conduction velocity, amplitudes of the examined nerves and degree of muscle weakness. Results: The average motor conduction velocity of n. peroneus in patients taking insulin therapy was 40.29 m/s (±4.2), while in patients taking oral therapy 32.83 m/s (±4.7); for N. tibialis it was 40.91 m/s (±2.3) taking insulin, and 34.16 m/s (±2.1) taking oral