- Email: [email protected]
Lyme neuroborreliosis – Case report
Clinical Neurophysiology Society of Serbia and Montenegro / Clinical Neurophysiology 119 (2008) e67–e74
Conclusions: The EXG parameters are electrophysiological indicators of cognitive functioning. Those parameters were significantly decreased in patients with PD, within theirs clinical symptoms that assumed cognitive dysfunction as one of the minor symptoms. doi:10.1016/j.clinph.2007.11.036
Lyme neuroborreliosis – Case report—S. Kostic 1, R. Sujic 1, V. Dedic 2, N. Gligic 3 (1 CHC Zvezdara, Centre for Neurology, Serbia, 2 BK University, Department of Computer Science, Serbia, 3 Hospital for Cerebrovascular Diseases ‘‘St. Sava’’ Belgrade, Serbia) Purpose: To point out that appropriate therapy could render subsequent symptomatic antiepilepthic therapy obsolete. Method and results: Case report of a 53-year-old woman presenting headache and partial seizure with right sided hand paraesthesia, few months ago. Only one risk factor was found (hypertension). Neurological examination revealed right sided hemiparesis. Routine blood analyses and physical examination were normal. CT scan showed one hypointesive lesion in left centrum semiovale. Brain MRI showed several hyperintensive changes on TW2 sequence. Lumbar puncture revealed slight pleocytosis (16/3) and oligoclonal IgG bands. Borrelia Burgdorfery serology was positive for both IgG and IgM in serum. EEG showed epileptiform discharges, median nerve SEP showed delayed right P/N13, N19 and P/N13 to N19, VEP showed low amplitude of P100 wave bilateral. Cephtriaxone was administrated in intravenous infusions 21 days 2.0 g bid and continue with oral doxycycline 100 mg bid. Control lumbar puncion showed less pleocytosis (8/3). Also titre IgG and IgM was less in serum. After two months patient was much improved without any pathological signs on EEG, EP and MRI. Conclusions: it is important to perform the Borrelia Burgdorferi serology due to great imitating potential of the disease (frequently misdiagnosed as multiple sclerosis or stroke). doi:10.1016/j.clinph.2007.11.037
Diabetic polyneuropathy in department of neurology, Banja Luka 2001–2005—Z. Vukojevic, A. Dominovic-Kovacevic, S. Grgic (Department of Neurology, Banja Luka, Bosnia and Herzegovina) Purpose: To measure the ratio between diabetic polyneuropathy and other types of neuropathies; determine gender prevalence of diabetic neuropathy in patients affected, and the frequency of particular types of diabetic neuropathy regarding the degree of nerve lesion. Methods and materials: In our five-year long research (2001– 2005), 188 patients were hospitalized with polyneuropathy, including 160 patients (85.10%) with diabetic polyneuropathy. We eliminated other types of polyneuropathies by using additional methods (electromyoneurography, blood tests, cerebrospinal fluid screening, and radiology screenings, etc.). Results: Noticeably, in the first three years of research the number of diabetic polyneuropathies was slightly increased, while in the following two years that increase was more visible.
e73
The highest number of patients was in the group with high and moderately high degree of nerve lesion (78%), while the rest of patients had extremely high and mild degree of nerve lesion. There was not noticed significant gender prevalence in patients (male 53.75%, female 46.25%). Conclusions: Diabetic polyneuropathy is the most common type of polyneuropathies in the industrial developed countries, representing 80–90% of all types of polyneuropathies, which are most commonly complication of diabetes mellitus. Diabetes mellitus has been increasing over the last decade and therefore its complications were more often seen. doi:10.1016/j.clinph.2007.11.038
Translocation t (2q, 7q) with mental retardation and epiˇ vorovic´ 1, O. Miljanovic´ 1, Z ˇ. C ˇ. lepsy—J. Stanisˇic´ 1, Z 2 1 Martinovic´ ( Pediatric Clinic, Institute for Pediatric Diseases, CHC Podgorica, Montenegro, 2 Institute of Mental Health, Belgrade, Serbia) We report the clinical picture and additional findings in a child with de novo translocation t (2q, 7q). The patient was born after an allegedly normal pregnancy and delivery. He walked alone by 2 years of age and first word was spoken at 1.5 year. His first generalized febrile seizure occurred at 2.1 years of age. At 3 years and 5 month, he was investigated for right-sided motor seizures. At that time, he showed ataxic gait, craniofacial dysmorphism (hypertelorism, antimongoloid position of the eyes, wide and depressed nasal bridge, otapostasis, law-set maxilla. marked progenia), pectus excavatus and deformed feet in valgus position. Psychological testing (at 7 years) revealed mild mental retardation with mainly attentional deficits. Sleep EEG recorded bilateral bursts of sharp and slow waves with left lateralization. Although seizures were well controlled with antiepileptic drug therapy, magnetic resonance revealed left hippocampal sclerosis. Cytogenetic diagnostics demonstrated a balanced de novo translocation t (2q, 7q). Chromosome 2q aberrations are associated with a variable phenotype – mild mental retardation with various types of tumors. The presented patient represents for the first time reported phenotype associating craniofacial dysmorphism with a mild mental retardation, together with partial epilepsy and hippocampal sclerosis. doi:10.1016/j.clinph.2007.11.039
West syndrome in tuberous sclerosis – Case report—T. Redzˇek Mudrinic´, M. Knezˇevic´ Pogancˇev (Children and Youth Health Care, Institute of Vojvodina, Novi Sad, Serbia) Epileptic spasms are the presenting symptom in 69% of patients with tuberous sclerosis. Purpose: To illustrate the clinical and neurophysiologic response after vigabatrin initial therapy in a patient with West syndrome in tuberous sclerosis. Case report: Infant, 6-month-old, was sent because of hypomelanotic macules and a history of seizures one month ago. Diagnosis of tuberous sclerosis was made on the presence of three major features: multiple subepedimal nodule with protrusion in
Conclusions: The EXG parameters are electrophysiological indicators of cognitive functioning. Those parameters were significantly decreased in patients with PD, within theirs clinical symptoms that assumed cognitive dysfunction as one of the minor symptoms. doi:10.1016/j.clinph.2007.11.036
Lyme neuroborreliosis – Case report—S. Kostic 1, R. Sujic 1, V. Dedic 2, N. Gligic 3 (1 CHC Zvezdara, Centre for Neurology, Serbia, 2 BK University, Department of Computer Science, Serbia, 3 Hospital for Cerebrovascular Diseases ‘‘St. Sava’’ Belgrade, Serbia) Purpose: To point out that appropriate therapy could render subsequent symptomatic antiepilepthic therapy obsolete. Method and results: Case report of a 53-year-old woman presenting headache and partial seizure with right sided hand paraesthesia, few months ago. Only one risk factor was found (hypertension). Neurological examination revealed right sided hemiparesis. Routine blood analyses and physical examination were normal. CT scan showed one hypointesive lesion in left centrum semiovale. Brain MRI showed several hyperintensive changes on TW2 sequence. Lumbar puncture revealed slight pleocytosis (16/3) and oligoclonal IgG bands. Borrelia Burgdorfery serology was positive for both IgG and IgM in serum. EEG showed epileptiform discharges, median nerve SEP showed delayed right P/N13, N19 and P/N13 to N19, VEP showed low amplitude of P100 wave bilateral. Cephtriaxone was administrated in intravenous infusions 21 days 2.0 g bid and continue with oral doxycycline 100 mg bid. Control lumbar puncion showed less pleocytosis (8/3). Also titre IgG and IgM was less in serum. After two months patient was much improved without any pathological signs on EEG, EP and MRI. Conclusions: it is important to perform the Borrelia Burgdorferi serology due to great imitating potential of the disease (frequently misdiagnosed as multiple sclerosis or stroke). doi:10.1016/j.clinph.2007.11.037
Diabetic polyneuropathy in department of neurology, Banja Luka 2001–2005—Z. Vukojevic, A. Dominovic-Kovacevic, S. Grgic (Department of Neurology, Banja Luka, Bosnia and Herzegovina) Purpose: To measure the ratio between diabetic polyneuropathy and other types of neuropathies; determine gender prevalence of diabetic neuropathy in patients affected, and the frequency of particular types of diabetic neuropathy regarding the degree of nerve lesion. Methods and materials: In our five-year long research (2001– 2005), 188 patients were hospitalized with polyneuropathy, including 160 patients (85.10%) with diabetic polyneuropathy. We eliminated other types of polyneuropathies by using additional methods (electromyoneurography, blood tests, cerebrospinal fluid screening, and radiology screenings, etc.). Results: Noticeably, in the first three years of research the number of diabetic polyneuropathies was slightly increased, while in the following two years that increase was more visible.
e73
The highest number of patients was in the group with high and moderately high degree of nerve lesion (78%), while the rest of patients had extremely high and mild degree of nerve lesion. There was not noticed significant gender prevalence in patients (male 53.75%, female 46.25%). Conclusions: Diabetic polyneuropathy is the most common type of polyneuropathies in the industrial developed countries, representing 80–90% of all types of polyneuropathies, which are most commonly complication of diabetes mellitus. Diabetes mellitus has been increasing over the last decade and therefore its complications were more often seen. doi:10.1016/j.clinph.2007.11.038
Translocation t (2q, 7q) with mental retardation and epiˇ vorovic´ 1, O. Miljanovic´ 1, Z ˇ. C ˇ. lepsy—J. Stanisˇic´ 1, Z 2 1 Martinovic´ ( Pediatric Clinic, Institute for Pediatric Diseases, CHC Podgorica, Montenegro, 2 Institute of Mental Health, Belgrade, Serbia) We report the clinical picture and additional findings in a child with de novo translocation t (2q, 7q). The patient was born after an allegedly normal pregnancy and delivery. He walked alone by 2 years of age and first word was spoken at 1.5 year. His first generalized febrile seizure occurred at 2.1 years of age. At 3 years and 5 month, he was investigated for right-sided motor seizures. At that time, he showed ataxic gait, craniofacial dysmorphism (hypertelorism, antimongoloid position of the eyes, wide and depressed nasal bridge, otapostasis, law-set maxilla. marked progenia), pectus excavatus and deformed feet in valgus position. Psychological testing (at 7 years) revealed mild mental retardation with mainly attentional deficits. Sleep EEG recorded bilateral bursts of sharp and slow waves with left lateralization. Although seizures were well controlled with antiepileptic drug therapy, magnetic resonance revealed left hippocampal sclerosis. Cytogenetic diagnostics demonstrated a balanced de novo translocation t (2q, 7q). Chromosome 2q aberrations are associated with a variable phenotype – mild mental retardation with various types of tumors. The presented patient represents for the first time reported phenotype associating craniofacial dysmorphism with a mild mental retardation, together with partial epilepsy and hippocampal sclerosis. doi:10.1016/j.clinph.2007.11.039
West syndrome in tuberous sclerosis – Case report—T. Redzˇek Mudrinic´, M. Knezˇevic´ Pogancˇev (Children and Youth Health Care, Institute of Vojvodina, Novi Sad, Serbia) Epileptic spasms are the presenting symptom in 69% of patients with tuberous sclerosis. Purpose: To illustrate the clinical and neurophysiologic response after vigabatrin initial therapy in a patient with West syndrome in tuberous sclerosis. Case report: Infant, 6-month-old, was sent because of hypomelanotic macules and a history of seizures one month ago. Diagnosis of tuberous sclerosis was made on the presence of three major features: multiple subepedimal nodule with protrusion in