Abstracts / Journal of the Neurological Sciences 333 (2013) e679–e727
Objective: The definitive criteria include biopsy of brain with clinical features of TBM. Getting an accurate diagnosis in the form of tissue biopsy is another challenge. Here we are presenting a case of tuberculous meningitis confirmed by neuroendoscopic ventricular examination and ventricular biopsy. Case presentation: A 17 year old lady presented 4 months history of fever, weight loss and meningism; she had inconclusive lumbar puncture and was started on anti-tuberculosis treatment empirically. She continued to deteriorate and presented to the neurosurgery team with low consciousness, hydrocephalous with trapped 4th ventricle. She underwent neuroendoscopy for VP shunt and during the procedure ventricular examination and biopsy of the ventricular wall. The histopathological examination confirmed the diagnosis; she had recovered well post procedure and the anti-tuberculosis treatment was modified as she developed abnormal liver function test with deranged INR. Conclusion: This is an interesting case where neuroendoscopy has helped to confirm diagnosis of tuberculous meningitis. Literature searches reveal case series of neuroendoscopy procedure done to treat tuberculous meningitis with hydrocephalous in late stage but this is one of the few cases in the literature where ventricular biopsy had been used to yield early diagnosis of tuberculous meningitis. This procedure has so far ZERO mortality on procedure risk and had been performed as a day procedure. doi:10.1016/j.jns.2013.07.2465
Abstract — WCN 2013 No: 2923 Topic: 36 — Other Topic Reduced expression of hippocampal BDNF, NGF and their cognate receptors in postmortem brain of suicide victims A.C. Mondal. Physiology, Raja Peary Mohan College, Uttarpara, India Background: The role of neurotrophins in directing brain growth and neuronal functioning is being increasingly recognized. Neurotrophins not only play an important role in cellular proliferation, migration, and phenotypic differentiation and/or maintenance in the developing central nervous system but also their presence is required in the adult CNS for maintenance of neuronal functions, structural integrity of neurons, and neurogenesis, which suggests that neurotrophins are biologically significant over the entire lifespan. Objectives: Investigation of expressions of BDNF, NGF with their respective receptors and few downstream signaling molecules in the hippocampus of the suicide victims. Materials and methods: These studies were performed in the hippocampus obtained from 20 suicide and 20 non-psychiatric control subjects. The neurotrophin levels were quantitatively measured through Sandwich ELISA, the expression of neurotrophin receptors and the downstream signaling molecules were determined by Western Blot. Finally mRNA levels of BDNF, TrkB and NGF, TrkA were determined by RT PCR. Results: A unique parallel decrease of the protein levels of BDNF, NGF and their cognate receptors in post-mortem suicide victims clearly correlated with the significant reduction of their mRNA levels at the hippocampal regions compared to the normal individuals. A marked decreased in the expression profiles of downstream signaling molecules like PLCγ, PKCδ, ERK 1, 2, Akt and CREB of suicide victims compared to non-psychiatric controls. Conclusion: Significant reduction of BDNF, NGF and their cognate receptors along with the dysregulation in BDNF/TrkB and NGF/TrkA signaling cascades in post-mortem brains might be of relevance to its pathophysiology of depression. doi:10.1016/j.jns.2013.07.2466
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Abstract — WCN 2013 No: 2927 Topic: 36 — Other Topic Symptoms and risk factors associated with carpal tunnel syndrome in east of Turkey: Evaluation of 767 cases R. Alpa, S. Ilhan Alpb, G. Bulutc, Y. Palancid, U. Turk Borue. aNeurology, Namik Kemal University, Turkey; bNeurology, Corlu State Hospital, Tekirdag, Turkey; cOrthopaedy, Kartal Research and Education Hospital, Istanbul, Turkey; dPublic Health, Faculty of Medicine, Dicle University, Diyarbakir, Turkey; eNeurology, Kartal Education and Research Hospital, Istanbul, Turkey Carpal tunnel syndrome (CTS) is the most common compression neuropathy with various etiologic factors and symptoms. In this study, risk factors and symptoms associated with CTS diagnosed cases were determined in our electrophysiology laboratory. The study involved 767 cases of suspected CTS who were examined by ENMG. Of these 97 (12.6 %) were male and 670 (87.4%) were female. The mean age of patients was 43. Twenty-eight (3.7%) of the cases were left handed and the remaining 739 (96.3%) were right handed. Of the cases 179 (23.4%) had complaints in the right hand, 110 (14.3%) in the left hand and 478 (62.3%) in both. The proportion of symptoms that developed during the night was 74.6%. The common symptoms were numbness (78%), weakness (75%) and pain in the shoulder and arm (77%). Examinations using the Tinnel, Phalen and pressure tests revealed positive in 65%, 63.5%, and 72% of patients, respectively. The proportion of CTS patients having other complaints was 35% obesity, 12% DM, 6% hypothyroidism, 1% RA, and 0.5% acromegaly. Of the patients 14% were smokers. Female patients with CTS also had pregnancy (19%), nursing (16%), menopause (31%), and premenopause (23%). Of the women with CTS 89% were housewives and of these 49% were making handicraft and the remaining 21% were agriculture and animal rearing. CTS was diagnosed in 93% of these patients on ENMG examination. CTS is common in women, obese, and those making handicrafts. Animal rearing is another etiological factor. doi:10.1016/j.jns.2013.07.2467
Abstract — WCN 2013 No: 2929 Topic: 36 — Other Topic Hearing outcome in children after non-polio enteroviral meningitis C.T. Choonga, N.W.H. Tanb, E.W.S. Hoc, S.S. Krishnamoorthyc, D. Lazarood, H.K.K. Tand. aNeurology, Paediatric Medicine, Singapore; b Infectious Disease, Paediatric Medicine, Singapore; cPaediatric Medicine, Singapore; dOtolaryngology, KK Women's & Children's Hospital, Singapore, Singapore Background: Long-term sequelae of meningitis including hearing impairments are concerns to parents and physicians alike. Hearing assessment of children, while useful, is logistically challenging requiring great skill and the frequent need for sedation. It is strongly recommended following bacterial meningitis in view of the significant risk for hearing loss. The situation is less clear with viral meningitis. Aims: We reviewed outcomes for hearing in children following nonpolio enteroviral meningitis to determine the utility of routine postenteroviral meningitis hearing screening. Methods: This is a retrospective records review of children b16 years with a cerebrospinal fluid polymerase chain reaction (PCR)-confirmed diagnosis of non-polio enteroviral meningitis who had undergone