Acta neurologica Belgica
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Acta neurologica Belgica · Jun 2013
Clinical and cognitive profiles of patients with both Parkinson's disease and essential tremor.
Although Parkinson's disease (PD) and essential tremor (ET) are distinct clinical disorders, their coexistence can sometimes cause diagnostic problems. In this study, we conducted detailed investigations of patients with both ET and PD (ET-PD) and compared their clinical and cognitive profiles with those of patients with only ET or only PD. This study examined three groups of patients: the first group had ET-PD concomitantly (n = 9); the second group had only ET (n = 9); the third group had only PD (n = 10). ⋯ In conclusion ET-PD patients differed from PD patients, showing more frequent familial tremor histories and lower levodopa responsiveness. This patient population also demonstrated more severe cognitive impairments than pure-ET patients. This result suggests that ET-PD patients are a subset of ET patients with more widespread neurodegeneration, which may indicate the presence of a syndrome that includes overlap between ET and PD.
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Acta neurologica Belgica · Dec 2012
Randomized Controlled TrialEffect of dexamethasone on the frequency of postdural puncture headache after spinal anesthesia for cesarean section: a double-blind randomized clinical trial.
In this study, we evaluated the effect of dexamethasone used as a prophylaxis for nausea and vomiting on the incidence of postdural puncture headache (PDPH) in pregnant women receiving spinal anesthesia for cesarean section. In a prospective, randomized, double-blind, placebo-controlled study, 372 women under spinal anesthesia received 8 mg of dexamethasone or placebo intravenously just after the umbilical cord was clamped. The rate of PDPH and correlated risk factors were evaluated. ⋯ This effect was most prominent on the first day (P value = 0.046) and disappeared on the second day after spinal anesthesia (P value = 0.678). Prophylactic treatment with 8 mg of dexamethasone not only increases the severity and incidence of PDPH, but is also ineffective in decreasing the prevalence of intra-operative nausea and vomiting during cesarean section. The treatment is a significant risk factor for the development of PDPH.
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Acta neurologica Belgica · Sep 2012
Case ReportsTransient hemiparesis caused by spontaneous cervical epidural hematoma.
Spontaneous cervical epidural hematoma (SCEH) is rare and can result in various clinical phenotypes. Transient focal neurological symptoms, which have not yet been reported on, can result in overlooking this differential diagnosis in patients presenting with passing neurological deficits and assuming the diagnosis of a transient ischemic attack. Therefore, a thorough documentation of patient history is of importance, since this can reveal symptoms suggestive of a different etiology. ⋯ Symptoms resolved spontaneously over 24 h without surgical intervention. Our case illustrates the variation in the clinical presentation of SCEH which can result in transient symptoms, even without surgical intervention. Therefore, in patients with transient focal neurological deficits this diagnosis should be included in the differential, particularly when cortical and cranial signs are lacking.
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Acta neurologica Belgica · Jun 2012
Plasma oxidative and inflammatory markers in patients with idiopathic Parkinson's disease.
Parkinson's disease (PD) is the most common neurodegenerative disorder after alzheimer's disease. Neuroinflammation and oxidative damage are implicated to be responsible for the pathogenesis of neurodegenerative diseases. However, there are a few studies showing the changes in the biomarkers for neuroinflammation and oxidative damage in neurodegenerative diseases. ⋯ Plasma ICAM levels at stage 1 and 2 and CRP levels at stage 2 patients were significantly higher than controls (p < 0.05, p < 0.05, and p < 0.01, respectively). We insist that further studies have to be conducted to establish neuroinflammation and oxidative damage in PD. Establishing the roles of these pathological processes in PD might be the key to effective therapy at an early stage by antioxidants and/or anti-inflammatory drugs.