Acta neurologica Scandinavica
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Acta Neurol. Scand. · Apr 2003
Case ReportsDramatic effect of levetiracetam on epileptic negative myoclonus.
To investigate the properties of levetiracetam in a patient with severe epileptic negative myoclonus. Treatment of epileptic negative myoclonus relies on the drugs that are effective in focal epilepsies, but it is usually pharmacoresistant. Levetiracetam is a new antiepileptic drug with a broad-spectrum activity that includes efficacy against positive myoclonus. ⋯ The result of levetiracetam treatment in this patient is encouraging, but efficacy should be confirmed in larger series. A long-term follow-up is also necessary to establish that this antimyoclonic effect of levetiracetam is maintained over a period of years.
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The purpose was to compare the completeness of case ascertainment in two stroke registers, one local population-based, the other a national quality register (Riks-Stroke), and to examine if patient characteristics could be affected by selection bias. ⋯ Because of selection bias, outcome data get skewed when case ascertainment does not embrace all stroke cases. A community-based stroke register is the golden standard when measuring stroke incidence.
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Acta Neurol. Scand. · Jan 2003
R-R interval variation and the sympathetic skin response in the assessment of the autonomic nervous system in leprosy patients.
The aim of this study was to evaluate possible autonomic nervous system (ANS) dysfunction in leprosy patients with the sympathetic skin response (SSR) and the heart rate (R-R) interval variation (RRIV) measurements which are easy and reliable methods for evaluation of autonomic functions. ⋯ We conclude that combined use of these two tests, both of which can be easily and rapidly performed in the electromyogram (EMG) laboratory using standard equipment, allows separate testing of parasympathetic and sympathetic function, and are very sensitive methods in assessing of ANS function in peripheral neuropathy in leprosy patients.
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Acta Neurol. Scand. · Dec 2002
Case ReportsDiffusion-weighted magnetic resonance imaging in early stage of 5-fluorouracil-induced leukoencephalopathy.
We report a case of 5-fluorouracil (5-FU)-induced leukoencephalopathy in which magnetic resonance imaging (MRI) of the brain, including diffusion-weighted imaging (DWI), was performed serially. The initial T2-weighted and FLAIR images showed diffuse mild hyperintensity in bilateral deep cerebral white matter and corpus callosum, which on T1WI appeared as non-enhanced faint hypointensity. Isotropic DWI disclosed the abnormality as well-conspicuous diffuse hyperintensity with decreased ADC. ⋯ Measurement of ADC along the three orthogonal directions showed the presence of directional dependence of diffusion throughout the length of study. These findings suggest that early stage of 5-FU-induced leukoencephalopathy is associated with reversible restricted diffusion and preservation of anisotropy. Diffusion-weighted imaging may be useful for the diagnosis.
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Acta Neurol. Scand. · May 2002
Diagnostic value of high signal abnormalities on T2 weighted MRI in the differentiation of Alzheimer's, frontotemporal and vascular dementias.
The occurrence of high signal abnormalities on T2 weighted images is strongly age related. The diagnostic value of these changes in a younger population with dementia is not currently known. We studied the potential of high signal changes on magnetic resonance imaging (MRI) in differentiating Alzheimer's disease (AD), frontotemporal dementia (FTD) and vascular dementia (VaD) in younger patients. ⋯ High signal changes on T2 weighted images on MRI are common across degenerative (AD and FTD) and vascular dementias. Although lacunes and grade III DWMH are specific for VaD, the low sensitivities (sensitivities: for lacunes, 0.32; for grade III DWMH, 0.16) limit their use as diagnostic markers for VaD. High signal changes on MRI should be interpreted with caution in dementias. Their presence, even in younger patients, should not deter one from diagnosing AD or FTD.