Journal of neurology
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The value of conventional transcranial Doppler ultrasound in the diagnosis and monitoring of cerebral vein thrombosis is unclear. Previous studies have suggested the usefulness of this method in two cases with superior sagittal sinus thrombosis that showed increased velocities of deep cerebral veins. The purpose of the present study was to evaluate the deep intracranial venous circulation in patients with that pathology. ⋯ One patient showed slightly increased velocities in the BVR, and the other two showed normal venous velocity values. This study confirms the usefulness of conventional transcranial Doppler ultrasound in detecting superior sagittal sinus thrombosis. However, a normal examination does not exclude this diagnosis.
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In 32 subjects without signs or symptoms of peripheral nerve disorder, sensory nerve action potentials (SNAPs), elicited by stimulation at the wrist, were recorded from the fingers of both hands with ring electrodes. Recordings from the volar proper digital nerves confirmed the standard distribution of the median and ulnar cutaneous innervation. ⋯ Furthermore, we found that the dorsal aspect of the proximal part of the ring finger is mainly supplied by the DCUN. These findings differ from the standard cutaneous innervation pattern as depicted in neurological textbooks, but they are in agreement with earlier anatomical studies.
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Neuroborreliosis, a manifestation of infection with the spirochete Borellia burgdorferi, has become the most frequently recognised arthropod-borne infection of the nervous system in Europe and the USA. The best criterion of an early infection with B. burgdorferi is erythema migrans (EM), but this is present in only about 40-60% of patients with validated borreliosis. Therefore use of the duration of the disease as a classification criterion for neuroborreliosis is increasing, the chronic form being distinguished from the acute when symptoms persist for more than 6 months. ⋯ Penicillin G 20 mega units/day and doxycycline 200 mg/day may be suitable for uncomplicated meningopolyneuritis, without involvement of the central nervous system. The durationof treatment--at least 2 weeks in the acute forms and 3 weeks in the chronic forms of neuroborreliosis--is very important for successful treatment. Corticosteroids are recommended only for patients with severe pain that does not respond to antibiotics an analgesics.