Acta neurologica Belgica
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Acta neurologica Belgica · Dec 2015
Tapia's syndrome in the intensive care unit: a rare cause of combined cranial nerve palsy following intubation.
Tapia's syndrome is characterized by unilateral paralysis of the tongue and vocal cord, and is caused by a concurrent lesion of both the recurrent laryngeal and hypoglossal nerves. The proposed mechanism in most patients is compression or stretching of these nerves on their extracranial course due to airway manipulation under general anaesthesia. As Tapia's syndrome is a rare and possibly devastating condition, recognition of the presence of concurrent paralyses is an important step in diagnosis and treatment. We report two cases of Tapia's syndrome as a complication of intubation in the intensive care unit.
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Acta neurologica Belgica · Sep 2015
Clinical TrialCapsaicin 8 % as a cutaneous patch (Qutenza™): analgesic effect on patients with peripheral neuropathic pain.
Evaluation of the analgesic effect after a single application of the capsaicin 8 % cutaneous patch (Qutenza™) in 37 patients suffering from painful, distal symmetric polyneuropathy (PNP) for an average of 5 years. Patients ranged from 40 to 78 years of age and 22 subjects were HIV-positive. Patients were observed 4 weeks prior to 12 weeks post administration. ⋯ Symptoms of painful PNP decreased over the period of investigation and 8 patients reported a reduction of systemic pain medication. In patients with an HIV infection, a significant extension of sleep was achieved for 2, 4 and 8 weeks after application. Thus, the application of the capsaicin 8 % patch resulted in a significant relief of neuropathic pain, a prolongation of sleep, a reduction of oral pain medication and a resumption of social activities.
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Migraine is a neurovascular disorder characterized by autonomic nervous system dysfunction and severe headache attacks. Studies have shown that changes in the intracranial vessels during migraine have an important role in the pathophysiology. Many studies have been conducted on the increased risk of stroke in patients with migraine, but insufficient data are available on the mechanism underlying the increase. ⋯ According to our results, the vasodilator response of cerebral arterioles to hypercapnia was lower in patients with chronic migraine. These findings showed the existence of impairments in the harmonic cerebral hemodynamic mechanisms in patients with chronic migraine. This finding also supports the existing idea of an increased risk of stroke in patients with chronic migraine due to impaired vasomotor reactivity.
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Acta neurologica Belgica · Jun 2015
A quantitative evaluation of damage in normal appearing white matter in patients with multiple sclerosis using diffusion tensor MR imaging at 3 T.
The white matter (WM) of the brain is damaged in multiple sclerosis (MS), even in areas that appear normal on standard MR imaging. The purpose of our study is to evaluate the damage of normal appearing white matter (NAWM) in patients with MS. In our study, 84 MS patients and 42 healthy adults underwent a routine brain MRI, including also diffusion tensor imaging (DTI). ⋯ The ADC values of the NAWM correlated with the EDSS scores. The present study demonstrated damage of the NAWM in MS patients, using DTI in 3.0 T. DTI may be used in the detection of subtle damage of the white matter.