Neurol Neurochir Pol
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Neurol Neurochir Pol · Jan 2003
[Brain metabolic disorders after chemotherapy in the study by magnetic resonance spectroscopy].
The purpose of our study was to evaluate CNS pathology due to chemotherapy neurotoxicity, using MRI and localized proton MRS in patients with lung cancer treated with cisplatine, Vinca alkaloids and etoposide. A reduction in N-acetylaspartate was expected as a result of chemotherapy neurotoxicity. ⋯ The decreased NAA/Cr ratio can indicate some neuronal loss caused by chemotherapy. The decrease in the Cho/Cr ratio could be associated with some myelin damage. The MRS results suggest the presence of a sub-clinical selective cerebellar neuropathy caused by chemotherapy. The MRS revealed that reaction to chemotherapy was different at the semi-oval center than that in the cerebellum. The results allow theorizing about an alternative or two-stage brain response to the neurotoxic factor found both in the cerebrum (the semi-oval center) and cerebellum. These initial results indicate that proton MR spectroscopy is a potentially useful modality for detecting an early stage of the CNS pathology caused by neurotoxicity of chemotherapy.
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Neurol Neurochir Pol · Nov 2002
Review[Restless legs syndrome and periodic limb movements in sleep: clinical features, epidemiology, diagnosis].
In this review article we summarise the clinical features, epidemiology and differential diagnosis of the Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS). RLS and PLMS belong to the most common causes which disturb sleep, and the RLS prevalence in the general population is estimated to range from 5 to 15%. The RLS is encountered in 10-20% of patients presenting with a problem of initiating and maintaining sleep, and in over 10% of patients with excessive daytime sleepiness. ⋯ PLMS are accompanied by usually short awakenings or transient arousals as demonstrated by sleep LEG resulting in sleep disruption. In establishing the diagnosis of RLS/PLMS idiopathic and secondary forms should be distinguished, and in particular, a number of other conditions (e.g. uremia or iron-deficiency) need to be ruled out. The clinical diagnosis of the RLS is based on the criteria of The International Restless Legs Syndrome Study Group, and the most useful laboratory support is gained from all-night polysomnography and high-resolution actography.
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Tumours of the brachial plexus according to present classification are included to soft tissue tumours. Because of rare occurrence of these tumours diagnostic and operative experience is relatively small. There is also a few number of publications regarding tumours of the brachial plexus. ⋯ Benign tumours of the brachial plexus can be effectively surgically treated using microsurgical techniques and, if necessary, nerve grafting. In case of malignant tumours many authors also recommend surgery with optimal sparing of the brachial plexus function and subsequent radio and chemotherapy. Low number A few cases in our series makes impossible to draw any epidemiological conclusions.
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The paper is a review of current experience with use of gabapentin--a new antiepileptic drug--in neurologic conditions others than epilepsy. Mechanism of action of the drug is not fully elucidated yet. ⋯ Clinical studies of gabapentin in movement disorders, such as Parkinson disease, essential tremor and atrophic lateral sclerosis are discussed in the paper. It can be summarized that gabapentin is a valuable medication and the use thereof in neurology is not limited to epilepsy.
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Neurol Neurochir Pol · Sep 2002
[Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis patients with dysphagia. A preliminary report].
Percutaneous endoscopic gastrostomy (PEG) has been proposed as symptomatic treatment of dysphagia in amyotrophic lateral sclerosis (ALS) patients. The aim of our study was to assess the safety and complications and survival after PEG implantations in 13 ALS patients. We discuss the factors related to survival in two groups: dead (6 out of 13 patients) and alive (7 out of 13) after PEG implantations. We demonstrate that the PEG procedure is quite safe and forced vital capacity (FVC) is a major factor related to survival after PEG implantation in studied patients.