Objective – The aim of the study was to assess the occurrence and the frequency of chemosensory dysfunction in patients with polyneuropathy (PNP).
Methods – We performed a prospective observational study. Olfactory function was assessed using the standardized ‘Sniffin’ Sticks’ test to measure odor threshold for phenyl ethyl alcohol, odor discrimination, and odor identification. Gustatory function was assessed using the standardized ‘taste strips’ test. In addition, we assessed etiology, neurophysiology, and severity of the PNP, and the patients’ comorbidities and medication.
Results – A total of 53 consecutive patients were enroled (15 women, 38 men; mean age 61 years); 27 of them (51%) exhibited olfactory dysfunction and 23 of them (43%) gustatory dysfunction. Patients with diabetic PNP had significantly lower taste scores than patients with inflammatory, genetic, or idiopathic PNP. In addition, odor identification was negatively correlated with PNP severity.
Conclusion – The applied bedside tests are useful to detect chemosensory dysfunction in patients with PNP. Chemosensory dysfunction is quite frequent in these patients.
Specific therapy of acute spinal ischemia is not established. We report the first case of an MRI-verified cervical spinal ischemia treated by thrombolysis and review the literature. A 72-year old woman with right-sided motor hemiparesis and trunk ataxia was treated by intravenous thrombolysis with full recovery. Three days later she developed again a severe right-sided sensorimotor hemiparesis and a second off-label intravenous thrombolysis was repeated. Magnetic resonance imaging revealed a right-sided posterior-lateral cervical spinal ischemia. Spinal ischemia may clinically present with a cerebral-stroke-like picture challenging diagnostic and therapeutic procedure. Systemic thrombolysis might be a treatment option in acute spinal ischemia. In addition, early repeated systemic thrombolysis may be considered in selected strokes.
Olfactory dysfunction in Parkinson´s disease is becoming more relevant. We report on a 38year old woman with right-sided hemiparkinsonism classified 1 degree of severity according to the Hoehn and Yahr scale. Despite not complaining of smell disturbances olfactory testing revealed pronounced hemihyposmia on the ipsilateral side of the marked decreased tracer uptake in the 123I-FP-CIT SPECT. To our knowledge pronounced hemihyposmia has been rarely described in patients with early signs and symptoms of Parkinson´s disease.
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