Background: Despite extensive research, it still remains controversial as to what the precise location of the critical lesions underlying amnesia actually is. The amnesic syndrome is believed to be heterogeneous and due to several distinct functional deficits. Patients and Methods: Two patients, a 45-year-old woman and a 56-year-old man, with sudden cardiopulmonary arrest and successful resuscitation, were left with a clear amnesic syndrome as main neurological sequela. During their revalidation period, they underwent a positron emission tomographic (PET) examination, utilizing the 13NH3 bolus technique at rest and after intravenous acetazolamide administration. Results: Both PET studies showed more or less similar features with a decrease in regional cerebral blood flow (rCBF) in the frontal, temporal and parietal lobes. In addition, the rCBF was increased in both thalami of the 45-year-old woman and in the striata of the 56-year-old man. Acetazolamide vasoreactivity was most lost in the frontal lobes. Conclusions: In the present PET study, we demonstrated that destruction of the inhibitory pathways to the thalamus and basal ganglia by ischaemic-hypoxic frontal lesions could be one of the mechanisms leading to amnesia.
Peripheral nerve injury and the effect of vitamins on the recovery process Although peripheral nerve injuries are usually not life-threatening, they can have a significant impact on the patient’s quality of life and daily functioning, with typical symptoms such as complete paralysis or severe neuropathic pain. The peripheral nervous system is capable of some regeneration and recovery, allowing conservative treatment in mild to moderate nerve damage. For severe peripheral nerve injuries surgical reconstruction remains the golden standard. However, despite the extensive knowledge of the pathophysiology of peripheral nerve trauma, a full functional recovery after a severe peripheral nerve injury is rare with the current therapeutic options. Success depends on a variety of factors: location and severity of the injury, age and physical condition of the patient, therapeutical approach, … Therefore, it is important to search for the best possible means to achieve maximal functional recovery. This article first discusses the current knowledge about the pathophysiology of peripheral nerve trauma, highlighting the most important factors that influence the recovery process. Subsequently, it will render a review of the influence of vitamins A/B/C/D/E/K on this recovery process: vit B and D seem to enhance the regeneration process of nerves and the functional recovery of the end organ, while vit C and E show an important antinociceptive effect.
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