BackgroundFor certain ocular movement abnormalities, the exact neuroanatomical localization of the causative lesion is still not defined. Oculomotor apraxia, apraxia of eye opening and closing, and motor impersistence are rarely reported in acute stroke, particularly following venous stroke.Case ReportA 34-year-old man presented with headache, vomiting, focal seizures with bilateral tonic-clonic movements, and altered sensorium. Magnetic resonance imaging revealed bilateral frontal and left parietal hemorrhagic infarcts, and contrast venography revealed superior sagittal sinus thrombosis. The patient received anticoagulant treatment with antiepileptics. On re-examination on day 3, the patient had a rare combination of apraxia of eyelid closure, motor impersistence, and oculomotor apraxia. By Day 10 of admission, all oculomotor abnormalities had subsided.ConclusionTo the best of our knowledge, this is the first report of the combination of oculomotor apraxia and apraxia of eyelid closure with motor impersistence in a patient with cerebral venous sinus thrombosis.
Objective: This study aims to determine the effectiveness of pregabalin for control of symptoms in mild to moderate idiopathic Carpal tunnel syndrome (CTS). Methods: In this randomized, placebo-controlled trial, 146 mild to moderate idiopathic CTS patients were randomized into pregabalin (n=74) and placebo group (n=72). Per protocol analysis was done in 131 patients; pregabalin (n=65) and placebo (n=66). Drug titration dose was 50 mg once daily for 1st week, twice daily for 2nd week and thrice daily for next 6 weeks. Primary outcome included change in Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of Boston Carpal Tunnel Questionnaire after 8th week. Secondary outcome was the change in clinical and electrophysiological grading after 8 weeks of therapy. Results: There was a statistically significant improvement in the mean SSS (14.92±3.72 vs. 16.55±4.45; P=0.025) and FSS (10.77±2.64 vs. 12.0±2.55; P=0.007) in the pregabalin group after 8 weeks. Mean clinical and electrophysiological grading changed significantly from 2.3±0.7 to 2.1±0.8 (P=0.001) and 1.9±0.7 to 1.8±0.8 (P=0.020) respectively in pregabalin group but not in placebo group. Discussion: This study demonstrates that pregabalin is effective in ameliorating symptoms and improving functional outcomes in mild to moderate idiopathic CTS.
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