Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.
Most cases of idiopathic Parkinson disease (IPD) are believed to be due to a combination of genetic and environmental factors. The purpose of this study is to investigate the relationship between toxocariasis and Parkinson disease (PD). Patients were selected from people who were admitted to the Movement Disorders Branch, Neurology Department of Elazığ University Faculty of Medicine Elazığ, Turkey. We studied specific IgG antibodies against Toxocara canis (T. canis) in 50 patients with idiopathic Parkinson and 50 healthy volunteers. We investigated the clinical history of three patients infected with T. canis. We also studied specific IgG antibodies against Toxoplasma gondii in these groups. Antibodies anti-Toxocara canis were found in 3 idiopathic PD (6%) (P = 0.121) and antibody titer was not found in control. A patient had history of the presence of dog in current dog ownership. We did not detect any statistically significant association between T. canis and IPD. But, we believe that further comprehensive studies are required for understanding whether there is a causal relation between toxocariasis and PD. We didn't find possible association between Toxoplasma gondii and IPD (P = 0.617).
The purpose of this study was to assess the effects of cervical rotations on flow velocity and volumes of vertebral arteries in healthy individuals and patients with cervical spondylosis and vertebrobasilar insufficiency. Twenty-eight patients with degenerative changes in the cervical spine (group 1), 24 patients with clinically proven vertebrobasilar insufficiency (group 2), and 20 healthy individuals (group 3) were evaluated. Significant difference was found in flow velocities of both vertebral arteries during neutral, 30-degree, 60-degree, and maximum rotations between groups 1 to 3 and groups 2 to 3. No significant difference was observed in flow velocities and volumes of the vertebral artery between groups 1 and 2. This occurrence might be explained by the fact that both groups have been affected not only by atherosclerotic changes but also by external pressure due to degenerative changes in the cervical spine.
ÖzetWe describe a 23 year old primigravid patient with severe preeclampsia complicated by posterior reversible encephalopathy syndrome (PRES), who presented with sensory and motor deficits and amnesia in the postpartum period Cranial magnetic resonance imaging (MRI) showed abnormal areas in the white matter of bilateral parieto-occipital lobes, indicating brain edema which disappeared completely on the follow-up scan taken four weeks after delivery together with complete symptom regression. The development of PRES in preeclampsia is discussed and the importance of prompt postpartum blood pressure control is emphasized.(J Turkish-German Gynecol Assoc 2010; 11: 216-9) Bu yazıda 23 yaşında, ilk gebeliği olan şiddetli preeklamptik bir hastada postpartum dönemde duyusal ve motor sinir bulguları ve unutkanlık ile ortaya çıkan bir posterior reverzibl ensefalopati sendromu (PRES) sunulmuştur. Kranyal manyetik rezonans görüntüleme (MRI) ile bilateral parieto-occipital loblarda beyin ödemine işaret eden anormal alanlar görülmüş olup, doğumdan dört hafta sonra kontrol amaçlı yapılan görüntüleme testi ile bu lezyonların tamamen kaybolduğu ve semptomların da gerilediği tespit edilmiştir. Preeklampside PRES gelişimi tartışılarak, bu hastalarda postpartum kan basıncı kontrolünün önemi vurgulanmıştır.
Pregnancy complicated by paraplegia is thought to be secondary to venous engorgement and to the resulting spinal cord ischemia in this case. Her neurological symptoms and signs gradually improved over the few days after cesarean delivery.
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