Backgro und: Sexual dysfunction in women with Parkinson's disease is poorly understood and research in this area is scarce. The objectives of this study were sexual function characterization in female Parkinson's disease patients, description of sexual dysfunctions, correlation with disease characteristics, and comparison with matched healthy controls. Methods: Social and demographic data from consecutive female patients with Parkinson's disease and matched healthy controls were collected. The following instruments were used: UPDRS, the Hoehn and Yahr scale, the Beck Depression Inventory-II, the Female Sexual Function Index, and the Sexual Dysfunction Inventory. The only exclusion criterion was cognitive deterioration precluding comprehension of the study scope and its instruments. Results: Of the 95 patients identified, 61 were included. Mean age was 66 years (range 40-89 years), and mean disease duration was seven years (range 1-18 years). Twenty-nine presented an akinetic-rigid syndrome, 25 tremoric disease, and, the remaining, a mixed type of disease. Mean "on" total/part III UPDRS scores were 46 6 15.0 and 31 6 8.9. Sexual dysfunction was present in 86.9% of patients and 79.0% of controls, according to the Female Sexual Function Index (p < .01), and in 57.4% of patients and 22.6% of controls, according to the Sexual Dysfunction Inventory (p < .001). Multivariate binary logistic regression identified age and depressive symptoms as positive predictors in the severity of sexual dysfunction. Disease duration, UPDRS part III score, Hoehn and Yahr stage, and antiparkinsonian medication did not show significant predictive value. Conclusions: Sexual dysfunction is more prevalent in women with Parkinson's disease than in controls and is predicted by older age and severity of depressive symptoms. V C 2016 International Parkinson and Movement Disorder Society
a b s t r a c tBackground and purpose: Dramatic recovery (DR) after thrombolysis is dependent of vessel recanalization and is predictive of favorable clinical outcome. Successful recanalization is not equivalent to DR. Our objective was to assess its frequency and evaluate clinical and biochemical predictors and their prognosis. Methods: We analyzed prospectively registered data from January 2007 to September 2012. All patients with anterior circulation stroke and NIHSS ≥ 10 were included. Improvement of ≥10 or a score ≤3 24 h after thrombolysis was defined as DR. Results: In the 230 patients included, DR frequency was 23% (53 patients). DR group had lower admission NIHSS (14 vs 17, p = 0.024), less total anterior circulation infarcts (p = 0.009), more partial anterior circulation infarcts (p = 0.003) and lower blood glucose on admission (118 vs 128 mg/dL, p = 0.013). All patients with DR had an Alberta Stroke Program Early CT Score (ASPECTS) ≥7, vs 89.3% without DR (p = 0.013). Arterial recanalization, defined as hyperdense middle cerebral artery sign disappearance on control CT, was more frequent in the DR group (68.4% vs 14.1%, p < 0.001). Intracranial hemorrhage on 24 h-control CT scan was less frequent in the DR group (p < 0.001). Multinomial logistic regression analysis showed that ASPECTS score was an independent predictor of DR (OR = 2.35, 95%CI = 1.32-4.16, p = 0.003) and CT evidence of recanalization was independently associated with DR (OR = 11.60, 95%CI, 3.02-44.53, p < 0.001). Conclusion: DR is a frequent occurrence. ASPECTS score is an independent predictor of DR, which is also independently associated with CT evidence of middle cerebral artery recanalization.
Background: The "other Babinski sign" consists in the co-contraction of the orbicularis and frontalis muscles, causing an eyebrow elevation during ipsilateral eye closure. It cannot be voluntarily reproduced. Aims of the study: To determine the utility of this sign in the differential diagnosis of hyperkinetic facial disorders. Methods: The presence of the sign was assessed in consecutive patients with blepharospasm, primary hemifacial spasm or post-paralytic facial syndrome treated in a botulinum toxin outpatient clinic. Results: Of the 99 patients identified, 86 were included, 41 with blepharospasm (32 female, mean age 71 ± 11 years), 28 with hemifacial spasm (16 female, mean age 65 ± 12 years) and 17 with post-paralytic facial syndrome (14 female, mean age 50 ± 17 years). The sign was detected in 67.9% of the patients with hemifacial spasm, in 23.5% of the post-paralytic facial syndrome group and in none of the patients with blepharospasm, exhibiting a sensitivity of 51% and a specificity of 100% for the diagnosis of hemifacial spasm/post-paralytic facial syndrome and a specificity of 76% for hemifacial spasm, compared to post-paralytic facial syndrome. Conclusions: This sign is highly specific for the diagnosis of peripherally induced hyperkinetic facial disorders. Its assessment should integrate the routine examination of patients with abnormal facial movements.
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