Patients with severe and persistent headache and other neurologic symptoms and signs should be considered for neurobrucellosis in endemic regions and to possibly receive longer therapy than 6 weeks. Brucella TA with Coombs test in CSF is sensitive and specific by using a cutoff of ≥1:8.

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We determined serum levels of ascorbic acid, betacarotene, retinol and alpha tocopherol and lipid peroxidation (as estimated by thiobarbituric acid reacting substances (TBARS) generation) in 24 multiple sclerosis (MS) patients and 24 healthy sex- and age-matched person as control. The levels of four antioxidant vitamins were significantly lower in MS patients compared to controls (p < 0.05). TBARS levels were significantly higher in the patients of MS compared to the controls (p = 0.001). In MS patients, the levels of beta-carotene, alpha tocopherol and ascorbic acid correlated significantly with each other (r2 = 0.689 - 0.779). It appeared that there was inverse correlation between the serum levels of ascorbic acid or beta-carotene, but not of alpha tocopherol or retinol, and TBARS levels in MS. The present study indicates that antioxidant vitamins (alpha tocopherol, beta-carotene, retinol and ascorbic acid) are decreased in sera of MS patients during an attack, and that this decrease may well be dependent on the increased oxidative burden as reflected by lipid peroxidation products. The role of antioxidant vitamin supplementation in prevention and/or treatment of MS remains to be explored.

The aim of this study is to investigate the frequency of unilateral cranial autonomic symptoms during migraine attacks, and to compare the clinical characteristics of migraine patients with and without unilateral cranial autonomic symptoms. One hundred and eighty-six consecutive patients with episodic migraine attacks were prospectively included. Cranial autonomic symptoms of the patients occurred during headache, frequency, duration, severity and character of headache, disease duration, presence of aura, laterality of headache, accompanying symptoms, relation of migraine attacks with menstruation, lesions detected on magnetic resonance images, and family history of migraine were recorded. The patients with and without unilateral cranial autonomic symptoms during headache were compared in terms of above-mentioned parameters. Seventy-seven (41.4 %) patients were observed to develop unilateral cranial autonomic symptoms during migraine attack. Disease duration was longer in the patients with unilateral cranial autonomic symptoms than in those without (p = 0.045). Headache was unilateral in 83.1 % of the patients with unilateral cranial autonomic symptoms (p = 0.001). Pure menstrual or menstrually related migraine attacks were more common in the patients with unilateral cranial autonomic symptoms (p = 0.043) and is thought that menstruation-related hormonal factors might have a triggering role on the trigeminal-autonomic reflex pathway. The longer disease duration in patients with unilateral cranial autonomic symptoms might be associated with the activation of pathophysiological mechanisms that cause cranial autonomic symptoms in time. Frequent unilateral pain in migraine patients with unilateral cranial autonomic symptoms is likely to indicate that the development of autonomic symptoms may share common mechanisms with the pathogenesis of trigeminal autonomic cephalalgias.

No abstract

A possible relationship between the pathophysiology of migraine, visual field defects and glaucomatous optic neuropathy is emphasized and VF screening for normal tension glaucoma is recommended in patients with migraine.

This study demonstrated that chronic pain is a common problem in patients with PD, that different pain types may co-exist, and that they may negatively affect the HRQoL of patients. Chronic pain was correlated with both disease-related factors such as rigidity and daily living activities and also general factors such as gender and depression. We found that chronic pain is the most significant predictor of quality of life in PD patients. We believe, that in addition to treating motor symptoms and complications associated with them, treatment of comorbid conditions such as pain and depression bear significance for improving the quality of life in PD patients. The study indicates that PD patients who are optimally treated, may require additional rehabilitation treatment for non-motor associated pain and thus improve their HRQoL.

Objective Deep brain stimulation (DBS) surgery has increasingly been performed for the treatment of movement disorders and is associated with a wide array of complications. We aimed to present our experience and discuss strategies to minimize adverse events in light of this contemporary series and others in the literature. Methods A retrospective chart review was conducted to collect data on age, sex, indication, operation date, surgical technique, and perioperative and late complications. Results A total of 181 patients (113 males, 68 females) underwent DBS implantation surgery (359 leads) in the past six years. Indications and targets were as follows: Parkinson's disease (STN) (n=159), dystonia (GPi) (n=13), and essential tremor (Vim) (n=9). Mean age was 55.2 ± 11.7 (range 9–74) years. Mean follow-up duration was 3.4 ± 1.6 years. No mortality or permanent morbidity was observed. Major perioperative complications were confusion (6.6%), intracerebral hemorrhage (2.2%), stroke (1.1%), and seizures (1.1%). Long-term adverse events included wound (7.2%), mostly infection, and hardware-related (5.5%) complications. Among several factors, only surgical experience was found to be related with overall complication rates (early period: 31% versus late period: 10%; p=0.001). Conclusion The rates of both early and late complications of DBS surgery are acceptably low and decrease significantly with cumulative experience.