Guillain-Barre syndrome--pathological connection with GvHD after allogeneic bone marrow transplantation.

The Guillain-Barre syndrome (GBS) could be a manifestation of neurotoxicity caused by multiple factors due to allogeneic bone marrow transplantations (alloBMT). In this paper we present a case of a 40-year old woman with chronic myeloid leukemia after alloBMT from her HLA identical brother. She developed the second grade of acute hepatic graft versus host disease (GvHD) shortly after alloBMT followed by chronic form. We observed Guillain-Barre syndrome probably triggering by GvHD in this patient.

[Clinical course and evolution of lesion in MRI in central pontine myelinolysis in a patient abusing alcohol]. / Przebieg kliniczny i ewolucja zmian w obrazie MRI centralnej mielinolizy mostu u pacjentki uzaleznionej od alkoholu.

The authors report a 44-year-old patient with at least a 10-year history of alcohol abuse in whom an organic brain syndrome developed with cerebellar ataxia, left-side hemiparesis and bulbar symptoms. MR imaging of the head demonstrated a large hyperintense focus in T2-weighted images involving the central part of the pons. Central pontine myelinolysis was diagnosed. Laboratory investigations showed no hyponatraemia. After withdrawal treatment and motor function rehabilitation the neurological symptoms regressed nearly completely. After 18 months control MR imaging demonstrated considerable reduction in the size of the myelinolysis area in the brainstem, despite the fact that the patient resumed alcohol drinking.

[Atrial fibrillation and carotid artery disease in ischemic stroke patients]. / Migotanie przedsionków i choroby tetnicy szyjnej wewnetrznej u pacjentów z udarem niedokrwiennym mózgu.

Ischemic strokes occurring in patients with non-rheumatic atrial fibrillation (AF) are due to a variety mechanisms, and not necessarily to cardiogenic embolism. The aim of the study was to determine the role and prevalence of carotid artery disease in stroke patients with AF, as well as its influence on the stroke prognosis. 513 consecutive patients with ischemic stroke participated in the study. The diagnosis was based on the clinical examination, brain CT and Doppler ultrasonography. Risk factors and clinical data were collected prospectively according to the Stroke Data Bank NIH protocol. AF was diagnosed in 166 (32.4%) patients. Carotid artery stenosis > 45% was present in 104 (20.3%). AF and co-existing carotid stenosis was found in 27 (5.3%) cases. There were 16.2% patients with carotid stenosis in the group with AF. In all groups 87 patients died (30-day mortality rate: 17%). The highest mortality rate was noted in the group with co-existing AF and carotid artery stenosis (25.9%), followed by the groups with AF only (21.6%) and no changes (15.9%), with the lowest mortality in the group with only vascular changes, i.e. stenosis or occlusion (9.1%). The carotid stenosis group differed significantly both from patients with co-existing AF and carotid stenosis (p > 0.01) and from those with AF only (p < 0.05).

[Neural listeriosis presenting as leptomeningitis: a case report]. / Neurolisterioza przebiegajaca pod postacia ropnego zapalenia opon mózgowo-rdzeniowych--przypadek kliniczny.

The Listeria monocytogenes infection is rare and difficult to diagnosis. However, it is associated with a high mortality in adults. A case is presented of a 78-year-old woman with an immunological deficit following viral infection (herpes zoster).

Positivity of serum "classical" onconeural antibodies in a series of 2063 consecutive patients with suspicion of paraneoplastic neurological syndrome.

This study determined the prevalence of classical onconeural Ab in a series of 2063 consecutive patients that were investigated because of suspicion of PNS as well as evaluated individual onconeural Ab in relationship to the clinical spectrum of associated neurological syndromes and tumor types detected in 70 patients finally diagnosed with PNS. We conclude that detectability of onconeural Ab is low among patients suspected with PNS. Specification of Ab is helpful in defining a neurological syndrome as paraneoplastic as well as in searching of underlying tumor. The success in tumor screening depends on the type of onconeural Ab.

Rapid-onset dystonia-parkinsonism: a fourth family consistent with linkage to chromosome 19q13.

Rapid-onset dystonia-parkinsonism (RDP, DYT12, MIM 128235) is a rare autosomal dominant movement disorder characterized by abrupt onset of slow, dystonic movements and prominent bulbar features. Three families and 1 isolated case have been described in the literature, and linkage to markers on chromosome 19q13 have been reported. Here, we describe the clinical features in a fourth family (the second in Europe) with 4 affected members, suggesting that RDP may be misdiagnosed for years and/or may mimic other dystonic/parkinsonian syndromes. By using haplotype analysis, we show that the family is consistent with linkage to markers on chromosome 19q13.