Assessment of Patients with Intracerebral Hemorrhage or Hemorrhagic Transformation in the VENOST Study.

INTRODUCTION: Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group. MATERIALS AND METHODS: In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded. RESULTS: CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was ≥3 in 23.1% of the patients in the CH group. DISCUSSION AND CONCLUSION: CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.

Behçet's disease as a causative factor of cerebral venous sinus thrombosis: subgroup analysis of data from the VENOST study.

OBJECTIVE: This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behçet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST). METHODS: VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis. RESULTS: BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%). CONCLUSIONS: BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score ⩾2).

Cerebral Venous Sinus Thrombosis as a Rare Complication of Systemic Lupus Erythematosus: Subgroup Analysis of the VENOST Study.

AIM: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. MATERIAL AND METHOD: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. RESULTS: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 ± 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. CONCLUSIONS: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.

P-wave dispersion doesn't increase in patients with epilepsy.

AIM: Epileptic seizures have occasionally been associated with cardiac conditions as atrioventricular blocks, long QT syndrome etc. P-wave dispersion (PWD), which is the difference between the longest (P max) and shortest P-wave duration (P min), is considered as a forerunner of atrial fibrillation. In this study, we investigated P-wave dispersion (PWD) in epileptic patients; based on the hypothesis that microthromboembolism may occur in atrial fibrillation. METHODS: Seventy five patients with mixed types of epilepsy and 50 age and sex matched healthy individuals were included into the study. P max, P min and PWD values were calculated for each subject from an ECG. RESULTS: The mean age of subjects in the epilepsy group and control group were similar (p>0.05). P max in patients with epilepsy was 125.1±0.7 ms, P min was 67.3±10.3 ms, and PWD was 57.6±8.3 ms while these values in the control group were 116.8±11.0 ms, 66.5±5.5 ms and 46.8±7.1 ms, respectively. There were no statistically significant difference between two groups (p>0.05). CONCLUSIONS: PWD does not increase in patients with mixed types of epilepsy. Therefore we believe that microthromboembolism due to atrial fibrillation can't cause epileptic seizures in patients with no structural heart disease.

Segmental vitiligo in a patient with thoracic outlet syndrome.

Reported here is a 35-year-old man with findings of thoracic outlet syndrome and bilateral segmental vitiligo on C8-T1 dermatomes. The possible causal relationship between the two disorders under the common denominator of cervical sympathetic involvement is discussed for the first time in the literature.

Headache as the sole presenting symptom of cerebral venous sinuses thrombosis: Subgroup analysis of data from the VENOST study.

OBJECTIVES: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes be the only symptom in these patients. This retrospective and prospective study was an investigation of any differences in terms of clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) and cases with other concomitant findings (non-isolated headache [NIH]). METHODS: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled in this research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared. RESULTS: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated by age group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IH group, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH group during follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group than in the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in the NIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group. CONCLUSION: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an important role in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.

Epileptic seizure during anaesthesia induction with etomidate.

In this report a 20-year-old male patient who had suffered tonic-clonic seizure after a single induction dose of etomidate until a bispectral index value of 60 is presented. Our best knowledge, this case is the first report of pure etomidate (with induction dose) induced generalized tonic clonic seizure proven with EEG. Anaesthesiologists should be careful against such a complication even in the induction stage of anaesthesia during etomidate use.

Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study.

BACKGROUND: Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. METHODS: Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. RESULTS: The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34 ± 9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38 ± 9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). CONCLUSION: The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study.

PURPOSE: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). METHOD: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. RESULTS: The mean age of the patients in the ES group was 39.73 ± 12.64 and 40.17 ± 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. CONCLUSIONS: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.

Use of ultrasonography in ulnar nerve entrapment surgery--a prospective study.

The purpose of our study is to assess the usefulness of high-resolution ultrasonography in observing the morphology and dynamics of the ulnar nerve in the cubital tunnel and also the efficacy of ultrasonography in a more accurate diagnosis and appropriate surgical treatment decision. Cross-sectional area of the ulnar nerves of 40 healthy volunteers in the control group were measured bilaterally at the level of the epicondyle, 2 cm proximal to and 2 cm distal to the epicondyle. Measurements were obtained for elbows both in extension and flexion. Then, we prospectively obtained the cross-sectional area values of 18 patients at the same levels, elbows in extension and flexion position, and compared the data obtained from the patient group and the control group. The differences between the cross-sectional areas of the ulnar nerves in extension and flexion were statistically significant in the patient population (p < 0.001). Mean cross-sectional area of the ulnar nerve in the patient population was calculated as 0.16 cm(2), and we accepted the cut-off point as 0.1 cm(2). This value for cross-sectional area yielded a sensitivity of 90% and a specificity of 100% in diagnosis of ulnar nerve entrapment. Results substantiated conspicuous morphological changes in ulnar nerve during flexion and extension of the elbow. We also observed that as the degree of the nerve displacement by virtue of elbow flexion that is discerned by ultrasonography increased, a more aggressive decompressive surgery was needed for an appropriate treatment.

Autofluorescence findings in Vogt-Koyanagi-Harada disease.

PURPOSE: To report shortwave autofluorescence (SW-AF) and near infrared autofluorescence (NIR-AF) findings in a case of Vogt-Koyanagi-Harada (VKH) disease. METHODS: A 22-year-old man presented with a 2-week history of headache, moderate hearing loss, discolored hair, and bilateral gradually decreased vision (20/800 bilaterally). Ophthalmologic examinations revealed bilateral granulomatous anterior uveitis and multiple patchy bullous retinal detachments. Fundus fluorescein angiography (FFA), SW-AF, and NIR-AF imaging were performed with a confocal scanning laser ophthalmoscope at the beginning and after resolution. The patient responded well to systemic prednisolone treatment. Visual acuity and hearing loss improved quickly (visual acuity 16/20 bilaterally). RESULTS: Multilobular dye pooling with a dark rim was observed in serous detached retinal areas on late-phase FFA. These areas were observed as hypoAF in SW-AF and NIR-AF mode due to the blockage. After resolution of serous detachment, numerous hypoAF granular dots were observed scattered over the previously serous detached areas in SW-AF and NIR-AF mode. These hypoAF granular dots were seen as window defect lesion in FFA and interpreted as retinal pigment epithelial damage or atrophy. CONCLUSIONS: SW-AF and NIR-AF imaging confirmed granular retinal pigment epithelium atrophy which corresponds to FFA findings. SW-AF and NIR-AF imaging methods are noninvasive and useful techniques for documentation of fundus changes in VKH disease.

The effects of gabapentin on acute and chronic pain after inguinal herniorrhaphy.

BACKGROUND AND OBJECTIVE: To find out whether preoperative gabapentin use had a favourable effect on long-term postoperative pain in patients undergoing inguinal herniorrhaphy. METHODS: Sixty male patients--aged 20-40 years--who were scheduled for unilateral inguinal herniorrhaphy under spinal anaesthesia were included in this prospective, randomized, double-blind study. The patients were randomly allocated to two groups: the gabapentin group (n=30) received single-dose 1.2 g oral gabapentin 1 h before surgery, and the placebo group received a placebo capsule instead. Spinal anaesthesia was performed with heavy bupivacaine, and all operations were performed by the same surgeon with the same technique. Postoperative analgesia was evaluated during sitting and lying with a visual analogue scale. Assessment of postoperative pain at 1, 3 and 6 months was carried out with an 11-point numerical rating scale; 0 indicating 'no pain' and 10 indicating 'worst pain imaginable'. Patients who had numerical rating scale scores of more than 0 were further evaluated with regard to the impact of pain on their daily activities. RESULTS: When compared with the placebo group, the gabapentin group displayed significantly lower visual analogue scale scores (lying and sitting) and total tramadol consumption at 8, 12, 16, 20 and 24 h after surgery (P<0.05) and higher postoperative patient satisfaction scores (P<0.05). Numerical rating scale scores at 1, 3 and 6 months after surgery were lower in the gabapentin group than in the placebo group (P<0.05). The number of patients whose daily activities were adversely affected by pain was smaller in the gabapentin group at the first month; however, the two groups were found to be similar at 3 and 6 months. CONCLUSION: We conclude that preoperative single-dose gabapentin decreases the intensity of acute postoperative pain, tramadol consumption and the incidence and intensity of pain in the first 6 months after inguinal herniorrhaphy.

Comparison of regeneration results of prefabricated nerve graft, autogenous nerve graft, and vein graft in repair of nerve defects.

The purpose of this study was to evaluate the effectivity of prefabricated nerve grafts in the repairing nerve defect and to compare them with the autogenous nerve graft and vein graft. Four groups were created, each containing 10 rats. First, nerve prefabrication was carried out in groups I and II during 8 weeks. For this purpose, jugular vein graft was sutured to the epineural windows on the peroneal and tibial nerve at the right side in an end-to-side fashion. To create neurotrophic stimulus, partial incision was performed on the nerves in group I, and gene therapy was performed by plasmid injecting to the adjacent muscles in group II. At the end of the eighth week, prefabricated nerve grafts, jugular vein, and the axons passing through it were taken. Then, gap was created on the left peroneal nerve in all groups. Defect on the peroneal nerve was repaired by using the prefabricated nerve grafts in groups I and II, the autogenous nerve graft in group III, and the vein in group IV. Assessment of nerve regeneration was performed by using electromyography. Morphological assessment was performed after follow-up period. According to electrophysiological and morphological results, the results of first three groups were similar. There was no statistically significant difference between three groups. Prefabricated nerve graft is as effective as autogenous nerve graft, and it can be used in the repair of nerve defects as autogenous nerve graft as an alternative.

Cerebral white-matter lesions in asymptomatic military divers.

INTRODUCTION: There is some concern that over a period of years, diving may produce cumulative neurological injury even in divers who have no history of decompression sickness. We evaluated asymptomatic divers and controls for cerebral white-matter lesions using magnetic resonance imaging (MRI). METHODS: The study enrolled 113 male military divers (34.4 +/- 5.6 yr) and 65 non-diving men (33.1 +/- 9.0 yr) in good health. Exclusion criteria included any condition that might be expected to produce neurological effects. Patent foramen ovale was not assessed. A questionnaire was used to elicit diving history. A 1.5-T MRI device was used to acquire T1, T2-weighted, and fluid attenuated inversion recovery (FLAIR) images of the brain. A lesion was counted if it appeared hyperintense on both T2-weighted and FLAIR images. RESULTS: MRI revealed brain lesions in 26 of 113 divers (23%) and in 7 of 65 (11%) controls, a difference that was statistically significant. There was no significant difference between the groups with respect to blood pressure, smoking history, or alcohol consumption, and no subject reported a history of head trauma or migraine. There was no relationship between MRI findings and age, diving history, or lipid profile in divers. DISCUSSION: The higher incidence of lesions in the cerebral white matter of divers confirms the possibility that cumulative, subclinical injury to the neurological system may affect the long-term health of military and recreational divers.

Neurological symptoms after a provocative dive: spinal DCS or anterior spinal artery syndrome?

Reported here is a 37-yr-old professional diving instructor who had developed complaints of back pain and weakness in the lower extremities after diving. He was eventually diagnosed as having spinal cord decompression sickness along with a likely diagnosis of anterior spinal artery (artery of Adamkiewicz) syndrome. Additionally, since the transthoracic echocardiography revealed patent foramen ovale, we hypothesized that it might have been a potential route for gas bubbles to occlude the anterior spinal artery in this diver.

The effect of male circumcision on pudendal evoked potentials and sexual satisfaction.

Circumcision is generally considered a simple, rapid operation with medical benefits which accrue throughout life. The influence of circumcision on sexual satisfaction has always been argued. In this study, the assessment of the pudendal evoked potentials (PEP) in adults before and at least 12 weeks after circumcision was done. Healthy males aged between 18-27 years, who were willing to undergo circumcision were included in the study. Before and after circumcision, sexual performance was evaluated with the Brief Male Sexual Function Inventory (BMSFI), consisting of sexual drive, erection, ejaculation, problem assessment, and overall satisfaction sections. Forty-three adult males were enrolled in the study. Mean PEP latency was 41.97 +/- 0.25 (39.90-44.50) ms and 44.73 +/- 0.33 (40.90-47.60) ms before and after circumcision, respectively. Mean difference between pre- and postoperative PEP values was 2.76 ms which was statistically significant (p < 0.001). Mean ejaculatory latency time was significantly longer after circumcision (p < 0.001). In the light of our findings, we conclude that circumcision may contribute to sexual satisfaction by prolonging PEP latency but further studies are warranted also regarding the other dimensions of circumcision.

Sonographic appearances of the normal ulnar nerve in the cubital tunnel.

PURPOSE: To investigate the sonographic characteristics of the normal ulnar nerve in the cubital tunnel, as well as any differences related to age, sex, and dominant arm. METHOD: Two hundred twelve elbows in healthy volunteers were evaluated sonographically. The cross-sectional area (CSA) of the ulnar nerve within the cubital tunnel was measured with the elbow in extension and in flexion. The presence and number of fascicles was determined. The displacement of the ulnar nerve out of the cubital tunnel in full elbow flexion was also investigated. RESULTS: The mean +/- SD CSA of the ulnar nerve was 6.6 +/- 1.7 mm(2) (6.7 +/- 1.8 mm(2) in men and 6.5 +/- 1.7 mm(2) in women). The mean CSA of the ulnar nerve was highest for subjects aged 50-59 years, and lowest for subjects aged 30-39 years. Forty-two of 212 (19.8%) ulnar nerves had 2 fascicles, and 5 (2.4%) had 3 fascicles. The remaining 165 (77.8%) nerves had 1 fascicle. During elbow flexion, 49 of 212 (23.1%) ulnar nerves showed subluxation, and 18 (8.5%) were dislocated. CONCLUSION: There were differences in the CSA of the ulnar nerve between some age groups, but there was no variation with sex or handedness. Sonography can evaluate the morphologic changes of the nerve during flexion of the elbow.

How Long does Denervation Take in Poliomyelitis? Or is it a Lifetime?"

BACKGROUND AND OBJECTIVE: This study aims to determine the period of reinnervation in patients with poliomyelitis. This research was conducted to identify the appearance of denervation potentials in patients with poliomyelitis as indicators for reinnervation. MATERIALS AND METHODS: A total of 246 male patients with poliomyelitis were assessed electrophysiologically between 1988 and 2007. The mean age was 22.8 (18-42). It has been an average of 19.9 ± 4.9 years since the beginning of complaints from the patients. RESULTS: The patients had no complaints of newly developing muscle weakness, fatigue, muscle and joint pain, and difficulties in breathing and swallowing. Neurological examinations revealed the absence of myotomal pain and sensory loss. Upon assessment of the patients' limbs, the following findings were revealed: two patients had left upper and lower limb involvement, two patients had left upper and right lower limb involvement, 6 patients had left upper limb involvement, 12 patients had both lower limb involvement, 105 patients had left lower limb involvement, 1 patient had both upper limb involvement, 2 patients had right lower and upper limb involvement, 12 patients had right upper limb involvement, 6 patients had both lower limb involvement, 95 patients had right lower limb involvement, and 3 had all the three extremities affected. The needle electromyography revealed the presence of denervation potentials in 25.2% (62) of the patients. CONCLUSION: When poliovirus attacks the motor neuron, this neuron may be completely destroyed, damaged, or unaffected. Reinnervation occurs when nearby functioning motor units send out terminal axon sprouts to reinnervate the damaged muscle fibers. As a consequence of poliomyelitis, several muscle fibers become atrophic and fibrotic, but others continue to survive. This study showed that patients with a history of poliomyelitis experienced denervation with subsequent reinnervation for many years.

Incidence of ischemic brain lesions in hyperbaric chamber inside attendants.

Concern is growing about the negative long-term effects of hyperbaric exposure on the central nervous system of divers. This study was conducted with magnetic resonance imaging (MRI) to evaluate attendants that work inside hyperbaric chambers (known as inside attendants) for hyperintense brain lesions. Ten inside attendants and 10 healthy nondiving subjects were included in the study. A questionnaire was used to obtain information about subjects' medical history, hyperbaric exposure history, alcohol intake, and smoking habits. T1-weighted, T2-weighted, and fluid-attenuated inversion recovery images were acquired with a 1.5-T MRI device. A lesion was included in the count if it was hyperintense on both T2-weighted and fluid-attenuated inversion recovery images. Although MRI revealed 3 hyperintense brain lesions in 2 of 10 inside attendants and in none of the controls, the differences between groups were not statistically significant (P=.147). The number of brain lesions counted did not correlate with the age of the inside attendants (r=0.007; P=.978), the number of hyperbaric exposures (r=-0.203; P=.574), or the duration of work as an inside attendant (r=0.051; P=.890). Investigators found a correlation, however, between the number of cigarettes smoked in a day and the number of brain lesions identified (r=0.779; P<.01). An increased incidence of hyperintense brain lesions was not observed in inside attendants who had never experienced decompression sickness compared with nondiving controls. Additional multicenter epidemiologic studies are needed if the occupational safety of inside attendants is to be enhanced.

The investigation into the cutaneous silent period in patients with essential tremor pre-treatment and post-treatment.

Although essential tremor (ET) is the most common movement disorder, little is known regarding its pathophysiology. Cutaneous silent period (CSP) is a spinal inhibitory reflex that causes suppression of the voluntary muscle contraction that is induced by strong electrical stimulation of the cutaneous nerves. Clinical interest in the CSP stems from its potential usefulness for evaluating segment and components of sensory nerves that are not well assessed by standard electrodiagnostic methods. The aim of this study was to investigate CSP in patients with ET before and after treatment. A total of 30 patients (12 females + 18 males), having ET diagnosis and propranolol treatment initiated, were studied with technique of CSP. Patient group's pre-treatment latency average is found 84.45 ± 18.63, average CSP duration 42.37 ± 11.82, and CSP final latency average 127.10 ± 19.13. According to post-treatment CSP analysis, it is seen that patients' average latency values are found 83.14 ± 20.92 and it is determined that there is no significant statistical difference compared to pre-treatment latency values (p > 0.05). Post-treatment average CSP duration is found 36.64 ± 13.38, and it is seen that there is a significant statistical shortening compared to pre-treatment durations (p < 0.05). Patients' post-treatment CSP final latency averages are found 123.17 ± 13.67, and it is determined that there is no significant statistical difference compared to pre-treatment latency values (p > 0.05). The main finding of this study is that in ET the CSP is prolonged and that treatment with propranolol shortens the CSP and brings it closer to normal values. A small dose of propranolol has the effect of shortening pathologically prolonged CSP in a subset of ET patients (women and without family history), making further investigations with this method interesting. From this point of view in our study, patients with ET treatment give an idea of the effectiveness of propranolol. In recent years, a technique of CSP is interested in the field of electrophysiology and shows the effect of ET that given other pharmacological treatment and also it can be considered a quantitative measure to compare them. The usefulness of CSP should be supported by further studies with more patients.