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.

Interferon ß associated nephropathy in a Multiple Sclerosis patient: A case and review.

BACKGROUND: Interferon beta (IFN ß) subtypes are largely used as immunomodulatory agents in Multiple Sclerosis (MS) treatment. While being generally well tolerated, they can cause various side effects. Adverse effects related to kidney are rarely reported. CASE REPORT: We report a 32 years old male patient who developed nephrotic syndrome while receiving IFN ß for MS. Biopsy showed focal segmental glomerulosclerosis. He went into remisson after cessation of drug and with the aid of angiotensin II antagonists. Here, we report this case and a review of similar cases reported in literature. CONCLUSIONS: Although it's a rare adverse effect and tend to show good prognosis physicians should pay careful attention to symptoms and findings of nephropathy during follow ups of patients under treatment with these agents.

A case of peduncular hallucinosis presenting as a primary psychiatric disorder.

Peduncular hallucinosis usually occurs due to vascular or infectious midbrain lesions or brain stem compression by tumors. We present a peduncular hallucinosis case in a 63-year-old female with brain stem infarction, which can easily be misdiagnosed as a psychiatric disorder.

[Chronic manganese intoxication due to methcathinone (ephedron) abuse: a case report]. / Metkatinon (Efedron) Kötüye Kullanimina Bagli Kronik Manganez Entoksikasyonu: Bir Olgu Sunumu.

Known as an occupational disease, chronic manganese intoxication is recently being observed among abusers of psychoactive substances. Methcathinone hydrochloride is obtained by combining ephedrine/pseudoephedrine and potassium permanganate. Various neuropsychiatric symptoms have been reported among Efedron users. Our patient is a 29 year old male, who was referred to our hospital from a state general hospital with a diagnosis of Conversion Disorder. He was hospitalized and preliminary diagnoses of Facititous Disorder, Conversion Disorder, Psychiatric Disorder due to a General Medical Condition and Antisocial Personality Disorder. He was abstinent from any substance for five years upon referral to our hospital and had a history of methcathinone abuse for 4.5 years. The backache dated back to 6 years ago and a disturbance of gait was added to the clinical picture. A speech disturbance, falling while walking downhill and walking on tiptoe were added in the last 2-3 years. In the neurological examination, extrapyramidal system findings, gait disturbance and the report on use of manganese compunds were found. The setting was changed from psychiatric ward to neuorology ward and evaluated by consultant neurologist. The case was diagnosed as ?Manganese Intoxication'. The aim of this report is to demonstrate and emphasize the importance of questioning the presence of manganese compounds in case of history of substance abuse. Other areas of interest are the shortage of data on the intravenous use of manganese and the cases reported in the literature coming from the former Soviet Union.