ABSTRACT
OBJECTIVE: The study aimed to evaluate the impact of postural changes on the F wave-related parameters and whether those changes were associated with clinical relaxation, which was achieved in restless legs syndrome patients with standing up. METHODS: F wave duration (FWD), compound muscle action potential duration (CMAPD), and FWD/CMAPD ratio were evaluated in supine and upward positions in 18 restless legs syndrome patients and compared with 18 age and gender-matched healthy volunteers. RESULTS: FWD/CMAPD was significantly higher for the tibial nerve at supine position (p = 0.043) but not at upright position (p = 0.206) and for ulnar nerve, both at supine (p = 0.007) and upright positions (p = 0.023) in RLS patients compared to controls. Ulnar FWD decreased significantly at the upright position in both control and RLS patients (p = 0.035, p = 0.028, respectively). CMAPD decreased only in the control group with standing up for both ulnar and tibial nerves (p = 0.048, p = 0.017, respectively). DISCUSSION: Ulnar and tibial FWD/CMAPD ratios increased in RLS patients compared to controls. However, FWD/CMAPD was not affected by the posture within the groups. Postural change seems to be a factor that decreased ulnar FWD both in RLS patients and the control group. Ulnar and tibial CMAPD reduced only in healthy controls with an upright position. Tibial and ulnar FWD/CMAPD ratios are favorable electrophysiological parameters diagnosing RLS. The tibial FWD/CMAPD ratio loses its significance only when the patient stands up, reflecting the clinical relief achieved with the postural change.
Subject(s)
Restless Legs Syndrome , HumansABSTRACT
BACKGROUND: The thalamus is known as the central sensory and motor relay station of the brain generally. However, cognitive decline due to thalamic lesions has been previously reported in different studies. Also, it has been observed that different cognitive subdomains are affected according to the localization of the lesion in the thalamus. OBJECTIVES AND METHODS: Detailed neurophysiological tests were performed on 28 patients with thalamic hemorrhage and the control group. Patients were grouped according to lesion localization. The results were compared with both the control group and the hemorrhage groups themselves. RESULTS: The performance of patients in all neuropsychological tests was significantly worse than that of the control group. Of the 28 patients, 15 had anterolateral, 5 had posterolateral, 5 had dorsal, and 3 had an anteromedial thalamic hemorrhage. The anteromedial group had the worst scores of almost all tests. Also, 2 situations came to notice in these tests. First, the posterolateral group achieved a remarkably low mean in the recall subgroup of the MMSE tests and verbal memory process tests. Second, the anterolateral group was found to have a low mean in both the language subgroup of the MMSE tests and the phonemic subgroup of the verbal fluency tests. CONCLUSION: It was concluded in this study that thalamic hemorrhages affect cognition entirely regardless of the lesion localization. It was also observed that the lateral part of the thalamus was associated with language, the posterior part with memory, and the anteromedial part with the rest of the cognitive subdomains.
ABSTRACT
OBJECTIVES: Isolated dysarthria caused by stroke is a rare condition and generally seen in infratentorial lesions, especially in cerebellar lesions. Isolated dysarthria associated with supratentorial ischemic lesions are also very rare and, these conditions were shown in only a few cases. In this study, six patients characterized by IHP due to supratentorial ischemic lesions are presented. PATIENTS AND METHODS: Physical examinations of patients were done by two different neurologists. The risk factors for stroke were determined. Localisations of lesions were identified by using magnetic resonance images(MRI). Corticolingual tract affection without sensorial and other corticospinal tract involvement was confirmed using Somatosensory evoked potentials(SEPs) and Transcranial Magnetic Stimulation(TMS). RESULTS: Unilateral lingual paresis was detected in all of the patients. The lesions were demonstrated on MRI slices. All lesions were on the same localization. The affection of the corticolingual tract without any other motor and sensory tract involvement was proven electrophysiologically. CONCLUSION: Corticospinal and corticobulbar fibers are very close to each other. Therefore common involvement is expected in cerebrovascular diseases. However, six patients with IHP caused by supratentorial ischemic lesions were reported in this study. Thus, a possible map of the corticolingual tract was drawn.