ABSTRACT
Montelukast is a well-established antiasthmatic drug with little side effects. It is a leukotriene receptor antagonist and recent research suggests cognitive benefits from its anti-inflammatory actions on the central nervous system. However, changes in brain activity were not directly shown so far in humans. This study aims to document changes in brain activity that are associated with cognitive improvement during treatment with Montelukast. We recorded EEG and conducted neuropsychological tests in 12 asthma-patients aged 38-73 years before and after 8 weeks of treatment with Montelukast. We found no significant changes on neuropsychological scales for memory, attention, and mood. In the EEG, we found decreased entropy at follow up during rest (p < 0.005). During episodic memory acquisition we found decreased entropy (p < 0.01) and acceleration of the background rhythm (p < 0.05). During visual attention performance, we detected an increase in gamma power (p < 0.005) and slowing of the background rhythm (p < 0.05). The study is limited by its small sample size, young age and absence of baseline cognitive impairment of the participants. Unspecific changes in brain activity were not accompanied by cognitive improvement. Future studies should examine elderly patients with cognitive impairment in a double-blind study with longer-term treatment by Montelukast.
ABSTRACT
Lymphangiomas are regarded as malformations arising from sequestration of lymphatic tissue that fail to communicate with the lymphatic system. Lymphangiomatosis is defined as a pathological condition where either multiple lymphangiomas are present or multiple organ systems are involved. We report a 30-year-old male who presented with cough, hemoptysis and severe dyspnea as the result of progressive chylothorax and chylopericardium. Despite three months of treatment with total parenteral fat-free nutrition, octreotide, repeated pleurocentesis, and pleuroperitoneal shunting, a life-threatening deterioration of his disease developed. Radiologic findings included multiple bilateral cystic lesions in the mediastinum, hili, pleura and pericardium, along the lymphatic vessels. Although general experience with surgical treatment of lymphangiomatosis is limited, our patient nevertheless made an almost complete functional recovery after pulmonary lymphangiectomy. Thus, preoperative risk assessment based primarily on radiologic findings may be misleading. To our knowledge this is the first report in the literature to indicate that surgery should be an option in patients with multiorgan lymphangiomatosis.