A case with a rare type of trigemino-oculomotor synkinesis: clinical and blink reflex study.

Several abnormal synkinetic eye movements during jaw movements may often be seen after trauma or congenitally in the Marcus Gunn jaw winking phenomenon. The most frequent type consists of unilateral ptosis and retraction of the ptotic lid upon moving the jaw. The authors describe a case with isolated simultaneous adduction of the left eye upon jaw movement. This paper presents a rare case of Marcus Gunn jaw winking with trigemino-oculomotor synkinesis.

Cervical spinal cord stimulation improves neurological dysfunction induced by cerebral vasospasm.

The effect of cervical spinal cord stimulation on the cerebral blood flow has been investigated both experimentally and clinically since 1986. Although the effect of the spinal cord stimulation on cerebral ischemia induced by cerebral vasospasm after subarachnoid hemorrhage has been investigated widely, neurological dysfunction induced by cerebral vasospasm and the effect of the spinal cord stimulation on neurological dysfunction have not been investigated so far. The aim of this study is to investigate the neurological dysfunction induced by cerebral vasospasm after subarachnoid hemorrhage and whether the spinal cord stimulation improves this neurological dysfunction or not in New Zealand albino rabbits. The animals were divided into sham and experiment groups: Sham group. Motor evoked potentials were recorded before experimental procedure was performed in this group. Just after, intracisternal saline was injected and 3 days later a stimulation electrode was placed in the cervical epidural space. Motor evoked potentials were recorded but electrical stimulation was not applied. Experiment group. Firstly, motor evoked potentials had been recorded before experimental procedure was performed in also this group. After then a stimulation electrode was placed in the cervical epidural space of the animals in which subarachnoid hemorrhage procedure was performed 3 days ago. Motor evoked potentials were recorded both before and after spinal cord stimulation. Motor evoked potential latencies and amplitudes did not change in the sham operation group. But, motor evoked potential latencies extended and the amplitudes decreased in the experiment group before spinal cord stimulation. Spinal cord stimulation improved the changes occurring in latencies and amplitudes in the experiment group. Spinal cord stimulation improves the neurological dysfunction induced by cerebral vasospasm and motor evoked potentials recording is a reliable electrophysiological method to detect cerebral vasospasm and to assess the effects of different treatments in cerebral vasospasm.

The effects of oxcarbazepine on oxidative stress in epileptic patients.

In the present study, erythrocyte lipid peroxidation, superoxide dismutase, glutathione peroxidase and catalase activities were determined in epileptic patients receiving oxcarbazepine monotherapy for 1 year and normal controls. Glutathione peroxidase, catalase, superoxide dismutase and malondialdehyde activities were investigated in a control group (15 normal healthy adults) and a group of 13 epileptic patients, before and after 1 year of oxcarbazepine treatment. The values of glutathione peroxidase and superoxide dismutase activities were statistically significant after 1 year of therapy and pretreatment. The values of malondialdehyde were significantly different from the normal subjects and pretreatment patients values. This study suggests that the antioxidant systems of epileptic patients receiving oxcarbazepine therapy for 1 year were significantly affected.

Evaluation of cerebral vasospasm with transcranial magnetic stimulation: an experimental study.

Despite the current use of several different methods for diagnosis and follow-up of cerebral vasospasm after subarachnoid hemorrhage, an easy, quick, reliable, and noninvasive method is still needed for evaluation of this entity. We investigated the value of transcranial magnetically evoked motor potential changes during the vasospasm period in a rabbit experimental subarachnoid hemorrhage model. We also recorded motor evoked potential changes after deferoxamine treatment during vasospasm. Our results reveal a significant increase in latency periods of evoked potentials during the angiographically proven vasospasm period (34.5%) over those in sham-operated rabbits (9.5%). With deferoxamine treatment, only a minor increase in latency periods (4.5%) was detected after subarachnoid hemorrhage. These results suggest the potential value of evoked motor potential recording as a diagnostic tool in cases of cerebral vasospasm.

Supression of cardiac parasympathetic functions in patients with right hemispheric stroke.

OBJECTIVES: The aim of this study was to investigate the relationship between sympathetic and cardiac parasympathetic function and the side of the lesion in stroke patients. METHODS: Thirty-two patients with stroke and 29 healthy age-matched control subjects were studied. Sympathetic skin responses (SSR) and RR interval variations (RRIV) during rest and deep breathing were recorded for the assessment of sympathetic and vagal parasympathetic function, respectively. RESULTS: The mean SSR amplitude values in patients compared with controls were 337 +/- 244 versus 1897 +/- 848 (P < 0.0001) for right hemispheric lesions and 466 +/- 398 versus 1873 +/- 843 (P < 0.0001) for left hemispheric lesions. The mean SSR latencies in patients compared with controls were 1526 +/- 163 versus 1395 +/- 109 (P < 0.05) for right hemispheric lesions and 1490 +/- 125 versus 1423 +/- 112 (P < 0.05) for left hemispheric lesions. RRIV (during deep breathing)/RRIV (at rest) ratios in patients compared with controls were 1.20 +/- 0.25 versus 1.84 +/- 0. 52 (P < 0.0001), and 1.55 +/- 0.88 versus 1.84 +/- 0.52 (P < 0.05) for right and left hemispheric lesions, respectively. CONCLUSION: Supression of vagal parasympathetic activity was more apparent in stroke patients with right hemispheric lesions in our series. Therefore, the right hemisphere seems to have a greater effect upon parasympathetic activity.

The effect of aspirin, ticlopidine and their low-dose combination on platelet aggregability in acute ischemic stroke: a short duration follow-up study.

We investigated the effects of aspirin (300 mg/d), ticlopidine (500 mg/d) and their low-dose combination (aspirin 100 mg/d plus ticlopidine 250 mg/d) on the platelet aggregability using the Wu and Hoak method. Each treatment group consisted of 25 patients with acute ischemic stroke. Platelet aggregation ratios (PAR) were measured on the 1(st) (before treatment), 10(th) and 90(th) days in the treatment groups and compared with those of 25 control cases. On the first day, comparison of PAR in each treatment group with the control was significant, while the differences between treatment groups were not significant. On the 90(th) day, differences of PAR between aspirin and control were significant, but differences between the other treatment groups and the control group were not significant, indicating a lower anti-aggregant efficacy of aspirin. Our study suggests that PAR determination can be used to assess the efficacy of anti-aggregant drugs. Our crude observation also suggests a higher anti-aggregant efficacy of ticlopidine, and aspirin plus ticlopidine, than aspirin. In addition, proper doses of aspirin plus ticlopidine may be a good choice for the prevention of ischemic stroke. Further studies are required to assess whether PAR determination could be useful for assessing patients at risk of stroke, and for drug selection for the prevention of stroke.

Aneurysmal peroneal nerve compression.

Vascular compression syndromes of the peroneal nerve are rare. The case history of a patient with a peroneal nerve compression caused by a true anterior tibial artery aneurysm is reported. The surgical excision of the aneurysm resulted in marked improvement.

Calcium channel blockers and essential tremor.

Acute effects of two calcium blockers, nifedipine and verapamil, were investigated on the tremor activity of 8 patients with essential tremor and compared with those of propranolol and placebo. Following a single oral dose of 10 mg of nifedipine, tremor intensity of the patients was increased by 71.4 +/- 22.6%. Nifedipine also enhanced physiological tremor in 6 healthy volunteers by 56.0 +/- 21.9%. This effect of nifedipine was not correlated with the increase in heart rate or decrease in systemic blood pressure. Verapamil (80 mg) did not appreciably alter the patients' tremor activity.

The effects of myasthenic immunoglobulins on neuromuscular transmission and thymus histology in mice.

An autoimmune reaction to the endplate acetylcholine receptor (AChR) is thought to be responsible for the muscular weakness of myasthenia gravis (MG). However, the significance of antithymic antibodies and the thymic AChR-like protein is still uncertain. We transferred immunoglobulins (Igs) from patients with MG to mice. Thymitis was observed in 12 of 14 mice, and miniature endplate potential amplitudes were reduced in 8. Control mice showed none of these abnormalities. Immunofluorescence examination failed to reveal the binding of human IgG, IgM, or IgA to the thymic tissue. Our findings support the hypothesis that antithymic antibodies may alter thymic histology.