Ischemic stroke as a rare complication of wasp venom allergy: two clinical scenarios.

Neurological complications after a single Hymenoptera insect sting are very rare. The authors of this paper describe two instances of cerebral ischemic stroke that occurred immediately after a wasp sting. Two distinct pathomechanisms involved in the cases are put forward. When diagnosing such cases, it is vital to rule out the possibility of an immunoglobulin E (IgE)-dependent reaction of hypersensitivity. However, if sIgE antibodies against wasp venom extract and/or its allergenic components are detected, after hospitalization the patient should be qualified for venom immunotherapy, which is the only efficient method of protection from severe allergic reactions caused by an insect sting. Although the incidence of ischemic stroke in patients stung by insects is very low, it is important to be aware of this complication. This will allow rapid implementation of appropriate diagnostics and treatment. The optimal stroke treatment (thrombolysis or mechanical thrombectomy) in these rare cases has not yet been established.

The Links between Parkinson's Disease and Cancer.

Epidemiologic studies indicate a decreased incidence of most cancer types in Parkinson's disease (PD) patients. However, some neoplasms are associated with a higher risk of occurrence in PD patients. Both pathologies share some common biological pathways. Although the etiologies of PD and cancer are multifactorial, some factors associated with PD, such as α-synuclein aggregation; mutations of PINK1, PARKIN, and DJ-1; mitochondrial dysfunction; and oxidative stress can also be involved in cancer proliferation or cancer suppression. The main protein associated with PD, i.e., α-synuclein, can be involved in some types of neoplastic formations. On the other hand, however, its downregulation has been found in the other cancers. PINK1 can act as oncogenic or a tumor suppressor. PARKIN dysfunction may lead to some cancers' growth, and its expression may be associated with some tumors' suppression. DJ-1 mutation is involved in PD pathogenesis, but its increased expression was found in some neoplasms, such as melanoma or breast, lung, colorectal, uterine, hepatocellular, and nasopharyngeal cancers. Both mitochondrial dysfunction and oxidative stress are involved in PD and cancer development. The aim of this review is to summarize the possible associations between PD and carcinogenesis.

Analysis of retinal nerve fibre layer, visual evoked potentials and relative afferent pupillary defect in multiple sclerosis patients.

OBJECTIVE: The aim of this study was to analyse retinal nerve fibre layer (RNFL), pattern-reversal visual evoked potentials (pVEPs) and relative afferent pupillary defect (RAPD) changes in multiple sclerosis (MS) patients with the consideration of past optic neuritis (ON). METHODS: Ophthalmological, neurological, OCT, RNFL and pVEP studies were conducted in 59 MS patients. RAPD tests were performed in 47 of them. Control group consisted of 28 healthy volunteers. RESULTS: Abnormal RNFL was found in 59% of cases of eyes with ON and 28% of eyes without ON. In eyes with ON, significantly lower RNFL values were indicated in the temporal and lower quadrants. Elongation of pVEP latency was found in 83% of eyes with ON and 60% of eyes without ON. The average value of pVEP latency was larger and the amplitude was lower in the subgroup of eyes with RNFL at the borderline or below the norm. RAPD was observed only in eyes with ON and with RNFL thinning. No association was found between the RAPD and pVEP parameters. CONCLUSIONS: VEPs were more frequently abnormal than RNFL in MS patients. RNFL damage in eyes without ON may indicate neurodegenerations in CNS of MS patients; it can also be the consequence of subclinical ON. SIGNIFICANCE: An analysis of RNFL and VEP can be useful for evaluating the optic nerve in MS patients.

Emotional prosody expression in acoustic analysis in patients with right hemisphere ischemic stroke.

OBJECTIVES: The role of the right cerebral hemisphere in nonverbal speech activities remains controversial. Most research supports the dominant role of the right hemisphere in the control of emotional prosody. There has been significant discussion of the participation of cortical and subcortical structures of the right hemisphere in the processing of various acoustic speech parameters. The aim of this study was an acoustic analysis of the speech parameters during emotional expression in right hemisphere ischemic strokes with an attempt to reference the results to lesion location. MATERIALS AND METHODS: Acoustic speech analysis was conducted on forty-six right-handed patients with right-middle cerebral artery stroke, together with 34 age-matched people in the control group. We compared the results of acoustic studies between patients with varying infarct locations and the control group. RESULTS: Variations in fundamental frequency during verbal expression of joy, anger and sadness were significantly smaller in the patient group than in the control group. Cortical lesion caused more restrictions in fundamental frequency variation in the expression of joy and a lower voice intensity in expressions of anger and joy compared to those patients with subcortical lesions. CONCLUSIONS: Cortical lesion was associated with a more impaired expression of emotional prosody than subcortical lesion. The results indicate the leading role of the cortical structures of the right hemisphere in the expression of emotional prosody.

[Disturbances of emotional prosody in schizophrenia]. / Zaburzenia prozodii emocjonalnej w przebiegu schizofrenii.

Disturbances in understanding and expression of emotional prosody of speech (aprosodia) belong to frequent but rarely described symptoms of schizophrenia, that negatively influence the life quality of patients. The role of prosody in the process of verbal communication is to complement and emphasize the language (linguistic prosody) and affective (emotional prosody) aspects of the spoken announcements. The authors review literature, including studies on functional brain imaging, and analyze profile and ground of the disturbances in the emotional prosody in patients with schizophrenia. Similarly to patients with damage to the right hemisphere, the speech of schizophrenia patients often is monotonous and deprived of emotional coloring, despite preserved experiencing of appropriate emotions, similarly to healthy subjects. In the acoustic speech analysis of patients with schizophrenic psychosis, reduced fundamental frequency of the utterance, clinically defined as aprosodia, was showed. It was noticed that the problems in identifying emotions concern mainly negative emotions and that bigger defects were demonstrated by men. The authors emphasize the need to recognize and include appropriate therapeutic treatments in prosody disturbances, which aim is to improve the well-being and social functioning of the patients.