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.

Tick paralysis with atypical presentation: isolated, reversible involvement of the upper trunk of brachial plexus.

Tick paralysis is a disease that occurs worldwide. It is a relatively rare but potentially fatal condition. The only way to establish the diagnosis is to carefully search for the tick paralysis. It is caused by a neurotoxin secreted by engorged female ticks. Tick paralysis generally begins in the lower extremities and ascends symmetrically to involve the trunk, upper extremities and head within a few hours. Although early-onset prominent bulbar palsy and isolated facial weakness without generalised paralysis are rare, there is no report in the English literature concerning isolated, reversible involvement of the upper trunk of brachial plexus caused by tick bite. We report a case of isolated, reversible involvement of the upper trunk of brachial plexus as a variant of tick paralysis. Diagnosis was confirmed with needle electromyography and nerve conduction examination. Within 2 weeks, the patient was fully recovered. The purpose of presenting this case is to remind clinicians that tick paralysis should be considered even in cases with atypical neurological findings admitted to the emergency department.

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.

Sneddon's syndrome and antithrombin III.

Sneddon's syndrome, an uncommon disorder, is characterized by multiple cerebrovascular accidents along with ideopathic livedo reticularis. In this article, two cases who had increased amounts of antithrombin III and were diagnosed with Sneddon's syndrome are presented.

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.