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Neurological Disorders

ISSN: 2329-6895

Open Access

Current Issue

Volume 9, Issue 8 (2021)

    Case Report Pages: 1 - 5

    Endoscopic Endonasal Approach to Skull Base Lesions. Surgical Outcome

    Orestes Lopez Piloto*, Tania Margarita Cruz Hernandez, Lismary Martinez Valdes, Emmanuel Batista Geraldino, Orestes Lopez Ayala, Luis Torres Alvarez and Claudia Diaz Villalvilla

    Introduction: The complexity of the pathology treated by this route, frequently of tumor origin, lies in the close anatomical relationship that they have with
    important neurovascular structures which, most of the time, are deformed, displaced or completely engulfed in them.
    Methods: A retrospective, descriptive, cross-sectional study was carried out. The universe of study was made up of all the patients operated by an endoscopic
    endonasal approach at the Institute of Neurology and Neurosurgery, in the period from May 2017 to April 2021.
    Results: A sample of 65 patients was identified. The average age was 52 years. Among the treated lesions, patients with pituitary macroadenomas (52.3%),
    followed by craniopharyngioma (20%) predominated. The postoperative complications that were recorded in our series were postoperative CSF fistula, epistaxis
    and vascular lesion (frontopolar artery) with a total of 3 cases (4.6%) and two deaths (2.9%) The degree of tumor resection in our series was total in 64.7% of the
    cases operated on by both the standard endoscopic endonasal approach (21.5%) and the extended approach for 43.2%.
    Conclusion: The endoscopic endonasal approach is a fundamental tool for the management of most lesions of the anterior cranial base and the sellar / parasellar
    region because it allows for extensive resections with a relatively low number of complications.

    Mini Review Pages: 1 - 3

    To Decrease the Negative Effects of Chronic Stress Overload, Simple Self-Care Must be Included in Our Daily Lives

    Rita K. Garnto*

    It is well known by the medical community that stress overload negatively impacts the health and well-being of individuals on psychological, emotional, spiritual, and
    physical levels. The results from multiple studies and research show that regular self-care does, in fact, help combat the negative effects of stress overload. However, the
    year 2020 has created such an elevated level of chronic stress that traditional self-care may no longer be enough to combat these negative effects effectively. By adding a
    new kind of self-care, called simple self-care to our busy daily schedules when done on a regular basis, has been proven to further reduce the negative effects of stress on
    a more immediate level. This paper examines the definition and concepts of simple self-care which has been federally copyrighted as a concept and theory of application,
    along with the benefits it has on creating a healthier lifestyle of stressing less and living happier. These results are supported by an accumulation of multiple studies and
    research which has been documented in reports and books pertaining to negative effects of chronic stress, human anatomy and physiology, and the benefits of self-care.
    The data suggests that by adding short intervals of simple self-care into our daily schedules regularly, we can start negating the harmful effects of stress overload and begin
    building up our stress resistance to better deal with chronic stress leading to a healthier and happier future.

    Review Pages: 1 - 5

    Recent Advances in Receptor and mediator of Neuropathic Pain

    Santosh Nagare*

    As we know that pain is the most common reason for which a patient takes medicine. Pain is not a single entity but may be classified as nociceptive pain, inflammatory
    pain, and neuropathic pain. In this review we have exclusively Neuropathic pain is caused by the direct lesion on the neuron or damage or dysfunction of peripheral
    or central neurons. Although the neuropathic pain is single entity theoretically but it involve broad arena of receptor and mediators like melanocortin and its receptor
    (Type4), TLR7, TLR8, Sphingosine-1 phosphate receptor, CCL2, P2X4, and PARP-1 regulated expression of inflammatory mediator. Because of such dynamic interplay
    amongst the mediators and its corresponding receptor in addition to the inflammatory ligand and its receptor even the smallest stimulation results in spontaneous intense
    pain after that it gets transformed into chronic pain syndrome which is difficult to treat. In chronic pain syndrome, plastic changes occur in nociceptive neurons which
    can’t be reversed by pharmacological treatment. In this review, we have discussed the core pathophysiology of neuropathic pain and advances in mediator and receptor
    accompanied their consequences or interaction to sustain the neuropathic pain.

    Editorial Pages: 1 - 1

    Shanmugam Rajendran*

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    Mini Review Pages: 1 - 8

    Sanal Flow Choking Leads to Aneurysm, Hemorrhagic Stroke and other Neurological Disorders in Earth and Human Spaceflight: New Perspective

    V.R.Sanal Kumar*, Rajaghatta Sundararam Bharath, Charlie Oommen, Nichith Chandrasekaran, Vigneshwaran Sankar, Ajith Sukumaran, Shiv Kumar Choudhary and Pradeep Kumar Radhakrishnan

    Evidences are escalating on the diverse neurological disorders associated with COVID-19 pandemic. The theoretical discovery of Sanal flow choking is a paradigm shift in the
    diagnostic science of asymptomatic stroke causing neurological disorders in earth and at the microgravity condition (human spaceflight). A critical review has been carried out herein for correlating the phenomenon of Sanal flow choking (PMCID: PMC7267099) and hemorrhagic stroke. Herein, we show that when systolic to diastolic blood pressure ratio (BPR) reaches the lower critical hemorrhage index (LCHI) the internal flow choking and shock wave generation occurs in the downstream region of the vessels, with sudden expansion, divergence, bifurcation, stenosis and/or occlusion, leading to pressure overshoot causing brain hemorrhage and/or neurological disorders. The critical BPR for internal flow choking is uniquely regulating by the biofluid/blood heat capacity ratio (BHCR). The BHCR is well correlated with BPR and blood viscosity. The closed form analytical model reveals that the relatively high and the low blood viscosity are risk factors of internal flow choking causing aneurysm and hemorrhagic stroke. In vitro data shows that fresh blood samples of healthy subjects evaporate at a temperature range of 37°C-40°C (98.6°F-104°F) and generate carbon dioxide, nitrogen, and oxygen gases in the vessel. The single phase in silico results demonstrated the occurrence of Sanal flow choking and pressure overshoot causing memory effect (stroke history) leading to progressive neurological disorders. We concluded that disproportionate blood thinning medication increases the risk of flow choking causing hemorrhagic stroke. The risk of brain hemorrhage and various types of neurological disorders in COVID-19 patients and others in earth and microgravity environment could be diminished by concurrently lessening the viscosity of biofluid/blood and flow turbulence by increasing the thermal tolerance level in terms of BHCR and/or by decreasing the BPR. The effect of Sanal flow choking is more severe in blood vessels with divergent/bifurcation regions because it leads to the shock wave generation and the transient pressure overshoot causing irreversible neuronal damage forming the core of infarction. We concluded that, for a healthy life all subjects with high BPR inevitably has high BHCR for reducing the risk of the internal flow choking (biofluid/Sanal flow choking) triggering neurological disorders as results of infraction.

    Volume 9, Issue 10 (2021)

      Case Report Pages: 1 - 3

      Lateral Medullary Infarction after Administration of mRNA COVID-19 Vaccine

      Priyankan Sharan

      As the COVID-19 Vaccination program is rampantly and progressively rolling out, increase in the number of adverse events become alarming and many rare complications have been notified. During the current period of COVID-19 vaccination, a high index of suspicion is required to identify thrombotic episodes following vaccination. However, it is important to remember that these side effects are rare and much less common than both cerebral venous thrombosis and ischemic stroke associated with COVID-19 infection itself. Neurological complications are potentially disabling AEFI (adverse event following immunization) that may range from facial palsy to stroke. The authors report the first case of lateral medullary infarct after administration of Moderna mRNA vaccine in Singapore.

      Review Pages: 1 - 6

      Non-Medical Hurdles for the Development of Causal Treatments in Neurodegenerative Diseases?

      Frank P. Maier-Rigaud

      Neurodegenerative Diseases (NDDs) occur when nerve cells in the brain or peripheral nervous system lose function over time and ultimately die. The risk of being affected by a neurodegenerative disease increases drastically with age. With increasing life expectancy neurodegenerative diseases have been on the rise. The absence of a cure for NDD implies a high burden to the individual patient but also a tremendous cost to society. This article advances some possible economic explanations for the absence of disease-modifying treatments for NDDs by exploring relevant non-medical hurdles in research and development. While the development of disease-modifying treatments for NDDs may present intrinsic hurdles existing economic research provides arguments why other explanations for the absence of causal therapies may play a role. Notably economic science can shed light on the incentives for developing causal treatments. In this article we analyse the innovation inhibiting effect of an already existing drug portfolio. Moreover we demonstrate that different regulatory mechanisms in essence price controls and health insurance as well as patent protection might distort companies’ incentives to innovate. This may tilt incentives towards research geared to smaller and lower incremental value innovations which could be an explanation for the lack of causal therapies in NDDs

      Commentary Pages: 1 - 2

      Brief Note on Mental Disorders and Psychological Wellness

      Vahid Eidkhani

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      Editorial Pages: 1 - 1

      Editorial on Neurological Disorders

      Shanmugam Rajendran

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      Volume 9, Issue 9 (2021)

        Editorial Note Pages: 1 - 1

        Fragile X Syndrome Protective for Subsequent Cancers

        Maryam Sotoudeh Anvari

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        Commentary Pages: 1 - 1

        HPTLC and GC-MS Analyses of Biologically Active Extracts and Fractions from Premna Latifolia Roxb Leaves

        Rajesh Kumar, Brijesh Kumar*, Ashutosh Kumar, Ajay Kumar, Manish Singh

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        Editorial Note Pages: 1 - 1

        Editorial on Neurological Disorders-September

        Shanmugam Rajendran

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        Review Pages: 1 - 4

        The Differences of Optical Coherence Tomography (Oct) and Pattern Electroretinogram (P-ERG) in Adult Patients with Anisometropic and Strabismic Amblyopia Might shows a Difference Injure in Visual Pass-Way

        Shuai Liu

        Objective: To investigate the changes of retinal thickness and P-ERG signals in adult patients with anisometropic and strabismic amblyopia. Methods: Sixty patients with monocular adult amblyopia, including 30 Anisotropic Amblyopes (AA group) and 30 Strabismic Amblyopes (SA group), were enrolled in our study at the outpatient clinic of The Hefei First Peoples Hospital of Anhui medical University from June 2019 to November 2020. Retinal Nerve Fiber Layer (RNFL) thickness was measured within 3.4 mm diameter range surrounding the optic nerve, and Ganglion Cell Complex (GCC) layer thickness within 6 mm diameter range surrounding the fovea by an Optovue RTVue Optical Coherence Tomography (OCT) in both amblyopic and fellow eyes. The amplitude and latency of P50 and N95 in Pattern-Electroretinogram (P-ERG) were recorded by a Roland electrophysiology instrument under two stimulation conditions with different temporal and spatial frequencies that were designed to bias the parvocellular and magnocellular pathways respectively. Data between amblyopic and fellow eyes was statistically analyzed by paired t test. The correlation between axial length and parameters of OCT and P-ERG was examined by Pearson correlation test. Results: Changes in RNFL thickness: In the AA group, RNFL thickness in temporal sector was significantly thinner (p=0.033), while that in the nasal, superior and inferior sectors increased (p<0.05) compared with fellow eyes. In SA group, no significant difference (each sector p>0.05) was found between amblyopic eyes and fellow eyes. Changes in GCC thickness compared with fellow eyes, in the AA group, GCC layer thickness of amblyopic eyes was significantly increased (p=0.039), whereas in the SA group, we did not find a significant difference between amblyopic eyes and fellow eyes (p>0.05). P-ERG stimulated mode biased the parvocellular pathway when compared with fellow eyes (n=15), in the AA group, the amplitudes of P50 (p=0.004) and N95 (p=0.038) were significantly decreased in amblyopic eyes, but no significant latent time difference (p>0.05) was found. In the same stimulus pattern, no statistically significant difference (n=15, p>0.05) between amblyopic eyes and fellow eyes was found in the amplitude and latency of P50 and N95 in the SA group. P-ERG stimulated mode biased the magnocellular pathway the amplitude and latency of P50 and N95 showed no statistically significant difference (p>0.05) in either the AA group or the SA group. We found no significant correlation between axial length and OCT, P-ERG parameters (p>0.05) in either group. Conclusion: Our results showed that the alterations in structure and function of retina that could be seen in adult anisometropic amblyopia were not found in adult strabismic amblyopia group. We thought the functional loss in anisometropic amblyopia was more bias to the parvocellular pathway. These findings indicated that the pathological mechanisms were different between anisometropic and strabismic amblyopia.

        Case Report Pages: 1 - 3

        Bilateral Cerebellar Ataxia with no Apparent Cerebellar Lesions: A Case of Wernekink's Commissure Syndrome

        Moussavou Cedrick

        Wernekink commissure syndrome was first described in 1941 by Lhermitte, but it wasn't until 1958 that it made its first appearance in a publication at the 22nd International Neurological Meeting. This syndrome takes its name from the first illustrations made in 1840 by Franz Joseph Julius Wilbrand, the successor of Friedrich Christian Wernekink (1798-1835). Wernekink's commissure syndrome is characterized by the combination of bilateral cerebellar ataxia with dysarthria or anarthria, associated with occasional internuclear ophthalmoplegia and delayed-onset palatal myoclonus (Holmes tremor), secondary to caudal paramedian midbrain infarction.

        Volume 11, Issue 3 (2023)

          Research Article Pages: 1 - 6

          Associated Risk of Anxiety among CAD Patients in PSCC in Qassim, Saudi Arabia

          Mansour M. Alharbi*

          DOI: 10.4172/2329-6895.11.3.551

          Context: The presence of anxiety in individuals with Coronary Heart Disease (CHD) is widespread, and it is related to a higher risk of negative outcomes. There has been a dearth of research on the management of anxiety in people with coronary artery disease.

          Aims: The present study aimed to determine the associated risk of anxiety among Coronary Artery Disease (CAD).

          Settings and design: This was a cross-sectional study conducted on a group of patients with IHD between the ages of 20 and 60 years.

          Methods and material: A total of 200 individuals participated. Medical records were one of the data sources. The data of patients who meet the selection criteria gathered from the cardiology departments of the PSCC in KFSH.

          Statistical analysis used: Statistical package for Social Science (SPSS) version 23 was used for statistical analysis.

          Results: This research comprised 200 patients, the majority of whom were male (81%) and female (19%). According to the findings, 70% of people had minimal depression, 13.5% had mild depression, 8.5% had moderate depression, 4.5% had severe depression, and 3.5% had moderately severe depression. Medications were utilized in the majority of cases (98%).

          Conclusion: Anxiety disorders that manifest themselves in the setting of heart disease must be recognized and treated with caution in the early stages of the disease. When giving medical therapy, it is important to examine the effects of the drugs on the heart, as well as the possibility of drug-drug interactions.

          Research Pages: 1 - 12

          Dysregulation of Insulin Signaling in Human AD Brain and Alleviation of A?-Induced Insulin Resistance by Amyloid-? Binding Peptide (ABP) in Neural Cells

          Yuka Sai, Balu Chakravarthy, Debbie Callaghan, Qiao Li and Wandong Zhang*

          DOI: 10.4172/2329-6895.11.3.552

          Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by the accumulation of extracellular amyloid-β peptides (Aβ) and intraneuronal neuro-fibribillary tangles in the brain. Increasing evidence builds a strong case for the role of soluble Aβ oligomers (AβOs) in the impairment of insulin signaling in AD. Insulin signaling pathway begins upstream at the insulin receptor by phosphorylating IRS1 and propagating the signal downstream to the PI3K/ Akt which down-regulates GSK3β activity for tau phosphorylation and activates mTORC1 that mediates a wide range of cellular functions. Our study found that human AD brains had high levels of Aβ peptides with cerebral amyloid angiopathy (AD/CAA) and showed low activities of insulin signaling-responsive transcription factors as compared to age-matched non-demented controls (ND). Our further studies with neuroblastoma 2a (N2a) cells stably transfected with a human AβPP695 gene (N2a-AβPP), which secrete excessive Aβ, show that the basal levels of the expression and phosphorylation of several but not all critical signaling proteins along insulin signaling pathway are dysregulated as compared to the parental N2a cells. N2a-AβPP cells were phenotypically insulin resistant in response to insulin stimulation. Pre-treatment of N2a-AβPP cells with the Aβ-binding peptide (ABP), which binds and removes Aβ oligomers, significantly enhanced insulin signaling response in cells compared to controls. Taken together, our data suggest that human AD/CAA brains had dysregulation of insulin signaling and that Aβ oligomers may be responsible for inducing the insulin-resistant phenotype in N2a-AβPP cells and the removal of Aβ oligomers by ABP improved insulin signaling and relieved insulin resistant phenotype.

          Case Report Pages: 1 - 4

          The Case of Acute Necrotizing Encephalopathy in an Adolescent with COVID-19

          Ling Liu, Rong Ou, ZongWen Chen, Wen Zhong and Hongxia Chen*

          DOI: 10.4172/2329-6895.11.3.553

          Introduction: Acute Necrotizing Encephalopathy (ANE) is a rare severe disease with high mortality or severe neurological sequelae characterized by rapid onset of consciousness disturbance and symmetric bilateral thalamic necrosis shown on imaging. To date, there have been limited investigations on SARS-CoV-2-related ANE, mainly in the form of case reports.
          Case presentation: A previously healthy 13-year-old girl presented with rapid deterioration of consciousness, status epilepticus, elevated aminotransferase, and symmetrical multi-focal brain lesions on MRI images during the Omicron pandemic. She accepted mechanical ventilation and had a good response to plasma exchange and continuous blood purification, intravenous immunoglobulin and high-dose methylprednisolone.
          Conclusion: ANE is a rapidly progressing disease that necessitates prompt detection through a combination of clinical presentation and imaging modalities. It is of paramount importance to enhance the awareness and knowledge of pediatricians regarding SARS-CoV-2-related encephalopathy. Upon diagnosis, treatment with high-dose intravenous methylprednisolone and IVIG should be contemplated. Additionally, plasma exchange and continuous blood purification could help alleviate liver damage in patients with ANE.

          Case Report Pages: 1 - 3

          Bluetooth Hyperosmia: Chemosensory Variant of Delusional Somatic Symptom Disorder: A Case Report

          Shweta Kalita, Nikita Mehdiratta* and Alan R. Hirsch

          DOI: 10.4172/2329-6895.11.3.554

          Objective: Correlation of Bluetooth transmission with subjective hyperosmia.
          Background: Subjective hyperosmia, as a manifestation of belief of exposure to Bluetooth transmission, with testing demonstrating the absence of true hyperosmia, has not heretofore been described.
          Case presentation: This 53-year-old right-handed single woman presented with a 10-year history of increased sensitivity to the aroma and enhanced perception of smells upon exposure to Wi-Fi electromagnetic radiation. She noted an intensity-duration effect: With higher intensity and duration of Wi-Fi exposure, her sense of smell would escalate and persist: After a few hours of exposure, her smell would jump to 190% of normal and last for two weeks.
          Result: Abnormalities in the neurological examination: Reflexes: 0 in both lower extremities. Chemosensory Testing: Alcohol Sniff Test: 8 (hyposmia). Gustation: Waterless Empirical Taste Test: Brothy: 4/8 (hypogeusia).
          Discussion: Nidus for such hyperosmic delusions may be a primary olfactory system disorder, with induction of ephaptic transmissions, causing intermittent phantosmia or otherwise misperceived odor, misattributed to the ambient environment. The assignment of the source of the hyperosmia to Bluetooth is consistent with the zeitgeist of mistrust and paranoia of higher technology. This may be a form of expectation effect due to visual evidence (high tower wires); suggestion combined with subcultural group dynamics with belief in harm of such electromagnetic/Bluetooth waves, with distorted information recall and misattribution. Suchgroup dynamics and shared misperceptions may fuel a delusion, as in the Mandela effect. Perchance, this case represents not having delusional hyperosmia due to a functional psychiatric disorder but instead having a neuroanatomic basis. Those with subjective hyperosmia and hypersensitivity to aromas have demonstrated hypertrophied gray matter volume in the posterior sub-region of the right hippocampus, left precuneus, left superior frontal gyrus, and right hypothalamus. In those with subjective hyperosmia, a neurological investigation is warranted.

          Case Report Pages: 1 - 2

          Restlessness in Opioid Withdrawal: A Unique Presentation of Whole-Body Involvement

          Nikita Mehdiratta*, Shweta Kalita, Drushti Birwatkar and Alan R. Hirsch

          DOI: 10.4172/2329-6895.11.3.555

          Introduction: Restless Leg Syndrome (RLS) is a known phenomenon observed in individuals experiencing opioid withdrawal, which can worsen heroin dependence. Typically,RLS affects only the legs, but this case report presents a unique instance of generalized Restless Body Syndrome (RBS) induced by opioid withdrawal.
          Case presentation: The report describes a 67-year-old male undergoing opioid detoxification who experienced restlessness throughout his body, resembling RLS sensations.The restlessness affected various areas, including the thorax, abdomen, back of legs, lower back, arms, and legs, excluding the face. The sensations were described as periodic electric waves that intensified at night or during periods of inactivity and improved with physical activity, mainly walking. Similar sensations were also noted during withdrawal from opioids or buprenorphine/naloxone, significantly when the dose was reduced to 1mg/day, and they resolved upon reintroduction of buprenorphine/naloxone.
          Results: Neurological examination revealed specific abnormalities, such as recent impaired recall, facial akinesia, decreased blink frequency, cog wheeling in upper extremities,a stooped, shuffling gait, and resting tremor in both upper extremities. Neuropsychiatric tests showed abnormal results in the Go-No-Go Test (4/6) and a minimal level of depression according to the Beck Depression Inventory Type-II (score: 9). The patient also scored as a problem drinker on the Michigan Alcohol Screening Test (score: 35).
          Discussion: Exploration of the similarities between RBS and RLS, highlighting that RBS affects additional areas of the body, including the upper extremities, thorax, and back. While RBS may represent a variant of RLS, it could also be a different condition. Another potential explanation is that it may be a form of serotonin syndrome induced by opioid use, including fentanyl, which can lead to generalized myoclonus. Although RLS associated with opioid withdrawal is well-documented, the underlying mechanisms responsible for its manifestation throughout the body, including the neck, remain unclear. One hypothesis suggests a generalized polyneuropathy affecting the upper limbs and lower extremities, particularly in cases of iron deficiency. The report suggests that variants of RBS may occur in individuals undergoing opioid withdrawal, potentially requiring low-dose opioids for treatment. Consequently, evaluating RBS as part of the assessment for opioid withdrawal is necessary.

          Volume 11, Issue 6 (2023)

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Citations: 1343

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