Neurological Disorders

ISSN: 2329-6895

Open Access

Current Issue

Volume 9, Issue 8 (2021)

    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.

    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

    Hidden Myths of Neurology to be explored

    Shanmugam Rajendran*

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    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 10, Issue 6 (2022)

        Research Pages: 1 - 11

        The International Concussion and Head Injury Research Foundation Brain Health in Retired Athletes Study of Ageing and Impact Related Neurodegenerative Disease (ICHIRF-BRAIN Study)

        Michael Turner*, Cliff Beirne, Antonio Belli, Kaj Blennow, Henrik Zetterberg, Bonnie Kate Dewar, Valentina di Pietro, Conor Gissane, Amanda Heslegrave, Etienne Laverse, Victoria McEneaney, Adrian McGoldrick, James Murray, Patrick O Halloran, Ben Pearson, Yannis Pitsiladis, Marco Toffoli, Huw Williams and Paul McCrory

        DOI: 10.4172/2329-6895.10.6.497

        Introduction and aims: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Large registry studies have demonstrated a dose response relationship between TBI and neurodegenerative disease; however, disentangling the direct effects of TBI from ageing and/or a progressive neurodegenerative process is problematic. This study is a prospective long term cohort study to examine a population of retired elite athletes at high risk of concussion and mTBI during their sporting careers compared to age and sex matched controls with no history of TBI. The aim is to determine the incidence and risk factors for neurodegenerative disease and/or age related effects on brain health in this population.

        Methods and analysis: A population of retired male and female elite athletes and controls aged 40-85 years, will be assessed at baseline and serial time points over 10 years during life using a multi-dimensional assessment including: Questionnaire; SCAT3/5; Neurological and physical examination; Instrumented balance assessment; Computerised neurocognitive screen; Neuropsychological assessment; Advanced MR brain neuroimaging; Visual saccades; Blood workup; Fluid biomarkers; Gut metabolomics; Salivary MicroRNA analysis; Genetic analysis; and where available Brain banking and neuropathology.

        Ethics and dissemination: Ethics approval was granted by St Mary’s University SMEC as well as at the various satellite trial sites. The trial is registered with ISRCTN (BioMed Central) with ID number: 11312093. In addition to the usual dissemination process, this phenotypically well characterised dataset will reside in a publicly accessible infrastructure of integrated databases, imaging repositories, and biosample repositories and de‐identified data will be made available to collaborating researchers.

        Research Pages: 1 - 8

        Psychometric Evaluation of the Fear of COVID-19 Scale among Syrian Population

        Fater Khadour, Younes Khadour, B. M. Ebrahem, Jack Nelson and Tao Xu*

        DOI: 10.4172/2329-6895.10.6.498

        Fear is a common emotional reaction to an impending threat like the pandemic caused by the COVID-19 virus. A fear of COVID-19 Scale has been developed to evaluate the severity of COVID-19 related fear. This study investigated the psychometric characteristics a Syrian Arabic version of the scale to give additional validation for the Arabic FCV-19S using an online survey of 1637 Syrian individuals. The results were compared with their responses to the Depression, Anxiety and Stress Scale and the Satisfaction with Life scale. Cronbach’s alpha for the Syrian version of the fear of COVID-19 scale was determined to 0.84.

        The scale’s ratings showed a significant negative relationship with life satisfaction and a significant positive association with sub-scales of the Depression, Anxiety and Stress Scale.

        Confirmatory factor analysis revealed that the Syrian version of the fear of COVID-19 Scale has a unidimensional structure which fits the data well. The scale has useful psychometric characteristics and can be employed to evaluate the severity of fear of COVID-19 among Syrian populations.

        Research Pages: 1 - 7

        The Effects of Cognitive Training of Prefrontal Functions in Patients with Parkinsons Disease

        Martina Piefke*, Hannah Vogel and Stefan Troche

        DOI: 10.4172/2329-6895.10.6.499

        The treatment of cognitive impairments in individuals with Parkinson’s disease (PD) poses a challenge on the therapy of the disorder. The current study examines the effects of a computer based cognitive training in patients with PD. 13 individuals with PD (3 females, 10 males) and 16 healthy controls (8 females, 8 males) participated in the study. They underwent a 6 week cognitive rehabilitation program, focusing on attention, working memory, and executive functions. We measured (i) pre and post-training cognitive performance with standard neuropsychological tests and (ii) improvement in the training tasks across the intervention. In both groups, performance improved significantly within all training modules (p<.001). A significant increase of performance was evident from pre to post-intervention untrained neuropsychological measures of working memory (p<.001). Moreover, correlational analyses showed that enhancement in each trained task was accompanied by improvement in the same cognitive domain in untrained neuropsychological tests. To our knowledge this study is the first providing evidence for a transfer of cognitive improvement in trained tasks to untrained neuropsychological measures in patients with PD. We propose that patients with PD will benefit from the inclusion of cognitive training in medical treatment of the disorder.

        Research Pages: 1 - 4

        Clinical and Radiological Findings with Long-Term Conservative Therapy in Lumbar and Cervical Disc Prolapse

        Omar Abdelhay Eldanasory*

        DOI: 10.4172/2329-6895.10.6.500

        Objectives: A retrospective analysis study of 40 patients, with cervical, and/or lumbar disc prolapse, to evaluate the effectiveness of long term conservative treatment.

        Method: The study involved 40 patients with acute or chronic onset of cervical or lumbar radiculopathy, due to disc prolapse between 2015 and 2019. All the data were obtained from the database in our institution. All patients had a standard neurological and clinical assessment, with follow up Magnetic Resonance Imaging (MRI) for a period ranging from 2 to 3 years. The Associations between clinical findings during the physical examination and follow up MRI imaging findings were compared and discussed. All patients were refusing surgery because of the surgical drew back occurring to their family members, medical problems preventing surgery, or they had improvement with long term conservative therapy. The protocol of medical treatment and physiotherapy were the same for all patients.

        Results: Long term conservative treatment for cervical and lumbar disc prolapses could be superior and better than surgical treatment in acute disc prolapse without any neurological deterioration. The surgical treatment of the cervical and lumbar disc prolapses in young patients has not been considered the gold slandered option of treatment because of the postoperative complications especially recurrence disc and the failed back surgery syndrome.

        Conclusion: The conservative treatment of cervical and/or lumbar disc prolapses of all patients was effective for long term therapy. The follow up MRI spine shows spontaneous regression of the disc materials. Therefore, conservative management of disc prolapses could be better than surgical management especially, in acute stages.

        Research Pages: 1 - 3

        Prevalence of Traumatic Brain Hemorrhages in Brain Death Patients

        Parvaneh Hassani*, Ziya Oddin Ahmadi, Shadi Halimi, Mehdi Abbasi, Sajad Besharati, Ali Sarreshtehdari, Mehran Shafiee and Rahele Khademi

        DOI: : 10.4172/2329-6895.10.6.501

        Background: Given the severity of the brain death burden and its main cause in emergency clinical settings, intracerebral hemorrhage due to concussion, determining the most common type of hemorrhage among these patients, helps us to predict the likelihood of progression of the vegetative outcome.

        Purpose: This study aimed to assess the prevalence of different types of intracranial hemorrhage in patients with brain death.

        Material and methods: 70 head traumatic brain dead patients who were referred to Masih Daneshvari hospital undergone assessment by CT scan to determine the prevalence of major intracranial hemorrhage types and their complications.

        Results: Subarachnoid hemorrhage (SAH) and subarachnoid hemorrhage (SDH) are the most common types of intracranial hemorrhage among patients with brain death. Overall, 45.7% and 40%, respectively, were associated with bleeding events with a change in the midline at 14.3% and edema at 12.9%. The middle shift was more common in SAH patients, while edema was more common in SDH patients. Each relative to the other.

        Conclusion: This study showed that SAH and SDH are the most common types of intracranial hemorrhage in patients with traumatic brain injury.

        Volume 10, Issue 7 (2022)

          Research Pages: 1 - 7

          Maxillofacial Fibrous Dysplasia-Diagnosis, Treatment and Reconstruction with a Personalized, 3D-Printed Titanium Implant: A Case Report

          Anna Dudzinska-Filkiewicz, Julianna Laczkowska-Serafin, Joanna Krysztopik and Anna Zurada*

          DOI: 10.4172/2329-6895.10.7.502

          Fibrous dysplasia is a rare disease belonging to benign, noncancerous bone and soft tissue related developmental disorders. A 34 year old male was admitted to the maxillofacial surgery unit to diagnose a rapidly growing, painless lesion with swelling in the right buccal region and increasing facial deformity for three months. Computed tomography (CT) images revealed an inhomogeneous, ill-defined lesion in the maxilla and maxillary sinus. Despite the lesion, the patient had no clinically significant neurological abnormalities. The lesion was diagnosed as fibrous dysplasia on the basis of preoperative tissue biopsy. The treatment of choice was complete surgical excision with immediate reconstruction and fixation of the orbital floor by implanting an alloplastic titanium mesh implant. Then, the patient underwent a secondary reconstruction of tissue defects using a personalized, 3D-printed titanium implant. Reconstruction of post resection defects covering a large craniofacial area is a challenge for maxillofacial surgeons due to the specific location of the face, especially considering psychological and technical aspects. The reconstruction method should be predictable and safe and should guarantee the best aesthetic effect, close to perfection. The ideal solution seems to be the use of an individually prepared, personalized 3D-printed titanium implant with anatomical detail mapping, which can perfectly recreate the missing tissues.

          Case Report Pages: 1 - 7

          Sudden-Onset Vertigo Associated with Persistent Spontaneous Torsional Nystagmus and Imbalance: A Unique Clinical Manifestation of Benign Paroxysmal Positional Vertigo but not Acute Unilateral Peripheral Vestibulopathy (Vestibular Neuritis)

          Xue-sheng Liu*

          DOI: 10.4172/2329-6895.10.7.503

          Objective: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disease. Acute unilateral peripheral vestibulopathy (AUPVP), previously termed vestibular neuritis (VN), is the 3rd most common peripheral vestibular neuropathy with unknown etiology and pathogenesis. This study aimed to explore the association between BPPV and AUPVP (VN) and identify the potential etiology and pathogenesis of AUPVP (VN).

          Methods: The clinical characteristics of 11 patients with sudden-onset vertigo associated with persistent spontaneous torsional nystagmus (PSTN) and imbalance were retrospectively reviewed. The effectiveness of the CCRM treatment was evaluated. The diagnosis of these patients was re.

          Results: Balance dysfunction significantly improved after the first CCRM treatment and was completely alleviated after two CCRM treatments. PSTN was transformed to gaze-evoked persistent torsional nystagmus after the first CCRM treatment, and the degree of nystagmus was reduced. PSTN stopped in subsequent CCRM treatments. The severity of the vertigo gradually reduced after each treatment. The clinical manifestations of these patients after one or three CCRM treatments were the same as those of BPPV patients. Vertigo, PSTN, and imbalance were alleviated entirely in all patients after several CCRM treatments, suggesting that these patients had atypical BPPV.

          Conclusion: Sudden-onset vertigo associated with PSTN and imbalance is a unique clinical manifestation of BPPV, caused by the canalith jam in the posterior semicircular canal or otolithiasis in multiple semicircular canals. The CCRM treatment is an effective therapeutic method for sudden-onset vertigo associated with PSTN and imbalance when central vestibular vertigo was excluded.

          Research Pages: 1 - 7

          Critical Appraisal of the National Institute for Health and Care Excellence (NICE) Guidelines for Spine Disorders using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II)

          Ning Liang*, Sizhan Wu, Simon Roberts, Navnit Makaram, James Reeves Mbori Ngwayi and Daniel Porter

          DOI: 10.4172/2329-6895.10.7.504

          Introduction: Disorders of the spine (as defined by the musculoskeletal structures surrounding the spinal neural elements) require evidence based, approach to their care. This evaluation used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to evaluate the methodological quality of evidence based guidelines on spine disorders published by The National Institute for Health and Care Excellence (NICE).

          Materials and methods: We systematically searched clinical guidelines on spine disorders published by NICE until December 2019. Four appraisers across three international centers independently evaluated the quality of eligible clinical guidelines using AGREE II. Mean AGREE II scores for each domain were calculated. In higher quality domains scores for individual items were analysed. The guidelines were grouped according to type and year of publication. Comparative statistics and intraclass correlation (ICC) calculations were performed.

          Results: A total of 37 guidelines published by NICE on spine disorders were identified. Mean scores for all six domains were as follows: Scope and Purpose (73.2%), Stakeholder Involvement (63.9%), Rigour of Development (68.1%), Clarity of Presentation (73.6%), Applicability (53.2%) and Editorial Independence (64.5%). The mean score for overall quality of all NICE spinal related guidelines was 68.8% (95% CI: 62.3-75.3). Interventional Procedure Guidelines were evaluated as possessing significantly lower overall quality than other types (p=0.007). Overall quality was significantly associated with year of publication (rs=0.476, p=0.0029). Evaluator ICC for each guideline ranged from 0.39 to 0.95.

          Conclusion: NICE guidelines on spine disorders demonstrated acceptable or good quality across most domains. Despite deficiencies in the applicability domain, their quality has improved over time. We recommend use of NICE guidelines for assessment and treatment of spine disorders.

          Research Pages: 1 - 4

          CNN Technique for Detecting Alzheimers Disease by Using MRI Images

          Dronavalli Jathinsai*, Narisetti Suhas, Pilla Adi Vishnu and Sasi Kumar P

          DOI: 10.4172/2329-6895.10.7.505

          Alzheimer’s Disease (AD) is very common neurological diseases these days. Alzheimer’s is one such gradual disorder that destroys memory and other significant mental functions that leads to dementia. It is necessary to detect and treat it in the initial stages itself in order to avoid any major disintegration. Using normal medical methods AD is very difficult to detect, so they used various classifications using MRI images to detect. In order to get better result, Image acquisition and pre-processing has been done. Over these years there are several approaches to detect and treat the brain diseases, now as the technology progressing rapidly this project has come up with an idea to integrate deep learning techniques to detect and understand the severity of brain’s condition of patient.

          Case Report Pages: 1 - 3

          Fatal Ischemic Stroke in a Patient with Mild Covid-19 Infection

          N. Mouloudi*, C. Moussavou, Y. Benmoh and A. Bourazza

          DOI: 10.4172/2329-6895.10.7.506

          Coronavirus disease 2019 (COVID-19) is a worldwide pandemic. It is currently established that patients with COVID-19 have a high risk of thromboembolic complications such as acute ischemic stroke which emerge as a serious complication of infection by the severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2). In this sense, we present the case of a 68 year old male with a history of mitral valve replacement that developed a devastating acute ischemic stroke in multiple vascular territories in the setting of mild COVID-19 infection despite adherence to therapeutic anticoagulation. It is likely that multiple mechanisms are involved in stroke related to COVID-19. Although, vascular inflammation and coagulopathy are emerging as features defining pathology underlying COVID-19. Given the failure of anticoagulants in the prevention of ischemic strokes in some cases, despite an optimized anticoagulation strategy, more research is required to explore new methods of anti-thrombotic and anti-inflammatory therapy for stroke prevention in patients diagnosed with COVID-19.

          Volume 9, Issue 9 (2021)

            Editorial Note Pages: 1 - 1

            Editorial on Neurological Disorders-September

            Shanmugam Rajendran

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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

            Fragile X Syndrome Protective for Subsequent Cancers

            Maryam Sotoudeh Anvari

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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.

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