Caspian Journal of Neurological Sciences
Volume:2 Issue: 5, Jul 2016

Carpal tunnel syndrome is the most common neuropathy in the general population. Nerve conduction studies are among the standard methods for diagnosing carpal tunnel syndrome. Electromyography is painful and unpleasant, and if nerve conduction studies can be used to diagnose axonal injury in carpal tunnel syndrome, electromyography might be replaced.
This study aimed to evaluate the predictability of electromyography findings by nerve conduction studies.
This cross-sectional study recruited 47 patients with carpal tunnel syndrome who attended electrodiagnostic unit in teaching hospitals in Isfahan in the spring and summer of 2015, among who both hands of 46 patients and only the left hand of one person were evaluated. Patients were selected by non-probability sampling and the relationship between parameters of nerve conduction studies and electromyography findings were determined based on the information obtained. The data were analyzed by Spearman’s test and Mann-Whitney test in SPSS-22.
The mean and standard deviation of participants’ age was 47.5±9.1 (range: 62-34 years old). According to data analysis, 37.6% of patients were diagnosed with neurogenic MUAP and 32.2% with neurogenic spontaneous activity. Based on the results, among 47 patients with carpal tunnel syndrome, CMAP amplitudes were most relevant to the findings of neurogenic electromyography among parameters of nerve conduction studies (31.2%) (p-value=0.002).
According to the results, axonal damage in carpal tunnel syndrome can be diagnosed by nerve conduction studies, especially in cases where electromyography is not possible (such as coagulation disorders, patient’s dissatisfaction, etc.).

Although the association between major depressive disorder (MDD) and low self-esteem is well established, we do not know if race and ethnicity modify the magnitude of this link.
Using a nationally representative sample of adults in the United States, we explored whether or not race alters the association between MDD and self-esteem.
Data came from the National Survey of American Life (NSAL), a nationally representative household survey with 3,570 African Americans (Blacks) and 891 Non-Hispanic Whites. Low self-esteem (Rosenberg Self-Esteem Scale) was the dependent variable, MDD (Composite International Diagnostic Interview) was the independent variables, gender, age and educational level were controls, and race was the focal moderator. Logistic regressions were used for data analysis.
In the pooled sample, MDD and low self-esteem showed reciprocal associations, above and beyond all covariates. Our model showed significant interaction between race and MDD, suggesting a stronger association between MDD and self-esteem among Blacks compared to Whites. We could find such interactions among men but not women.
Depression and low self-esteem are more strongly linked among Blacks than Whites, particularly among men. It is not clear whether depression leaves a larger scar on self-esteem for Blacks or that Blacks are more vulnerable to the effect of low self-esteem on depression.

Musculoskeletal pain is a major clinical problem, but researchers lack viable animal models to study this phenomenon. However, formalin injections are widely used to produce tonic and neurogenic nociceptive responses in rodents. Rodents can present a potential animal model for pain.
To develop a muscle pain model with intramuscular injection of formalin in rats.
We injected formalin intramuscularly at different concentrations (50 µl; 2%, 4% and 8%) and compared them to its plantar surface subcutaneous injection (50 µl; 2%). Pain responses were scored in the first phase (1-7 minute), interphase (8-14 minute) and the second phases of 2A (15-60 minute) and 2B (61-90 minute).
After intramuscular and subcutaneous formalin injection, rats showed nociceptive behaviors for less than 10 minutes, and then nociceptive behaviors decreased significantly or stopped. Subsequently, the second phase showed ongoing peripheral activity. In the first phase subcutaneous injection was more painful and in second phase intramuscular injection with doses of 2% and 4%.
We developed a novel muscle pain model based on tonic nociceptive behaviors in rats; following intramuscular formalin injections. This model has great clinical relevance and can facilitate new studies on pain.

Cancer can lead to fatigue and the manifestation of psychological symptoms in patients, including depression, anxiety, and stress.
The aim of this study was to investigate the relationship between fatigue and psychological symptoms in patients with gastrointestinal cancer.
The study had a descriptive, cross-sectional design. We assessed levels of fatigue and the psychological health of 70 patients with gastrointestinal cancer who had been referred to the cancer institute in Tehran, Iran in 2014.We used the Rhoten Fatigue Scale to assess patients’ levels of fatigue and the Depression Anxiety Stress Scale (DASS-21) to assess their psychological symptoms. We performed a correlation analysis and stepwise multiple linear regression to compare the relationship between fatigue and psychological symptoms in the cancer patients.
There was a significant relationship between psychological symptoms, including depression, stress, and anxiety and fatigue in patients with gastrointestinal cancer (p Our study results demonstrate that the severity of fatigue is related to the extent of psychological symptoms (depression, anxiety, and stress) in patients with cancer. A patient’s depression and anxiety predicts the fatigue.

Behçet’s disease (BD) is a multisystemic inflammatory vasculitis of unknown etiology, and vasculitis being its major pathological feature. We studied the prevalence of microembolic signals (MES) in patients with diagnosis Behçet's disease. We also tried to determine the frequency of MES in BD patients with or without neurological involvement.
This study enrolled 40 patients who fulfilled the diagnostic criteria of International Study Group for BD during 2012 to 2013. Bilateral transcranialDoppler ultrasound of the middle cerebral arteries was performed by multigate method. MES were identified based on the criteria of International Consensus group on Microembolus Detection.
We found MES in none of our patients with BD. We measured intima-media thickness in all patients.
It seems that in our population core histopathologic phenomenon to be other than MES andvasculiticphenomenonmay be implicated as a pathophysiologic factor for central nervous system involvement.The clarification of this subject needs further investigations on Iranian BD patients.

Migraine and other recurrent headaches are considered a major public health concern. Levetiracetam, a broad spectrum anti-epileptic have been used in migraine prophylaxis.
Assessment the efficacy of levetiracetam on migraine in comparison to sodium valproate.
This randomized double blind clinical trial was performed on patients with migraine headache, diagnosed based on ICDH-version B criteria. One group received levetiracetam and the other group received valproate sodium. The number of migraine attacks per month, the mean duration of attacks and the intensity of pain (VAS) and disability due to headache (MIDAS) were assessed at first and after four weeks of treatment. Data were analyzed in SPSS 20 by Mann-Whitney-U and Chi-square tests. The significance level was set Thirty patients (28 women and 2 men, mean age of 35.14±7.3 years) remained in the valproate group and 33 patients (31women and 2 men, mean age of 36.33±6.7 years) in the levetiracetam group. The patients in both groups showed a statistically significant reduction in the frequency of headache (p=0.0001); intensity of headache (p=0.004); mean duration of attacks (p=0.0001) and MIDAS score of disability (p=0.004) compared to baseline. There was also a statistically significant difference between the two groups in terms of frequency of attacks (p=0.0001), intensity of pain (p=0.0001); and MIDAS score (p=0.0001), by the end of the treatment with superiority of levetiracetam.
Levetiracetam, compared to valproate, yielded better results in prophylaxis of migraine headache.

We report a rare genetic disorder case of neuroacanthocytosis with clinical profile (oro-lingual-facial abnormal involuntary movements, neuropathy) and typical magnetic resonance findings (cerebral atrophy, bilateral caudate nuclei atrophy with dilated anterior horns of the lateral ventricles), positive family history in his brother and acanthocytosis in peripheral blood smear.

Asterixis, firstly described in metabolic encephalopathies, may occur unilaterally in patients with various focal brain diseases. Although hardly localizing, most reported cases have showed a contralateral thalamic pathology; but Lesions in the medial frontal lobe, parietal lobe, brain stem, basal ganglia, insular lesions, may also cause unilateral asterixis. In this article, three cases of acute cerebral vascular event with unilateral or asymmetrical asterixis were described: first patient with left sided hemiparesis and asterixis that ultimately diagnosed as right thalamic hemmorrage; second patient with right sided hemiparesis and asterixis after acute left thalamic infarction and a patient with transient right sided weakness and bilateral asymmetrical asterixis secondary to a transient ischemic attack in left internal carotid territory. We then provided a literature review of published similar cases to emphasize on asterixis as a focal neurological sign.