فهرست مطالب

Caspian Journal of Neurological Sciences
Volume:9 Issue: 32, Jan 2023

  • تاریخ انتشار: 1401/11/05
  • تعداد عناوین: 8
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  • Nazanin Razazian*, MohammadAli Sahraian, Mansour Rezaei, Sharareh Eskandarieh, Seyedeh Elham Mousavi, Negin Fakhri Pages 1-8
    Background

    It is currently recommended to vaccinate against SARS CoV-2 for people with multiple sclerosis (MS), but it is uncertain what effect it will have on people with MS (PwMS).

    Objectives

    We aimed to compare the side effects of the first and second doses of the Sinopharm vaccine in PwMS.

    Materials & Methods

    This descriptive-analytical follow-up study was conducted on PwMS patients in Kermanshah province, Iran, who received the Sinopharm vaccine using the nationwide MS registry of Iran (NMSRI) by available methods between May and August 2021. Using a researcher-made questionnaire, demographic and clinical information about PwMS, as well as side effects from the Sinopharm vaccine were collected by telephone 5-14 days after the first and second doses. Data were analyzed using SPSS software version 25.

    Results

    Study participants included 188 PwMS, including 148 females (78.7%) and 40 males (21.3%). PwMS had Median age of 42.66±11.1 years and Median 9.57±7.0 for disease duration. In the 1st dose, the prevalence of side effects was significantly higher than in the second dose (58.5% vs 47.0%, P=0.012). Fatigue (30.1%), myalgia (29.8%), fever (25.0%), and headache (22.3%) were the most common in the first dose, and fatigue (27.1%), headache (18.6%), myalgia (17.5%) and fever (14.9%) were the most common in the second dose. COVID-19 was present in 51 people (27.3%) before vaccination.

    Conclusion

    Sinopharm vaccine side effects were significantly more prevalent in the first dose than in the second dose. Most side effects are moderate in severity and transient.

    Keywords: Vaccination, BIBP COVID-19 vaccine, COVID-19 vaccines, Multiple sclerosis
  • Mahdi Barzegar*, Hosein Nouri, Omid Mirmosayyeb, Hossein Motedayyen, Nasim Nehzat, Vahid Shaygannejad Pages 9-14
    Background

    Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disease in the central nervous system. Association between NMOSD and Helicobacter pylori (H. pylori) infection has been investigated, but few studies have assessed the relationship between H. pylori and seronegative AQP4-Ab NMOSD.

    Objectives

    This study aimed to survey the association between H. pylori infection and NMOSD patients with seronegative AQP4-Ab status, as well as the possible relationship between the presence of H. pylori and clinical characteristics.

    Materials & Methods

    This cross-sectional study was carried out in Kashani Hospital affiliated with the Isfahan University of Medical Sciences, Isfahan, Iran, from October 2017 to May 2019. A total of 35 consecutive seronegative AQP4-Ab NMOSD patients and 37 sex and age-matched healthy controls participated in the study. Demographic and clinical characteristics were obtained from all participants. We assessed participants’ seroprevalence of IgG and IgM antibodies against H. pylori. The Association of H. pylori with NMOSD was determined.

    Results

    The frequency of IgG and IgM Ab H. pylori seropositivity in NMOSD patients was 22.9% and 40.0%, respectively. Among HC, 11(29.7%) and 20(54.1%) were positive for IgG and IgM Ab H. pylori. Although the rate of H. pylori IgG (OR=0.700, 95%, CI=0.243, 2.017, P=0.420) and IgM Ab (OR=0.567, 95%, CI=0.222, 1.444, P=0.233) seropositivity in NMOSD were lower than NMOSD, these differences were not statistically different. No clinical variables associated with H. pylori IgG and IgM seropositivity infection seropositivity.

    Conclusion

    These findings show that possibly there is no relationship between H. pylori infection and seronegative AQP4-Ab NMOSD.

    Keywords: Neuromyelitis optica, Aquaporin 4, Helicobacter pylori
  • Sara Shoja*, Nikoo Saeedi, Seyed Mehran Homam Pages 15-21
    Background

    Although much research on patients with epilepsy (PWE) has focused on psychiatric disorders such as depression, anxiety, and psychotic disorders, the relationship between epilepsy and personality disorders has not been frequently studied.

    Objectives

    The study aimed to evaluate borderline personality traits in PWE.

    Materials & Methods

    In this case-control study, we evaluated 211 PWE who were consecutively referred to 22 Bahman Hospital, Mashhad, Iran, in 2021. We also compared the patients with an age-matched and gender-matched control group. The Borderline personality traits were assessed by the second subscale of the schizotypal questionnaire (STB) which is known as the borderline personality scale questionnaire. Data were coded and analyzed by SPSS software, version 20.

    Results

    Epilepsy group had significantly higher borderline personality features in comparison with the control group (P=0.029). PWE had significantly higher scores in hopelessness (P=0.017) and impulsivity factors (P=0.046) on the STB questionnaire. Our results revealed that PWE who were married (P=0.011) and who had epilepsy for more than 10 years, had significantly higher borderline personality traits (P=0.04).

    Conclusion

    PWE are more likely to have borderline personality traits. Therefore, it is important to screen epileptic patients to detect it earlier to avoid further consequences and its possible effects on therapeutic responses.

    Keywords: Epilepsy, Personality, Seizures
  • Marjan Asadollahi*, Mohammad Samadian, Zeinab Sadat Hasheminezhad, Leila Simani Pages 22-29
    Background

    Epilepsy surgery has become a successful treatment option for patients with drug-resistant epilepsies.

    Objectives

    This study aimed to assess temporal lobe epilepsy (TLE) surgery outcome and its association with epilepsy duration, the presence of pre-surgical generalized tonic-clonic seizure (GTCS), and brain MRI findings.

    Materials & Methods

    This retrospective study was performed from 2016 to 2020 at Loghman-Hakim Hospital, Tehran, Iran. The patients’ demographic data, epilepsy type, duration, frequency, brain image findings, the selected surgical approaches, and histopathological findings were collected. The post-operative seizure outcome was expressed one year according to the proposed International League Against Epilepsy (ILAE) classification system. The independent sample t-test, chi-square, and one-way analysis of variance were applied to analyze the differences between variables in terms of quantitative and categorical data.

    Results

    A total number of 69 TLE surgeries were enrolled in our study. No differences were found in the surgical outcome base on the ILAE classification system of patients with lesional vs non-lesional MRIs (P=0.834). In patients with mesial temporal sclerosis, no correlation was found between the surgical approaches including selective amygdalohippocampectomy, anterior temporal lobectomy, and post-operative seizure outcome (P=0.142). Seven patients (10.1%) developed post-operative functional seizures.

    Conclusion

    In our study, the epilepsy duration and the presence of GTCSs before surgery had no effect on the surgery outcome. In patients with mesial temporal sclerosis, amygdalohippocampectomy, and anterior temporal lobectomy did not confer different surgical outcomes. TLE patients with normal MRI showed similar surgical outcomes as lesional patients. A significantly high proportion of our patients developed functional seizures, postoperatively

    Keywords: Anterior temporal lobectomy, Epilepsy, Temporal lobe, Therapy
  • Sara Ghafouri*, Simin Jahani, Elham Maraghi, Somayeh Biparva Haghighi, Neda Sayadi Pages 30-38
    Background

    The intensive care unit memory (ICUM) assessment tool is a practical tool for memory monitoring after the discharge from ICU.

    Objectives

    This psychometric study purported to validate ICUM for a sample population of Iranian patients hospitalized in ICU.

    Materials & Methods

    This research was a descriptive-analytical study that was conducted at Ahvaz University of Medical Sciences in 2022. A total of 96 patients were selected through the convenience sampling method and were asked to complete the questionnaire 2 weeks and 8 weeks after their discharge from the hospital. Exploratory factor analysis was run to validate the tool’s structure. The reliability of the ICUM tool was checked by the testretest method and the Cronbach alpha coefficient for memory subscales.

    Results

    To increase the qualitative face and content validity of the tool in Persian, some vague items were modified according to the suggestions of the participants, language, and nursing experts. For the quantitative face validity, the item coefficient was calculated, and the minimum score obtained was 4.4. For the quantitative content validity, the content validity ratio (CVR) and content validity index (CVI) were calculated. The minimum obtained scores were CVI=0.7 and CVR=0.6. Thus, all the items were confirmed. The implementation of the factor analysis was confirmed with KMO=0.65. The highest Cronbach alpha coefficient for delusional memory was 0.62 and the highest test-retest correlation for factual memory was 0.95.

    Conclusion

    The Persian version of ICUM has strong test-retest reliability, but weak internal consistency reliability. It is recommended that future studies evaluate the tool’s reliability over an extended period.

    Keywords: Memory, Intensive care, Critical care
  • Amirreza Ghayeghran*, Elaheh Ghahramani, Alia Saberi, Hamidreza Hatamian, Enayattollah Homaie Rad, Samaneh Ghorbani Shirkouhi, Rita Khayami, Mehri Fallahi, Fatemeh Shafaei, Parisa Shahshahani, Zoheir Reihanian Pages 39-49
    Background

    Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. COVID-19 has presented a significant challenge to the care providers of patients with MS.

    Objectives

    The present study aimed to investigate the frequency of COVID-19 infection and its seropositivity in MS patients in Guilan, Iran, in 2021.

    Materials & Methods

    In this analytical-cross-sectional study, all patients with relapsing-remitting MS registered in the Guilan MS Association with an expanded disability status scale of less than 5 who were referred for evaluation participated in the study. Information related to the clinical and serological symptoms of COVID-19 infection, changes in drug use, and the occurrence of new attacks were collected. Serological results of COVID-19 (IgG) among them were registered.

    Results

    In total, 260 patients with MS (78.8% women, and 21.2% men) with a Mean±SD age of 38.7±9.9 years, and a Mean±SD duration of MS of 8.9±4.9 years were investigated. The most commonly used drugs were Dimethyl fumarate, Interferon, and Rituximab, respectively. Thirty-three patients (12.6%) had a clinical COVID-19 infection, of which 32 people had a mild and only one had a critical infection. Eight patients (1.3%) had positive COVID-19 IgG tests. No significant relationship was found between the COVID-19 infection with the type of medication, medication change, clinical attack of MS, and co-morbidities (P>0.05).

    Conclusion

    A few patients had positive COVID-19 IgG tests and clinical COVID-19 infection. The vast majority had mild disease, and the clinical attack was not related to COVID-19 infection.

    Keywords: COVID-19, Multiple sclerosis, Infection
  • Shahin Koohmanaee*, Seyyedeh Azadeh Hoseini Nouri, Vahid Aminzadeh, Manijeh Tabrizi, Reza Bayat, Fatemeh Kharaee, Maryam Shahrokhi, Afagh Hassanzadeh Rad, Saber Najafi Chakoosari, Setila Dalili, Ehsan Kazemnejad Leili Pages 50-55
    Background

    Neuronal ceroid lipofuscinoses (NCL) is a rare progressive neurodegenerative disorder caused by more than 530 mutations of at least 13 different genes (CLN 1-14). NCL is a part of the lysosomal disease characterized by the presence of neuronal and extraneural autofluorescent lipopigment accumulations that leads to motor and mental deterioration, developmental regression, seizure, vision loss, and premature death. NCL is classified into four main groups based on the different clinical manifestations and age of presentation. In this study, we aimed to report an unusual presentation of NCL with CLN6 mutation without retina involvement.

    Case Presentation

    We reported a 10-year-old boy with mixed types of seizures, developmental delay, cognitive problems, unsteady gait, and speech disorders. Although after a thorough assessment, CLN6 mutation was diagnosed, he had all symptoms of this mutation, except the visual impairment.

    Conclusion

    According to recent NCL case reports from Asia, full familiarity with its presentation by pediatricians and neurologists is obligatory. Children with developmental regression or refractory seizures, who also have visual or other neurological symptoms such as ataxia and other cerebellar symptoms, even at older ages, should be evaluated for NCL. Attention to ophthalmological examinations and neurological signs and confirming the diagnosis by biopsy or genetic analysis is desirable to prevent missed diagnosis.

    Keywords: Neuronal ceroid-lipofuscinoses, Phenotype, Mutation, Vision disorders
  • Lida Mahfoozi*, Paridokht Karimian Pages 56-60
    Background

    Mucormycosis is a rare disease with high morbidity and mortality, and its diagnosis is difficult and often delayed. Also, the disease tends to progress rapidly. Therefore, urgent surgical and medical intervention is lifesaving.

    Case Presentation

    A 24-year-old woman with diabetes since 3 months ago presented with excessive tearing in her left eye, unilateral headache with epistaxis, and loss of consciousness at Razi Hospital, Rasht City, Iran, in June 2021. A clinical and pathologic diagnosis of mucormycosis was established. Imaging the head and paranasal sinuses revealed extensive involvement of the brain, paranasal sinuses, and left orbit. Treatment with liposomal amphotericin B (5 mg/kg) was administered for about 50 days until discharge. During the treatment period, the patient underwent several surgical procedures, such as enucleation of the left eye, surgery on soft and hard palates, sinuses, and neurosurgery for debridement of necrotizing tissues. After 50 days of intensive medical and surgical treatments, the patient was recovered and discharged.

    Conclusion

    In the era of the COVID-19 pandemic, many diabetic patients acquire that infection. Physicians caring for these patients should be alert to mucormycosis as a complication of severe or mild COVID-19 infection. Early diagnostic and therapeutic interventions could be lifesaving for these patients.

    Keywords: Mucormycosis, Diabetes mellitus, COVID-19