A forty-two-year-old male patient without any known chronic diseases presented to the emergency department in July 2020 with headache, fever, coughing, nauseavomiting, and weakness for the past 3 days. In the Cytotoxic lesion of the corpus callosum (CLOCC) stems from a variety of causes such as malignancies, drug treatments, metabolic disorders, subarachnoid hemorrhage, and infections, and often presents as encephalitis or encephalopathy.During this pandemic, we saw 2 cases with this lesion; the first one was a 42-year-old male who presented to the emergency department with complaints of headache, fever, and cough. There was a ground-glass opacity in the thorax computed tomography, and diffusion restriction was found in the corpus callosum splenium in the cranial magnetic resonance imaging (MRI) performed for headache that did not resolve with analgesic treatment during hospitalization due to the preliminary diagnosis of Coronavirus diseases-2019 (COVID-19) pneumonia. In the second case, Severe Acute Respiratory syndrome Coronavirus-2 polymerase chain reaction was found to be positive in the examinations performed during his admission to the emergency service due to weakness and presyncope, and diffusion restriction was observed in the corpus callosum splenium like the first case in cranial imaging. The follow-up cranial MRI was normal in both cases, so they were diagnosed with CLOCC.We aimed to report the present cases with COVID-19 associated CLOCC since they presented only as a headache and a presyncope without any mental deterioration.
Objectives: The aim of this study was to evaluate neurological and neurophysiological features of leprosy. Methods: Seventy seven hospitalized leprosy patients (52 male, 25 female) were examined neurological and neurophysiologically between 2010 and 2012. Standard procedures were performed for evaluating sensory and motor conduction studies to all patients. Motor studies were carried out on median, ulnar, tibial and common peroneal nerves. Sensory studies were carried out on median, ulnar and sural nerves. Sympathetic skin response (SSR) recordings on both hands and feet, and the heart rate (R-R) interval variation (RRIV) recordings on precordial region were done in order to evaluate the autonomic dysfunction. Results: The mean age was 59.11±14.95 years ranging between 17 and 80 years. The mean duration of disease was 35.58±18.30 years. Clinically, the patients had severe deformity and disability. In neurophysiological examinations, sensory, motor conduction studies of the lower extremities were found to be more severely affected than upper, and sensory impairment predominated over motor. Abnormal SSRs were recorded in 63 (81.8%) cases of leprosy. Abnormal RRIVs were recorded in 41 (53.2%) cases and abnormal RRIVs with hyperventilation were recorded in 55 (71.4%) cases of leprosy. Significant differences were found between SSR and sensory conduction parameters of median, ulnar nerves as well as motor conduction parameters of median, ulnar and peroneal nerves (p<0.05). Conclusion: Peripheral nervous system dysfunction is accompanied by autonomic nervous system dysfunction in leprosy patients. Sympathetic involvement may predominate over parasympathetic involvement.
COVID-19 has been associated with central nervous system manifestations; however, cerebral venous thrombosis is rarely reported. A 34-year-old woman was admitted to the hospital with headache and recurrent seizures; she was recently discharged after COVID-19 pneumonia. Cranial magnetic resonance imaging and magnetic resonance venography showed cortical vein thrombosis in the right frontal lobe. SARS-CoV-2 RNA was detected in cerebrospinal fluid analysis. The patient was anticoagulated and put on antiepileptics. The most probable mechanism underlying the venous thrombosis is COVID-19-associated hypercoagulability. However, the relation between the viral RNA in cerebrospinal fluid analysis and the thrombosis is controversial.
Aim of the study: Parkinson’s disease is the second most common neurodegenerative disorder. The present study investigates the role of vitamin D deficiency thought to be one of the etiopathological and modifying factors in Parkinson’s disease that is known to be multifactorial. Materials and Methods: Designed as a retrospective review of medical records, this study compares the serum vitamin D levels of the idiopathic Parkinson’s disease patients with and without dementia to those of the healthy individuals with no metabolic/degenerative disorders. It also investigates the relationship between the patients’ Standardized Mini-Mental State Examination (SMMSE) and the Unified Parkinson’s Disease Rating Scale (UPDRS) scores and serum vitamin D levels to show the effects of vitamin D on motor symptoms and cognitive functions. Results: In this study, we compared the serum vitamin D levels of 40 Parkinson’s disease patients and 15 Parkinson’s disease patients with dementia to those of the control group comprising 30 healthy individuals. Vitamin D levels were 21,4±15,9 ng/mL in the control group; 16,5±6,4 ng/mL in Parkinson’s disease patients and 13,8±4,5 ng/mL in Parkinson’s disease patients with dementia. All the patient groups had significantly lower vitamin D levels than the control group (p<0,005). Within the Parkinson’s disease group, furthermore, the dementia group had lower vitamin D levels than the non-dementia group. Having examined the relationship between the SMMSE scores and serum vitamin D levels, we found a significant difference in the Parkinson’s disease dementia group (p: 0,020), as well as a relationship of 59,4% in the same direction. On the other hand, there was no significant difference in either patient group in the scores of UPDRS evaluating clinical disability. Conclusion: Consistent with the literature, the present study found that people with Parkinson’s disease had lower mean values of serum vitamin D levels than the control group and showed that serum vitamin D levels were correlated with the cognitive performance. However, the study could not find a relationship between the serum vitamin D levels and the motor performance.
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