Bee venom acupuncture has been widely used in Oriental medicine with limited evidence of effectiveness. Most of the complications due to bee venom acupuncture are local or systemic allergic reactions. However, serious medical and neurological complications have also been reported. We herein describe the treatment of a 68-year-old woman who developed progressive quadriplegia 10 days after receiving multiple honeybee venom sting acupuncture treatments. The electrophysiological findings were consistent with Guillain-Barré syndrome (GBS). The temporal relationship between the development of GBS and honeybee venom sting acupuncture is suggestive of a cause-and-effect relationship, although the precise pathophysiology and causative components in honeybee venom need to be verified.

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Background: Elevated homocysteine (hcy) levels are associated with dementia, which is a frequent nonmotor symptom of Parkinson's disease (PD). High levels of hcy in PD patients treated with levodopa are thought to result from increased synthesis during the metabolism of levodopa by COMT, and that use of a COMT-inhibitor may reduce hcy levels. In this study, we sought to clarify the effects of COMT-inhibitors on dementia in PD patients. Methods: Thirty-eight PD patients without dementia (PDwoD), 35 PD patients with dementia (PDD), and 48 controls were enrolled in this study. All subjects underwent neuropsychological testing and a neurological examination. The hcy levels were measured in all subjects, and the relationship between hcy levels and dementia was evaluated in two PD groups (those that underwent treatment with levodopa-alone versus treatment with levodopa plus a COMT-inhibitor). Results: Patients in the PDD group showed higher hcy levels than patients in the PDwoD group, though there was no significant difference in the hcy level between PDwoD patients and healthy controls. Regarding the effects of a COMT-inhibitor, there was no correlation between hcy levels in the 2 PD subgroups, indicating that there were no significant effects of the COMT-inhibitor on PDD. In addition, the odds ratio for PDD with the use of a COMT-inhibitor was 0.864 (95% CI= 0.342-2.180). Conclusions: These results are in agreement with previous studies in that levodopa treatment in PD patients leads to elevated hcy concentrations. COMT-inhibitors, on the other hand, had no preventive effect on cognitive impairment in PD patients.

Background: The natural history of acute symptomatic ICA occlusion remains unclear. Short term follow-up studies have been rarely reported. Therefore, the objective of this study was to determine the natural history of acute ICA occlusion through short-term follow-up. In addition, we determined factors associated with recanalization and poor outcome. Methods: We consecutively enrolled acute ischemic stroke patients within 7 days who had acute symptomatic internal carotid artery occlusion. Demographic data, stroke subtypes, National Institute of Health Stroke Scale (NIHSS) score, and modified Rankin scale score at 3 months were recorded. Carotid duplex ultrasonography, CT angiography, or digital subtraction angiography in 2-9 days after the initial angiography was conducted to check recanalization pattern of ICA. Recanalization was classified into complete, partial, or no recanalization. Results: A total of 64 patients with acute symptomatic ICA occlusion were enrolled in this study. Follow-up vessel studies were completed for 53 patients. Follow-up carotid duplex sonography was performed for 23 patients. CT angiography was performed for 9 patients. Both carotid duplex sonography and CT angiography were performed for 21 patients. Complete recanalization was observed in 5 (9.4%) of the 53 patients. All five patients received thrombolysis. Partial recanalization was observed in 8 (15.1%) patients. The remaining 40 (75.5%) patients did not show recanalization. Cardioembolism (P=0.008) and thrombolytic treatment (P=0.025) were factors associated with complete recanalization. However, recanalization (P>0.999) was not associated with favorable clinical outcome. Conclusion: Recanalization of symptomatic internal carotid artery occlusion was identified in 13 (24.5%) patients. Cardioembolism and thrombolytic treatment were factors significantly associated with complete recanalization.