Current Journal of Neurology
Year:2009 | Volume:7 | Issue:24|Papers Count:13

Introduction: To compare the efficacy of ritalin with stimdat, as a treatment for attention deficit/hyperactivity disorder (ADHD) in youths aged 6-12 years through a double blind controlled trial. Methods: A total of 42 youths (6-12 y) with ADHD as defined by DSM-IV were randomized to Ritalin and Stimdat dosed on an age and weight adjusted basis at 1 mg/kg for 5 weeks double blind clinical trial. Subjects were assessed by child psychiatrist at base line 21 and 35 days after the medication started and rated by both teachers and parents with the ADHD Rating Scale. Results: No significant differences between Ritalin and Stimdat were observed on ADHD Parent and teacher Rating Scale but it observed In ADHD teacher Rating Scale between two groups. There were no significant differences between the two protocols; in terms of the dropouts. Decreased appetite, abdominal pain, dry month, tic, sadness and emotional labiality were observed more in the Stimdat group: Conclusion: We reveld that the efficacy of stimdat was similar to Ritalin based on the controlled trial. The results of this study must be considered preliminary. The longer studies are needed to compare the efficacy and side medications.

Introduction: Headache is a common symptom that constitutes a major health problem to all countries in the world. Tension-type headache and migraine comprise two third of different kinds of headaches. This study was conducted to estimate the prevalences of migraine and tension -type headaches,(TTH) it's associated occupational risk factors among Shiraz hospitals staff , to report on clinical characteristics of migraine and TTH, and comparison of headaches with IHS diagnosis criteria.Methods: This was a case- control study using prevalence data a random sample (stratified random sample) of 1023 hospital staffs of Shiraz (Iran). Subjects were stratified by personnel category (nurse, clerical and manual). For each patient, two controls of the same sample were selected who had never been diagnosed as having migraine or tension type headaches. Logistic regression was used for data analysis.Results: Prevalence of Migraine was estimated as 11.2% (115 subjects), tension-type headache as 19.5% (199 subjects) and coexisting migraine and tension headaches 3.2% (33 subjects). In this study , clinical characteristics of headache like type ,site, number , intensity ,concomitant symptom headaches , also that effects of headaches on work have surveyed.TTH and migraine headaches was significantly associated with self reported abnormal sleep pattern and female gender. Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly.Conclusion: The average of prevalence of migraine and tension headaches were lower than in western countries but higher than in previous studies conducted in other Asian countries. Clinical characteristics were almost consistent with IHS criteria, Headache- related missed work rates higher for subjects with Migraine headache, also tension – type headache and migraine were separate disorders and not part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.

Introduction: To compare between sodium chloride and dextrose 5% solutions in symptoms relief of acute migraine attack. Dehydration has been reported in acute migraine attacks, and fluid replacement therapy could relieve its symptoms. However, administered fluid composition may be effective in headache relief process in acute migraine attacks.Methods: We selected 40 patients with known chronic migraine-type headaches referred to Emergency Department for acute attack of headache, and allocated them in two groups. The first group (N=20, 10 males and 10 females, mean age=29.0 years; SD=5.3 years, mean headache duration=11.4 years; SD=5.0 years) administered with 500 ml of 0.9% sodium chloride solution infusion during 15 minutes. Second group (N=20, 10 males, and 10 females, mean age=27.2 years; SD=7.7 years, mean headache duration=7.2 years; SD=6.1 years) received 500 ml of 5% dextrose solution infusion in 15 minutes. The patients were unaware of administered fluid type and they were monitored for their attacks recur for up to 30 minutes after infusion completed.Results: The reduction in pain severity in all patients in Saline group was considerable and there was no need to use analgesics after about 30 minutes of infusion completion, while dextrose solution group need to take analgesic and anti-emetic therapy after 5 minutes of infusion completed. This was not statistically significant (P=0.143, Fischer’s exact test). On the other hand, nausea and vomiting were the first symptoms relieved during Saline infusion, however, there was no improvement in nausea and vomiting condition in second group.Conclusion: Although not statistically significant, our results could open new horizons in abortive therapy profile of migraine attacks and gleams to make new explanation to headaches pathophysiology. It seems that more clinical studies with greater sample sizes are yet needed in this era.

Introduction: This study sought to determine if amantadin affects weight gain in schizophrenics patients taking olanzapin or clozapin.Method: In before after clinical trial Twenty-eight adults had gained at least 5kg with olanzapin or clozapin were assigned to receive amantadin in addition to alanzapin or clozapin.The length of time taking alanzopin or dlozapin ranged from 6-30 months. Body mass index. Psychiatric statuses were assessed at baseline and 12 weeks.Results: After finishing the study, the mean weight of subjects decreased from 79.54 to 77.8 & BMI 25.81 to 25.35 these change were statistically significant. Positive and negative syndrome scale scores remained stable.Conclusions: Amantadin induced weight stabilization in subjects taking olanzopin or clozapin and was well tolerated.

Introduction: The purpose of this study is to investigate fatigue in multiple sclerosis (MS), its pathophysiologic factors, the tolerability and the safety of medical and non-medical treatments and methods for measuring fatigue.Methods: Fatigue is common in all types and stages of MS but its pathophysiology is not clear. There are few medications for the treatment of fatigue. Amantadine is the best-known agent although its efficacy and the duration of action are limited. Pemoline and modafinil are also two alternatives affecting fatigue. DAP (diaminopyridine), Aspirin, methylphenidate and fluoxetine are also other medicines in this category that need to be investigated more. Rehabilitation (physiotherapy), regular physical exercises and body cooling are very important in controlling the symptoms of MS. There are different ways for the measurement of fatigue. There is no laboratory marker for fatigue.The result of this short clinical study can be a guide for the diagnosis of MS fatigue, differentiating it from similar physical and mental conditions and the effects of medicines and necessary treatments for MS patients with fatigue.

Introduction: Antiepileptic drugs are prescribed in the treatment of epilepsy and many other diseases considering that in our community the prevalence of epilepsy is relatively high. Anticonvulsants like other drugs have many various side effects including hepatitis, renal failure and mucocutaneous complications that the last one may lead to hospitalization and death. Early diagnosis and treatment of these complications can prevent morbidity and mortality in many cases. In this review, common mucocutaneous side effects of anticonvulsants are outlined.

Introduction: Essential tremor is the most common abnormal movement in the world .there is no associate neurologic abnormality. Tremor in this disease has low frequency and it's prevalence is 3 to 5 percent in community.Methods: This prospective study was conducted on 120 patients with essential tremor in neurology clinic of shahid mostafa Khomeini hospital (shahed university) from 2005to 2008. Patients assigned randomly in two groups. 59 patients received propranolol 40 mg 3 times daily for 3 weeks and 61 patients in another group received gabapentin 300 mg 3 times daily for the same duration. Fahn – Tolosa-Marin tremor rating scale (TRS) that is a numerical scale (0-88) was used for evalution in both groups.Results: 120 patients completed the study.56 (47%) patients were male and 64(53%) patients were female. Mean age was 43.9(26-59) years old .At the beginning of study the TRS was 38.6±1 and 39.1±1 in patients taking propranolol and gabapentin respectively. at the end of study TRS was 28.4±1 and 25.6±1 in propranolol and gabapentin group respectively. Statistical analysis with SPSS software showed significant difference in both group after treatment. (P<0.0005).Conclusion: Gabapentin can be used as an effective drug in the treatment of essential tremor it's efficacy is at least equal to propranolol. Due to its lower side effects and better tolerance especially in patients with cardiac and respiratory problems and in older patients this drug can be as the first selection in these patients.

Introduction: Seizure is one of the most common causes of children hospitalization. It has many etiologies such as febrile convulsion, epilepsy, meningitis, DPT vaccination, encephalitis, hypocalcemia and etc. this study was conducted to evaluate the causes of seizure in 1 month to 15 years old children, admitted in Alzahra and Amin hospitals (Isfahan-Iran) due to seizure during 32 months before 2005.Methods: This study was conducted to evaluate the causes of seizures in children. Required data was obtained from patients files. Children were assigned into 18 items groups and probable seizure etiologies were assigned. Obtained data was analyzed, using chi-square test and SPSS software, V 11.5 (SPSS. Inc, Chicago IL.).Results: The most common causes of seizure in one month to 15 years old children were febrile convulsion (40.5%), epilepsy (34.6%), shigella encephalopathy (9.2%), meningitis (5.9%), encephalitis (3.6%), hypocalcemia (1.6%), DPT vaccine complication (1.2%), mumps meningoencephalitis (0.8%), hyponatremia (0.6%), congenital metabolism disorders (0.4%), hypernatremia (0.4%), hypoxic ischemic encephalopathy (0.2%), glycogen storage disease (0.2%), intracranial hemorrhage (0.2%), hypertensive encephalopathy (0.2%), hemodialysis side-effect (0.1%), brain tumor (0.1%) and hypoglycemia (0.1%).Conclusions: Overall, it was found that febrile convulsion was the most common cause of seizure in children. The most common season of children hospitalization due to seizure was summer and seizure was more common in boys.

Introduction: Considerable attention is focused on the effects of the electromagnetic field (EMF) due to its wide-ranging use in every day of life. Appliances and various equipments are sources of electromagnetic fields with a wide-range of technical characteristics. Power lines and almost all kinds of household electrical appliances Emit EMF. Epidemiological studies suggest a possible link between EMF exposures and clinically recognized medical disorders in people; in this study we investigated the effect of EMF on frontal cortex of mouse.Methods: 30 BALB/c mice were selected and divided in 2 of experimental & Control groups. Experimental group was exposed to 50 Hz, 0.5mT EMF for 4 hours per days in, 6 days per week for 2 months. Controls was not exposed to EMF but were in the same condition. Animals were killed after 2 months exposing of EMF and the brain were removed and the left frontal lobe of 2 groups was selected. After normal routine processing, slices were stained with cresyl violet for histological examination and evaluated with image tool software. The data were analyzed in highly significantly P< 0.05 with SPSS software.Results: Some histological and degenerative changes were seen in neurons of frontal lobe in experimental group compare to control group. These features were including shrinkage of pyramidal cell in experimental animals. Statistical results like changes of long diameter of pyramidal cell was decreased related to the same neuronal cells in control groups P<0.05. Finally the number of pyramidal cell in experiment groups has decrees in compare with control groups.Conclusion: It can be concluded that long term exposure to EMF has detrimental effects on the morphological changes of neurons of the frontal cortex and may lead to the degenerative phenomenon on the pyramidal cells.

Introduction: The issue of infertility in patient with multiple sclerosis (MS) has not been fully studied. However, it is only recently that the intricate interactions between the disease and reproductive function in women have begun to be explored. It is clear that there is important neuro-immuno-endocrine interaction at a cellular and molecular level. Dysfunctions within the hypothalamic- pituitary- gonadal axis occur frequently among women with MS and induce menstrual disturbance and subsequent infertility. Moreover, literature show that some medical treatment used in MS may exert determinable effects on germ cell which lead to infertility. These findings approved the hypothesis of probable fertility disorders during MS which lead to infertility. The aim of this case report is to introduce a women with MS and primary infertility which not only our treatment method had not decrease her fertility (corticosteroid therapy and other follow up) but also resulted in effectiveness of proposed infertility treatment and bearing child.