Current Journal of Neurology
Year:2006 | Volume:5 | Issue:14|Papers Count:12

Background: Lead toxicity is a medical problem in Iran. Therefore we aimed to evaluate clinical findings and possible complications of lead poisoning in the workers of two traditional-tile-factories.Materials and Methods: Researchers visited workers in the factories and collected data by direct history taking and physical examinations. data were recorded in previously designed forms. Blood sampling was performed for biochemical, toxicological and hematologic studies. Blood and Urine lead concentration were measured by an atomic absorption technique (Heated Graphite Atomisation) using Perkin-Elmer 3030 instrument. Data were analyzed by SPSS-11.5 software and Chi-square, student T-test and Pearson correlation tests were used accordingly. The numerical data were expressed as mean x standard deviation.Results: Overall 108 male subjects ages 37±7.8 years were studied. Length of daily lead exposure was 9.8±6 years. Lead concentration in 2004 and 2005 were 520.5±323.2 and 361.5±176.9 mg/L, respectively. The subjective findings were mainly on the central nervous system such as loss of memory (57%), moodiness (56.1%), agitation (47.7%), drawsiness (36.4%), headache (29.9%).The main objective clinical findings were peripheral neuropathy of upper limb (37%), suppression of deep tendon reflexes in upper limbs (25.7%), tremor (23.3%), peripheral neuropathy of lower limbs (17%).Conclusion: This study showed that lead has toxic effects on the teeth (bone), central and peripheral nervous system, hematologic and renal function, and also changes in serum lipid concentration.

Background: Carpal tunnel syndrome is an important cause of pain and functional impairement of the hand due to compression of the median nerve at wrist. About 0.5% of the general population affected. About 3% of adults have symptomatic electiodiagnostically confirmed corpal tunnel syndrome. In patients whose condition fails conservative treatment, surgical division of the transverse carpal ligament, either by an open or endoscopic procedure, promptly improves or relieves sensory complaints 75% to 99% of the time.Materials and Methods: Between 1997 and 1999, 63 patients with surgical treatment for carpal tunnel syndrome were studied in Rasht Poorsina hospital. The diagnosis of carpal tunnel syndrome confirmed clinical and electrodiagnostic. Pain, tingling, burning, numbness or some combination of these symptoms on the palmar aspect of the thumb, index and middle fingers, and radial half as tinel's sign, Phalen's maneuver, etc were clinical characteristics.Neurophysiological confirmation required a distal median motor latency of >4.6 ms combined with a median sensory nerve action potential of <15 m V After preparating of patients for operation, the surgeon made an incision 4-5 cm long, extending distally from the distal wrist crease, and released the transverse carpal ligament under direct visualization.Findigs: 48 patients (76.2 %) were female and 15 patients (23.8%) were male. Female to male ratio was 3.2 to 1. The maximum age was 63 years and the minimum age was 25 years. 14 (22.2%) of patients had underlying conditions: 11 (17.4%) diabetes mellitus, 2 (3.2%) rheumatologic disorders, 1 (1.6%) both diabetes mellitus and hypothyroidism.Results: Carpal tunnel syndrome is a common clinical problem with lack of an standard ideal criterion for treatment. According to our data, sever disease that required surgery, is more frequent in females but as we know, it is consistently milder in female patients than in male patients17. thus, we should explain this discrepancy. In our study, the mean age of patients was 44.81±8.67 years. The majority of subjects were active in social and occupational activities (such as worker and employee), thus decreasing age of severity in our region should be considered as an important view and this significant problem should be solved properly. A history of nocturnal symptoms has moderate sensitivity (51-77%) and specificity (27-68%). Phalen maneuver has sensitivity and specificity between 40% and 80%.Conclusion: Carpal tunnel syndrome is a common clinical problem that responds well to treatment. Because of decreasing age of patients with severe disease, primary care physicians should be aware of the different aspects of this syndrome when the patients required proper treatment, should refer them to neurologists for decision making as soon as possible, to prevent subsequent debilities especially in a younger and active patients.

Background: Various investigations were done about the relation of infection with atherosclerosis. We will study about the role of one of these infection; helicobacter pylori in atherosclerotic plaque formation in Right and Left Common Carotid Arteries (CCAs) and exteracranial portions of Internal Carotid Arteries (ICAs).Materials and methods: Antibody against Helicobacter Pylori (HP.IgG) was measured in 42 cases that had a plaque in at least one of CCAs or ICAs and 82 control subjects doesn't have any plaque in those arteries.Findings: In this study HP.IgG was positive in 69/5% of control subjects without any plaque and 69% of cases with an atherosclerotic plaque and there wasn't any significant difference (p=1/000). The means of HP.IgG titers were 53/80 in controls group and 45/36 in case subjects without any prominent difference (p=0/438).Results: We compared the means of HP.IgG titers in patients with a plaque with stenotic severity <50%, between 50% and 75% and >75% and there wasn't any significant difference between these 3 groups (p=0/090). Also, similar assessment was done in females and males separately and any association between HP.IgG seropositivity and atherosclerotic plaque or its stenotic severity wasn't seen.Conclusion: HP.IgG isn't a predictor of atherosclerotic plaque formation and its progression in CCAs and ICAs.

Idiopathic calcification of basal ganglia or Fahr's syndrome is a rare disease characterized by deposition of calcium in cerebral basal ganglia specially globus pallidus. Neurological signs include speech disturbance, gait and movement disorders. Urinary incontinence and seizures have been declared as other complications, too. Mild disturbance of concentration and memory, personality and behavioral changes, psychosis, dementia and mental retardation are categorized as psychiatric manifestations. We report a 56- year old man who had been under the treatment of typical antipsychotic agents for ten years with the diagnosis of psychosis. He withdrew the drugs because of frequent acute dystonias and gradual development of dysarthria. Four years ago he received medication with the diagnosis of hypo-parathyroidism documented on the history of nephrolithiasis and calcification of cerebellar hemispheres on CT Scan. Such treatment-resistant psychotic disorders may lead to considering organic conditions in which prescribing the typical antipsychotics may develop movement disorders and extrapyramidal side effects. Hypoparathyroidism should also be noted as a differential diagnosis. His little sister suffers from mental retardation and choreoathetosis. Also the little brother suffers from the same but milder condition. We will study the whole family to investigate the probable familial pattern of the disease.

Background: Cervical spine fracture is serious and often fatal complication of ankylosing spondylitis. Although this complication is relatively uncommon, it is clear the patients with advanced disease and complete cervical spine ankylosis are at increased risk of sustaining cervical fracture ossification of ligaments, synovial joints and other soft tissue structures affects spine in ankylosing spondylitis. Fracture in these patients can produce an unstable condition, similar to a shearing type of classic spine injuries. The fracture levels predominantly are in lower cervical (C5-C6 and C6-C7). In this case presentation we report C4 slice fracture with minimal displacement management.

Hypomelanosis of Ito (HI) is a heterogeneous and complex nearocutaneous disorder affecting the skin, brain, eye, skeleton, and other organs. The skin findings are distinctive and, in fact, are.the only constant feature of HI; hypopigmented whorls, streaks, and patches tend to follow Blaschko's lines. Blaschko's lines form a V-shaped pattern over the back, an S-shaped pattern over the anterior trunk, and linear streaks over the extremities.HI was first described by Ito as incontinentia pigmenti achromians, but it is now commonly known as HI to avoid confusion with incontinentia pigmenti. HI affects male and female subjects equally and is usually a sporadic disorder with minimal recurrence risk.Our patient was a 17-year-old boy who came to our clinic with tonic – clonic seizures since he was 5. He had aura before seizures as epigastric pain and facial numbness. Past medical history and family history of patient was negative. There was short of stature and macrocephaly in his physical exam. There were also V-shaped hypopigmented lesions over the back and linear over the extremities.A systolic murmur of grade I-II was heard in aortic area and chest wall of patient had a pattern of pectus excavatum. Other physical exams were normal. In neuroimaging studies, in brain MRI, there were multiple periventricular white matter lesions that were very similar to MRI findings of multiple sclerosis. As a result of our findings, clinicians should consider HI as a differential diagnosis of diseases with periventricular white matter lesions especially multiple sclerosis.

Background: Many studies have showed that electromagnetic fields decreased WSSM. in this study the Objectives: effect of electromagnetic fields on WSSM is investigated on rats.Materials and methods: 102 male rats with weight (225-25) gr were classified in 17 groups (n=6). They were addicted by morphine injection according to Pinelli Method. 16 groups of them exposed to electromagnetic fields with 25, 50, 75 and 100 Hz frequency and with magnetic field 0/5, 1/5, 2/5 and 3/5 G intenscity. One group was chosen as control. 1) awiniWSSM in jumping, climbing, rearing, diarrhea, weight loss, ptosis by naloxan injection (5mg/kg/Ip) at all animals were investigated.Resalles: WSSM were obtained by counting the jumping, yawing, climbing, rearing. And the amoul of weinwt 1366 the ptosis, diarrhea were scord from +1 to +4.Conclusion: This study showed that magnetic fields caused the significant decreased on wawing, ptosis, weight loss and diarrhea at all of the exposure groups (P<0.001). Rearing and alimbing decrease significantly in groups that exposed to electromagnetic fields and this fields with 25 Hz frequency and 0/5 G intensity have minimum and with 100 and 75 Hz frequency and 3.5 G intensity have maximum effects on WSSM.