1,720,999 research outputs found

    Cluster headache: When to worry? Two case reports

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    The clinical criteria for cluster headache (CH) are included in Chapter 3 of the International Classification of Headache Disorders, 3rd beta edition (ICHD-III). CH may sometimes be secondary to other pathologies

    18F-FDG-PET and MRI in autoimmune encephalitis: a systematic review of brain findings

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    In the diagnostic assessment of autoimmune encephalitis (AE) associated with antineural antibody (Ab) imaging with 18F-fluorodeoxyglucose (FDG), positron emission tomography (PET) was initially only used to screen for occult malignancies in paraneoplastic cases. Today accumulating evidence also supports the use of PET imaging for the objective assessment of metabolic changes in the brain of patients with AE. On the other hand, magnetic resonance imaging (MRI) of the brain reveals a variable picture depending on the specific syndrome and associated antibody, and may be normal in a sizable proportion of patients.From a systematic review of the literature, it seems that some specific metabolic patterns correlate with the presence of specific Ab, such as a cerebral posterior hypometabolism in anti-NMDAR encephalitis, and a mesiotemporal hypermetabolism (associated with hyperintensities and swollen structures on MRI T2) in encephalitis with LGI1 and onconeural Ab. To ascertain the prognostic value of FDG-PET and its role in driving therapy, larger (preferably longitudinal) studies are needed on age-matched, untreated patients with the same Ab status, who undergo imaging at a similar time after the onset of their symptoms. This would enable a systematic correlation between MRI and FDG-PET findings, and help to clarify a number of unsolved clinical and technical issues

    Selective Cerebellar Atrophy Associates with Depression and Fatigue in the Early Phases of Relapse-Onset Multiple Sclerosis

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    Cerebellar dysfunctions have been associated to depressive disorders and cognitive impairment in neurodegenerative diseases. The objective is to analyze the associations between cerebellar atrophy, depression, and fatigue in the early phases of relapse-onset multiple sclerosis (RRMS). Sixty-one RRMS patients and 50 healthy controls (HC) were enrolled and clinically evaluated by means of expanded disability status scale (EDSS), Rao's brief repeatable battery of neuropsychological tests (BRB-NT), Delis-Kaplan executive function system sorting test, beck depression inventory II (BDI-II), and fatigue severity scale (FSS). The relationships between MRI variables and clinical scores were assessed. Depressed RRMS (dRRMS) had significantly lower Vermis Crus I volume compared with not depressed RRMS (ndRRMS) (p = 0.009). Vermis Crus I volume was lower in dRRMS suffering from fatigue than in ndRRMS without fatigue (p = 0.01). The hierarchical regression models which included demographic and clinical data (age, sex, and disease duration, FSS or BDI-II) and cerebellar volumes disclosed that cerebellar lobule right V atrophy explained an increase of 4% of the variability in FSS (p = 0.25) and Vermis Crus I atrophy explained an increase of 6% of variability in BDI-II (p = 0.049). Since clinical onset, atrophy of specific cerebellar lobules associates with important clinical aspects of RRMS. Cerebellar pathology may be one of the determinants of fatigue and depression that contribute to worsen disability in RRMS
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