Clinical Neuroscience - 2024;77(3-4)

Clinical Neuroscience

MARCH 30, 2024

Clinical Neuroscience

MARCH 30, 2024

Personalized analysis of pain–weather associations: a pilot study

TUBOLY Gábor , HORVÁTH Gyöngyi , NAGY Kamilla , NAGY Edit

It is a wellknown belief that weather can influence human health, including pain sensation. However, the current data are controversial, which might be due to the wide range of interindividual differences. The present study aimed to characterize the individual pain–weather associations during chronic pain by utilizing several data analytical methods.

Clinical Neuroscience

MARCH 30, 2024

[Thrombolysis treatment and multi- disciplinary management of central retinal artery occlusion in comparison with traditional ophthalmological treatment options ]

VAJDA Szilvia, GUNDA Bence, KNÉZY Krisztina, BARSI Péter, VARGA Csaba, MAUROVICH-HORVAT Pál, BERECZKI Dániel, NAGY Zoltán Zsolt

[The management of central retinal artery occlusion (CRAO) has long been conservative therapy with limited efficacy carried out in ophthalmology departments together with etiolo­gi­cal investigations lacking a standardised protocol. However, CRAO is analogous to ischemic central nervous system stroke and is associated with increased stroke risk, thus, systemic thrombolysis treatment and multidisciplinary management can be beneficial. Since May 2022, at Semmelweis University CRAO patients diagnosed within 4.5 hours are given intravenous thrombolysis therapy and undergo etiologic workup based on current stroke protocols. Here we report our experience with the multidisciplinary, protocol-based management of CRAO in comparison with former non-protocol based ophthalmological conservative treatment.

We reviewed CRAO patients’ data treated conservatively and with paracentesis within 6 hours at the Department of Ophthalmology between 2013 and 2022 including changes in visual acuity, neurolo­gical and cardiovascular findings compared to those in the thrombolysis project. 

Of the 78 patients receiving non-protocol care, visual improvement was seen in 37% with natural course, 47% with conservative treatment and 47% with paracentesis. Four patients had significant carotid stenosis (2 underwent endarterectomy), 1 carotid dissection, 6 cardioembolism and 1 giant cell arteritis. Of the 4 patients within 4,5 hours, 3 gave their consent to the clinical trial and were treated with thrombolysis and underwent a full etiological assessment. 
2 pa­tients had improved visual acuity, 2 pa­tients had significant carotid stenosis and underwent endarterectomy, 1 patient was started on anticoagulation for newly diagnosed atrial fibrillation.

CRAO patients presenting within 4,5 hours are rare and more patients are needed in our study to establish the efficacy of thrombolysis. However uniform protocollized evaluation helps identifying embolic sources thus, avoiding further and potentially more serious thromboembolic events.]

Clinical Neuroscience

MARCH 30, 2024

Neuropathic pain and mood disorders in earthquake survivors with peripheral nerve injuries

HALIL Can ALAYDIN, GUL Melisa BOZDOGAN, RUMEYSA PALTACI, ZULFIKAR ARLIER, HALIT FIDANCI, MEHMET YILDIZ

Natural disasters, such as earthquakes, frequently result in mood disorders among affected individuals. It is established that neuropathic pain arising from traumatic neuropathies is also linked to mood disorders. This study investigates the influence of neuropathic pain on the development of mood disorders in earthquake survivors with peripheral nerve injuries, following the earthquake centered in Kahramanmaraş on February 6, 2023.

Clinical Neuroscience

MARCH 30, 2024

The effect of anesthetic blockade of greater occipital nerve during the withdrawal period of the medication overuse headache treatment

MIRAC Aysen UNSAL, TUGRUL AYDIN

Discontinuation of medication still remains a key element in the treatment of medication overuse headache (MOH), but there is no consensus on the withdrawal procedure. We aimed to share the promising results of anesthetic blockade of greater occipital nerve (GON), which can be an alternative to existing treatments during the early withdrawal period of MOH treatment.

Clinical Neuroscience

MARCH 30, 2024

Validity and reliability of the Turkish version of the Informant Assessment of Geriatric Delirium Scale

CELIK Buket , BILIK Ozlem, KOÇBILEK Deveci Zeynep , DAMAR Turhan Hale , ÖZ Didem , DENIZMEN Zeynep

Delirium is a common complication developing in el­derly patients. Therefore, it is important to diagnose delirium earlier. Family caregivers play an active role in early diagnosis of de­lirium and build a bridge between health professionals and patients. The purpose of this research was to achieve the validity and reliability of the Turkish version of the Informant Assessment of Geriatric Delirium Scale (I­AGeD).

Clinical Neuroscience

MARCH 30, 2024

Perineural 5% dextrose versus corticosteroid injection in non-surgical carpal tunnel syndrom treatment

OZGE OCEK, DERYA GUNER

We aimed to investigate the difference of clinical and electrophysiological improvement between perineural corticosteroid injection therapy and perineural 5% dextrose injection therapy in carpal tunnel syndrome. Total of 92 wrists that were diagnosed as mild-to-moderate idiopathic CTS and completed their follow-up were included in our study. The severity of pain, symptom severity and functional status were assessed by visual analog scale.

Clinical Neuroscience

MARCH 30, 2024

[Comparison of pain intensity measurements among patients with low-back pain]

NAGY Zoltán, KISS Nóra, SZIGETI Mátyás, ÁFRA Judit, LEKKA Norbert, MISIK Ferenc, MUCSI István, BANCZEROWSKI Péter

[Pain intensity is the most frequently assessed health domain in clinical studies among patients with low-back pain. Visual analogue scale (VAS) and Numeric rating scale (NRS) have been the mostly used measurement tools for pain intensity. We proposed to correlate these instruments to a generic health-related quality of life measurement tool in order to show the scale with superior clinical relevance.

We used cross-sectional, convenience sampling. 120 patients with chronic low-back pain administered the 29-item Patient Reported Outcomes Measurement Information System Profile with NRS included, and the VAS scale in the National Institute of Mental Health, Neurology and Neurosurgery. We determined the correlation between PROMIS domain T-scores and VAS and NRS scores.

We performed Spearman rank correlation test to calculate the correlation coefficient. We found VAS scales measuring pain had weak to moderate correlations with all PROMIS health domains (r = 0.24–0.55). Therefore, we compared correlation of PROMIS domain scores with PROMIS pain intensity numeric rating scale and VAS scales. PROMIS domains had moderate to strong correlations with pain intensity scale (r = 0.45–0.71). PROMIS physical function short form [r = –0.65, 95% CI (–0.75) – (–0.55)] and PROMIS pain interference short form (r = 0.71, 95% CI 0.63 – 0.79) had the strongest correlation with pain intensity item.

NRS has showed greater correlation with PROMIS domain T-scores than VAS scale. This may prove that NRS has greater connection to another health domains, thus it correlated more to health-related quality of life than visual scale. We recommend NRS to use in further clinical studies conducted among patients with low-back pain.]

Clinical Neuroscience

MARCH 30, 2024

Lightning strike‑induced cauda equina syndrome: a case report

AYSEGUL AKKAN SUZAN, BETUL OZENC, AYSE Gamze SAHIN, ZEKI ODABASI

Peripheral nerve injuries after being struck by lightning have been documented. Here, we report a case of cauda equina syndrome induced by lightning. A 27-year-old man presented with numbness, a burning sensation in the saddle region, and increased urinary urgency after being struck by lightning. He had absent Achilles reflexes and paresthesia in the saddle region upon neurological examination, and magnetic resonance imaging of the spine was normal.

Clinical Neuroscience

MARCH 30, 2024

[Middle meningeal artery embolization to treat acute epidural haematoma, case report and literature review ]

OLÁH Benedek, OLÁH Csaba Zsolt

[The treatment of acute epidural haematoma is surgery as soon as possible, elimination of the source of bleeding and evacuation of the haematoma. In case of small epidural haematoma, strict neurological and radiological follow-up is necessary. In a significant percentage of cases, open surgery must also be performed within a few days. In case of small epidural haematomas, embolization of the middle meningeal artery is considered as an alternative solution. We review the literature on middle meningeal artery embolization and present our first treatment. Our case report is the first European report about an acute epidural haematoma which was treated by embolization of middle meningeal artery. Our case study is the first report in which a patient was treated with both open surgery and endovascular treatment for acute epidural haematoma within a year.]