Clinical Neuroscience

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FEBRUARY 20, 2002

Clinical Neuroscience - 2002;55(01-02)

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Clinical Neuroscience

[Treatment of migraine in hypertension and ischemic heart disease]

FICZERE Andrea, CSIBA László

[Migraine is a common disorder with a prevalence of 9-10% in Hungary. Migraine can be accompanied by hypertension and/or ischemic heart disease sometimes in younger patients, but more frequently in the elderly, which is important for therapeutical considerations. The article reviews the literature with special focus on hypertension and coronary heart disease. In the second part, the authors summarize their experiences on headache patients.]

Clinical Neuroscience

[Pregnancy and psychiatric disturbances]

SZÁSZ Anna, KOVÁCS Zsuzsanna

Clinical Neuroscience

[Contemporary interpretation of rehabilitation]

KULLMANN Lajos

[The study selects some changing and developing aspects of the contemporary considerations of rehabilitation and relates them closely to neurological rehabilitation. Functional diagnostics aims at the assessment of impairments and functioning. Several internationally recognized methods of neurological rehabilitation have already been adapted in Hungary. Author emphasises the use of International classification of functioning, disability and health, officially accepted by the Assembly of the World Health Organization in 2001. Its use for functional diagnostics is also possible. The everyday practice of teamwork is still problematic. Its implementation in rehabilitation is inevitable. The neurological rehabilitation is a special field where the cooperation of many teammembers is needed. The attitude to human beings in rehabilitation is different from medicine at large. It considers man not only as biological but also as social beings with own life history, thus helping to achieve compliance and increasing autonomy. The author mentions the possibility for the cooperation with organisers of the independent living movement. The separation of quality of life and health status assessments is suggested. Attention is called to the requirements of the adaptation of assessment methods and an initial account of own experiences is given.]

Clinical Neuroscience

[Personal comments]

JANSZKY József, RÁSONYI György, BÉKÉS Judit, HOLLÓ András, HALÁSZ Péter

Clinical Neuroscience

[Chemotherapy of recurrent supratentorial malignant gliomas (Phase II study)]

ÁFRA Dénes, SIPOS László, VITANOVICS Dusan

[At the Hungarian National Institute of Neurosurgery 73 recurrent supratentorial malignant tumours were treated by chemotherapy during the last ten years. Chemotherapy was applied after postoperative radiotherapy but in some cases following reoperation only. All cases were clinically and by CT or MRI verified recurrences. Forty-three patients received BCNU-DBD (dibromodulcitol) treatment (23 anaplastic astrocytoma - AA, and 20 glioblastoma multiforme - GM): day 1. BCNU 150 mg/sq.m. in iv. infusion, day 2. dibromdulcitol 1000 mg/sq orally was given. This course was repeated every six weeks, altogether 2-8 times. Sixteen patients with AA responded with complete or partial regression but only 6 did with GM. Median survival was 14 and 7 months, the difference proved to be significant, p=0.0091. PCV combination (procarbazine, CCNU, vincristine) was applied to 16 patients with AA and 14 cases with recurrent oligodendroglioma (O). Treatment started with vincristine 1.5 mg/sq. m. iv. (2.0 mg maximum), the next day CCNU 100 mg/sq.m. was given, followed by procarbazine 60 mg/sq.m. on days 8-22. and finished by the same dose of vincristine on day 30. The course was repeated after one month, mostly six times. Six patients with AA did not respond; in cases of oligodendroglioma all but one responded with complete or partial improvement. It is remarkable that no significant difference was found between the survivals of BCNU-DBD or PCV treated AA patients. Chemotherapy of supratentorial malignant glioma recurrences with nitroso-ureas and their combination proved to be efficacious. It also seems, that in recurrent cases lower grade gliomas show better response rate than glioblastomas.]

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Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

[Earlier and more efficiently: the role of deep brain stimulation for parkinson’s disease preserving the working capabilities]

DELI Gabriella, BALÁS István, KOMOLY Sámuel, DÓCZI Tamás, JANSZKY József, ASCHERMANN Zsuzsanna, NAGY Ferenc, BOSNYÁK Edit, KOVÁCS Norbert

[Background – The recently published “EarlyStim” study demonstrated that deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD) with early fluctuations is superior to the optimal pharmacological treatment in improving the quality of life and motor symptoms, and preserving sociocultural position. Our retrospective investigation aimed to evaluate if DBS therapy was able to preserve the working capabilities of our patients. Methods – We reviewed the data of 39 young (<60 years-old) PD patients who underwent subthalamic DBS implantation at University of Pécs and had at least two years follow-up. Patients were categorized into two groups based on their working capabilities: Patients with active job (“Job+” group, n=15) and retired patients (without active job, “Job-” group, n=24). Severity of motor symptoms (UPDRS part 3), quality of life (EQ-5D) and presence of active job were evaluated one and two years after the operation. Results – As far as the severity of motor symptoms were concerned, similar (approximately 50%) improvement was achieved in both groups. However, the postoperative quality of life was significantly better in the Job+ group. Majority (12/15, 80%) of Job+ group members were able to preserve their job two years after the operation. However, only a minimal portion (1/24, 4.2%) of the Job- group members was able to return to the world of active employees (p<0.01, McNemar test). Conclusion – Although our retrospective study has several limitations, our results fit well with the conclusions of “EarlyStim” study. Both of them suggest that with optimal timing of DBS implantation we may preserve the working capabilities of our patients.]

Hypertension and nephrology

[Press Release of the Hungarian Society of Hypertension Concerning the New American Hypertension Limit – the Hungarian Limit Remains 140/90 mmHg Still!]

Clinical Neuroscience

[IDIOPATHIC TOLOSA-HUNT SYNDROME: FOUR ADDITIONAL CASES]

D Kirbas, B Topcular, ME Ozcan, N Sakalli Karagoz, G Gul, I Aslan Kalyoncu

[Idiopathic Tolosa-Hunt syndrome (ITHS) is a very rare cause of painful ophthalmoplegia characterized by unilateral orbital pain, ipsilateral oculomotor paralysis and prompt response to steroids. In this paper we report 4 additional cases of ITHS. This rare cause of painful ophthalmoplegia effects the cranial nerves due to a granulomatous lesion of unknown etiology in the cavernous sinus or superior orbital fissure. The International Headache Society redefined the diagnostic criteria for ITHS but it is still mostly a diagnosis of exclusion. Careful evaluation and follow-up is essential for diagnosis. Optimal therapy duration and dosage and prophylactic treatment in recurrent cases needs further research.]

Hypertension and nephrology

[Hungary’s anthropometric position based on national public health screening (2010-2017). Data and correlation analysis - Part I.]

KÉKES Ede, BARNA István, DAIKI Tenno, Dankovics Gergely, †KISS István

[The aim of the study is to present a Hungarian anthropometric profile on a full-scale basis (body mass, BMI, waist circumference, waist/hip ratio, percentage of body fat, abdominal fat mass) based on the data of the “Nationwide Comprehensive Health Screening Program in Hungary 2010-2020” collected over 8 years. In the analysis we processed 70,094 women and 67,549 men. We found, that in the Hungarian society, overweight and obesity was on the rise between 2010 and 2017, and beyond 2014 its rate was ever higher. Growth of body fat and abdominal fat is characteristic for both sexes, but abdominal obesity in relative terms of waist size, waist/hip ratio and percentage of body fat is significantly higher in morbid obese women. The fact is particularly worrying that these growth trends are already present in age groups of 18-26. These signs warn us definitely that we need to take a greater part in influencing the lifestyle, eating habits of individuals and in the promotion of physical activity.]