Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 07 58 63 EN Roshanak Mehdipour-Dastjerdi Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Fereshteh Ashtari Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Vahid Shaygannejad Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Marjan Mansourian Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Ali Safaei Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2017 03 04 2018 02 24 Background: Neuromyelitis optica spectrum disease (NMOSD) is a chronic inflammatory demyelinating disorder that involves central nervous system (CNS) with high affinity for involvement of optic nerve and spinal cord. In current study, due to high prevalence of NMOSD in Isfahan, Iran, we have aimed to assess brain and spine magnetic resonance imaging (MRI) of patients with NMOSD. Methods: This cross-sectional study was performed on 62 patients with diagnosis of NMOSD, who referred to MS clinic of Kashani hospital, Isfahan City, during 2015-17. Patients' age, age of onset, primary brain and spine MRI findings, and expanded disability status scale (EDSS) were recorded in check list. Patients underwent new brain and spine MRI. Data were analyzed with SPSS software. Descriptive data were reported by mean ± standard deviation (SD). Results: 62 known cases of NMOSD including 9 (14.5%) men and 53 (85.5%) women with mean age of 34.32 ± 10.26 years, mean age of onset of 28.03 ± 12.09 years, and mean EDSS of 2.63 ± 1.55 were assessed. 33.9% of patients were anti-neuromyelitis optica (NMO) antibody seropositive. Longitudinal extensive transverse myelitis (LETM) and segmental spinal lesions were found in 66.1% and 29.0% of patients, respectively. Diagnostic NMO brain lesions and posterior periventricular lesions were seen in 38.7% and 67.7% of patients, respectively. Two patients had tumefactive lesions. Conclusion: In current study, we found high rate of posterior periventricular lesions in brain MRI and segmental lesions in spine MRI of both anti-NMO antibody seropositive and seronegative patients. As these lesions are not in NMOSD diagnosis criteria, more considerations are recommended. In addition, tumefactive lesions in patients with NMOSD were an exciting finding of this study that should be discussed about more. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1268 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1268/372

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 12 86 88 EN Marianna Riolo Department of Experimental Biomedicine, Neuroscience Clinic, University of Palermo, Palermo, Italy Valentina Arnao Department of Experimental Biomedicine, Neuroscience Clinic, University of Palermo, Palermo, Italy Fabio Giacalone Department of Experimental Biomedicine, Neuroscience Clinic, University of Palermo, Palermo, Italy Roberto Citarrella Biomedical Department of Internal and Specialized Medicine (DIBIMIS), University of Palermo, Palermo, Italy Daniela Cabibbi Department of Science for the Promotion of Mother and Child Health, University of Palermo, Palermo, Italy Massimo Cajozzo Department of Oncological and Stomatological Surgical Disciplines, University of Palermo, Palermo, Italy Paolo Aridon Department of Experimental Biomedicine, Neuroscience Clinic, University of Palermo, Palermo, Italy 2018 02 28 2018 04 12 Doege-Potter syndrome: When seizures and hypoglycemia collide https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1516 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1516/376

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 07 89 90 EN Seyed Mohammad Baghbanian Bualicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran Abdorreza Naser Moghadasi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran 2017 11 09 2018 02 28 https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1437 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1437/377

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 07 97 98 EN Mohammad Reza Sasani Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Ali Reza Dehghan Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2017 09 01 2018 02 19 Unilateral internal carotid artery agenesis: Correct diagnosis using computed tomography (CT) scan https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1398 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1398/381

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 07 82 85 EN Arezoo Chouhdari Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Kaveh Ebrahimzadeh Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Omidvar Rezaei Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Samadian Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Giv Sharifi Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammadreza Hajiesmaeili Anesthesiology Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2018 01 21 2018 02 19 Background: Postoperative meningitis (POM) is the most dreaded cause of morbidity and mortality in neurosurgery patients. This study aimed to identify incidence and mortality rate as well as related factors to outcome in patients with POM. Methods: This descriptive longitudinal study conducted on patients with POM in duration of 2 years. Incidence and mortality rates as well as related factors were studied. Results: The incidence and mortality rates of POM was 8.9% and 50%, respectively. There were statistically significant association between male gender, as well as having mechanical ventilation, and death outcome in univariable analysis. In addition, in multivariable logistic regression analysis, length of intensive care unit (ICU) stay of more than 7 days [Odds ratio (OR): 1.2, confidence interval of 95% (95%CI): 1.02-6.2), mechanical ventilation (OR: 1.1, 95%CI: 1.05-5.1], positive cerebrospinal fluid (CSF) culture (OR: 2.4, 95%CI: 1.9-4.08) were predicting factors to death outcome. Finally, we found an inverse relationship between survival function and length of ICU stay in patients with POM. Conclusion: According to the high rates of incidence and mortality due to POM in this study, preventive studies to decrease this dreaded cause of morbidity and mortality in neurosurgery patients should be the planned. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1498 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1498/379

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 07 64 70 EN Rozita Doosti Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Mansoureh Togha Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Abdorreza Naser Moghadasi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Aida Aghsaei Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Amir Reza Azimi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Saeideh Khorramnia Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Zahra Moinfar Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Fereshteh Ensani Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Hossein Harirchian Iranian Center for Neurological Research, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Alireza Minagar Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA Mohammad Ali Sahraian Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Iranian Center for Neurological Research, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran 2017 09 06 2018 02 24 Background: Since most patients with relapsing-remitting multiple sclerosis (RRMS) are women, the present study aimed to determine whether treatment of patients with MS by cytotoxic agents is associated with an increased risk of cervical dysplasia. Cancer screening is often neglected in the chronic diseases such as MS, so more attention in this field was needed. Decreasing morbidity and mortality due to cervical cancer is the most important goal of screening in female MS patients especially in child bearing age. Thus, it can be said that this is the first study which investigated this important issue. Methods: A total of 129 individuals participated in this cohort study. They were assigned into 3 groups including 43 patients with MS who were treated with cytotoxic drugs, 43 patients with MS on immunomodulators, and 43 normal healthy controls. Pap smears were performed following standard methods and the results obtained from the three groups were compared by statistical analysis. Demographic data, Expanded Disability Status Scale (EDSS), and Pap smear changes were analyzed by SPSS software. Results: The most commonly detected abnormality in all examined patients and healthy controls was inflammation. Five patients with MS who were treated with cytotoxic agents revealed benign cellular changes (BCC) in their Pap smear that were statistically significant in comparison with other groups (P = 0.03). Patients who took Mitoxantrone presented BCC more than other groups [Odds ratio (OR) = 9.44, 95% confidence interval (CI): 1.46-60.70]. There was no significant difference between mean duration of MS diagnosis (P = 0.12), mean duration of previous MS treatments (P = 0.25), and mean duration of current MS treatments (P = 0.21) in patients with BCC compared to normal healthy controls or inflammatory change. Conclusion: According to the results of present study, BCC is more frequently observed in patients with MS who were treated with cytotoxic agents with immunosuppressive effect. Since BCC is a ‘premalignant condition’, the authors suggest that mandatory annual Pap smear should be performed for patients with MS who are treated with cytotoxic agents irrespective of their age in order to detect early signs of malignancy. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1403 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1403/373

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 07 91 94 EN Masoud Etemadifar Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Fatemeh Sabeti Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mehri Salari Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2018 01 06 2018 02 24 Interferon beta-1b-induced thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) in a patient treated for multiple sclerosis: A case report https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1488 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1488/380

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 2 2018 04 ty of Medical Sciences Current Journal of Neurology 2717-011X 16 4 2017 10 07 178 184 EN Kadir Bahcecı Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey Ebru Umay Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey Ibrahim Gundogdu Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey Eda Gurcay Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey Erhan Ozturk Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey Sibel Alıcura Otolaryngology-Head and Neck Surgery Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey 2016 11 17 2017 08 21 Background: Swallowing and swallowing-related quality of life studies following stroke were almost always performed by including both patients with brainstem and cortical involvement. It was aimed in this study to show the presence of dysphagia in patients with only cortical ischemic stroke and to investigate the interaction between dysphagia and quality of life as well as to evaluate the effect of a rehabilitation program in the acute phase. Methods: Seventy-two patients with cortical stroke (between 0 and 30 days) and dysphagia were included. Swallowing function of patients was assessed by dysphagia screen questionnaire and fiberoptic endoscopic assessment. Also, functional impairment and swallowing quality of life were assessed. The swallowing rehabilitation program for 4 weeks was given to all patients. Results: All patients demonstrated disorders related to oral phase (n = 69, 95.8%), pharyngeal phase (n = 4, 5.6%) or both phases. The swallowing function, swallowing quality of life and functional impairment were improved at the end of therapy. Conclusion: Swallowing quality of life is severely affected in cortical hemispheric stroke patients and can be improved with an early rehabilitation program. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1178 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1178/353

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 4 2017 10 07 185 191 EN Jafar Mehvari-Habibabadi Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Reza Basiratnia Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Houshang Moein Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Zare Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Majid Barakatain Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Yahya Aghakhani Department of Clinical Neurosciences, University of Calgary, Calgary, Canada Nasim Tabrizi Isfahan University of Medical Sciences, Isfahan, Iran Department of Neurology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 2017 08 07 2017 08 21 Background: To investigate ictal onset patterns (IOP) in scalp electroencephalography (EEG) of patients with temporal lobe epilepsy (TLE) and their prognostic effect on the postoperative outcome. Methods: We conducted a retrospective cohort study between 2011 and 2015 in our referral Epilepsy Surgery Center enrolling adult patients with refractory TLE and a visible epileptogenic lesion in magnetic resonance imaging (MRI), who underwent epilepsy surgery. Demographic, clinical and MRI findings were collected and ictal findings during video-EEG monitoring were reviewed in detail. The correlation between preoperative findings and the postsurgical outcome was analyzed. Results: We reviewed 303 seizures in 93 patients. Rhythmic theta and rhythmic spike/sharp and wave were respectively the most common initial ictal pattern and late significant discharges. Engel class I outcome was observed in 88.2% of patients. Female sex, aura, the absence of secondary generalization, rhythmic theta as initial ictal pattern and concordance of ictal-interictal EEG findings were correlated with favorable 1-year postsurgical outcome. Conclusion: Preoperative clinical and EEG findings can provide valuable information regarding postsurgical prognosis in TLE patients. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1377 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1377/354

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 4 2017 10 07 192 200 EN Laleh Habibi Nanotechnology Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Abbas Tafakhori Department of Neurology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Ir