Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 05 28 154 160 EN Nooshin Delfan Department of Genetics, School of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran Hamid Galehdari Department of Genetics, School of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran Mohammad Shafiei Department of Genetics, School of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran Farideh Ghanbari-Mardasi Department of Genetics, School of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran Tahereh Latifi Department of Genetics, School of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran Nastaran Majdinasab Multiple Sclerosis Society, School of Rehabilitation, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Iran Tahereh Seifi Department of Genetics, School of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran 2017 12 09 2018 04 19 Background: One of the demyelinating and inflammatory diseases of the central nervous system (CNS) is multiple sclerosis (MS). Though pathogenesis of MS is still unknown, both genetic and environmental factors are involved. The human leukocyte antigen (HLA) class-II alleles including HLA-DRB5*01, DQB1*0602, DRB1*1501, and DQA1*0102 may have remarkable effect in MS risk although it is controversial in studies. As there is no data with respect to the HLA-DRB1*1501-DRB5*01 correlation with MS in Khuzestan Province, Iran, the goal of the survey was to investigate the association of this haplotype with MS in this population. Methods: The study focused on DRB5*01-DRB1*1501 haplotype association with MS in 200 patients and 200 healthy individuals. Typing of HLA was carried out by polymerase chain reaction (PCR) amplification with sequence-specific primers (SSP) method. SPSS software was used for the statistical analyses. Results: No association between DRB5*01+-DRB1*1501+ and MS was found (P = 0.156). Distribution of DRB1*1501+-DRB5*01- (carrying DRB1*1501+ but not DRB5*01-) and DRB1*1501--DRB5*01- haplotypes was statistically different between patients and controls (29.73% vs. 11.81%, P < 0.001) and (42.16% vs. 68.50%, P < 0.001), respectively. However, DRB1*1501--DRB5*01+ revealed no association with MS (15.13% vs. 11.81%, P = 0.403). HLA-DRB1*1501--DRB5*01+ was significantly more frequent among female patients with MS (16.19% vs. 6.12%, P = 0.019) and Persian group (17.11% vs. 5.79%, P = 0.027). Positive correlation of HLA-DRB1*1501+-DRB5*01- haplotype with the expanded disability status scale (EDSS) steps from 5 to 10 was observed (62.50% vs. 25.76%, P = 0.026). Moreover, no meaningful association was shown among the haplotypes with EDSS, course of MS, ethnicity, and gender. Conclusion: Our findings suggest that DRB1*1501+-DRB5*01- and DRB1*1501--DRB5*01- haplotypes may have positive association with MS risk. Also, this survey indicates that HLA-DRB1*1501--DRB5*01+ is involved in susceptibility of the disease among women and Persians. DRB1*1501+-DRB5*01- genotype frequency may have a key role in MS developing. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1464

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 11 29 192 194 Daniel Kondziella Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of Clinical Medicine, University of Copenhagen, Denmark Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway Sara Bech Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark 2018 10 20 2018 11 29 Portrayal of a young female in 16th century Islamic art: Does she have anti-NMDAR encephalitis? https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1660

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 11 29 200 202 EN Mehdi Khaleghi Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Alireza Arefidoust Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Rahele Yaftian Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Omid Ghamarnejad Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey Seyyed Mohammad Ghodsi Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2018 08 31 2018 11 29 Supratentorial intraparenchymal schwannoma in a 44-year-old woman: A rare case report https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1635

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 11 29 174 179 EN Reza Boostani Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Ramin Sadeghi Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Amir Sabouri Department of Neurology, School of Medicine, Washington University, Saint Louis, Missouri, USA Ali Ghabeli Marvdasht Shahid Motahhari Hospital, Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2018 07 20 2018 11 29 Background: The human T-cell lymphotropic virus type-I (HTLV-I) is the first identified pathogenic human retrovirus. Breastfeeding has been reported to be the predominant route of vertical transmission of HTLV-I. The objective of this systematic review was to pool and evaluate the data on the transmission of HTLV-I with different infant-feeding practices on children born to HTLV-I-positive mothers. We conducted a systematic review of comparison of HTLV-I transmission risk to breastfed and bottle-fed babies. Methods: We searched the following databases: MEDLINE, SID, Magiran, and Cochrane Library. The search strategy was limited to articles in English. Initial screening identified 254 citations; of these, 96 potentially relevant articles were identified. After reviewing the 96 full-text articles in detail, 7 reports met the inclusion criteria for this review. Results: Pooled odds ratio (OR) and risk difference (RD) of HTLV-I transmission in the breastfed group compared to the bottle-fed infants were [OR = 3.48, 95% confidence interval (CI): 1.58-7.64, P = 0.0020, Cochran’s Q = 27.7, P = 0.0010, and I2 = 67.5%] and (RD = 17.1%, 95% CI: 7.5%-26.7%, P < 0.0001, Cochran’s Q = 106, P < 0.0001, and I2 = 91.5%). So, we have evidence to support that exclusive breast feeding more than 6 months in comparison to bottle feeding highly increases transmission rate of HTLV-I infection. We have also enough evidence to support that exclusive breast feeding up to 6 months compared to bottle feeding does not increase transmission rate of HTLV-I infection (pooled OR = 0.912, CI: 0.45-1.80; OR: 3.83, CI: 1.80-8.10, respectively). Conclusion: The current meta-analysis showed that short period (less than 6 months) of breastfeeding did not increase risk of HTLV-I infection transmission from mother to child among breastfeeders and more than 6 months of breastfeeding significantly increased the risk of HTLV-I infection. However, our meta-analysis shows that refraining from breastfeeding can decrease the risk of vertical HTLV-I transmission. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1614

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 12 10 189 191 EN Samira Yadegari Department of Neuro-Ophthalmology and Strabismus, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Masoud Aghsaei-Fard Department of Neuro-Ophthalmology and Strabismus, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Akbari Department of Neuro-Ophthalmology and Strabismus, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Arash Mirmohammad-Sadeghi Department of Neuro-Ophthalmology and Strabismus, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran 2018 02 14 2018 12 10 Background: Eight-and-a-half syndrome (EHS) is one-and-a-half syndrome [(conjugated horizontal gaze palsy and internuclear ophthalmoplegia (INO)] plus ipsilateral fascicular seventh cranial nerve palsy. Involvement of lower pontine tegmentum including the abducens nucleus, the ipsilateral medial longitudinal fasciculus (MLF), and the adjacent facial colliculus contribute to the clinical findings of EHS. Recently, nine syndrome with addition of hemiparesis or hemianesthesia to EHS (due to involvement of adjacent corticospinal tract or medial lemniscus) is suggested. Methods: Consecutive patients with presentation of EHS or nine syndrome were reviewed from referral neuro-ophthalmology and strabismus clinics. Results: Three cases of EHS were identified with different etiologies of intracerebral hemorrhage (ICH), demyelination, and neuromyelitis optica spectrum disorder. Moreover, one case of "nine syndrome" due to ICH was described. Brain magnetic resonance imaging (MRI) in all of them revealed lesion in lower tegmentum of pons. Conclusion: Apart from different etiologies, recognition of EHS or nine syndrome allows precise localization of the lesion to lower pontine tegmentum ipsilaterally. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1510

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 12 10 161 166 EN Mansoureh Togha Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Kamran Shirbache Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Reza Rahmanzadeh Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Zeinab Ghorbani Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran School of Nutritional Sciences and Dietetics, School of Nutrition and Food Technology, Tehran University of Medical Sciences, Tehran, Iran Zahra Yari Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Clinical Nutrition and Dietetics, School of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran Farshid Refaeian Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Shirin Behbahani Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Parsa Panahi Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran 2018 04 03 2018 11 14 Background: Idiopathic intracranial hypertension (IIH) encompasses patients with elevated intracranial pressure (ICP). Generally, it is difficult to make a differential diagnosis between IIH and co-existing migraine headaches. Thus, this article intends to estimate the prevalence of migraine in patients with IIH and explain the occurrence of new-onset migraine after the diagnosis of IIH. Methods: The case group included 108 patients with IIH referred to the neurology wards of three university hospitals. A random sample of controls (n = 103) were recruited from patients hospitalized in the surgery and orthopedics ward. A checklist for migraine diagnosis was filled out. Cerebrospinal fluid (CSF) pressure and presence or absence of papilloedema (PE) in the patients and any necessary data were also recorded from the inpatient medical documents. All statistical analyses were done by SPSS software. Results: There were 70 (64.80%) and 22 (21.40%) migraineurs in the case and control groups, respectively, and the difference was found to be significant (P < 0.001). In 26 (37.14%) migraine cases in the IIH group, the disorder was diagnosed after developing IIH. Also, there was a past medical history of having migraine in 44 (62.85%) migraineurs. In the fully adjusted regression models, the odds of being affected by migraine in patients with IIH was 6.17 times greater than the controls [odds ratio (OR) = 7.15, 95% confidence interval (CI) = 3.56-14.36, P < 0.010]. The patients’ mean CSF opening pressure was 32.10 ± 1.03 cmH2O and 93 (81.60%) subjects were found to have PE. Conclusion: It was demonstrated that subjects with IIH might have about a 6-time higher likelihood of developing migraine headache than the general population. These considerations can help prevent misdiagnosis of migraine headache as the recurrence of IIH or uncontrolled IIH and subsequent inappropriate management. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1542

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 12 16 195 196 Eda Derle Department of Neurology, School of Medicine, Baskent University, Ankara, Turkey 2018 09 16 2018 12 07 Iron chelation in treatment of superficial siderosis https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1644

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 4 2018 12 20 rsity of Medical Sciences, Tehran, Iran. Ahmad Aoude Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Soheil Naderi Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Zeynab Najafi Department of Pediatrics, School of Medicine AND Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Morteza Faghih-Jouibari Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Distinction between radiation necrosis and recurrence of intraparenchymal tumors is necessary to select the appropriate treatment, but it is often difficult based on imaging features alone. We developed an algorithm for analyzing magnetic resonance spectroscopy (MRS) findings and studied its accuracy in differentiation between radiation necrosis and tumor recurrence. Methods:   Thirty-three   patients   with   a   history   of intraparenchymal brain tumor resection and radiotherapy, which had developed new enhancing lesion were evaluated by MRS and subsequently underwent reoperation. Lesions with Choline (Cho)/N- acetyl aspartate (NAA) > 1.8 or Cho/Lipid > 1 were considered as tumor recurrence and the remaining as radiation necrosis. Finally, pre-perative MRS diagnoses were compared with histopathological report. Results: The histological diagnosis was recurrence in 25 patients and necrosis in 8 patients. Mean Cho/NAA in  recurrent  tumors  was  2.72,  but  it  was  1.46  in radiation necrosis (P < 0.01). Furthermore, Cho/Lipid was significantly higher in recurrent tumors (P < 0.01) with the mean of 2.78 in recurrent tumors and 0.6 in radiation     necrosis.    Sensitivity,    specificity,    and diagnostic accuracy of the algorithm for detecting tumor recurrence were 84%, 75% and 81%, respectively. Conclusion: MRS is a safe and informative tool for differentiating    between   tumor   recurrence   and radiation necrosis. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/576 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/576/226

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 35 40 Siamak Abdi Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shahram Oveis-Gharan Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farnaz Sinaei Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Askar Ghorbani Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Serum troponin elevation, characteristic of ischemic myocardial injury, has been observed in some acute ischemic stroke (AIS) patients. Its cause and significance are still controversial. The purpose of this study is to find determinants of troponin elevation and its relationship with stroke severity and location. Methods:Between January 2013 and August 2013, 114 consecutive AIS patients confirmed by diffusion- weighted magnetic resonance imaging were recruited in this study. Serum troponin T level was measured as part of routine laboratory testing on admission. Ten lead     standard     electrocardiogram    (ECG)     was performed and stoke severity was assessed based on National Institutes of Health Stroke Scale (NIHSS). Results: Troponin T was elevated in 20 (17.6%) of 114 patients. Patients with elevated troponin were more   likely   to   have   higher   age,   higher   serum creatinine  and  ischemic  ECG  changes.  Troponin levels were higher in patients with more severe stroke measured  by  NIHSS  [7.96  (6.49-9.78)  vs.  13.59 (10.28-18.00)].  There  was  no  association  between troponin and locations of stroke and atrial fibrillation. There were 6 (5%) patients with elevated troponin in the presence of normal creatinine and ECG. Conclusion:  Stroke  severity,  not  its  location,  was associated   with   higher   troponin   levels.   Abnormal troponin levels are more likely, but not exclusively, to be due to cardiac and renal causes than cerebral ones. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/575 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/575/227

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 41 46 Saeid Khosrawi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Parisa Taheri Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Seyed Hasan Hashemi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2015 10 14 Background: H-reflex is a valuable electrophysiological technique for assessing nerve conduction through entire length of afferent and efferent pathways, especially nerve roots and proximal segments of peripheral nerves. The aim of this study was to investigate the relation between normal values of flexor carpi radialis (FCR) H-reflex latency, upper limb length and age in normal subjects, and to determine whether there is any regression equation between them. Methods: By considering the criteria of inclusion and exclusion, 120 upper limbs of 69 normal volunteers (68 hands of 39 men and 52 hands of 30 women) with the mean age of 39.8 ± 11.2 years participated in this study. FCR H-reflex was obtained by standard electrodiagnostic  techniques,  and  its  onset  latency was recorded. Upper limb length and arm length weremeasured   in   defined   position. The   degree   of association between these variables was determined with  Pearson correlation and  linear  regression was used for obtaining the proposed relaions. Results: Mean FCR H-reflex latency was found to be 15.88 ± 1.27 ms. There was a direct linear correlation between FCR H-reflex latency and upper limb length (r = 0.647) and also arm length (r = 0.574), but there was no significant correlation between age and FCR H-reflex latency (P = 0.260). Finally, based on our findings, we tried to formulate t