Current Journal of Neurology
Volume:12 Issue: 4, Autumn 2013

There have been several studies done on the role of metals in the occurrence of multiple sclerosis (MS) disease, but their roles have not been confirmed yet. Because of the lack of information on this issue, this study compared the serum level of copper and zinc in MS patients with their levels in a control group. This was an analytical, cross-sectional study conducted in Kerman (a medium size city), Iran. We assessed the serum level of copper and zinc in 58 MS patients and 39 healthy individuals, who were selected from the relatives of cases and matched for age and sex. The average serum level of Copper in cases and controls were 93.7 and 88.9 ml/dl, respectively. The corresponding numbers for Zinc were 36.7 and 40.9 ml/dl, respectively. There was no significant difference between the two groups (copper: P = 0.459; zinc: P = 0.249). The groups were matched for age, sex, and family. However, we did not find a considerable difference between the level of these metals in MS patients and controls.

Astrocytes are cells within the central nervous system which are activated in a wide spectrum of infections, and autoimmune and neurodegenerative diseases. In pathologic states, they produce inflammatory cytokines, chemokines, and nitric oxide (NO), and sometimes they induce apoptosis. Their protease-activated receptors (PARs) can be activated by proteases, e.g. thrombin and trypsin, which are important in brain inflammation. The current study aimed to investigate the effects of different concentrations of trypsin (1 to 100U/ml) on cultured astrocytes. In the present study, two-day rat infants’ brains were isolated and homogenized after meninges removal, then cultivated in DMEM+10% FBS medium. 10 days later, astrocytes were harvested and recultivated for more purification (up to 95%), using Immunocytochemistry method, in order to be employed for tests. They were affected by different concentrations of trypsin (1, 5, 10, 15, 20, 40, 60, 80, and 100 U/ml). To reveal the inflammation progress, NO concentrations (the Griess test) were assessed after 24 and 48 hours. The results showed that trypsin concentration up to 20 U/ml caused a significant increase in NO, in a dose-dependent manner, on cultured astrocytes (P < 0.001). Trypsin 20 U/ml increased NO production fivefold the control group (P < 0.001). At higher concentrations than 20 U/ml, NO production diminished (P < 0.001). At 100 U/ml, NO production was less than the control group (P < 0.001). Inflammatory effects of trypsin 5-20 U/ml are probably due to the stimulation of astrocytes’ PAR-2 receptors and the increasing of the activation of NF-κB, PKC, MAPKs. Stimulation of astrocytes’ PAR-2 receptors causes an increase in iNOS activation which in turn leads to NO production. However, higher trypsin concentration possibly made astrocyte apoptosis; therefore, NO production diminished. These assumptions need to be further investigated.

Recent studies have demonstrated controversial results and somewhat increased frequency of multiple sclerosis (MS). We reevaluated the files of MS patients from Qom Province of Iran in order to investigate the epidemiology of the disease. Demographic and clinical records of 592 MS patients were reviewed, which included; age, sex, date of birth, marital and occupation status, presenting symptoms, time of onset, type and family history of MS, and history of autoimmune or other diseases. At the time of our study, 11 patients had died, and 581 were alive with a total female-to-male ratio of 3.4. The mean age of onset of the disease was 34.25 ± 9.01 for all the patients. 11.2% of patients had positive family history of MS. The majority of patients (80.1%) showed relapsing-remitting (RR) pattern. The prevalence of MS was calculated as 50.4/100000 for Qom. Qom is located within a high risk zone of MS. Although we found evidences about the role of environmental factors, geographical distribution, and etcetera, many more studies need to be performed in this respect.

Health assessment in patients with epilepsy (PWE) should include both clinical outcomes and health related quality of life (HRQOL) measures. The quality of life (QoL) in epilepsy-31 inventory (QOLIE-31) is widely used for QOL studies in epilepsy. This study aims to evaluate psychometrics of the Persian version of the inventory (QOLIE-31-P). Following a standard forward-backward translation and cultural adaptation, the construct validity of the QOLIE-31-P was assessed by explanatory factor analysis, multi-trait scaling analysis, and known group comparison. The criterion validity was assessed by calculating the Pearson correlation to SF-36 (36-item short-form health survey). The reliability was assessed by calculating Cronbach’s alpha and test-retest study. The factor analysis extracted from 8 factors explaining 70.35% of the variations. Item-scale correlations revealed that individual items significantly had the strongest association with the domain they were loaded on. The Pearson coefficient of correlation between QOLIE-31-P and the overall scores of SF-36 was 0.876 (P < 0.0001). Patient with medically controlled seizures scored higher than those who experienced seizures during the previous year to study date (P < 0.0001). The Cronbach’s α of overall QOLIE-31-P inventory was 0.9. The overall test-retest coefficient of correlation was 0.68 (P = 0.003). QOLIE-31-P is a valid and reliable tool to be applied in health assessment of patients with epilepsy.

Multiple sclerosis (MS) is one of the most important autoimmune diseases recognized by demyelination and axonal lesion. It is the most common cause of disability in the young population. Various immunomodulatory and immunosuppressive therapies, including different formulations of interferon beta (IFNβ), glatiramer acetate (GA), mitoxantrone, and natalizumab are available for this disease. However, interferon has been the best prescribed. Although the precise mechanism of IFNβ is unclear, many studies indicate some potential mechanism including blocking T cells activation, controlling pro- and anti inflammatory cytokine secretion, preventing activated immune cell migration through BBB, and inducing repair activity of damaged nerve cells by differentiating neural stem cells into oligodendrocytes. These molecular mechanisms have significant roles in IFNβ therapy. More researches are required in order for us to comprehend the mechanism of action of IFNβ, and improve and develop drugs for more efficient MS treatment.

The new-AEDs, whose developments were motivated following the discovery of the valproate and its marketing in the U.S in 1978, have presented more therapeutic options. There are approximately twenty four FDA-approved antiepileptic drugs for use in patients with epilepsy, five of which were identified and have come on to the market between 2009 and 2012. The new-AEDs are of interest, not due to their efficacy, but rather owing to better tolerance, favorable pharmacokinetic profile, fewer interactions, and in some instances, lesser protein binding. No standard AED or those in developing have all properties of an ideal antiepileptic drug, thus to achieve desirable outcome, physicians should be aware of pharmacokinetics (PKs) and pharmacodynamics (PDs) of drugs. This review describes briefly the major features of the new AEDs.

Balo’s concentric multiple scleroses (MS) is a rare demyelinating disease and a variant of multiple sclerosis. We report a case with interesting misleading clinical history and typical RI findings of Balo disease.A 19-year-old girl presented with fever and left hemiparesis following dental procedure 15 days ago. On physical examination fever and left limbs forces loss were noted. On CT scan a hypodense mass like area, and in MRI a low T1 and high T2, and flair concentric onion-like partial enhancement of mass in parieto-frontal periventricular white matter was detected. Regarding the findings tumefactive MS, Low grade glioma, lymphoma, and abscess and regarding the history of abscess formation were in differential diagnosis. After therapy and no improvement in clinical condition and MRI findings during 2 months, the patient underwent stereotactic biopsy and tumefactive balo MS was revealed. After 4 months of intensive therapy, the patient was discharged with normal condition.

Intracranial lipomas are congenital malformations. These uncommon lesions have an incidence of 0.1 to 1.7% of all intracranial tumors. Most cases are located at midline and 5% are along the sylvian fissures. If symptomatic, seizures are the most common symptom. These tumors are slow growing and have favorable outcome. We report a case of a 25-year-old man whose CT and MRI revealed a lesion in right sylvian fissure suggesting a lipoma with abnormal vasculature and overlying cortical dysplasia.

Anti-phospholipids syndrome (APS) is considered a non inflammatory auto-immune disease with a significant thrombophilic risk with varied clinical manifestations. The purpose of the current study was to investigate the frequency of thrombotic and nonthrombotic events in patients with APS. In this retrospective study, 102 deResults