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25 June 2016, Volume 12 Issue 2
    

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    Editorial
  • PAN Weidong
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 57-63. https://doi.org/10.12022/jnnr.2016-0047
    Abstract ( ) Download PDF ( ) HTML ( )   Knowledge map   Save
    With the publicity of the concept of precision medicine, some researchers or doctors have proposed that the precision medicine is the same as the concept of treatment based on syndrome differentiation of traditional Chinese medicine according to the same individual treatment methods. This paper summarizes what the individual treatment is and indicates the similarity and differentiation between the two concepts from microscopic and macroscopic points of view. Integrative neurology needs the dynamic integration of the two individual and precision methods. This integrated way may decrease the rates of misdiagnosis and therapeutic errors and improve the neurologic clinical effects.
  • Comments on Guideline
  • LI Jianping
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 64-70. https://doi.org/10.12022/jnnr.2016-0006
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    The evidence-based guideline of diagnostic approach to pauci- or asymptomatic hyperCKemia developed and released by European Federation of Neurological Societies (EFNS) has provided the definition, clinical manifestation, diagnostic procedure and prognosis of this disease. Pauci- or asymptomatic hyperCKemia is defined as a condition that creatine kinase (CK) value beyond 1.5 times the upper limit of normal with no muscular signs. For the etiology searching, collection of the related family history is essential and the non-neuromuscular conditions that might contribute to hyperCKemia are needed to be excluded before further investigation. A muscle biopsy is preferred if one or more of the following are present: the serum CK value is ≥3 times the normal, the electromyogram suggests myopathic condition, the patient is < 25 years of age or there is a clue of exercise intolerance. The long-term prognosis of pauci- or asymptomatic hyperCKemia is generally quite favorable.
  • Original Research
  • ZHUANG Yan, LU Jingjue, MENG Fanping, SUN Kexing, ZHAN Qing
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 71-75. https://doi.org/10.12022/jnnr.2016-0018
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    Objective: To explore the effectiveness of interactive scalp acupuncture therapy for post-stroke gait in hemiplegia and mobility. Methods: Ninety post-stroke patients with gait in hemiplegia who were sequentially recruited in this study and meeting the inclusion criteria were randomly divided into three groups: interactive scalp acupuncture group (n = 30, interactive scalp acupuncture therapy combined with rehabilitation training at the same time), traditional scalp acupuncture group (n = 30, rehabilitation training performed after scalp acupuncture therapy) and control group (n = 30, only rehabilitation training). All patients were continuously treated for 3 months. The 5-meter turn-back test was applied to evaluate the improvement in gait quality after treatment. The modified Barthel Index was used to evaluate the effect of improvement in mobile ability on comprehensive rehabilitation efficiency. Results: After treatment, the walking time of 5-meter turn-back test and the modified Barthel Index of three groups were both improved as compared with those before treatment (all P < 0.01). The improvement degree in walking time of 5-meter turn-back test of interactive scalp acupuncture group was significantly greater than those of traditional scalp acupuncture group (P < 0.05) and the control group(P < 0.01). Meanwhile, the difference in modified Barthel Index before and after treatment of interactive scalp acupuncture group was significantly greater than that of the control group (P < 0.05), and also greater than that of the traditional scalp acupuncture group but with no statistical significance (P > 0.05). Conclusion: Interactive scalp acupuncture therapy can improve the recovery of post-stroke patients with gait in hemiplegia, thus improve the patients' mobile ability.
  • LIN Zhi, LI Jianping
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 76-80. https://doi.org/10.12022/jnnr.2016-0008
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    Objective: To evaluate the predictors for ocular myasthenia gravis (OMG) conversing to secondary generalized myasthenia gravis (GMG). Methods: Thirty-three patients initially diagnosed of OMG were followed-up for three years to observe the progression of the disease. According to the outcomes at the end of the follow-up, the patients were divided into two groups: OMG group (n = 13, maintaining OMG) and GMG group (n = 20, conversing to GMG). The clinical characteristics and laboratory findings were compared between the two groups. Results: The quantitative myasthenia gravis score (QMGS), positive rates of anti-acetylcholine receptor antibody (AChRAb) and antinuclear antibody and the incidence rates of accompanying with thymoma and diabetes of GMG group were all significantly higher than those of the OMG group (all P < 0.05). Conclusion: This study suggests that higher QMGS, positive expressions of AChRAb and antinuclear antibody and accompanying with thymoma and diabetes may be used as the predictors for the poor outcomes of OMG conversing to GMG.
  • WU Yuanmin, SHEN Liping, GU Jing, CHEN Xuelian, WANG Ping, SHEN Lirong, YAO Xiaoqing, CAI Weixin, WANG Qiudong, YANG Zhoujian
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 81-86. https://doi.org/10.12022/jnnr.2016-0025
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    Objective: To explore the effectiveness of modified Wendan Decoction combined with lidocaine in integrative medical treatment of Lermoyez syndrome. Methods: Twenty patients with Lermoyez's syndrome received intravenous injection with lidocaine for 3 days and oral modified Wendan Decoction for 2 weeks. Before treatment and after 4-week follow-up, the severities of vertigo, low-tone hearing loss, tinnitus and the sensation of ear fullness were evaluated. Results: Of 20 patients, the low-tone hearing was obviously improved in 3 (15%) patients, moderately improved in 9 (45%) patients, and not improved in 8 (40%) patients. The sensation of ear fullness and tinnitus were relieved in 16 (80%) and 17 (85%) patients, respectively, and not relieved in 4 (20%) and 3 (15%) patients. The overall disease control rate of vertigo was 100% including 65% (13/20) achieving full control and 35% (7/20) achieving almost control. Conclusion: The integrative medical treatment with modified Wendan Decoction combined with lidocaine for Lermoyez syndrome can get good efficacy, which provides clinical evidence for further investigation of potential therapeutic methods for this disease.
  • Review
  • LIU Xiaohui, LIU Xueyuan
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 87-93. https://doi.org/10.12022/jnnr.2016-0041
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    With the increasing incidence of dementia, more and more attention has been given to this disease. It has already been a clinical difficult problem threatening the health of mankind, especially for the aged people. After Alzheimer's disease, vascular dementia (VaD) is the second leading cause of senile dementia, including ischemic or hemorrhagic cerebrovascular diseases or a variety of clinical dementia due to low blood flow induced by heart and circulatory disorders. VaD is a promising disease for prevention and treatment, and it has been a hot topic in recent years. Therefore, this article summarizes the recent advances in molecular and genetic mechanism of VaD.
  • DANG Cuijiao, JIANG Wenfei, SUN Chuanhe, LIAO Weilong, PAN Weidong
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 94-101. https://doi.org/10.12022/jnnr.2016-0036
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    Inefficient glutamate receptor A2 (GluA2) Q/R site-RNA editing and related downregulation of adenosine deaminase acting on RNA2 (ADAR2) expression as well as pathological transactivation response DNA-binding protein 43-kD (TDP-43) can simultaneously occur in the same motor neurons in patients with amyotrophic lateral sclerosis (ALS), suggesting that there may be an association among these molecular abnormalities in ALS patients. The animal experiment has found that after knock-down of ADAR2 gene, the motor neurons of the rats showed a chronic death. The abnormal mislocalization and aggregation of TDP-43 fragments induced by ADAR2 difficiency results in nerve cell toxicity, then accelerating the degeneration and death of the motor neurons. This paper summarizes the role of inefficient GluA2 Q/R site-RNA editing and TDP-43 pathology in sporadic ALS, and discusses the possible influencing factors associated with inefficient RNA editing mediated by ADAR2, hoping to provide useful information to develop a novel therapeutic strategy for ALS.
  • WANG Lijing, ZHAN Qing
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 102-105. https://doi.org/10.12022/jnnr.2016-0045
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    Physical disability is common in stroke survivors. Sarcopenia after stroke has a strong impact on the decision and efficiency of rehabilitation and it may lead to the delayed recovery of patients. The pathogenesis of sarcopenia has not been investigated in details. “Stroke-related sarcopenia” was proposed in 2013 and several factors have been well known to contribute to sarcopenia, such as immobilization, impaired feeding and the activation of ubiquitin proteasome pathway. This paper reviews the recent studies on pathogenesis of stroke-related sarcopenia and distinguishes it from sarcopenia induced by other diseases, providing a basis for the prevention and therapy of sarcopenia after stroke.
  • DING Jie, HAO Yong
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 106-111. https://doi.org/10.12022/jnnr.2016-0022
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    Accumulating data has supported an autoimmune basis in patients with drug-resistant epilepsy (DRE). Neural-specific autoantibodies targeting both intracellular and plasma membrane antigens promote epilepsy through different mechanisms. Semeiology of epileptic seizure, neural-specific autoantibodies, inflammatory cerebrospinal fluid (CSF) findings, magnetic resonance imaging (MRI) and electroencephalograph (EEG) contribute to make diagnosis of autoimmune epilepsy. Immunomodulatory treatment may be a prospective effective therapy for autoimmune epilepsy, such as corticosteroids, immunoglobulins, plasmapheresis, cyclophosphamide, rituximab and azathioprine. Recent studies have indicated that cyclosporine A, FK-506 and rapamycin are effective for autoimmune epilepsy. In addition, plasma exchange is also one of the treatment options in acute phase. Prompt diagnosis and early treatment with immunotherapy and maintenance treatment in stable stage may lead to better outcomes. This review summarizes and analyzes the progress in pathophysiology, clinical presentation, diagnosis and management of autoimmune epilepsy.
  • Case Report
  • SUN Yameng, ZHANG Ying, GUAN Yangtai
    Journal of Neurology and Neurorehabilitation. 2016, 12(2): 112-116. https://doi.org/10.12022/jnnr.2016-0049
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    This paper reports the diagnosis and management of a 65-year-old male patient with thrombotic thrombocytopenic purpura (TTP) presenting with neurological symptoms. The onset of the disease was sudden, presenting with cerebral manifestations including aphasia, limb numb and weakness. The symptoms observed were variable and fluctuant. After admission, this patient had a fever. The laboratory examination revealed anemia, peripheral thrombocytopenia, moderate renal involvement, schistocytosis, a severe functional deficiency in ADAMTS13 and positive anti-ADAMTS13 antibodies. Clinical and biological anomalies ascertained the diagnosis of idiopathic TTP. With the rapid diagnosis and therapeutical plasma exchange immediately performed, the patient reached a complete recovery.