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25 September 2016, Volume 12 Issue 3
    

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    Comment on Guideline
  • Comment on revised terminology and concepts for organization of seizures and epilepsies of the International League Against Epilepsy
    FENG Zhiying
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 117-122. https://doi.org/10.12022/jnnr.2016-0037
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    A report on revised terminology and concepts for organization of seizures and epilepsies proposed by International League Against Epilepsy (ILAE) Commission on Classification and Terminology in 2010 has revised concepts, terminology, and approaches for classifying seizures and epilepsy, aiming to establish the international consensus on classification and terminology, reflect the fundamental relation between the classification and the terminology, and provide guidance on making appropriate treatment protocols in clinical practice. Generalized seizures and focal seizures are redefined for seizures as occurring in bilaterally distributed networks (generalized) and within networks limited to one hemisphere (focal), respectively. Furthermore, genetic, structural-metabolic and unknown which represent modified concepts are used to replace idiopathic, symptomatic, and cryptogenic categories. Organization of forms of epilepsy is first described by specificity: electroclinical syndromes, constellation, and epileptic encephalopathies. This paper interprets the key changes in terminology and concepts for organization of seizures and epilepsies in the revised terminology and concepts for organization of seizures and epilepsies of the ILAE.
    • Original Research
  • Effectiveness and prognosis-related factors of intravenous thrombolysis in patients with acute ischemic stroke
    GENG Jieli, SONG Yeping, JIN Haifeng, CHEN Ying, LIN Yan, SUN Yameng, PAN Yuanmei, YU Ling, SHI Guowen, XU Qun
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 123-130. https://doi.org/10.12022/jnnr.2016-0032
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    Objective: Intravenous thrombolysis is the most effective therapy that guidelines have recommended for treating acute ischemic stroke. This study aims to evaluate the factors related to the clinical outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis. Methods: This study recruited 136 patients with acute ischemic stroke treated with intravenous recombinant tissue plasminogen activator (rt-PA). The demography, vascular risk factors and the characteristics of acute ischemic stroke were recorded. The early improvement which was defined as complete resolution of the neurologic deficit or an improvement from baseline in the score on the National Institute of Health Stroke Scale (NIHSS) 24 hours after intravenous thrombolysis and the independent functional outcomes which was defined as a score of 0 or 1 on the modified Rankin scale (mRS) three months after the onset of stroke were evaluated. The factors related to early improvement and late independent functional outcomes were examined by univariate and multivariate analyses. Results: Sixty-six patients (48.5%) achieved early improvement and 64 patients (47.1%) achieved late independent functional outcomes. The early efficacy 2 hours, 24 hours and 7 days after intravenous thrombolysis had relevance to the later prognosis (all P < 0.05). Lower systolic pressure was independently associated with better early improvement (P < 0.05). Conclusion: Decrease in systolic blood pressure before intravenous thrombolysis may promote the early improvement in patients with acute ischemic stroke. The early response to intravenous thrombolysis may predict the late outcomes.
  • Effectiveness of Biodex dynamic and static balance testing and training system for balance recovery in patients with Parkinson’s disease
    YU Xiaoming, ZHOU Huanxia, WANG Honglin, JIANG Liming, ZHAN Qing
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 131-136. https://doi.org/10.12022/jnnr.2016-0043
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    Objective: To evaluate the effectiveness of Biodex dynamic and static balance testing and training system for balance recovery in patients with Parkinson’s disease. Methods: Forty-two eligible patients with Parkinson’s disease were randomly divided into general balance training group (control group, n = 21) and the Biodex dynamic and static balance testing and training group (study group, n = 21), and received the general balance training and Biodex dynamic and static balance training for 6 weeks, respectively. The dynamic and static balance function was evaluated before training and six weeks after training. The Berg Balance Scale was also used to examine the patients’ balance function. Results: As compared with before training, the static balance score of the study group was obviously improved after training for 6 weeks (P < 0.05); in the control group, the balance function score of forward and backward adjustment was not remarkably improved after training (P > 0.05). After training for 6 weeks, the balance function scores of overall, forward, front-left and front-right adjustments of the study group were significantly improved than those before training and those of the control group after training (all P < 0.05), but the scores of left and right adjustments were not significantly improved as compared with those of the control group after training (both P > 0.05); in the control group, only the scores of left and right adjustments were significantly improved after training (both P < 0.05). The Berg Balance Scale score of the study group was also obviously improved as compared with that before training and that of the control group after training (both P < 0.05). Conclusion: Biodex dynamic and static balance testing and training system is superior to the general balance training in improving the balance function of the patients with Parkinson’s disease, especially in forward, left, right, front-left and front-right adjustments.
  • Magnetic resonance imaging diagnosis of tuberculum sellae meningioma: A report of 59 cases
    LIANG Haisheng, SHEN Jiankang, ZHAO Jiangmin
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 137-141. https://doi.org/10.12022/jnnr.2016-0016
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    Objective: To evaluate the features and diagnostic value of magnetic resonance imaging (MRI) for tuberculum sellae meningioma. Methods: Presurgical MRI features of 59 patients with histopathologically identified tuberculum sellae meningioma between January 1995 and December 2015 were analyzed retrospectively. Results: Fifty-nine patients including 15 males and 44 females were evaluated. The bases of the tumors were all located around the tuberculum sellae or diaphragmasellae. On MRI T1-weighted image (T1WI), all tumors showed slightly iso- or hypo-intense and iso- or hyper-intense on T2WI. Obvious homogenous enhancement of tumor on enhanced scanning images of MRI was seen in 57 cases, and the remaining 2 cases showed uneven enhancement. The dural tail sign on enhanced scanning images was observed in 45 cases. Conclusion: MRI examination plays an important role in qualitative diagnosis and localization of tuberculum sellae meningioma, providing a valuable guide for selection of surgical approach, evaluation of the extent of tumor resection, and the prediction of operation risks.
  • Related factors of stroke onset in patients with sleep apnea syndrome
    LI Youmei
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 142-145. https://doi.org/10.12022/jnnr.2016-0039
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    Objective: To investigate the expressions of serum inflammatory markers and markers for endothelial function in patients with sleep apnea syndrome (SAS) complicated with stroke, and explore the risk factors related to stroke onset in SAS patients. Methods: This study included 35 patients with simple SAS and 38 SAS patients complicated with stroke. The expression levels of serum endothelial nitric oxide synthase, malondialdehyde (MDA) and tumor necrosis factor α (TNFα) were detected and compared between the simple SAS patients and the SAS patients complicated with stroke. The related factors of stroke onset in patients with SAS were examined. Results: The expression levels of serum endothelial nitric oxide synthase, MDA and TNFα in SAS patients complicated with stroke were significantly higher than those in simple SAS patients (all P = 0.000). Univariate analysis showed that gender (P = 0.012), age (P = 0.009), the course of SAS (P = 0.000) and the history of hypertension (P = 0.000) were associated with stroke onset in SAS patients. Multivariate analysis showed that the course of SAS [hazard ratio: 9.12 (95% confidence interval: 2.15-13.88); P = 0.000] and the history of hypertension [hazard ratio: 5.05 (95% confidence interval: 2.74-10.52); P = 0.000] were the independent factors for stroke onset in SAS patients. Conclusion: The expression levels of serum inflammatory markers and markers for endothelial function in SAS patients complicated with stroke are increased, indicating the further dysfunction of endothelial cells. The course of SAS more than one year and the history of hypertension are independent risk factors involved in the onset of stroke in SAS patients.
    • Review
  • Advances in clinical research on post-stroke seizure
    YAO Mengsha, HAO Yong
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 146-151. https://doi.org/10.12022/jnnr.2016-0024
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    Post-stroke epileptic seizures and post-stroke epilepsy are common complications of stroke, which significantly devastate the physical and mental health of patients as well as their relatives. Unfortunately, few practical guidelines are available about the prevention, diagnosis and treatment of post-stroke seizure. Different subtypes of stroke with various risk factors can induce different kinds of seizure and epilepsy, whereas intracerebral hemorrhage has been universally recognized as the primary risk factor leading to post-stroke seizure or epilepsy. Additionally, people can only make prevention strategies which directly focus on potential risk factors, and this may be the most reliable and feasible way because of the lack of qualified prevention assessments and interventions currently. As for diagnosis and treatment, magnetic resonance imaging (MRI) arterial spin labeling (ASL) and new generation anti-epileptic drugs have recently become the hot spots, respectively. This review summarizes the advances in clinical research on risk factors, diagnosis, prevention and treatment of post-stroke epileptic seizures and post-stroke epilepsy in recent years, and discusses the possibilities of future research.
  • Kallikrein-kinin system and epileptogenesis
    ZOU Jing, LU Qinchi
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 152-156. https://doi.org/10.12022/jnnr.2016-0048
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    The kallikrein-kinin system (KKS) is an important endogenous pathway involved in a serial of physiological and pathological changes, such as blood pressure controlling and inflammation. It has been proved to exert a role in several disorders of central nerve system, including epilepsy. Studies of different animal models, including pilocarpine-indued, audiogenic kindling and amygdaloid kindling animal models, have showed that the expressions of the bradykinin receptors B1 and B2 were both up-regulated, or showed that the relative ratio of bradykinin receptor B1 to B2 was elevated. In patients with temporal lobe epilepsy and hippocampal sclerosis, the levels of bradykinin receptors B1 and B2 in pyramidal neurons and kallikrein 1 in astrocytes were all over-expressed in hippocampus. It has been suggested that bradykinin receptor B1 may be pro-convulsant while bradykinin receptor B2 may be linked to neuroprotection. The possible underlying mechanisms include promoting blood-brain-barrier disruption, inducing the release of excitatory amino acids, and mediating the inflammatory response. KKS may become a novel target for prevention and treatment of epilepsy. This paper summarizes the advances in research on KKS and epileptogenesis.
  • Endogenous neural stem cells and ischemic stroke
    CHEN Miao, ZHAN Qing
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 157-160. https://doi.org/10.12022/jnnr.2016-0044
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    Neural stem cell therapy, as a new therapeutic method for all kinds of nervous system diseases, has aroused wide concern for over 20 years since being first found in 1992. Ischemic stroke is highly concerned because of its high incidence, high mortality and high disability rate. The research advances in functions of endogenous neural stem cells in nerve regeneration and neovascularization and their interactions as well as the related regulators in these two important processes after ischemic stroke are summarized in this review, hoping to provide new ideas of accelerating neural functional recovery after ischemic stroke.
  • Application of electrophysiology in rehabilitation evaluation after stroke and its clinical significance
    WANG Qinying, ZHAN Qing
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 161-167. https://doi.org/10.12022/jnnr.2016-0017
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    Electrophysiology, as a kind of objective, quantitative, noninvasive and repeatable method, plays an irreplaceable role in the rehabilitation assessment of stroke patients. The surface electromyography has been applied especially in kinematic analysis and the evaluation of muscle function. The electroencephalogram can be used to identify the cortical function. Through evoked potential examination, the state of motion, perception and cognition of stoke patients can be assessed. The transcranial Doppler can be used to detect the changes of cerebral blood flow during rehabilitation. It has a positive value in evaluating the functional disturbance of post-stroke patients and making the rehabilitation plan by using electrophysiological techniques. This review summarizes the advances in electrophysiology in rehabilitation evaluation after stroke and its clinical significance.
    • Case Report
  • Morvan’s syndrome: One case report and literature review
    WU Hengqu, LI Jianping, ZHANG Ying
    Journal of Neurology and Neurorehabilitation. 2016, 12(3): 168-172. https://doi.org/10.12022/jnnr.2016-0023
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    This paper reports the diagnosis and management of a 65-year-old male patient with Morvan’s syndrome presenting with neurological symptoms including myokymia, myasthenia, hyperhidrosis, sleeping disorder and visual hallucination. Diagnostic examination revealed probable malignant lesion of the thymus gland, and the abnormality in immunologic function including positive expression of peripheral blood anti-voltage-gated potassium channel antibodies. This patient was definitely diagnosed of Morvan’s syndrome and reached clinical partial recovery after symptomatic and supportive treatment.
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