Atilla Oguzhanoglu

QUANTITATIVE EEG ANALYSIS IN OBSESSIVE COMPULSIVE DISORDER

Quantitative analysis of the EEG (q-EEG) in patients with obsessive compulsive disorder (OCD) showed a decreased beta and an increased theta power at frontotemporal regions. The patients who had higher scores in doubting test (Maudsley Obsessive Compulsive Questionnaire) and more severely ill patients shared similar q-EEG features. The relative theta powers were significantly increased and alpha powers were significantly decreased in these patients, particularly in the frontotemporal region. It was suggested that the q-EEG may be useful in investigating the OCD patients with heterogeneous characteristics.

SOMATOSENSORY EVOKED POTENTIAL AND HISTOPATHOLOGICAL INVESTIGATIONS IN ISCHAEMIA-INDUCED BRAIN DAMAGE: EFFECTS OF TRIMETAZIDINE IN RATS

We studied the protective effects of trimetazidine (TMZ) on brain damage by means of somatosensory evoked potentials (SEP) in rats. The TMZ group did not show any statistically significant difference from the control group with respect to SEPs. However, the percentage of cells with ischaemic cell damage in hippocampal regions was significantly smaller in the TMZ group than the control group. Trimetazidine reduced the number of damaged cells in the cerebral tissue during the ischaemia-reperfusion damage. It was suggested that higher doses of trimetazidine may further reduce the number of cells with ischaemic damage.

Reversible hyperintense T2 MRI lesions of basal ganglia after an electrical injury

An 16-year-old man was exposed to an electrical current under 220 V over a period of 5 s. The electrical current pathway was from right hand to left foot. After the electrical shock, he suffered from a cardiac arrest. When admitted to the hospital, he had a ventricular fibrillation. He was intubated and defibrillated several times. The patient was transported to continuous care unit with a Glasgow score of eight points. Cranial CT was normal. On the fourth day of admission, secondary generalized seizure occurred and, T2 weighted axial MRI scan on the fourth day demonstrated a marked increased in signal intensity from the bilateral lentiform nucleus (Fig. 1A). At neurological examination, on 20th day of injury, he had truncal ataxia, choreo-athetoic movements at his limbs. Cortical vision loss was noticed and hypo-perfusion in the left posterior parietal region was obtained by SPECT examination. No cortical potentials could be evoked by light flashes or pattern changes. We repeated the MRI and observed the same findings as previously. After 1 week, truncal ataxia was improved and after 2 months, the choreo-ahtetoic movements in his limbs decreased, cortical visual recovery began to oc-

Lower motor neuron disease associated with myelofibrosis

We present a patient who has signs pointing to the involvement of lower motor neurons and myelofibrosis. To our knowledge, unlike lymphoproliferative disorders, co-occurrence of myelofibrosis and lower motor neuron disease (MND) has not been reported so far. A 64-year-old male patient was admitted to our hospital with the complaint of painful cramps in his neck and forearms. On physical examination marked hepatomegaly and splenomegaly were found. On neurologic examination nasal quality of the voice and slight palatal weakness were detected. There were generalised slight weakness and atrophy in both proximal and distal muscle groups. Fasciculations were observed especially in forearm muscles and it was observed that he had been avoiding head movements because of painful muscle cramps. Deep tendon reflexes were hypoactive. Nerve conduction studies were normal. By needle electromyography, giant motor unit action potentials (amplitudes up to 8 mV), fibrillation potentials, positive sharp waves and fasciculation potentials were detected in all muscles which were investigated. A hypercellular bone marrow (100%) was determined by bone marrow biopsy. In addition to increased production of the myeloid and megakaryocytic lines, abnormal aggregation and grouping of megakaryocytes were seen. Reticular fibers were increased. He had some benefit of dyphenilhydantoin treatment given for the painful cramps in his neck and forearm muscles. Hydroxyurea treatment was started for myelofibrosis. Six months later, his general condition was better, and the painful cramps were completely resolved. No marked deterioration has been detected in neurologic examination and electromyography for 1 year.

Bilateral ptosis and gaze paresis due to unilateral thalamic lesions

In this report, we present three cases of bilateral ptosis associated with vertical and/or horizontal gaze paresis due to unilateral thalamic lesions. As far as we know, there is only one earlier report of bilateral ptosis due to an isolated thalamic lesion. In the light of our cases, we propose that cortical efferent pathways, known as supranuclear pathways, descend from supranuclear centers to diencephalic centers which serve eye opening. In addition, vertical and horizontal gaze may be affected by these thalamic lesions.