Founded in 1997. Publishes articles on the aetiopathogenesis, clinical, diagnostic, therapeutic and preventive advances in neurological, neurosurgical and related diseases.
Vilniaus universiteto leidykla / Vilnius University Press
“Died of Respiratory Muscle Paralysis”: Etiopathogenesis, Diagnosis, and Treatment of Poliomyelitis in Interwar Lithuania
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">The first cases of poliomyelitis date back to ancient times: a possible case of polio was depicted in one of the earliest sources in human history – an Egyptian funerary stele from around 1400 BC. It took more than one millennium before the term ‘poliomyelitis’ was coined. In the 18<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">th<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> century medical literature, the disease was still called “debility of the lower extremities”, while inflammation of the gray matter in the spinal cord was observed during autopsy studies, without knowing its causative agent. Meanwhile, in the 19<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">th<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> century, polio was known as Heine-Medin disease, whose epidemics, especially in densely populated cities of the Old and New Worlds became more and more frequent. The huge number of individuals with polio, as well as severity of residual symptoms prompted scientists to further studies on the etiology of the disease, to search for effective preventive and treatment methods. Finally, virologists Macfarlane Burnet and Jean MacNamara identified three types of poliovirus in 1931. The invention of the ‘iron lung’ in the early 20<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">th<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> century was an important milestone in symptomatic treatment of acute paralysis of respiratory muscles caused by polio. In 1952, the first successful injectable polio vaccine, developed by Jonas Salk, was finally introduced; a decade later, the oral polio vaccine, developed by Albert Sabin, helped to accelerate the scale of vaccination worldwide. As a result, poliomyelitis no longer exists in developed countries today; the last case of polio in Europe was recorded in 1998.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">The aim of this study is to find out how the etiology, pathogenesis and clinical manifestations of poliomyelitis were perceived, what diagnostic and treatment methods were used in Lithuania in the period of 1920–1939. By examining the publications on poliomyelitis cases in the scientific journal <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Medicina<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">, published in Lithuania during the interwar period, we reveal how the etiology and pathogenesis of poliomyelitis were perceived by physicians in our country, and how this disease was diagnosed and treated. By conducting a microanalysis of only one disease – poliomyelitis – and comparing the treatment of polio patients in Lithuania with the data available from other regions of the time, we also aim to indirectly assess the level of development of medical care in interwar Lithuania.
Copyright (c) 2025 Laura Kasperiūnaitė | Eglė Sakalauskaitė - Juodeikienė https://creativecommons.org/licenses/by/4.0
Phacomatoses: From Cutaneous Signs to Neurological Diagnosis
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Phacomatoses are a group of genetically determined multisystemic conditions that mainly affect the skin, eyes and central nervous system. Many phacomatoses present with specific skin manifestations, whose accurate evaluation can significantly contribute to establishing the correct diagnosis. The aim of this article is to review the most common phacomatoses: neurofibromatosis type 1, tuberous sclerosis complex, Sturge-Weber syndrome, and ataxia–telangiectasia. We discuss their epidemiology, etiology, the latest diagnostic criteria and clinical features with particular emphasis on dermatological manifestations.
Copyright (c) 2025 Authors https://creativecommons.org/licenses/by/4.0
Factors Worsening the Course of Myasthenia: Latest Research and Insights
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Myasthenia (Latin: <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">myasthenia gravis<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">, MG) is an autoimmune disease that affects the neuromuscular junction, leading to pathological muscle fatigue. The main symptom of the disease is muscle fatigue, which becomes more pronounced after exertion and may be especially noticeable later in the day. The disease may affect either facial muscles or all skeletal muscles of the body. In recent years, the prevalence and incidence of myasthenia have significantly increased, prompting greater attention toward identifying factors that exacerbate symptoms and minimizing their impact. Pregnancy is one such factor – as symptoms of myasthenia may worsen during pregnancy, particularly in the first trimester and/or postpartum, regardless of the overall severity of the disease. Symptom exacerbation may also be triggered by certain medications, such as antibiotics (e.g., azithromycin, aminoglycosides, fluoroquinolones). Cardiovascular drugs, such as beta-blockers, may likewise have a detrimental effect. The use of magnesium supplements is also not recommended for patients with myasthenia, as they can disrupt impulse transmission at the neuromuscular junction. Immunotherapy using immune checkpoint inhibitors in oncology can also induce exacerbations of myasthenia. It is important to note that botulinum toxin, used in aesthetic procedures, can also lead to muscle weakness. Many other factors may trigger symptom worsening as well, including an elevated body temperature, depression, respiratory infections, and insomnia. Thus, pregnancy, medications, heat, thyroid disorders, depression, infections, and insomnia – all these factors must be assessed and, wherever possible, controlled in patients with myasthenia so that to ensure an improved quality of life and a milder disease course. This article reviews literature data on factors exacerbating myasthenia.
Second international Vilnius neuroscience conference for young researchers, 2026. Abstract book
Copyright (c) 2026 Authors https://creativecommons.org/licenses/by/4.0
Changes in Headaches Characteristics during Pregnancy
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Headache is one of the common conditions affecting people worldwide, with migraines and tension-type headaches being the most prevalent. Pregnancy introduces hormonal fluctuations, particularly increased estrogen levels, which can influence headache characteristics. This study aimed to assess changes in headache patterns among pregnant women.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1" /><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">A prospective survey was conducted at the Lithuanian University of Health Sciences Kaunas Clinics (LSMUL KK), involving 67 pregnant women who experienced headaches before or during pregnancy. The participants completed a questionnaire evaluating headache characteristics and the <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">MIDAS<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (Migraine Disability Assessment) questionnaire to assess functional impairment. The data were analyzed by using statistical methods, including the χ² test, the Mann-Whitney test, and the Fisher’s exact test.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1" /><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">It was found that 77.6% of the participants experienced headaches during pregnancy, compared to 89.6% before pregnancy. Among women who had headaches both before and during pregnancy, 70.5% reported no change in severity, while 29.5% experienced either worsening or improvement. Pressing and pulsating headache types decreased by approximately 25% during pregnancy. Besides, in 27.2% of the respondents, headache was associated with a reduction of daily activity impairment, thereby suggesting a potential positive impact of hormonal changes.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1" /><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">These findings highlight the complex interaction between pregnancy-related hormonal changes and headaches. While a significant fraction of women experience headache relief, others develop new headaches or undergo symptom worsening. Further research with larger cohorts is needed to deepen our understanding of the impact of pregnancy on headache disorders.
Copyright (c) 2024 Ainas Beinakaraitis | Livija Sadauskaitė | Augustė Juknelytė-Spūdienė | Antanas Vaitkus https://creativecommons.org/licenses/by/4.0
The Relationship between Mental and Sleep Disorders: A Literature Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Even in ancient times, it was understood that rest and sleep are vital processes, as essential as breathing, eating, and other bodily functions. However, only in recent decades science has demonstrated that sleep is an active process involving neuronal network stabilization, restoration of brain and whole-body energy reserves, proper protein structure formation, promotion of macromolecule synthesis, processing and long-term retention of information, emotional regulation, reduction of oxidative stress-induced cellular damage, regulation of immune responses, and the clearance of toxic metabolites and protein degradation products. In cases of mental and sleep disorders, these processes are disrupted. The aim of this review article is to analyze the relationship between sleep and mental disorders, while focusing on different groups of psychiatric conditions. We also discuss the comorbidity of sleep and mental disorders, explore how sleep disturbances may trigger relapses or worsen psychiatric symptoms, and characterize core changes in sleep architecture for various mental disorders. Additionally, we review the effects of psychotropic medications on sleep, therapeutic considerations for their usage, and present combined psychotherapeutic and pharmacological treatment strategies that can optimize the treatment outcomes for both sleep and mental disorders.
Copyright (c) 2024 Eglė Sakalauskaitė - Juodeikienė | Algis Jaraminas https://creativecommons.org/licenses/by/4.0
The Role of Orthostatic Hypotension in the Development of Nocturia in Parkinson’s Disease
<p lang="en-GB" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Background. Parkinson‘s disease is a chronic neurodegenerative disorder where one of the most common non-motor symptoms is nocturnal urination, also known as nocturia. It can be caused by sleep disturbances, increased urine production and impaired urine storage. Disorders of the autonomic nervous system, such as orthostatic hypotension (OH), may also contribute to nocturia. The aim of this review article is to assess the association between nocturia and OH in PL and to discuss possible diagnostic and therapeutic approaches. <p lang="en-GB" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Materials and methods. A non-systematic review of the scientific literature was performed. Publications were retrieved by PubMed search engine using keywords and their combinations The non-systematic literature review included publications published in 2016–2025. Results. Nocturia is one of the frequently occurring non-motor symptoms of Parkinson’s disease, significantly impairing patients’ sleep quality and overall well-being. Its causes are related to increased urine production and storage disorders; however, increasing attention is being directed toward autonomic nervous system dysfunctions, especially orthostatic hypotension. The accumulation of α-synuclein in the autonomic nervous system, characteristic of Parkinson’s disease, may be one of the contributing factors in the development of orthostatic hypotension. Orthostatic hypotension and the associated supine hypertension may worsen the manifestation of nocturia. Diagnosis requires careful medical history-taking, blood pressure monitoring during changes in body position, and laboratory tests. Treatment demands a comprehensive approach: lifestyle modifications, physical exercise, pharmacotherapy, and other methods, depending on the individual patient’s needs and the possible causes of nocturia. Conclusions. Orthostatic hypotension and other related conditions may play an important role in the manifestation of nocturia. For individuals with Parkinson’s disease, a personalized and thorough assessment of symptoms is essential, with particular attention to manifestations of autonomic nervous system dysfunction.
Copyright (c) 2024 Deimantė Košytė | Jolita Čičelienė https://creativecommons.org/licenses/by/4.0
Diagnostic Challenges of Ataxia with Oculomotor Apraxia Type 2 (AOA2): A Clinical Case Presentation with Literature Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Ataxia with oculomotor apraxia type 2 (AOA2) is an autosomal recessive cerebellar ataxia (ARCA) caused by loss-of-function mutations in the SETX gene. AOA2 is among the most frequently diagnosed non-Friedreich ARCAs in individuals across Europe, which makes it important to understand its clinical feature and laboratory findings for accurate diagnosis and patient care. This disorder typically presents during adolescence with progressive cerebellar ataxia, sensorimotor neuropathy, tremor, oculomotor abnormalities, and may also lead to infertility. Key diagnostic markers, prominent in more than 95% of patients, are elevated alpha-fetoprotein (AFP) levels and cerebellar atrophy – most commonly, in the vermis and anterior lobe of the cerebellum, as observed on brain <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Magnetic Resonance Imaging<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> (MRI); however, definitive diagnosis is made based on genetic testing. Currently, no disease-modifying therapy exists, and disease management focuses on symptomatic treatment and rehabilitation. This article presents a case of a 29-year-old female patient with AOA2, whose diagnosis was delayed due to initially low AFP levels that became elevated only after the disease progressed. Moreover, the patient experienced unusually rapid disease deterioration, especially after contracting COVID-19 – within 12 years of symptom onset, she became wheelchair-dependent. This case illustrates the complexity of AOA2 diagnosis when early biomarkers or definitive genetic confirmation are absent, thus highlighting the value of repeated AFP evaluation over time.
Copyright (c) 2025 Greta Galinytė | Gintarė Baranauskienė | Rūta Kaladytė Lokominienė https://creativecommons.org/licenses/by/4.0
Clinical and Patient-Reported Effects of Ketogenic Diet and Intermittent Fasting for Multiple Sclerosis: Literature Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Multiple sclerosis is the most common chronic inflammatory autoimmune disease affecting the central nervous system. Its prevalence is increasing, with an estimated 2.8 million people affected worldwide. The development of multiple sclerosis is associated with various factors, including Epstein-Barr virus, ultraviolet B radiation, smoking, vitamin D deficiency, and genetic predisposition. This disease is more prevalent in Western countries, thereby indicating that nutrition might be an additional risk factor, as typical Western diets high in energy, saturated fats, and sugars are linked to neuroinflammation.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Ketogenic diet and intermittent fasting have shared aspects, as ketogenic diet was created to replicate the effects of fasting. Patients demonstrate a considerable interest in these dietary approaches – as diet is the most frequently searched self-management strategy among individuals with multiple sclerosis, according to internet search data. When it comes to the effects of these diets for multiple sclerosis patients, ketogenic diet tends to provide more consistent improvements in physical, cognitive, and emotional symptoms, while intermittent fasting mainly enhances cognition and the quality of life. Both diets appear to be safe and feasible, with mostly mild and temporary side effects, although the disease duration, disability level, and relapse rate may influence the likelihood of adverse events.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">This literature review explores the effects of ketogenic diet and intermittent fasting for multiple sclerosis patients, including symptom, metabolic, and body composition changes, as well as adverse events, patient perceptions and adherence challenges.
Copyright (c) 2025 Greta Ramonaitė | Ieva Sereikė https://creativecommons.org/licenses/by/4.0
Cognitive Impairment in Heart Failure: Unraveling the Pathophysiological Mechanisms, Diagnostics and Therapeutic Strategies
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">The article analyzes the link between heart failure (HF) and cognitive impairment (CI), emphasizing that about one-third of patients with HF experience some degree of cognitive decline. The main mechanism behind the development of CI is reduced cerebral blood flow, although inflammatory, neurohumoral, metabolic, and structural changes in the brain are also important. CI worsens treatment adherence in HF patients and increases the risk of hospitalization and mortality. Diagnostic tools include neuropsychological tests, imaging studies and biomarkers. Treatment should be comprehensive – incorporating both pharmacological and non-pharmacological approaches. The article highlights that successful care for these patients requires collaboration between cardiologists and neurologists to improve cognitive function and overall health.
Copyright (c) 2024 Authors https://creativecommons.org/licenses/by/4.0
Review of Prognostic Testing for Amyotrophic Lateral Sclerosis and Frontotemporal Dementia
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Frontotemporal dementia and amyotrophic lateral sclerosis are neurodegenerative diseases with distinc clinical presentation, but interconnected with each other. Frontotemporal dementia most often presents as behavioural or speech impairment, whereas amyotrophic lateral sclerosis presents as progressive weakness of voluntary muscles. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">C9orf72 <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">repeat expansion<em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">is the most common genetic cause of both diseases although there are more causative genes for these diseases separately. As the knowledge of frontotemporal dementia and amyotrophic lateral sclerosis is expanding, more relatives of affected patiens inquire about prognostic testing. Unfortunatelly, there are no definitive recommendations for prognostic testing and because of partial penetrance of causative gene variants and unknown genetic cause of high number of cases, clinical interpretation of prognostic testing is complicated.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">This article provides review of recommendations and limitations of prognostic testing for frontotemporal dementia and amyotrophic lateral sclerosis.
Multiple Sclerosis: The Disease and its Association with Changes in the Gut Microbiota
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">The human gut microbiota influences the host’s health through various physiological mechanisms. It interacts with the immune system by modulating the activity of T and B lymphocytes and other immune cells. A balanced microbiota maintains the intestinal barrier function by preserving intestinal mucosa’s integrity and preventing invasions of pathogens. Conversely, an imbalance in gut microbial content, known as dysbiosis, may promote pro-inflammatory immune responses associated with the pathogenesis of various autoimmune neuroinflammatory diseases.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS) and is characterised by demyelination, gliosis, inflammation, and neuronal loss. More than 2.8 million people worldwide have been diagnosed with MS. The incidence of the disease in Lithuania significantly increased between 2001 and 2015. Researchers are investigating the etiology of MS to better understand genetic predisposition and other factors contributing to its development. The gut microbiota is of great interest due to potential links between dysbiosis and the onset of MS. Recent studies indicate that the composition of gut microbiota plays a role in the pathogenesis of MS and is one of the key factors in the development and progression of the disease. The microbiota composition in MS patients differs from that of healthy individuals. A study by Thirion et al. observed a decrease in <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Peptostreptococcus<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">, <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Micrococcus<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">, <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Enterococcus<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">, and <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Lactobacillus,<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> alongside an increase in bacterial genera such as <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Staphylococcus<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">, <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Fusobacterium<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">, <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Bacteroides<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">, and Porphyromonas in MS patients. Understanding the interaction between the gut microbiota and MS may provide new targets for therapeutic interventions and emphasize the importance of maintaining microbiota balance as a key aspect of neurological health.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">This review article provides information on the disease, its epidemiology, and etiology, and analyses the association between the microbiota and MS.
The Role of GLP-1 Receptor Agonists in Eating Disorders: Appetite Regulation and Neurobiological Mechanisms
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Valgymo sutrikimai, tokie kaip nervinė anoreksija, nervinė bulimija ir persivalgymo sutrikimas, dažnai siejami su neurobiologinėmis disfunkcijomis, įskaitant dopamino ir atlygio sistemų pokyčius. Naujausi tyrimai rodo, kad GLP-1 receptorių agonistai (GLP-1RA) gali turėti terapinį poveikį ne tik metaboliniams, bet ir psichologiniams sutrikimams. GLP-1 reguliuoja gliukozės apykaitą, slopina apetitą ir veikia dopamino signalų perdavimą atlygio sistemose, o tai gali padėti mažinti persivalgymo epizodus. Tyrimai rodo, kad GLP-1RA gali sumažinti su stresu susijusį valgymą, nes veikia pagumburio-hipofizės-antinksčių ašį ir mažina nerimo sukeltą kompulsinį maisto vartojimą. Klinikiniuose tyrimuose pastebėta, kad semaglutidas ir liraglutidas veiksmingai mažina persivalgymo simptomus ir potraukį kaloringam maistui. GLP-1RA poveikis persivalgymo sutrikimui buvo reikšmingesnis nei tradicinių vaistų, tokių kaip SSRI, topiramatas ar lizdeksamfetaminas, tačiau jų ilgalaikis poveikis dar nėra pakankamai ištirtas. Nors ir duoda teigiamų rezultatų, GLP-1RA gali sukelti šalutinius poveikius, įskaitant virškinimo sutrikimus, hipoglikemiją ir galimus psichikos būklės pokyčius. Būsimi tyrimai turėtų įvertinti jų ilgalaikį poveikį ir galimą derinimą su kitais gydymo metodais, pavyzdžiui, kognityvine elgesio terapija.
Complicated Diagnosis and Treatment of Giant Cell Arteritis: A Five-Year Follow-up
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">A 68-year-old male started experiencing a localized headache in the left temporal region, which later spread to the right side. Initially, his symptoms were nonspecific; therefore, he visited several neurologists and was diagnosed with cephalgia. However, the symptoms progressed, the pain spread to the temporomandibular joints, and problems with chewing and swallowing developed. One month later, the patient noticed a subfebrile fever, as well as a severe headache and swelling of the eyes; consequently, he was admitted to the Department of Internal Medicine. An increased erythrocyte sedimentation rate and C-reactive protein were established. Color-coded duplex sonography revealed the concentric hypoechoic thickness of the walls in both superficial temporal arteries with increased blood flow velocities. The temporal arteries were very rigid and painful; therefore, it was difficult to perform an ultrasound examination. Subsequently, giant cell arteritis was diagnosed. The patient received an intravenous course of methylprednisolone, followed by prednisolone and methotrexate tablets.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Five years later, the patient did not feel any pain or discomfort in the temporal area bilaterally at the follow-up visit. In control extracranial color-coded duplex sonography, the ‘halo’ sign was not observed, and the blood flow velocities were normal in both superficial temporal arteries. The ultrasound examination did not show signs of vasculitis.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Every patient aged >50 years old with a new onset of headache and an increased erythrocyte sedimentation rate of ≥ 50 mm/h and/or high C-reactive protein levels should be checked for giant cell arteritis. Patients with giant cell arteritis should be monitored closely not only to prevent relapses but also to evaluate complications of treatment. Color-coded duplex sonography of superficial temporal arteries is an advantageous method not only for diagnosis but also for the monitoring of the disease. Raising awareness of giant cell arteritis is paramount and can help diagnose it in time.
Perception of Nervous System Physiology in “Theory of Organic Beings” by Jędrzej Śniadecki (1768–1838)
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Jędrzej Śniadecki (1768–1838) was a graduate of the universities of Krakow and Pavia, a professor of chemistry at Vilnius University, a prominent Vilnius physician, one of the founders of the Vilnius Medical Society, and the editor of the scientific and cultural journal <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Dziennik Wileński<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">. He was also the author of many publications, including the three-volume treatise <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Teorya jestestw organicznych<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (“Theory of Organic Beings”, I–III volumes were published in 1838). According to modern science historians, this <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">opus magnum<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> was one of the first and most important monographs exploring the fields of biochemistry and physiology in the Western world at the time. In this article, we examine how Jędrzej Śniadecki introduced the basics of the anatomy and physiology of the nervous system, how he explained the principles of nerve functions, the process of sleep and its significance to human health. Also, by comparing Śniadecki’s postulates with the 17<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">th<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">–19<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">th<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">-century publications of the Western European scientists, we discuss whether Jędrzej Śniadecki was a scientist of his time – a disseminator of the most advanced medical theories and scientific knowledge, or he was actually an original researcher in the field of nervous system physiology, an innovator who was ahead of his time.
Surgical Management of Drug-Resistant Epilepsy through Corpus Callosotomy: Case Report and Literature Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Corpus callosotomy is a palliative surgical procedure used for a selected group of patients with <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Drug-Resistant Epilepsy<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (DRE) when antiepileptic drugs fail to achieve seizure control. While it significantly reduces seizure frequency, it does not cure epilepsy. In this article, we present the case of a 45-year-old man with DRE unresponsive to pharmacological treatment, who underwent a complete corpus callosotomy. Postoperatively, seizure frequency decreased by 80%, and functional independence improved, though some neurological deficits persisted. A systematic literature review was conducted on the role of corpus callosotomy in the treatment of epilepsy, patient selection criteria, clinical outcomes, and advances in surgical techniques. Future directions include minimally invasive approaches and neurostimulation therapy as complementary strategies for seizure management epilepsy.
Radiological Imaging Findings of Perineural Spread in Head-and-Neck Malignancies: Literature Review
<em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Perineural Spread<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (PNS) is a critical mechanism of tumor progression in head and neck malignancies, often remaining clinically undetected until the advanced stages. Given its significant implications for treatment planning and patient prognosis, early and accurate diagnosis through radiological assessment is essential. This literature review explores the epidemiology, clinical significance, diagnostic modalities, and, in particular, the radiological characteristics of PNS. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Magnetic Resonance Imaging<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (MRI) remains the gold standard for detecting PNS due to its superior soft tissue contrast and detailed evaluation of nerve involvement. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Computed Tomography<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (CT) and <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Positron Emission Tomography<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (PET) serve as complementary imaging modalities, aiding in the assessment of bony changes and metabolic activity, respectively. This review highlights the key radiological features of perineural tumor spread, including nerve enhancement, foraminal enlargement, obliteration of fat planes, and secondary signs such as muscle denervation. Understanding these imaging findings is crucial for accurate staging, guiding therapeutic decisions, and optimizing the patient outcomes.
magnetic resonance imaging (MRI) computed tomography (CT)
Persistent Postural-Perceptual Dizziness
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Persistent postural-perceptual dizziness (PPPD) is a common cause of dizziness and vertigo. This term was first described fairly recently by the International Classification of Vestibular Disorders in 2017. The symptoms include unsteadiness, vertigo or dizziness, lasting at least 15 days per month for 3 months or longer. The symptoms are exacerbated by upright posture, standing, walking or in the presence of various visual stimuli. The cause of this disorder is still unknown, although it is believed that it is related with the discoordination of the peripheral sensory and the central nervous systems. The onset of dizziness has been explained as the result of failure of integrating visual, vestibular and proprioreceptive signals into the central nervous system. The symptoms are often succeeding a previous vestibular disorder, e.g. vestibular neuronitis, benign paroxysmal positional vertigo (BPPV), Ménière’s disease or other disorders. Psychological factors also play a part in the onset of PPPD – patients quite frequently present a history of anxiety, neurotic tendencies and depression. PPPD diagnosis is clinical, a thorough anamnesis and clinical examination are crucial. In order to diagnose PPPD correctly, a set of all five criteria, established by the Bárány society, should be met. The treatment is usually multimodal, consisting of vestibular rehabilitation, cognitive behaviour therapy, selective serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI).<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">This review describes the term of PPPD, the symptoms of the disease, epidemiology, etiology, pathogenesis, comorbidities, also the diagnostic criteria and treatment of PPPD. The purpose of this article is to educate about this disease and to encourage more research, as well to seek better care for patients, accomplished by a multidisciplinary team of healthcare professionals.
Cognitive Function in Duchenne Muscular Dystrophy Patients
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Duchenne muscular dystrophy is a rare, progressive, X-linked recessive disorder, characterized by impaired synthesis of the protein dystrophin. Motor symptoms in boys typically emerge within the first year of life, followed by progressive cardiac involvement. In recent years, an increasing body of research has highlighted the role of dystrophin in brain development and function, with notable impacts on cognitive performance and language development. It has been observed that boys with Duchenne muscular dystrophy are frequently diagnosed with intellectual impairment, verbal memory impairment, learning and reading difficulties. Among the earliest developmental concerns, often, a language delay is manifested. Increasing evidence supports a link between the absence of specific dystrophin isoforms and intellectual disabilities. Mutations in the distal regions of the dystrophin gene, affecting isoforms such as Dp140 or Dp71, are associated with a higher risk of cognitive impairment and more severe intellectual disability. This paper provides a literature review on cognitive function in Duchenne muscular dystrophy.
Neurological Manifestations, Diagnostics, and Treatment of Giant Cell Arteritis: A Literature Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Giant cell (temporal) arteritis is the most common primary systemic vasculitis. The main manifestation of this disease is new onset headache affecting people over 50 years old with an increased erythrocytes sedimentation rate (≥50mm/h). Other non-specific symptoms can include fever, loss of appetite, weight loss, fatigue, jaw pain and polymyalgia. The progression of the disease can lead to temporary or permanent monocular blindness due to retinal artery lesion and circulation problems. Later, the cerebral arteries can also be damaged, leading to stroke, more often in the posterior circulation.<br style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1"><span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Painful, prominent, red temporal vessels with reduced pulses are observed in clinical examinations. A reliable and quick instrumental diagnostic method for giant cell arteritis is the extracranial color-coded duplex sonography. Typical sonographic findings in temporal arteritis are a ‘halo’ sign and increased blood flow velocities in the superficial temporal arteries. Other diagnostic methods include contrast-enhanced magnetic resonance imaging with angiography, positron emission tomography, and temporal artery biopsy. Once the diagnosis has been established, treatment with corticosteroids is initiated immediately, often with additional cytostatics (with the objective to reduce the risk of relapse), and biologic therapy with the interleukin 6 receptor antagonist <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Tocilizumab<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">. If the treatment is started on time, the prognosis is good in the majority of cases. However, 1 in 3 patients experience a relapse episode in the first 2–3 years after the initial diagnosis. If the blindness has already occurred, it is usually irreversible. The treatment can prevent further complications, such as blindness in the unaffected eye and a reduction of the stroke risk. Clinical follow-up and extracranial color-coded duplex sonography are beneficial in observation of the disease progression, while allowing to make any required treatment corrections. Temporal arteritis is an insidious disease, usually starting with unspecific symptoms, such as fatigue and headache. Every patient older than 50 years old with a new onset headache and increased inflammatory markers should be carefully checked for temporal arteritis. If giant cell arteritis is diagnosed, the treatment must be started immediately in order to avoid blindness and stroke.
Decoding Parkinson’s Disease: Roles of Genes and Neuroinflammation – A Narrative Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Parkinson’s disease (PD) is a progressive neurodegenerative condition characterized by dopaminergic neuronal loss in the substantia nigra, which is accompanied by both genetic and inflammatory causes. Recent studies have highlighted the simultaneous importance of genetic predisposition and neuroinflammatory mechanisms in disease development, progression, and clinical heterogeneity. The present paper intends to review current research on the roles of neuroinflammation and genetic variables in PD etiology, as well as to assess their interplay, diagnostic relevance, and treatment promise. This narrative review brings together data from recent studies on monogenic mutations (e.g., SNCA, LRRK2, GBA1), inflammatory signaling pathways, glial cell dysfunction, experimental models, and biomarker research. Therapeutic developments addressing these processes are also discussed, with a focus on translational progress and new trends. The combination of neuroinflammation and genetics provides significant insights into the disease pathogenesis. A focus is observed on developing biomarkers and precision medicine approaches that target both pathways; this provides hope for an earlier diagnosis and more successful, tailored treatment strategies in the future.
Copyright (c) 2025 Mhd Bashir Almonajjed | Ahmed Abdelghafar | Nezar Al Jammaz | Mahdi Wardeh | Shahad Shtat | Samar Abuhadayed | Lana Majbour https://creativecommons.org/licenses/by/4.0
First international Vilnius neuroscience conference for young researchers, 2025. Abstract book
Neuromyelitis Optica Spectrum Disorder: A Case Report
<em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Neuromyelitis Optica Spectrum Disorder<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (NMOSD) is a rare inflammatory and demyelinating disease of the central nervous system affecting the optic nerves and the spinal cord. Diagnosis of NMOSD is based on the Diagnostic Criteria of the <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">International Panel for NMOSD diagnosis<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (IPND). This paper introduces the case of a man who developed bilateral blindness and acute paralysis of legs. The MRI scan of the brain and spinal cord revealed lesions characteristic of transverse myelitis and bilateral optic neuritis. The serum test performed was negative for aquaporin-4-IgG (AQP4-IgG). Based on the diagnostic criteria of IPND, the patient was diagnosed with NMOSD and prescribed with immunosuppressive methylprednisolone IV once a day for five days and changed to prednisolone PO. The clinical case described here demonstrates the importance of assessing the clinical symptoms as well as brain and spinal cord images in the diagnosis of NMOSD in seronegative AQP4-IgG patients.
Role of SWI in Identifying Microhemorrhages in Mild Traumatic Brain Injury
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">Mild traumatic brain injury (mTBI) is a prevalent neurological condition which can result in long-term cognitive and functional impairments, often linked to microhemorrhages and subtle bleeding that may not be visible when using the conventional imaging techniques, such as CT or standard MRI. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Susceptibility Weighted Imaging<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (SWI) has emerged as a valuable tool for detecting these subtle abnormalities due to its enhanced sensitivity to magnetic susceptibility differences. This literature review explores the role of SWI in identifying microhemorrhages associated with mTBI. It examines the advantages of SWI over the traditional imaging modalities, highlighting its capability to detect microbleeds that are crucial for accurate prognosis of mTBI. Furthermore, the review discusses the integration of SWI with other advanced imaging techniques, such as <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Quantitative Susceptibility Mapping<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (QSM), to improve diagnostic accuracy and monitor imaging changes over time.
microhemorrhages cerebral microbleeds (CMBs)
quantitative susceptibility mapping (QSM)
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Advances in the treatment of multiple sclerosis in recent decades have allowed an increasing number of people to reach advanced age without significant disability. Most disease-modifying drugs are designed to suppress active inflammation and reduce the risk of relapses; however, as patients age, the pathogenetic mechanisms of the disease change, and progression independent of relapse activity (PIRA) begins to prevail. The prolonged duration of drug-induced immunosuppression, combined with age-related comorbidities, may lead to adverse effects. In this article, we review age-related changes in multiple sclerosis pathogenesis and the associated treatment challenges.
Subacute Sclerosing Panencephalitis Outcomes Based on the Treatment Initiation Stage: A Systematic Literature Review
<em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Background and Objectives<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">: <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Subacute Sclerosing Panencephalitis<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> (SSPE) is a rare, progressive, and fatal neurological disorder caused by persistent measles virus infection, predominantly affecting children. The recent resurgence of measles globally, driven by declining vaccination rates, has highlighted the need for effective SSPE management strategies. Currently, treatment approaches focus on managing symptoms and slowing down the disease progression. This review aims to systematically evaluate treatment outcomes for SSPE based on the disease stage at which the therapy is initiated. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Materials and Methods<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">: A comprehensive <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">PubMed<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> search identified publications from 1994 to 2024 with the objective to list studies covering in detail SSPE treatment regimens and reporting on patient outcomes by the disease stage at treatment initiation. The inclusion criteria were as follows: randomized controlled trials, cohort studies, and case reports which clearly documented the treatment initiation stages and outcomes. The review classified cases into six treatment groups based on the most used medication combinations for the early (stages I–II) and advanced stages (stages III–IV) of SSPE. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Results<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">: A total of 30 studies comprising 80 SSPE cases met the inclusion criteria. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Ribavirin<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> combined with interferon and <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Isoprinosine<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> showed favorable outcomes, particularly in early-stage patients. In contrast, <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Isoprinosine<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1"> monotherapy resulted in the highest progression rates across both stages. Other combinations demonstrated varied effectiveness. Antiepileptic drugs provided symptomatic relief but did not alter the disease progression. <em style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-mce-fragment="1">Conclusions<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;" data-mce-fragment="1">: This systematic review highlights the influence of the SSPE treatment initiation stage on the patient outcomes, suggesting that a tailored approach based on the disease progression may improve the treatment efficacy.
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