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
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
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.
First international Vilnius neuroscience conference for young researchers, 2025. Abstract book
Copyright (c) 2025 Authors https://creativecommons.org/licenses/by/4.0
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.
Copyright (c) 2024 Gabija Gurskaitė | Rūta Samaitienė Aleknienė https://creativecommons.org/licenses/by/4.0
Adrenoleukodystrophy: Symptoms, Treatment and Newborn Screening. Literature Review and Clinical Case
Adrenoleukodystrophy is a rare genetic disease which causes adrenal gland insufficiency and damages the nervous system. It is inherited through the X chromosome in a recessive manner. Due to the ABCD1 gene mutation, there is a disorder of peroxisomes, thus very long-chain fatty acids are not degraded properly. There are 3 main forms of X-ALD: cerebral X-adrenoleukodystrophy, adrenomyeloneuropathy, and Addison’s disease. We present a case of a 7-year-3-month-old boy who was diagnosed with cerebral X-adrenoleukodystrophy. The patient was hospitalised because of episodic strabismus, hearing difficulty, gait abnormalities, and behavioural changes. His maternal grandmother had an unspecific demyelination. There were typical lesions of X-adrenoleukodystrophy in the patient’s magnetic resonance tomography imaging, whereas the Loes score was 15. Laboratory testing showed an elevated concentration of very long-chain fatty acids, and genetic testing confirmed the ABCD1 gene mutation. The patient’s disease was evaluated as advanced; therefore, allogeneic stem cell transplantation was not performed. The treatment consisted of Lorenzo oil, hormone therapy, and a low-fat diet. After summarising the literature, 6 main groups of symptoms are suggested: behavioural changes, hearing and visual impairment, neuromuscular system disorders, central nervous system impairment, nonspecific and other non-neurological symptoms. The best results of allogeneic stem cell transplantation were observed in patients with standard or very low risk. Autologous stem cell transplantation with gene therapy showed similar results as allogeneic stem cell transplantation. Vorinostat, rituximab, and intrathecal mesenchymal stem cell transplantation were described as unsuccessful treatment methods. The prevalence of X-ALD is estimated from 1:4,845 to 1:17,000, depending on the country. The most effective value of C26:0 Lyso-phosphatidylcholine concentration for newborn screening was 0.3-0.36 μmol/l.
Efficacy of Monoclonal Antibodies Against Calcitonin Gene-Related Peptide for Medication Overuse Headache in Migraine Patients: Literature Review
Medication overuse headache (MOH) is a type of headache that is caused by an excessive use of pain-relief medication, most commonly in individuals with migraine. This condition negatively impacts the quality of life of those affected, while also placing a significant socioeconomic burden on the healthcare system. Over the past decade, preventive treatment has become a lot more prominent in the management of MOH in an attempt to reduce the risk of medication overuse. Although medication groups such as antidepressants, beta-blockers, and antiepileptics are still being used for preventive treatment, more recent and specific treatments, namely, monoclonal antibodies against calcitonin gene-related peptide (CGRP), are being increasingly applied. This review article discusses the epidemiology and risk factors of MOH as well as the latest clinical studies investigating the efficacy of monoclonal antibodies against CGRP in treating MOH in patients suffering from migraine.
ilgai vartojamų vaistų sukeltas galvos skausmas
Treatment Tactics for Psychosis in Parkinson’s Disease: A Literature Review
Parkinson’s disease is a neurodegenerative disorder which leads to a progressive disability. The loss of dopaminergic neurons and disturbances in their connections cause deficient signaling of dopamine circuits, which results in motor and non-motor symptoms. Cognitive and behavioral disturbances are also common, including the possible onset of psychotic symptoms. Data on the prevalence of psychosis, caused by Parkinson’s disease is limited, as diagnostic criteria are not universally applied. Modified NINDS (National Institute of Neurological Disorders and Stroke) criteria can be used. Several scales have been developed to assess the risk of psychosis development, to confirm the diagnosis, and to evaluate the symptom severity. For reliable diagnosis, it is advisable to use multiple scales, considering individual patient symptoms and differential diagnoses. Pharmacological treatment may include antipsychotics (quetiapine, clozapine), dopamine D2 receptor antagonists, 5-HT2A receptor ligands, medications for dementia, anxiolytics, antidepressants, and gabapentin. Non-pharmacological treatment may include electroconvulsive therapy, deep brain stimulation, and transcranial direct current stimulation. Use of treatment algorithms is recommended. Further research is necessary to discover new drugs specifically targeting the treatment of this disorder. Although Lithuania does not yet provide access to Pimavanserin, a drug specifically indicated for psychosis associated with Parkinson’s disease, other treatments can be recommended for patients, along with psychological counseling and collaboration with psychiatrists and psychologists.
The Use of Cannabinoids to Treat Insomnia
Insomnia is a sleep disorder characterized by difficulty falling asleep or maintaining sleep after waking up. With the increasing pace of life and high levels of stress, there is a rising number of individuals reporting sleep disturbances. Recently, there has been a growing interest in various cannabis preparations, particularly in cannabinoids derived from Cannabis sativa plants, for the treatment of insomnia. Delta-tetrahydrocannabinol (THC) and cannabidiol (CBD) are commonly used to treat insomnia. Both of these substances have shown potential in improving sleep quality and have historically been used to induce sleep. Despite their widespread use, there is still a lack of reliable research to prove their effectiveness. Nevertheless, cannabinoids remain frequently used substances in the management of sleep disorders. While THC and CBD may enhance the sleep quality by reducing nighttime awakenings, shortening sleep onset latency, and increasing the total sleep time, their efficacy in treating insomnia lacks scientific validation. Additionally, there are safety concerns associated with cannabinoids, including potential negative impacts on the sleep quality, risk of abuse or dependence, and the development of tolerance with long-term use. This article provides a comprehensive review of literature concerning the effects and safety of cannabinoids on sleep and sleep-wake rhythms, as well as their potential benefits in treating insomnia and other sleep disorders.
Humour Runs through the Multicoloured Mosaic of Neuropsychotherapy: Scoping Review
Background. The investigation is devoted to explore the possibilities of humour to treat neuropsychiatric disorders which, in the last decade, have significantly increased. The aim of the study is to describe the growing investigations, in which various styles and forms of humour are used in the treatment of neuropsychiatric disorders, and to evaluate their therapeutic peculiarities. Overall research question. What is the role of humour in the treatment of neuropsychiatric disorders? Material and methods. Scientific investigations were analysed, grouped, interpreted and generalized. Information for literature review was collected in the PubMed and Google Scholar databases. Overall, 25 articles published between 2013 and 2023 and written by 171 authors (from 28 countries) were analysed. Results. The investigations concisely reviewed herein are associated with the only therapeutic form – the usage of humour in the treatment of neuropsychiatric disorders. The results of the investigations are divided into five sections: the use of humour in the context of different coping strategies (5 investigations); the use of only humour in the treatment (6 investigations); the use of the styles of humour in the treatment (5 investigations); comprehension of humour by patients (6 investigations), and clinical trials which revealed the sense of humour in the brain of patients (4 investigations). Conclusions. The results of the reviewed investigations showed that the therapeutic potential of humour is high enough to broaden the horizon of neurology to some extent. The growing popularity of humour usage in the treatment of neuropsychiatric disorders could encourage this kind of therapeutic activity in Lithuania as well.
Posterior Reversible Encephalopathy Syndrome in Guillain-Barré Syndrome: 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">Guillain-Barré Syndrome<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"> (GBS) is an acute, immune-mediated neuropathy of the peripheral nervous system, characterized by rapidly progressive, symmetrical weakness of the limbs and the reduction or absence of tendon reflexes. GBS is a rare neurological disorder diagnosed based on the clinical history, neurological examination, cerebrospinal fluid analysis and electroneuromyography (ENMG). In rare cases, GBS can occur together with other syndromes. <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">Posterior Reversible Encephalopathy Syndrome<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"> (PRES) is a clinical-radiological condition defined by acute neurological symptoms and characteristic imaging findings. The manifestation of these syndromes may be influenced by congenital <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">Klippel-Feil Syndrome<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"> (KFS), which is diagnosed by imaging studies observing fusion of at least two vertebrae of the cervical spine. This syndrome can lead to spinal canal stenosis, reduced neck mobility, and a lower hairline. In this article, we present a 72-year-old female patient who presented to the Emergency Department due to impaired speech and disorientation. Neurological examination revealed findings consistent with encephalopathy. Detailed diagnostic evaluation confirmed a diagnosis of GBS presenting with PRES, accompanied by KFS. This case illustrates the diversity of clinical symptoms in GBS and highlights the importance of a comprehensive differential diagnosis when evaluating patients with suspected demyelinating polyneuropathy.
posterior reversible encephalopathy syndrome
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