A 45 year old male sought consultation in our neurology clinic with the complaint of persistent genital uncomfortable sensations and pain. After extensive investigations, there was no underlying urological or neurological disease demonstrable. He was diagnosed to have restless genital syndrome and was given pramipexole and gabapentin with significant improvement of his symptoms. Our patient suggests that pramipexol and gabapentin may be useful as treatment for restless genital syndrome.

A 45 year old male sought consultation in our neurology clinic with the complaint of persistent genital uncomfortable sensations and pain. After extensive investigations, there was no underlying urological or neurological disease demonstrable. He was diagnosed to have restless genital syndrome and was given pramipexole and gabapentin with significant improvement of his symptoms. Our patient suggests that pramipexol and gabapentin may be useful as treatment for restless genital syndrome.
Anxiety Disorders ; Anti-Anxiety Agents

BACKGROUND: Cerebral venous thrombosis (CVT) is a rare disease and it has different etiologies. Inherited or acquired prothrombotic state plays a key role in the development of CVT.METHODS: A 28-year-old man who presented to our emergency department with persistent headache and accompanied by complaints of nausea and vomiting over a week. Neurologic examination revealed bilateral papilledema. Brain computed tomography showed a hyperdense area on the posterior part of the occipital lobe. Brain magnetic resonance imaging and magnetic resonance venography revealed thrombosis of CVT. Homozygous mutations were found for methylenetetrahydrofolate reductase (MTHFR). MTHFR CG677T gene mutation and blood tests showed elevated homocysteine levels on the etiological screening. There was no other etiology for CVT.RESULTS: Headache and other complaints were improved after treatment of heparin, warfarin, and vitamin B12. No recurrence of symptoms was observed upon outpatient follow-up.CONCLUSION: Since CVT is an important cause of headache, we recommend etiology screening for patients who present with CVT for MTHFR gene mutations and family counseling should be provided.

There is increasing evidence that inflammation is involved in the mechanisms of acute ischemic stroke. The utility of neutrophil-to-lymphocyte ratio (NLR) has recently been reported to help in the prognostication of stroke. The utility of NLR in the diagnosis of stroke remains uncertain. In this retrospective study, patients with acute ischemic stroke who presented within the first 24 hours of symptom onset to our clinic from September to December 2019 were studied, involving 93 patients with stroke and 60 control. The mean age in the stroke group was 71.7 ± 12.2 years whereas it was 72.6 ± 5.7 in the control group (p=0.405). The female/male ratio was 47/46 in the stroke group and it was 26/34 in the control group (p=0.411). The NLR level was higher in patients with ischemic stroke as compared to control (p=0.029) whereas hemoglobin levels were lower in the patient group (p= 0.025). The ROC curve analysis revealed that a NLR cutoff point of 2.34 had 61.3 % sensitivity and 60% specificity in detecting patients with ischemic stroke. The regression analyses also revealed that the NLR and hemoglobin levels were predictors for stroke. In conclusion, NLR and hemoglobin may potentially be paraclinical markers in differential diagnosis of stroke.

BACKGROUND AND OBJECTIVES: Vitamin D is generally known to be closely related to inflammation. The effects of vitamin D on coronary artery disease (CAD) are not fully explained. Nowadays, coronary artery ectasia (CAE) cases are common and are regarded as being a kind of CAD. We aimed to investigate, in a case-control study, the relationship between vitamin D and CAE without an associated inflammatory process. SUBJECTS AND METHODS: This study population included 201 patients (CAE group, 121 males; mean age, 61.2±6.4 years) with isolated CAE; and 197 healthy individuals (control group, 119 males; mean age, 62.4±5.8 years), comprising the control group, who had normal coronary arteries. These participants concurrently underwent routine biochemical tests, tests for inflammatory markers, and tests for 25-OH vitamin D in whole-blood draws. These parameters were compared. RESULTS: There are no statistical significance differences among the groups for basic clinical characteristics (p>0.05). Inflammatory markers were recorded and compared to exclude any inflammatory process. All of them were similar, and no statistical significance difference was found. The average parathyroid hormone (PTH) level of patients was higher than the average PTH level in controls (41.8±15.1 pg/mL vs. 19.1±5.81 pg/mL; p<0.001). Also, the average 25-OH vitamin D level of patients was lower than the average 25-OH vitamin D level of controls (14.5±6.3 ng/mL vs. 24.6±9.3 ng/mL; p<0.001). In receiver operating characteristic curve analysis, the observed cut-off value for vitamin D between the control group and patients was 10.8 and 85.6% sensitivity and 75.2% specificity (area under the curve: 0.854, 95% confidence interval: 0.678-0.863). CONCLUSION: We found that there is an association between vitamin D and CAE in patients who had no inflammatory processes. Our study may provide evidence for the role of vitamin D as a non-inflammatory factor in the pathophysiology of CAE.
C-Reactive Protein* ; Case-Control Studies ; Coronary Artery Disease ; Coronary Vessels* ; Dilatation, Pathologic* ; Humans ; Inflammation ; Male ; Parathyroid Hormone ; ROC Curve ; Sensitivity and Specificity ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*