Non-ketotic hyperglycemia (NKH) is recognized both as a direct cause of a precipitating factor of many types of epileptic seizure, including simple partial motor, complex partial as well as reflex motor seizure, choreoathetosis and ballismus. Its association with isolated visual alteration is less known. A 74-year-old diabetic woman with visual complaints manifested as flashing colorful lights (red, yellow and blue) in both visual field with progressive increase in frequency. Among the laboratory tests, NKH of 508mg/dL stood out. Slow waves from the right occipital region maximum at O2 associated with visual symptom were recorded in EEG. Brain MRI showed subcortical T2WI and FLAIR hypointensities in the right occipital lobe with scanty enhancement. Patient was treated with hydration and insulin and her symptoms disappeared after hyperglycemia was corrected. We stress that isolated visual episodes may be initial manifestation of occipital lobe simple partial seizure associated with NKH.
Aged ; Brain ; Dyskinesias ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Female ; Humans ; Hyperglycemia ; Insulin ; Light ; Occipital Lobe ; Precipitating Factors ; Reflex ; Seizures ; Visual Fields

BACKGROUND: We investigated the prevalence of dementia and mild cognitive impairment (MCI) and their risk factors in an urban community-dwelling elderly people over 65 years old. METHODS: A two-phase investigation was performed from January 2010 to December 2011. In Phase I, all subjects (n=9,485) responded to the Korean version of the Mini-Mental State Examination (K-MMSE). Based on the K-MMSE score the subjects were classified into two groups ('Normal' and 'Cognitive decline'). In Phase II, cognitive decline subjects were diagnosed as dementia or MCI according to the neuropsychological tests and doctor's interview. We also surveyed the socioeconomic and medical factors in Normal, Dementia and MCI groups. And we compared and analyzed the socioeconomic and medical risk factors by multiple logistic regressions in Dementia and MCI group. RESULTS: The prevalence of dementia and MCI was obtained 5.4% and 4.3%, respectively. Old age, alcohol intake, living together, low economic status, jobless in the past, diabetes mellitus, previous stroke, lower BMI and family history of dementia were associated with the increased dementia risk. Higher education, hypertension and physical activity were associated with the decreased dementia risk. And old age, alcohol intake, higher education, previous stroke, lower BMI and physical activity were common risk factors in MCI group. CONCLUSIONS: The prevalence of dementia and MCI was obtained much lower than previous reports. Dementia and MCI patients had common socioeconomic and medical risk factors. It is also important to control the risk factors earlier to prevent the increase of patients in dementia. And in order to prove the hypothesis that early control of the risk factors can decrease the occurrence of dementia, the further prospective studies are needed.
Aged* ; Dementia* ; Diabetes Mellitus ; Education ; Humans ; Hypertension ; Logistic Models ; Mild Cognitive Impairment ; Motor Activity ; Neuropsychological Tests ; Prevalence* ; Risk Factors* ; Stroke

No abstract available.
Movement Disorders

Hypertensive brainstem encephalopathy (HBE) is a variant of hypertensive encephalopathy characterized by brainstem and cerebellar involvement. Simultaneous supratentorial involvement in HBE is rarely reported as a vasogenic edema in subcortex and/or periventricular white matter. A 36-year-old woman visited hospital due to headache lasting 7 days before admission. Initial blood pressure was 270/170mmHg. T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging revealed multifocal high signal intensity lesions in upper medulla, pons, midbrain and cerebellar hemisphere. Especially, atypical periventricular lesions were shown as perpendicular fingers to the lateral ventricle like multiple sclerosis. Her clinical symptoms and radiological lesions were subsided with lowering blood pressure. We herein report a HBE with unusual supratentorial involvement mimicking multiple sclerosis.
Blood Pressure ; Brain Stem ; Edema ; Female ; Fingers ; Headache ; Humans ; Hypertensive Encephalopathy ; Lateral Ventricles ; Magnetic Resonance Imaging ; Mesencephalon ; Multiple Sclerosis ; Pons ; Posterior Leukoencephalopathy Syndrome

No abstract available.
Asian Continental Ancestry Group ; Encephalitis, Japanese ; Humans ; Temporal Lobe

BACKGROUND: Chronic kidney disease (CKD) is known to be associated with atherosclerosis and silent small-vessel occlusion, but there is scant information regarding the association between CKD and acute stroke. The aim of this study was to establish whether CKD influences the outcome and mortality rate after acute ischemic stroke. METHODS: From January 2005 to June 2008, patients with CKD and with normal kidney function were identified from the entire population of patients presenting with acute ischemic strokes at Soonchunhyang university hospital. We analyzed the baseline demographics, risk factors, stroke severity, functional outcome, mortality rate, and the prognostic factors affecting mortality in the two groups, and investigated the causes of death. RESULTS: Totals of 541 patients with normal kidney function (age 67.0/12.6 years; mean/SD) and 66 patients with CKD (age 70.8/11.9 years) were recruited. Hypertension and diabetes were more prevalent in the CKD group. National Institutes of Health Stroke Survey scores at admission (8.3/8.5 vs 5.5/6.0, p=0.001) and Modified Rankin Scale (mRS) scores at discharge (2.32/1.5 vs 1.92/1.5, p=0.067) were higher in the CKD group than in that with normal kidney function. Patients with CKD had a higher case-fatality rate (median survival time 13.9/13.6 months) than those without CKD (median survival time 19.2/13.2 months) and CKD was an independent prognostic factor for mortality after acute ischemic stroke. Cox proportional hazard analysis leukocytosis (hazard ratio, HR=4.46; 95% confidence interval, CI=1.28-15.52), high cardioembolic risk (HR=7.68; 95% CI=1.59-37.08), and poor (mRS> or =3) functional outcome at discharge (HR=8.67, 95% CI=2.19-34.33) were significant influencing factors on mortality in the CKD group. CONCLUSIONS: Compared with the normal kidney function condition, CKD is associated with a higher mortality after acute ischemic stroke. Leukocytosis, high cardioembolic risk, and poor functional outcome may be important prognostic factors of mortality from acute ischemic stroke with CKD.
Atherosclerosis ; Cause of Death ; Demography ; Humans ; Hypertension ; Kidney ; Leukocytosis ; National Institutes of Health (U.S.) ; Renal Insufficiency, Chronic ; Risk Factors ; Stroke

BACKGROUND AND PURPOSE: PurposezzInterest in gender differences in the effects of acute stroke is growing worldwide. However, gender differences in functional recovery after acute stroke in the Korean population have yet to be evaluated. The aim of this investigation was to compare long-term functional outcomes between male and female after acute stroke. METHODS: Patients with acute stroke were enrolled prospectively between January 2005 and January 2009. Baseline characteristics, risk factors, stroke subtypes, time delay from onset to arrival at a hospital, active treatment, and stroke severity were compared between male and female. Differences in mortality and disability at discharge, and at 3 months and 1 year after stroke onset were also investigated. Functional disabilities were categorized into two groups: good outcome (score on modified Rankin scale < or =2) and poor outcome (score on modified Rankin scale >2). RESULTS: Among 1,055 patients with acute stroke, 575 were male (aged 64.83+/-11.98 years, mean+/-SD) and 480 were female (aged 70.09+/-13.02 years). There were no gender differences in mortality at 3 months and 1 year after stroke. The frequency of poor outcomes was higher in female patients than in male patients at discharge (39.8% versus 30.9%, respectively; p=0.003), the 3 months follow-up (32.3% versus 20.8%, respectively; p<0.001), and the 1 year follow-up (31.1% versus 18.7%, respectively; p=0.001). After adjusting for multiple confounding factors including age and stroke severity, the female gender persisted as a predictor of poor functional outcome at 3 months and 1 year after stroke. CONCLUSIONS: Female patients have greater difficulty than male patients in recovering from a disabled state after acute stroke. Future studies should investigate the causes of this gender difference.
Female ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Risk Factors ; Stroke

BACKGROUND AND PURPOSE: PurposezzInterest in gender differences in the effects of acute stroke is growing worldwide. However, gender differences in functional recovery after acute stroke in the Korean population have yet to be evaluated. The aim of this investigation was to compare long-term functional outcomes between male and female after acute stroke. METHODS: Patients with acute stroke were enrolled prospectively between January 2005 and January 2009. Baseline characteristics, risk factors, stroke subtypes, time delay from onset to arrival at a hospital, active treatment, and stroke severity were compared between male and female. Differences in mortality and disability at discharge, and at 3 months and 1 year after stroke onset were also investigated. Functional disabilities were categorized into two groups: good outcome (score on modified Rankin scale < or =2) and poor outcome (score on modified Rankin scale >2). RESULTS: Among 1,055 patients with acute stroke, 575 were male (aged 64.83+/-11.98 years, mean+/-SD) and 480 were female (aged 70.09+/-13.02 years). There were no gender differences in mortality at 3 months and 1 year after stroke. The frequency of poor outcomes was higher in female patients than in male patients at discharge (39.8% versus 30.9%, respectively; p=0.003), the 3 months follow-up (32.3% versus 20.8%, respectively; p<0.001), and the 1 year follow-up (31.1% versus 18.7%, respectively; p=0.001). After adjusting for multiple confounding factors including age and stroke severity, the female gender persisted as a predictor of poor functional outcome at 3 months and 1 year after stroke. CONCLUSIONS: Female patients have greater difficulty than male patients in recovering from a disabled state after acute stroke. Future studies should investigate the causes of this gender difference.
Female ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Risk Factors ; Stroke

No abstract available.
Glioma*