Distinct from migraine with aura or hemiplegic migraine, a rare clinical entity of migraine-like headache, transient focal neurologic deficit and CSF pleocytosis (HaNDL) has been known. Although the etiology or pathogenesis is unknown, possibility of viral infection or inflammation has been suggested. We report a 25-year-old man diagnosed as HaNDL with literature review. (J Korean Neurol Assoc 19(3):302~304, 2001)
Adult ; Aphasia ; Headache* ; Humans ; Inflammation ; Leukocytosis* ; Migraine Disorders ; Migraine with Aura ; Neurologic Manifestations*

No abstract available.
Pneumonia*

No abstract available.
Encephalitis* ; Glioma* ; Recurrence*

Meningioma is generally regarded as benign and extracranial metastasis of intracranial meningioma is rare. About 60 cases of distant metastasis of meningioma have now been reported. Angioblastic meningioma, although a rare type, shows rapid growth and sarcomatous change frequently, and has higher incidence of metastasis than other types of meningioma. The authors report a case of malignant angioblastic meningioma arisen in left olfactory groove with multiple metastasis to skeletal system. The available literature regarding these tumors is reviewed.
Incidence ; Meningioma* ; Neoplasm Metastasis*

Anti-leucine-rich glioma inactivated-1 (LGI1) limbic encephalitis (LE) is a rare neurological disorder that has a subacute course of progressive encephalopathy and fasciobrachial dystonic seizures. We report a patient with anti-LGI1 LE that presented with atypical manifestations that complicated the diagnosis. A 62-year-old woman presented with a chronic course of memory disturbance and a subsequent relapse with an altered mental status after 10 months. The patient reported frequent chest pain of squeezing and dull nature, typically lasting 10-30 seconds. The chest pain was related to partial seizures, which were confirmed by video-EEG monitoring. Anti-LGI1 antibody was identified in serum and CSF. The patient's symptoms improved by immune modulation treatment. Patients with anti-LGI1 LE can experience atypical partial seizures, and a chronic relapsing course. Clinical suspicions and video-EEG monitoring are helpful for the early diagnosis and effective immune modulation.
Chest Pain ; Diagnosis ; Early Diagnosis ; Female ; Glioma ; Humans ; Limbic Encephalitis* ; Memory ; Middle Aged ; Nervous System Diseases ; Recurrence ; Seizures

BACKGROUND AND PURPOSE: We performed this study to explore the various diagnostic roles of video-EEG monitoring (VEM) and to assess the outcome after VEM. METHODS: 1749 patients who underwent VEM in the adult epilepsy section were included. We classified purposes of VEM and assessed outcome after VEM or epilepsy surgery guided by VEM. The outcome was assessed according to seizure frequency during the previous 12 months from the day of follow-up evaluation. RESULTS: The purposes of VEM were presurgical evaluation (68.5%), confirmation of epilepsy (15%), classification of seizures (9.4%), diagnosis of pseudoseizures (5.5%), and detection of nonconvulsive status epilepticus (1.7%). The efficiency of VEM was 89.2%, highest for presurgical evaluation (97.1%) and lowest for confirmation of seizures (66.0%). The number of events detected and the number of days needed differed according to the purposes of VEM. Epilepsy surgery was performed in 629 patients. The outcome of patients with epilepsy surgery was significantly better compared with patients without surgery despite presurgical evaluation (p<0.0001). Various other illnesses with transient symptoms as well as various epileptic syndromes were diagnosed by VEM. Better outcomes were observed in patients in whom VEM was used for classification and confirmation of seizures compared with patients in whom VEM was used for presurgical evaluation. CONCLUSIONS: VEM is a useful tool for various purposes. The efficiency, number of events and days of VEM differed according to the purposes. Patient outcome was also dependent on the purpose of the VEM as well as on treatment modalities.
Adult ; Epilepsy ; Follow-Up Studies ; Humans ; Seizures ; Status Epilepticus

Rheumatoid arthritis (RA) is an autoimmune disease involving the synovial membrane of peripheral joints. T cells specific for self antigens may play a critical role. Identification of T cell receptors (TCR) of such specific T cell clones is very important for treatment, prevention and identification of relevant autoantigens. To identify specific T cells, TCR V beta family repertoire and the clonal expansion of T cells were analyzed in this study. The percentage of V beta 5+ or V beta 8+ cells in the synovial fluid mononuclear cells (SFMCs) was similar to that in the peripheral blood mononuclear cells (PBMCs). However, the percentage of DR+ T cells in the SFMCs was higher (p< 0.01). Analyzing the clonality of T cells in 8 V beta families (V beta 1, V beta 5, V beta 8, V beta 14, V beta 16, V beta 17, V beta 18, V beta 20), clonal expansions in CD8+ T cells from the SFMCs were found more frequently than in the PBMCs. The patterns of clonal expansions were discrepant between the SFMCs and the PBMCs even in the same patient, which suggests several inflamed tissue specific T cell clonal expansions in the SFMCs. These T cell clones might be activated by autoantigens which are not identified yet and responsible for the RA pathogenesis.
Arthritis, Rheumatoid/*metabolism/pathology ; Base Sequence ; Blood Cells/*metabolism ; Clone Cells ; Female ; Human ; Male ; Molecular Probes ; Molecular Sequence Data ; Polymerase Chain Reaction ; Receptors, Antigen, T-Cell/genetics/*metabolism ; Support, Non-U.S. Gov't ; Synovial Fluid/cytology/*metabolism ; T-Lymphocytes/*metabolism

BACKGROUND: Intracerebral hemorrhage (ICH) is associated with a considerable proportion of stroke and head injuries, but except for supportive care, there is no medical therapy available. Transplantation of human neural stem cells (NSCs) can be used to reduce behavioral deficit in experimental ischemic infarct model. However, effect of stem cell transplantation in experimental intracerebral hemorrhage (ICH) is unknown. We hypothesized that NSCs could migrate and differentiate into neurons or glial cells, and improve functional outcome in ICH. METHODS: Experimental ICH was made by intrastriatal administration of bacterial collagenase in adult rats. Animals were randomized to receive intravenously either immortalized Lac-Z positive human NSCs (5x1 06 in 500microL, n=15) or same volume of saline (n=12) on the following day. Animals were evaluated for 8 weeks after surgery with behavioral test battery. After 8 weeks, animals were sacrificed and the brains were sectioned. Transplanted NSCs were detected by X-gal histochemistry or beta-gal immunohistochemistry, and differentiation of grafted NSCs were evaluated by double labeling of GFAP, NeuN, or neurofilament. RESULTS: Transplanted NSCs migrated to the side of peri-hematomal areas, and differentiated into neurons and astrocytes. NSCs injection group showed improved performances on rotarod test after 2 weeks and on limb placing test after 5 weeks compared with control group (p<0.05) and these effect persisted up to 8 weeks. CONCLUSIONS: Intravenously injected NSCs enter rat brain with ICH, and differentiate into astrocytes or neuronal cell, which lead to functional recovery. These findings show the possibility that NSCs can be used to reduce neurological deficits in the experimental ICH.
Adult ; Animals ; Astrocytes ; Brain ; Cerebral Hemorrhage* ; Collagenases ; Craniocerebral Trauma ; Extremities ; Humans* ; Immunohistochemistry ; Neural Stem Cells* ; Neuroglia ; Neurons ; Rats ; Rotarod Performance Test ; Stem Cell Transplantation ; Stroke ; Transplants