RESUMEN
OBJECTIVE: Activation of trigeminovascular system is thought to play an important role in migraine pathogenesis. Blink reflex (BR) test is an easy method to study the trigeminal system. Latencies recorded in BR test were evaluated to examine neurophysiological changes that occur in migraine patients. METHODS: A total of 40 patients diagnosed with migraine (9 with aura and 31 without aura) according to the International Headache Society (IHS) International Classification of Headache Disorders, 2nd edition, and 30 healthy control subjects were assessed using BR test. Supraorbital nerve was stimulated on each side, and unilateral early component (R1), and bilateral late component (R2) latencies were evaluated. RESULTS: Significantly longer latency values were recorded on both right and left sides (RR1 and LR1) as well as both ipsilateral and contralateral R2 on the left side (LR2i and LR2c) in the migraine group compared to the control group. Longer RR1 and LR1 latencies were found in patients with migraine who had an attack at the time of study (p<0.01). There was no statistically significant correlation between the location of pain and latencies in the interictal period (p>0.05). But significantly longer R1 and R2i latencies were found at the symptomatic side of patients examined during the headache attack (p=0.037 and p=0.028 respectively). There was no statistically significant correlation between the recorded latencies and gender, attack duration, attack frequency and migraine type (p>0.05). CONCLUSION: Results of BR test in the present study are thought to point to a dysfunction in brainstem and trigeminovascular connections of patients with migraine headache and support the trigeminovascular theory of migraine.
RESUMEN
BACKGROUND: The neurological manifestations of Crohn's disease are rare, dominated by multiple mononeuropathies, peripheral neuropathies (PN) of axonal and demyelinating types, myopathies and the abnormalities of the white matter. In our study, we aimed to report electrophysiological follow-up of a patient with chronic polyradiculoneuritis associated with newly diagnosed active Crohn's disease. CASE: A 32-year-old male patient was admitted with the complaints of abdominal pain and diarrhea for three years and an ascending weakness of all four extremities since two years. On his medical history he did not have any other disease and none of the members of his family had similar complaints. The neurological examination revealed a weakness of the especially distal muscles (2-3/5) with areflexia, hypotonia and distal atrophia in all extremities. He also had a glove and stocking hypoestesia. Routine biochemical and hematological examination were in normal ranges except C-reactive protein. The analysis of the cerebrospinal fluid showed an albumino-cytological dissociation. CONCLUSION: Our results suggest that peripheral neurological findings could be regarded as a possible extraintestinal manifestation of Crohn's disease. It is important to remember that inflammatory bowel diseases may be a reason for a newly diagnosed polyneuropathy (acute or chronic demyelinated polyneuropathy) and therefore detailed examinations are needed if the patients do not have the commonly observed reasons for the development of polyneuropathy and be careful in inflammatory disease patient to develop polyneuropathy.