PURPOSE: The aim of this neurophysiological study was to retrospectively analyze visual evoked potentials (VEPs) acquired during an examination for diagnosing optic nerve involvement in patients with Lyme neuroborreliosis (LNB). Attention was focused on LNB patients with peripheral facial palsy (PFP) and optic nerve involvement. METHODS: A total of 241 Czech patients were classified as having probable/definite LNB (193/48); of these, 57 were younger than 40 years, with a median age of 26.3 years, and 184 were older than 40 years, with a median age of 58.8 years. All patients underwent pattern-reversal (PVEP) and motion-onset (MVEP) VEP examinations. RESULTS: Abnormal VEP results were observed in 150/241 patients and were noted more often in patients over 40 years (p = 0.008). Muscle/joint problems and paresthesia were observed to be significantly more common in patients older than 40 years (p = 0.002, p = 0.030), in contrast to headache and decreased visual acuity, which were seen more often in patients younger than 40 years (p = 0.001, p = 0.033). Peripheral facial palsy was diagnosed in 26/241 LNB patients. Among patients with PFP, VEP peak times above the laboratory limit was observed in 22 (84.6%) individuals. Monitoring of patients with PFP and pathological VEP showed that the adjustment of visual system function occurred in half of the patients in one to more years, in contrast to faster recovery from peripheral facial palsy within months in most patients. CONCLUSION: In LNB patients, VEP helps to increase sensitivity of an early diagnostic process.
- MeSH
- dítě MeSH
- dospělí MeSH
- faciální paralýza patofyziologie diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymská neuroborelióza * patofyziologie diagnóza komplikace MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci zrakového nervu * patofyziologie diagnóza MeSH
- nervus opticus patofyziologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zraková ostrost fyziologie MeSH
- zrakové evokované potenciály * fyziologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The aim of this neurophysiological study was to monitor changes in the visual and cognitive function of HIV-infected patients treated with combination antiretroviral therapy. METHODS: Eleven adult Czech HIV+ patients, with a mean age of 35 years and CD4 cell count ≥ 230 × 106 cells/L of blood at the time of enrollment, underwent four to six examinations over the course of 2.5 years to evaluate pattern-reversal and motion-onset visual evoked potentials (P-VEPs and M-VEPs), visually driven oddball event-related potentials (ERPs) and Montreal Cognitive Assessments. In addition to evaluating the intraindividual change in the observed parameters, we also compared patient data to data from eleven age- and gender-matched controls. RESULTS: We did not find any significant differences in P-VEPs between the patients and controls or in the paired comparison of the first and last visit. The only significant finding for P-VEPs was a linear trend in prolongation of the 20' P-VEP P100 peak time. In M-VEPs, we found a significant intergroup difference in the N160 peak time recorded during the first visit for peripheral M-VEPs only. During the last visit, all N160 peak times for patients differed significantly from those of the control group. The only intervisit difference close to the level of significance was for peripheral M-VEPs, which confirmed the trend analysis. No significant differences between patients and controls were found in the ERPs, but the P300 peak time showed a significant difference between the first and last visits, as confirmed by the trend. Patient reaction time was not significantly delayed at the first visit; however, it was prolonged with time, as confirmed by the trend. CONCLUSION: Our aim was to evaluate whether antiretroviral treatment in HIV+ patients is sufficient to preserve brain visual function. The optic nerve and primary visual cortex function tested by the P-VEPs seem to be preserved. The prolongation of the M-VEPs suggests an individually detectable decline in CNS function, but these changes did not show a progression during the follow-up. From a longitudinal perspective, the trends in peak time prolongation of the 20' P-VEP, peripheral M-VEP, ERP and reaction time suggest a faster decline than that caused by aging in healthy populations, as previously described in a cross-sectional study.
- MeSH
- antiretrovirové látky terapeutické užití MeSH
- dospělí MeSH
- elektroretinografie MeSH
- evokované potenciály fyziologie MeSH
- HIV infekce farmakoterapie patofyziologie MeSH
- kognice fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladý dospělý MeSH
- počet CD4 lymfocytů MeSH
- průřezové studie MeSH
- reakční čas fyziologie MeSH
- vnímání pohybu fyziologie MeSH
- zraková ostrost fyziologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- zrakové korové centrum fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Publikační typ
- abstrakt z konference MeSH
PURPOSE: The goal of the current study was to explore visual function in virally suppressed HIV patients undergoing combined antiretroviral therapy (cART) by using pattern-reversal and motion-onset visual evoked potentials (VEPs). METHODS: The pattern-reversal and motion-onset VEPs were recorded in 20 adult HIV+ patients with a mean age of 38 years and CD4 cell counts ≥230 × 10(6) cells/L of blood. RESULTS: Nine out of 20 patients displayed VEP abnormalities. Pattern-reversal VEPs pathology was observed in 20% of subjects, and 45% HIV patients had impaired motion-onset VEPs. Five out of 16 neurologically asymptomatic HIV patients had prolonged motion-onset VEP latencies in both eyes. Four neurologically symptomatic patients displayed simultaneously abnormal motion-onset and pattern-reversal VEP latencies: monocular involvement was observed in two patients with Lyme and cytomegalovirus unilateral optic neuritis. Binocular involvement was noted in two patients with cognitive deficits. Correlation analysis between disease duration, CD4 cell count, HIV copies in plasma, MoCA and electrophysiological parameters did not show any significant relationships. CONCLUSIONS: The functional changes of the visual system in neurologically asymptomatic virally suppressed HIV patients displayed higher motion-onset VEP sensitivity than in standard pattern-reversal VEP examinations. This promising marker, however, has no significant association with clinical conditions. Further exploration is warranted.
- MeSH
- analýza rozptylu MeSH
- antiretrovirové látky terapeutické užití MeSH
- dospělí MeSH
- HIV infekce farmakoterapie imunologie patofyziologie virologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- počet CD4 lymfocytů MeSH
- rozpoznávání obrazu fyziologie MeSH
- virová nálož MeSH
- vnímání pohybu fyziologie MeSH
- zánět zrakového nervu patofyziologie virologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- očkování, komplikace, protivirová léčba,
- MeSH
- chřipka lidská epidemiologie komplikace virologie MeSH
- kontrola infekčních nemocí MeSH
- lidé MeSH
- rizikové faktory MeSH
- vakcíny proti chřipce terapeutické užití MeSH
- věkové rozložení MeSH
- virus chřipky A, podtyp H1N1 izolace a purifikace účinky léků MeSH
- Check Tag
- lidé MeSH
- MeSH
- algoritmy MeSH
- antibakteriální látky aplikace a dávkování MeSH
- Chlamydia trachomatis izolace a purifikace patogenita MeSH
- chlamydiové infekce diagnóza farmakoterapie prevence a kontrola MeSH
- Chlamydophila pneumoniae patogenita MeSH
- Chlamydophila psittaci izolace a purifikace patogenita MeSH
- diferenciální diagnóza MeSH
- financování organizované MeSH
- lidé MeSH
- mužské urogenitální nemoci diagnóza farmakoterapie mikrobiologie MeSH
- ofloxacin aplikace a dávkování MeSH
- ženské urogenitální nemoci a komplikace těhotenství MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- MeSH
- klíště patogenita MeSH
- lidé MeSH
- lymeská nemoc patologie prevence a kontrola MeSH
- nemoci přenášené klíšťaty epidemiologie prevence a kontrola MeSH
- parazitární nemoci patologie MeSH
- virové nemoci patologie MeSH
- viry klíšťové encefalitidy patologie prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
S pomocí dvou kazuistik je popsána diagnostika a terapie tenióz včetně základních faktů týkajících se tohoto u nás stále vzácnějšího onemocnění. Text je doplněn o fotografickou dokumentaci nálezů a graf výskytu tasemnic v České republice v letech 1990-2000.
- MeSH
- albendazol MeSH
- cysticerkóza diagnóza terapie MeSH
- dospělí MeSH
- lidé MeSH
- mebendazol MeSH
- praziquantel MeSH
- Taenia klasifikace parazitologie MeSH
- tenióza diagnóza etiologie farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- Geografické názvy
- Česká republika MeSH
