Vascular Dementia and Movement Disorders November 6-7, 2019 Yokohama, Japan

Biography:

Tisha Gay C. Tancongco is a graduate of Medicine at the age of 25 years from Cebu Institute of Medicine, Cebu city, Philippines. She is currently on her 3rd yr of Internal Medicine residency training at Maria Xavier University Hospital, which is a tertiary medical center located in Cagayan de oro, Philippines.

Abstract:

Non-ketotic hyperglycemia among type II diabetic patients has been documented to cause a rare movement disorder called Hemichorea-hemiballism syndrome. This is a hyperkinetic movement disorder presenting as a continuous, non-patterned, involuntary movements caused by a basal ganglia dysfunction. The movement disorder has an overall incidence of 1 in 500,000 of the general population, while the incidence directly caused by non-ketotic hyperglycemia is yet to be determined.

This case is a 76-year old male who presented with involuntary movements of the right extremities. The increasing intensity of the involuntary movements over 10 days prompted consult to a physician. On admission, the patient was conscious with stable vital signs. Involuntary movements of the right upper and lower extremities were observed. The patient had uncontrolled diabetes with an HBA1c of 12.6%, FBS of 128mg/dl and negative for urinary ketones. The Brain MRI with contrast demonstrated T1 hyperintensity signals involving the left caudate and left lentiform nucleus. The T2/FLAIR weighted imaging showed mixed hyperintense and hypointense signals on the left basal ganglia consistent with abnormal MRI findings in diabetic patients with non-ketotic hyperglycemia. The patient was then treated for diabetes and was maintained on risperidone and clonazepam for the involuntary movements. After 5 months, the patient’s diabetes were controlled, and the involuntary movements has completely resolved.

The case highlights non-ketotic hyperglycemia in a diabetic patient presenting as Hemiballismus-Hemichorea syndrome. The prompt recognition and correction of hyperglycemia leads to a rapid improvement of symptoms, less neurologic sequelae and an overall favorable prognosis.

Biography:

Subhas Bhuin has completed his  MBBS , MD General Medicine , and pursuing DM Neuromedicine from  BANGUR INSTITUTE OF NEUROSCIENCES , IPGMER , KOLKATA, INDIA.

Abstract:

Introduction - Clinical  profile and severity correlation  of ataxia patients in our population is still  varied . This study is taken up to explore this aspect. Methods - A cross-sectional study  was conducted at XXX. Clinical parameters with  severity correlation( SARA scale )  in selected patients  was determined. Results: In 188 patients  , 127  had cerebellar ataxia(SCA 2, 3, 1 ,6 ,12  , MSA C , Wilsons disease) , 42  had sensory ataxia  mainly  Sensory ataxic  GBS, CIDP  variant(CISP) , Sjogrens  and 19 had  Mixed cerebellar sensory ataxia (Multiple sclerosis , Vitamin E deficiency  ). Cerebellar ataxias had  higher  disability at presentation (  mean SARA score- 21.87)  than mixed ataxias ( SARA – 19.68). Increase in SARA score was seen more in mixed ataxias  (3.64)  than  cerebellar  ( 3.01) . Disability progression   is more in MSA C and SCA 2 has lesser degree of progression  ( despite  highest SARA score- 28.5  at presentation). Conclusion -    MSA C,   SCA ,  Multiple sclerosis  are  majority in  respective ataxia groups..  Maximum disability and  progression is seen in MSA and SCA (SARA scale) . Chances of  early detection and knowledge about progression of ataxia spectrum in our population is attempted.Limitations :  Further follow up of the patients with ataxia required to get a clear insight Further Scope :  Early diagnosis and management strategies can be validated for better management and prevention of deterioration to make the otherwise debilitating  ataxia disorders a preventable  one. Conflict of interest- Nil 

Biography:

Pavel Novak has degree in electronics and biomedical engineering. He has completed his Dr.-Ing. (PhD) at the age of 31 years from Technical University in Munich, Germany. He performed applied research for the Fraunhofer Institute for Solid State Technology. Afterwards he was Head of Electronics Development at Dornier Medizintechnik. In 1990 he become Head of Development at Storz Endoskop GmbH. He changed to Storz Medical AG in Kreuzlingen, Switzerland in 2003 as Product Deveopment Director. Currently he is Science & Technology/CBD Director. He has published more than 60 papers, holds over 60 patents and is BMT, ISMST and ALSMS member.

Abstract:

Acoustic waves, or shockwaves respectively are used in medicine since 1980. First application was for extracorporeal kidney stone disintegration. Meanwhile, low intensitiy acoustic waves proofed to be efficient for the treatment of non-unions, tendon and muscular pain, wound healing, heart insufficiency, erectile dysfunction, aesthetic and finally also neurological indications. The working principle is the mechanical stimulation of biological processes called mechanotransduction resulting in increased cell metabolism, release of nitrid oxide (eNO) and numerous growth factors like VEGF, BMP, TGF-β, GABA, BDNF and GDNF. There is also an anti-inflamatory effect and the stimulation of stem cells and the inate imune system. There are no significant side effects. Alzheimer’s disease or dementia in general is multi modal disease resulting from different causes like deposition of dedicated proteins (tau, beta-amyloid), inflamation, redused blood supply and others. This might be the reason why the phamaceutical solutions failed till now. On the other hand, the acoustic wave stimulation, or TPS with its broad scope of effects is more efficient. First the effect of acoustic pulses on brain was tested in-vitro and on behalf of animal tests (Sprague-Dawley rats) the safety margins were evaluated. The multicenter clinical pilot study with 35 patients showed a significant improvemet of the Alzheimer’s disease symptoms of 20% measured with CERAD Plus battery of tests. The treatment consisted of 6 sessions in 2 weeks, with 6000 pulses, energy flux density of 0.2 mJ/mm2 at 5Hz. These data were sufficient for the CE mark clearance in Europe. Further RCT studies are ongoing.