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Myasthenia gravis (MG) is an autoimmune disease caused by the presence of immunoglobulin G (IgG)1 and IgG3 complement activating antibodies against the nicotinic acetylcholine receptor, which affects the neuromuscular junction leading to fluctuating muscle weakness due to impaired neuromuscular transmission. The association of MG and demyelinating diseases is rare, but it has been described before and it could be part of an unspecific immune activation, due to genetic susceptibility or it could just happen randomly. Demyelinating diseases (DD) in MG patients can occur as monophasic events (myelitis, optic neuritis, acute disseminated encephalomyelitis) or recurrent diseases (multiple sclerosis, recurrent transverse myelitis) and since the incidence of DD is higher in MG patients than in general population this association could be part of an autoimmune syndrome or genetically induced. We present the case of a 30 year old woman who presented with an unspecific onset of MG and after 5 months was readmitted to our unit with transverse myelitis (with negative aquaporin 4 antibodies) which regressed after 5 days of combined intravenous corticotherapy and immunoglobulin treatment.

Background. Multiple sclerosis (MS) has a variable clinical and pathological course and pace, which eventually turns over years of that progression into a major source of disability especially among young adults. The regional incidence and prevalence data course are of utmost interest (i.e., they tend to be higher in Europe within the last decade) mirroring diagnosis improvement, earlier and better treatment choices and an improved physio-pathological insight as shown by most recent studies (1). The incidence and prevalence data tend to be higher in Europe within the last decade and are explained by diagnosis improvement and earlier and better treatment solutions for the patients mirrored by most recent studies (1). The objective of the present study is to assess data available concerning the prevalence of multiple sclerosis in Romania and in Central and South-eastern Europe in a regional view. Material and method. A literature search has been performed in PubMed, DIMDI, Web of Science, and Google Scholar to retrieve population-based studies in Central and Eastern Europe and epidemiological reviews through years 1960-2015. We searched the term “MS” combined with one of the following: “epidemiology” or “incidence” or “prevalence”. We also did a manual search of reference list of the relevant articles. Results. 38 studies met the inclusion criteria and were analysed. The epidemiologic data available for Central and Eastern Europe during the period 1960-2015 support the heterogeneity both of this region’s resident population and of the studies design, making any global data assessment difficult, with a questionable reliability, therefore justifying a newer reappraisal.

We present the case of a 25 years-old HIV infected patient with low CD4 count who presented seizures and receptive language disturbances. The MRI fi ndings were highly suggestive for cerebral Toxoplasmosis. An empirical treatment for Toxoplasma gondii was started, with favorable outcome. We discuss the MRI fi ndings in cerebral toxoplasmosis in immunocompromised patients. [ABSTRACT FROM AUTHOR]

Progressive multifocal leukoencephalopathy is a demyelinating disease of the central nervous system caused by the reactivation of latent JC virus. Since its initial description, there have been changes in its epidemiology, clinical presentation, evolution and prognosis. Some decades ago, it was considered a rare disease, but now it is a major complication of AIDS and represents an obstacle to the use of promising treatments for autoimmune disorders. Although the survival rate has increased in the last years, still no specific treatment for JC virus is available and further research is needed for a more effective management of the disease. [ABSTRACT FROM AUTHOR]

Melatonin, the hormone synthesized mainly by the pineal gland, is a key member of the complex monoaminergic signaling system, and a circadian regulator with pleiotropic functions. This ubiquitary lipophilic and hydrophilic molecule acts both at cellular and subcellular level, exerting anti-infl ammatory, anti-oxidative and anti-apoptotic activities, extremely important in the nervous system, given its high vulnerability to oxidative injury. Melatonin deprivation and the consecutive chronodisruption are associated with multiple behavioural abnormalities, psychiatric disorders and neurodegenerative diseases. The present review summarizes the available information concerning the link between melatonin, monoaminergic neurotransmission and the pathophysiological bases of these conditions. [ABSTRACT FROM AUTHOR]

Background. Multiple sclerosis (MS) has a variable clinical and pathological course and pace, which eventually turns over years of that progression into a major source of disability especially among young adults. The regional incidence and prevalence data course are of utmost interest (i.e they tend to be higher in Europe within the last decade) mirroring diagnosis improvement, earlier and better treatment choices and an improved physio-pathological insight as shown by most recent studies. (1) The incidence and prevalence data tend to be higher in Europe within the last decade and are explained by diagnosis improvement and earlier and better treatment solutions for the patients mirrored by most recent studies. (1) The objective of the present study is to assess data available concerning the prevalence of multiple sclerosis in Romania and in Central and Southeastern Europe in a regional view. Material and method. A literature search has been performed in PubMed, DIMDI, Web of Science, and Google Scholar to retrieve population based studies in Central and Eastern Europe and epidemiological reviews through years 1960-2015. We searched the term “MS” combined with one of the following: “epidemiology” or “incidence” or “prevalence”. We also did a manual search of reference list of the relevant articles. Results. 38 studies met the inclusion criteria and were analyzed. The epidemiologic data available for Central and Eastern Europe during the period 1960-2015 support the heterogeneity both of this region's resident population and of the studies design, making any global data assessment difficult, with a questionable reliability, therefore justifying a newer reappraisal. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus type 1 (HIV-1) is a member of Lentivirus genus of retroviruses that can determine a relatively slow encephalitis. The pathogenesis of HIV-1 encephalitis (HIVE) can be discussed in terms of neuroinvasion, neurotropism and neurovirulence. Several mechanisms are implicated in the pathogenesis, some of them being still under investigation. [ABSTRACT FROM AUTHOR]

Dandy-Walker malformation is a rare congenital malformation that involves the cerebellum and the fourth ventricle. Symptoms, which often occur in early infancy, include developmental delay, enlarged head circumference, or signs and symptoms of hydrocephalus. We present the case of a 70-year-old female who has led a normal life with an incidental Dandy-Walker malformation discovery. [ABSTRACT FROM AUTHOR]

Non-ketotic hyperglicemia has been described as a rare metabolic cause of hemichorea hemiballismus, especially in elderly patients with newly diagnosed or poorly controlled diabetes. We present the case of a 63-year-old male presenting with HCHB and characteristic findings on brain CT scan. [ABSTRACT FROM AUTHOR]

Herpes simplex encephalitis (HSE) is a serious disease, with increased risk of morbidity and mortality. We present the case of a 55 years old male who was admitted in our clinic with the suspicion of encephalitis with a MRI scan highly suggestive for HSE. [ABSTRACT FROM AUTHOR]

An abstract of the article "Calculating without words: a case of severe aphasia with remarkable arithmetical skills," by E.C. Rosca and colleagues, is presented.

Myasthenia gravis (MG) is an autoimmune disease caused by the presence of immunoglobulin G (IgG)1 and IgG3 complement activating antibodies against the nicotinic acetylcholine receptor, which affects the neuromuscular junction leading to fl uctuating muscle weakness due to impaired neuromuscular transmition. The association of MG and demyelinating diseases is rare, but it has been described before and it could be part of an unspecifi c immune activation, due to genetic susceptibility or it could just happen randomly. Demyelinating diseases (DD) in MG patients can occur as monophasic events (myelitis, optic neuritis, acute disseminated encephalomyelitis) or recurrent diseases (multiple sclerosis, recurrent transverse myelitis) and since the incidence of DD is higher in MG patients than in general population this association could be part of an autoimune syndrome or genetically induced. We present the case of a 30 year old woman who presented with an unspecifi c onset of MG and after 5 months was readmitted to our unit with transverse myelitis (with negative aquaporin 4 antibodies) which regressed after 5 days of combined intravenous corticotherapy and immunoglobulin treatment. [ABSTRACT FROM AUTHOR]

Melatonin, the hormone synthesized mainly by the pineal gland, is a key member of the complex monoaminergic signaling system, and a circadian regulator with pleiotropic functions. This ubiquitary lipophilic and hydrophilic molecule acts both at cellular and subcellular level, exerting anti-infl ammatory, anti-oxidative and anti-apoptotic activities, extremely important in the nervous system, given its high vulnerability to oxidative injury. Melatonin deprivation and the consecutive chronodisruption are associated with multiple behavioural abnormalities, psychiatric disorders and neurodegenerative diseases. The present review summarizes the available information concerning the link between melatonin, monoaminergic neurotransmission and the pathophysiological bases of these conditions.

From mild muscular contractions to gross jerks affecting the whole body, myoclonus is an involuntary movement caused by an excessive discharge from a group of neurons located in one or multiple sites from cortical to peripheral level. Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the CNS caused by oligodendroglial destruction due to JC virus. Usually it manifests with focal neurological deficits such as motor weakness, sensory abnormalities, visual disturbances, cognitive impairments, movement disorders having a low incidence in these patients. We report a rare case of myoclonus as a neurological complication of PML in AIDS, analyzing the link between the stage of HIV infection, the MRI lesions and the type of myoclonus, being also aware of potential interactions between the antiepileptic drugs and the antiretroviral therapy.

The infarcts of the spinal cord are a relatively rare disease, being described in small series of cases or case reports. We describe a case of a 51 year old female with a partial form of anterior spinal artery infarct presenting only brachial diplegia, with MRI scan showing a medullar infarct in the anterior spinal cord, from C3 to T1. [ABSTRACT FROM AUTHOR]

The article offers information about neuropathic pain, clinical and management aspects. According to the International Association for the Study of Pain (IASP), the neuropathic pain is a pain resulting from disease or damage of the peripheral or central nervous system, and from dysfunction of the nervous system. It mentions also that neuropathic pain is a debilitating condition characterized by severe, relentless chronic nerve pain caused by a primary lesion or dysfunction of the nervous system. Moreover, the neuropathic pain may be classified in central neuropathic pain, peripheral neuropathic pain and mixed neuropathic pain.

An abstract of the article "Mepivacaine subcutaneous infiltrations in acute migraine treatment: an observational study," by M. Simu and colleagues is presented.