ABSTRACT Background: Nonconvulsive status epilepticus (NCSE) is a condition that needs timely diagnosis and treatment. It has insignificant clinical features and presents high risk of misdiagnosis. Objective: To investigate NCSE among patients with stroke, given that stroke plays an important role in the etiology of NCSE. Methods: In this retrospective study, acute stroke patients who were admitted and followed up at a stroke outpatient clinic between January 2013 and March 2016 were included. Patients with previous histories of epilepsy, brain tumor, head trauma, hypertensive encephalopathy, arteriovenous malformation, subarachnoid hemorrhage or cerebral venous thrombosis were excluded. Demographic properties, stroke etiology, imaging method, EEG findings, stroke severity according to the NIHSS score, functional disability and modified Rankin Scale were recorded for all patients. Results: Thirty-nine out of 792 stoke patients experienced NCSE. The mean age of the study population was 70±1.2 years (min-max: 46‒90). The study population was composed of 28 females (71.8%) and 11 males (28.2%). NCSE had early onset in 23 patients (59%) and late onset in 16 (41%). The early-onset NCSE patients were older and this was statistically significant between the groups (early onset: 73.5±11.5; late onset: 65.9±12.1; p=0.04). A history of previous stroke was more frequent in the late-onset NCSE group (14; 87,5%) than in the early-onset group (11; 47.8%) (p=0.01). The prognosis was worse in the early-onset group, but without statistical significance. Conclusion: Changes in mental status in the early stages of stroke are mostly attributed to stroke itself, but NCSE should be suspected in the right clinical setting, such as in older patients with suspicious anatomical and clinical associations.

Syphilis is a bacterial inflammation of Treponema pallidum. Neurosyphilis is a poorly understood complication and might occur any time during the course of infection. Myelitis is an uncommon complication of neurosyphilis and have been infrequently reported in the literature. A 63-year old male patient was admitted to the hospital with the symptoms of upper and lower motor neuron diseases. Serological diagnosting tests were positive in both serume and CSF. His toracal spinal MRI revealed an intramedullary high-signal intensity lesion on T10 and diagnosed as syphilitic myelitis and treated 10 days with ceftriaxone 2g/day. During 6 months of the follow-up his neurological and neuroimaging findings were recovered. If the primary infection is untreated, inflammation of CNS arteries end up with store-mimic manifestations of meningovascular syphilis. Due to sphilitic myelitic cases are frequent in the literature, neurosyphilis should be in mind for the differential diagnosis the reason why it could be treatable.

Acute idiopathic demyelinating optic neuritis is frequently the initial manifestation of multiple sclerosis (MS). We aimed to discuss the value of color vision testing to detect possible optic nerve involvement in patients with MS who had no history of optic neuritis. We evaluated color vision with Farnsworth-Munsell 100 (FM-100) hue test. Total error scores (TES), partial error scores for the red-green axis (RGS) and blue-yellow axis (BYS) were calculated. Topographic optic disc parameters (RNFL, RA, DA, CV, RV, and vertical CAD ratio), total macular volume (TMV), central macular thickness (CMT), and retinal ganglion cell layer (RGCL) were determined using spectral domain optical coherence tomography (SD-OCT). Choroidal thickness (CT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). Pattern visual evoked potentials (PVEP) were also performed. Twenty-eight patients with RRMS (56 eyes) and 25 healthy controls (50 eyes) were included. P100 latencies were significantly delayed and P100 amplitudes were significantly reduced in the patient group compared with the controls (p <= 0.05). Statistically significant thinning was found in temporal quadrant in the patient group compared with the controls (p = 0.002). TES RGS, and BYS were all increased in the patient group but this was not statistically significant. We found no correlation between TES, RGS, BYS, and P100 latencies or OCT parameters. In our investigation as to whether color vision testing could be a simple biomarker for showing neurodegeneration of the anterior visual pathway regardless of optic neuritis, PVEP and OCT-assessed RNFL thickness seemed to be a more valuable biomarker than color vision testing. (C) 2018 Elsevier Ltd. All rights reserved.

INTRODUCTION: Non-convulsive status epilepticus is a condition that needs timely diagnosis and treatment with insignificant clinical features and high risk of misdiagnosis. We aimed to reveal late onset NCSE in patients with stroke where stroke plays a role in the etiology. METHODS: We conducted a retrospective analysis of patients who presented to our outpatient stroke clinic between January 2013 to January 2016. A week after the stroke, patients were defined as late onset NCSE. A total of 9 patients were included. Demographic properties, stroke etiology, imaging modality, EEG findings, stroke severity according to NIHSS score, functional disability, modified Rankin Scale were recorded for all patients. RESULTS: A total of 9 patients were included. The mean age of the study population was 70,5± 9,6 years. There were 8 (88,9%) females, and 1 male. Eight of nine patients had middle cerebral artery, 1 patient had posterior cerebral artery infarct. While 5 patients had cardioembolic stroke, 4 patients had cryptogenic stroke. DISCUSSION AND CONCLUSION: The late onset NCSE after ischemic stroke is not a rare entity. NCSE should be kept in the differential diagnosis of apathy patients with older age and large stroke.