Group Of Neurological Disorders Research Articles

The effect of underlying diseases on pneumonia risk in patients with neurogenic or tumor-related dysphagia: a retrospective cohort study.

To analyze the association of neurological disorders (ND) and head and neck cancer (HNC) with dysphagia severity and aspiration pneumonia occurrence. Retrospective cohort study conducted at a university dysphagia center) for two consecutive years. Patients with ND or HNC were included if they had undergone a flexible endoscopic swallowing evaluation (FEES) at the dysphagia center, and at least one food consistency had been sampled and recorded. Outcomes of interest were swallowing safety, highest penetration-aspiration-score (PASmax), way of food intake, presence of a tracheal tube, and occurrence of pneumonia within the past two years. Of 257 consecutive patients, 199 were enrolled in the study and classified according to their underlying diagnosis into ND (120 patients) or HNC (79 patients). Forty-three HNC patients (54.4%) and 54 ND patients (45%) showed critical dysphagia in FEES (PAS ≥ 6). Binary logistic regression comparing both groups showed patients with ND to be 2.31 times more likely to develop pneumonia. However, if the 32 stroke patients were excluded from the calculation, PASmax remains the only significant variable affecting pneumonia risk in both groups. Liquids were the main challenge for ND patients, while aspirating HNC patients struggled with all consistencies. The study shows that patients with HNC and ND differ in pneumonia risk only if stroke patients are included in the ND group. If they are excluded, the PAS score is the only remaining risk factor for pneumonia. Thickening liquids may not be suitable for all dysphagic patients; individually tailored measures might be more helpful, especially for HNC patients.

Treatment outcomes and overactive bladder symptoms after midurethral sling in female patients with or without various neurological diseases.

We investigated surgical outcomes and changes of overactive bladder (OAB) symptoms after midurethral sling in female stress urinary incontinence (SUI) patients with or without neurological disease (ND) without spinal cord injury. Patients who underwent midurethral sling for SUI between January 2009 and December 2018 were reviewed. Postoperative changes in OAB symptoms (de novo occurrence or resolution) within 1 year were compared in each preoperative symptom subset with a 1:1 matched analysis between non-neurological disease (NND) and ND group. A total of 855 patients (median follow-up: 49.8 months; mean age: 57.9 ± 9.3 years) were included. Successful SUI correction was achieved in 95.0% of NND and 93.7% of ND patients (p = .440). Among 797 patients (711 NND and 86 ND) without remnant SUI, 227 had SUI only, 198 had SUI with urgency, and 372 had mixed urinary incontinence (MUI) preoperatively. The ND patients tended to be older (62.8 ± 9.2 vs. 57.2 ± 9.0 years) and had higher proportions of diabetes (24.4% vs. 8.0%), hypertension (47.7% vs. 26.7%), and MUI (64.0% vs. 44.6%) than NND patients (p < .001, respectively). After matching age, diabetes, and hypertension, the incidence of de novo OAB was higher in ND patients (SUI only; 21.1% vs. 5.3%; p < .001) while resolution rates of urgency urinary incontinence (UUI) were similar (MUI; 57.7% vs. 53.9%; p = .414). Success rates of midurethral sling and resolution of UUI were comparable between NND and ND patients. In patients with neurological conditions, de novo OAB symptoms were more likely to develop.

The characteristics of neurocardiogenic syncope in children

Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI. Results : Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P