Læknablaðið : fylgirit - 01.05.2002, Blaðsíða 41

POSTERS / 3 3RD SNC & 2ND SCNN
differences were observed between the older patients and controls.
Conclusion: The quality of life of stroke patients showed no
significant changes at 6 months and at 1 year after stroke. Stroke
affects particularly the quality of life of the younger stroke patients.
P08 - Hemiballism in a patient with intracerebral hematoma
Haldre S, Körv J, Roose M
University of Tartu, Tartu, Estonia
Objective: Lesion of the subthalamic nucleus may cause contra-
lateral hemiballistic syndrome. It may be preceded by sensory or
motor complaints indicative of a vascular event involving the upper
midbrain or diencephalon.
Material and methods: We describe a patient (84 y., male) who
presented with the history of subjective rightsided weakness and
uncontrolled movements in his right hand and leg that developed
one day later.
Results: The patient had arterial hypertension for 10 years. On
admission he was fully awake, there were ballistic movements in his
right side, there was no obvious paresis. During sleep the symptoms
were less prominent. CT scan disclosed in thalamus intracerebral
hematoma with diameter of 1 cm. Haloperidol was used as symp-
tomatic treatment. The movement disorder decreased to some
extent. The patient became drowsy and disoriented. Finally he was
transferred to the longterm treatment facility.
Conclusion: The reported patient with hemiballism had small
hemorrhage in the basal part of the thalamus which is typical for
such case. However, at our department there have been only few
stroke patients who have presented with hemiballism. We have
recorded the syndrome on the tape and would like to present video
as an illustration to this case.
P09 - Intrathecal apolipoprotein E production is reduced in
multiple sclerosis
Schwarz C, Bachner M, Schiefermeier M, Kollegger H
Department of Clinical Neurology, University of Vienna, Austria
Objective: To compare apolipoprotein E (ApoE) concentrations in
cerebrospinal fluid (CSF) and plasma of patients with clincally
definite, relapsing multiple sclerosis (MS) with those of age-
matched controls, using the distribution of ApoE genotypes (e 3/3
vs e non3/3) and the presence or absence of relapses as grouping
variables.
Material and methods: We investigated 24 MS patients (18 women,
mean age 33.4 [7.2] years; 6 men, 34.3 [8.4] years; 14 patients with,
10 patients without relapses) and 28 (17 women, 11 men) age-
matched headache sufferers without neurologial deficits and nor-
mal CSF findings (controls). Neurological evaluation and routine
CSF examination were carried out and ApoE concentrations (CSF,
plasma) were measured using an enzyme-linked immunosorbent
assay. ApoE genotypes were determined by a restriction fragment
length polymorphism method. For statistical analysis Mann-
Whitney rank-sum tests were used.
Results: We found that the ApoE concentration in CSF (but not in
plasma) of MS patients was lower than that of controls (0.31 [0.10]
vs 0.40 [0.14] mg/dl; P=0.035) and that the distribution of ApoE
genotypes had no influence on ApoE production. The ApoE con-
centration in CSF of patients with relapses was not different from
that of patients without relapses (0.30 [0.09] vs 0.33 [0.12] mg/dl;
P=0.585).
Conclusion: In conclusion, we demonstrate that intrathecal ApoE
production in MS patients - irrespective of ApoE genotypes and
the presence or absence of acute relapses - is reduced. The
molecular mechanisms underlying this reduction of intrathecal
ApoE production in MS patients are unknown but might provide
valuable information on oligodendrocyte dysfunction and give
clues how myelin repair could be promoted.
P10 - The ICAM1 K469E dimorphism is not associated with
multiple sclerosis in Sweden
Masterman T, Zhang Z, Hellgren D, Anvret M, Hillert J
Huddinge University Hospital, Karolinska Institutet. Stockholm, Sweden
Intercellular adhesion molecule (ICAM)-l is expressed on brain-
vessel endothelial cells; through interaction with integrins on leuco-
cytes, ICAM-1 mediates the migration of immune cells through the
blood-brain barrier. ICAM-1 expression is increased on the CNS
microvessels of multiple sclerosis (MS) patients, and administration
of anti-ICAM-1 antibodies reduces the severity of signs and patho-
logical changes in an MS-like animal nrodel. The gene encoding
ICAM-1 has been mapped to chromosome 19pl3, a region whose
possible involvement in MS is supported by the results of British
and American whole-genome screens. An A-to-G transversion in
exon 6 of the gene results in a glutamate-for-lysine substitution in
codon 469 of the translated protein. Homozygosity for the K469E
A allele was found to be more common in MS patients than in
controls in Polish and Finnish datasets, but not in a Dutch dataset.
We genotyped by pyrosequencing 644 Swedish MS patients and 662
Swedish controls for the ICAMl exon 6 dimorphism; genotype
frequencies did not differ significanlly between patients and con-
trols, even after patients were stratified according to carriage status
for the MS-associated HLA class II specificity DR15.
P11 - Chronic reflex sympathetic dystrophy with dystonia
(Complex Regional Pain Syndrome) developing months after
cervical spinal cord injury
Guömundsdóttir Þ, Daníelsdóttir G, Guömundsdóttir V, Sveinbjörnsdóttir S
Dept. of Neurology, Landspítalinn University Hospital, Reykjavík, Iceland
RSD syndrome is characterised by variable disturbances of auto-
nomic, sensory and motor systems following trauma to the head,
spine or limbs.
We describe a case history of a 22 year old male, who in April
2000 sustained a blunt trauma to the back of his head and neck
while skiing. Initial symptoms were left ptosis, paresthesia and pain
in the left shoulder and arm and a slight power reduction in the left
limbs. He had urinary retension in the first 24 hours after the injury
which resolved temporarily. MRTs of the cervical spinal cord and
brain were normal. His symptoms remained stationary for three
months after which he developed progressive spasticity with promi-
nent dystonia and increasing pain in the left shoulder and upper
limb. These symptoms progressed over the next 5 months, resulting
in almost complete left sided paralysis with dystonic posturing of
the limbs, a progressive pain and urinary retention. A repeat MRI
of the cervical spine was normal. X-rays of the limbs showed patchy
demineralization of the bones in the left leg. Isotope bone scan
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