‘Twenty syndrome’ in neuromyelitis optica spectrum disorder

A 30-year-old woman presented with recurrent hiccups, vomiting and painful diminution of vision and gait instability for 1 day. She had one-and-a-half syndrome, bilateral seventh cranial nerve paresis with bilateral symptomatic optic neuritis and left-sided ataxic haemiparesis. We described her disorder as the ‘twenty syndrome’ (11/2+7+7+2+2+½=20). MRI of her brain revealed demyelination predominantly in right posterolateral aspect of pons, medulla and bilateral optic nerves. Serum antiaquaporin-4 antibody came out positive. Thus, she was diagnosed as neuromyelitis optica spectrum disorder (NMOSD). She responded brilliantly to immunosuppressive therapy. This is the first ever reported case of the ‘twenty syndrome’ secondary to cerebral NMOSD.

Гистохимический анализ активности 3β-гидроксистероиддегидрогеназы в нейронах ствола головного мозга крысы

The histochemistry method was used to study the activity of 3β-hydroxysteroid dehydrogenase (GSDG) in the neurons of the medulla oblongata and the pons medulla. It was revealed that GSDG-positive neurons are detected by this method in neurons of the nucleus (giant cell, para giant cell, intermediate reticular, medial vestibular and others), as well as in the internuclear zones. Spectrophotometric analysis showed that the intensity of the response to GDD in cells of the brain stem is high and in neurons of the giant cell nucleus exceeds that in Purkinje cells of the cerebellar cortex.