SCFA Treatment Alleviates Pathological Signs of Migraine and Related Intestinal Alterations in a Mouse Model of NTG-Induced Migraine

Background: There is a growing realization that the gut–brain axis signaling is critical for maintaining the health and homeostasis of the Central Nervous System (CNS) and the intestinal environment. The role of Short-Chain Fatty Acids (SCFAs), such as Sodium Propionate (SP) and Sodium Butyrate (SB), has been reported to counteract inflammation activation in the central and Enteric Nervous System (ENS). Methods: In this study, we evaluated the role of the SCFAs in regulating the pathophysiology of migraine and correlated dysregulations in the gut environment in a mouse model of Nitroglycerine (NTG)-induced migraine. Results: We showed that, following behavioral tests evaluating pain and photophobia, the SP and SB treatments attenuated pain attacks provoked by NTG. Moreover, treatments with both SCFAs reduced histological damage in the trigeminal nerve nucleus and decreased the expression of proinflammatory mediators. Ileum evaluation following NTG injection reported that SCFA treatments importantly restored intestinal mucosa alterations, as well as the release of neurotransmitters in the ENS. Conclusions: Taken together, these results provide evidence that SCFAs exert powerful effects, preventing inflammation through the gut–brain axis, suggesting a new insight into the potential application of SCFAs as novel supportive therapies for migraine and correlated intestinal alterations.

Symptom of Hemifacial Spasm Is Not Affected By State of Consciousness: A Case Report

Background: Hemifacial spasm is characterised by twitching of the muscles innervated by facial nerve. It is believed to result from hyperexcitability of the facial nerve nucleus or ephaptic transmission within the proximal facial nerve segment of the facial nerve nucleus. Often we observe spasm in an awakening situation. Actually contractions persist during sleep. To our knowledge, there were no reports on how it manifests under disturbance of consciousness. Herein we report a case whose symptoms sustained under coma status.Case presentation: A 74-year-old female suffered from right side primary hemifacial spasm for 20 years and used to accept botulinum toxin injection in our clinic. Unfortunately she was carried to emergency department in our hospital after traumatic right pneumothorax by accident. During emergency rescue cardiac arrest and apnea happened. She was then hospitalized in emergency intensive care unit for further therapy. During hospitalization, she was under coma status. Vital signs were stable and symptoms of hemifacial spasm sustained. A multidisciplinary consultation was request to identify whether it was focal cortical seizures involving the right side facial muscles. Physical examination revealed brief involuntary clonic or tonic contractions accompanied with the ‘Babinski-2’ sign. Synthesize the relevant data including past history, clinical manifestation and negative head computed tomography scanning, diagnosis was made as hemifacial spasm. Herein symptoms of hemifacial spasm were not life threatening and anti-epileptic drug was not necessary.Conclusions: It’s better for nonspecialists to prompt diagnose instead of under or misdiagnose the symptoms as seizures as inappropriate diagnostic or therapeutic measures may be taken inadvertently.

Eight and a Half Syndrome: A Rare Case of Pontine Infarction

Introduction: This case report describes “one-and-a-half” syndrome with supranuclear facial palsy. Case: 39 years old male hypertensive patient presented with right facial nerve palsy, internuclear ophthalmoplegia and conjugate gaze palsy. Neuroimaging showed acute posterior pontine infarct at medial longitudinal fasciculus, paramedian pontine reticular formation, abducens nerve nucleus and seventh nerve fascicular zone. Observation: “One-and-a-half”syndrome is characterized by a lateral gaze palsy in one direction and internuclear ophthalmoplegia in the other. Our patient had Right sided one and a half syndrome along with the right facial nerve palsy. Conclusion: Eight and a half syndrome is a rare manifestation of pontine infarction.

Co-transplantation of bone marrow mesenchymal stem cells and monocytes in the brain stem to repair the facial nerve axotomy

After the facial nerve axotomy (FNA), the distal end of the axon would gradually decay and disappear. Accumulated evidence shows that transplantation of bone marrow mesenchymal stem cells (BMSCs) reveals potential in the treatment of nervous system diseases or injuries. This study is aimed at investigating the therapeutic effects of co-transplantation of BMSCs and monocytes in FNA. We found that co-culture significantly elevated the CD4+/CD8+ ratio and CD4+ CD25+ T cell proportion compared with monocytes transplantation, and enhanced the differentiation of BMSCs into neurons. After the cell transplantation, the lowest apoptosis in the facial nerve nucleus was found in the co-transplantation group 2 (BMSCs:monocytes= 1:30). Moreover, the lowest expression levels of pro-inflammatory cytokines and the highest expression levels of anti-inflammatory cytokines were observed in the co-transplantation group 2 (BMSCs: monocytes= 1:30). The highest expression levels of protein in the JAK/STAT6 pathway and the SDF-1/CXCR4 axis were found in the co-transplantation group 2. BMSC/monocyte co-transplantation significantly improves the microenvironment in the facial nerve nucleus in FNA rats; therefore these findings suggest that it could promote the anti-/pro-inflammatory balance shift towards the anti-inflammatory microenvironment, alleviating survival conditions for BMSCs, regulating BMSC the chemotaxis homing, differentiation, and the section of BMSCs, and finally reducing the neuronal apoptosis. These findings might provide essential evidence for the in-hospital treatment of FNA with co-transplantation of BMSCs and monocytes.

Trigeminal trophic syndrome

Trigeminal trophic syndrome is a rare nosological pathology form of the face. Based on the literature data and 11 own observations, the article discusses the pathogenesis, diagnosis and treatment of skin sensations, ulcerative and other cosmetic defects that occur after injury of the peripheral branches, Gasser's node, root, and the upper sensitive trigeminal nerve nucleus in the dorsolateral part of the pons Varolii upper section in the brain stem. The clinical disease manifestations are described in detail with the characteristics of the lesions, their localization, course dynamics, and mental status patterns of patients. The article presents a detailed list of pathological conditions with which trigeminal trophic syndrome should be differentiated (malignant epithelioma, mycoses, focal fibrosing alopecia, leprosy, syphilis, diabetes mellitus, cutaneous manifestations in diseases of internal organs and connective tissue (scleroderma, temporal arteritis, Wegener's granulomatosis), central and peripheral nervous system, substance abuse, psychosomatic disorders, somatopsychosis, autoaggression, Munchausen syndrome, etc.). KEYWORDS: skin ulcers, neurotrophic disorders, trigeminal trophic syndrome, deafferentation, iatrogenic complications. FOR CITATION: Belopasov V.V. Trigeminal trophic syndrome. Russian Medical Inquiry. 2020;4(9):566–572. DOI: 10.32364/2587-6821-2020- 4-9-566-572.

An atypical manifestation of lateral medullary syndrome

ABSTRACT Lateral medullary syndrome is a common brainstem stroke associated with a classical triad of Horner’s Syndrome, ipsilateral ataxia and hypalgesia and thermoanasthesia of ipsilateral face. We report a case of a 49-year-old diabetic, non-hypertensive, postmenopausal female who presented with symptoms involving the left dorsal medulla along with right sided hemiparesis and left UMN-type facial palsy. Contralateral hemiparesis was explained by caudal extension of infarct involving the pyramids before decussation at the medulla, known as Babinski–Nageotte Syndrome. UMN-type facial palsy was attributed to involvement of hypothetical supranuclear aberrant corticobulbar fibres of facial nerve which descend down in the contralateral ventromedial medulla, decussate at level of upper medulla and then ascend in the dorsolateral medulla to reach the facial nerve nucleus. Association of these two entities with Wallenberg’s Syndrome have been reported separately in literature, but not together as in this case.

Morphometric study of the neurons in human hypoglossal nerve nucleus during early gestation

Hypoglossal nerve, XII cranial nerve is responsible for the motor innervation of the tongue muscles, which assists in various motor activities such as chewing, swallowing, vocalization. Thus, weakness of this nerve will lead to weakness and deviation of the tongue to one side. Clinically besides these functions it is also responsible for the most important function such as modulation of respiration and drinking behavior. Thus, a detailed study about the cell dynamics, which involves the development of neurons in the hypoglossal nerve nucleus becomes essential. 12 foetuses [Gestational age 10 – 24 weeks] were included in the study. They were divided into 4 groups based on their gestational age and CRL measurements. Hypoglossal nucleus extends throughout the length of medulla oblongata in the para-median plane. Tissues were collected from hind brain section and section of medulla. The tissues will be processed by routine histological procedure were stained with hematoxylin & eosin and also with Holmer’s Silver nitrate to study the histological details. Morphometric study covered the cell dimensions and volumes of hypoglossal neurons and its nucleus. From these data, coefficients were drawn to identify the proportion of growth between cell and nuclear volume. Morphometric analysis of hypoglossal nerve neurons in human from 10th to 24th gestational week concludes that the primitive migratory cells seen in the initial period and later it will become round neuroblast. In the initial 16 weeks nucleus occupied the entire volume of the cell.Keywords: Hypoglossal nerve nucleus, Deglutition, Mastication, Morphometry, Histogenesis