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Introduction: Diabetes is one of the most prevalent diseases in the world. Today there are 100 milion diabetics around the world and in Iran it is about 1.5 milion. The prevalence of symptomatic neuropathy is 15% but with NCV it will increase to 50%. Regarding the suffer produced by neuropathy and that there is no effective treatment for that, this is necessary to investigate new treatment options. Materials and Methods: This is a clinical trial study, done during a 3 months period in vali-e-asr hospital in year 2004. 100 diabetic patients were selected randomly and divided into two equal groups. A complete sensorimotor assessment was performed and a questionnaire consisting history and clinical symptoms including limb pain, murmur and paresthesia and examinations such as pin prink test, position and vibration assessment, was completed. NCV was also done and blood sugar and HbA1c was measured. In case group 2000 micrograms vit B12 was prescribed twice weekly and in control group 10mg nortiptiline every night was prescribed. After 3 months patients were assessed again. Data was analysed using mean and standard deviation and Chi square, K-S, Leven, T and Mann Whitney tests. Results: Based on visual analage scale the difference between pain number before and after treatment was decreased 3.66 (3.66-4.25) in case and 0.48 (0.54-1.13) in control group (P<0.001). Also the difference between paresthesia number before and after treatment was decreased 2.98 (2.51-3.44) in case and 1.06 (064-1.47) in control group (P<0.001). The difference between murmur number before and after treatmat was decreased 3.48 (2.93-4.02) in case and 3.48(2.93-4.02) in control group (P<0.001). There was no significaut difference between NCV, vibration, position and pin prink test results. Conclusion: Changes in clinical symptoms in case group in comparison to those in control group was significant, but changes in physical assessment findings (pin prink, Position, vibration and NCV) was not significamt.

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Introduction: Relationship between Multiple Sclerosis (MS) and primary headaches is not well recognized yet and the studies that have been done had different results. The aim of this study was to investigate the relation between primary headaches and multiple sclerosis. Materials and Methods: In this historical cohort study, 117 patients with actual MS were selected by convenience sampling as case group and 351 healthy subjects as control group. The incidence of primary headaches was assessed by a physician using a questannaire. Variables under investigation were age, sex, type of MS, Expanded Disability Status Score (EDSS), and characteristics of headache based on International Headache Society (IHS) classification. Data analysis was done using Chi-square, t-test, Fisher exact test, and logistic regression. Results: 53.8% of MS group and 27.4% of control group had chronic headaches (p=0.0001). Frequency of Migraine and tension type headaches among patients with headache in MS group were 73.1% and 26.98%, and in control group were 40.6% and 58.7% respectively. There was a statistically significant relation between Relapsing-Remitting MS and migraine headache (p<0.001).There was not any correlations between headache and using Interferone, MS duration, and EDSS. Conclusion: The results of this study indicate that primay headaches, especialy migraine without aura, are common in MS patients comparing to general population.

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Background: In the recent years, oxidative stress was attended as one of the causal factors of ischemic stroke. In terms of the role of genetic, geographic and ethnic factors in the prevalence of stroke, This study was designed to compare the oxidative stress indexes of stroke patients with normal healthy subjects in this geographic area. Methods and Materials: In this case-control study, 36 patients older than 50 years with ischemic stroke and 45 healthy subjects with same age and sex, were enrolled. Five milliliter blood were drawn from all subjects. Samples were centrifuged and plasma was separated. Total antioxidant capacity, lipid peroxidation and thiol levels were measured respettively by FRAP, TBA and HU methods. Then the result was analyzed using t-test. Results: Results showed total antioxidant capacity and thiol plasma levels were lower in stroke patients in compare to healthy subjects, but only the thiol group had significant difference(P=0/001). Although lipid peroxidation showed a slight but non-significant difference in stroke patients in compare to control group. Conclusion: These findings suggest oxidative stress in patients with acute ischemic stroke may be conseaqence of an imbalance in oxidant/antioxidant homeostasis. Therefore it may be useful to recommend antioxidant medications or diet for these patients.

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  Background: Stroke is one of the important causes of death. However the prognostic factors are not clearly defined. There are many evidences which show the role of inflammatory factors during the progression of stroke but the relation of CRP and stroke is still vague. This study was designed to determine the relation between CPR Level and WBS with severity of stroke (according to CNSS score) and volume of infarct in stroke patients.

  Methods and Materials : This is a cross sectional study performed during the winter and spring of 2007 on 49 patients with stroke hospitalized in Vali-e-Asr hospital of Arak.Clinical examination was done by using CNSS scoring. The CRP and WBC were measured in the first 72 hour of onset of the disease. The CT scanning together with infarct volume estimation was performed at the same time.

  Results : There was no correlation between the volume of infarct with CRP serum level (r=-0.14, p=0.39 ) and WBC (r=-0.17, p=0.92 . Also there was no correlation between CNSS score with CRP level (r=-0.04, p=0.81) and WBC (r=-0.124, p=0.40) too, but there was a significant correlation between CNSS score and stroke volum in brain CT scan (r=-0.43, p=0.006 ).

  Conclusion: According to data in this study there was no correlation between serum acute phase reactant, the volume and severity of infarction.

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Background: Multiple sclerosis (MS) is a demyelinating disease of central nervous system which has different clinical manifestations. Noticing the role of vitamin B12 in synthesis of myelin tissue and the existence of different views about its pathogenesis and causes, we decided to evaluate B12 serum levels in MS patients. Materials and Methods: In a case-control study, 40 patients with definite clinical diagnosis of MS and 80 traumatic patients hospitalized in the emergency ward of Vali-asr Hospital of Arak (the control group) were chosen. The level of blood vitamin B12 was measured for all the subjects through the same type of kit and clinical checklist. Data were analyzed through t-test. Results: The mean vitamin B12 serum level in case and control groups were, respectively, 295±133.3 pg/dl and 257.73±91.3 pg/dl which did not indicate a significant difference(p> 0.05). However, in terms of the type of clinical manifestations, the mean vitamin B12 serum level in MS patients showed at least one sensory, motor, or sphinctery symptom lower than the control group. This difference turned out to be significant(p< 0.05). In terms of MRI findings, patients with brainstem and vertebra plucks respectively had the maximum and minimum vitamin B12 serum levels. Conclusion: Although a significant difference was not observed between the mean vitamin B12 serum levels, based on the significant decreases in the serum levels of this vitamin in some of the patients with subtypes of MS, further studies with larger sample sizes and over longer periods of time are suggested.

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Background: Cerebral venous sinus thrombosis is a rare form of brain stroke caused by thrombosis in venous sinuses of Dura. This study reports on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure. Case: A 33-year-old woman with past history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month is described in this study. She was febrile and in brain CT scan hemorrhagic focus in left posterioparietal and temporal lobe was reported. MRI and MRV proved venous sinus thrombosis in left transverse sinus. In laboratory assessment, brucellosis was confirmed as well. The patient treated with anticoagulant, anti-brucellosis, and antiepileptic agents and discharged in good condition with medication orders. Conclusion: Clinical suspicion and accurate evaluation is the most important clue in the diagnosis and treatment of brucellosis and venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.