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Enra Suljić-Mehmedika

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Introduction: Electroencephalography can also be used to monitor long-term recovery of the patient after acute phase of the disease. Impaired neurocognitive function after infection, similar to brain injury, may present a transient but also prolonged problem for the functioning of an individual. Some studies have shown that importance of EEG may not be significant in sequel monitoring, because the extensive changes in EEG seen with severe forms of CNS infection do not necessarily imply a longer-term poor outcome. Aim: To examine the predictive potential of electroencephalography (EEG) in regard to the emergence of neurological and cognitive sequelae of acute central nervous system (CNS) infection. Methods: The study included 62 patients treated at the Clinic for Infectious Diseases, Clinical Center of Sarajevo University, who were diagnosed with acute CNS infection. The EEG record was characterized as: normal, non-specific changes of mild, moderate and severe degree and specific changes. The sequelae (headache, cognitive dysfunction, neurological and neurophysiological disorders, audiological and behavioral disorders) was evaluated by combining neurological, psychiatric, pediatric, otolaryngological, ophthalmic and infectological examination in the Neuroinfective Counseling Department for up to 6 months after discharge. Results: After a treatment of an acute CNS infection 25 (40.3%) patients had no sequelae and 37 (59.7%) were with sequelae. The EEG in the initial stage of the disease (Wald’s coefficient = 12.8), followed by the age of the patients (Wald = 6.4), had the greatest influence on the prediction of sequela (p=0.0001). For each additional degree of verified pathological changes in the EEG, the risk of sequelae was increased by 5 degrees (OR = 5.3), respectively. There was no statistically significant association between changes in cerebrospinal fluid (CSF) findings, meningeal symptoms, and signs with sequelae development. Conclusion: Younger age, as well as severe clinical status of a patient, which implies a disorder of consciousness and seizures on admission, are associated with irreversible consequences on a previously mentally healthy individual. Pathological changes (Delta and Theta waves, spike slow complex wave) on the EEG finding significantly predicted presence of sequelae. .

CONFLICT OF INTEREST: NONE DECLARED Neck pain syndrome is described as: Pain in the neck affects at least once in a lifetime every second person, and also 10 % of adult population suffers from chronic pain in this area. It is more often among women. A constant increase of incidence in the industrialized countries is noticed. It is also the leading cause of referral to physical rehabilitation. It is causing huge financial costs in the health care system. There is no consensus regarding Neck pain syndrome management, but many therapeutic modalities are applied: a) to isolate (or manage) rare, but potentially dangerous states that can cause neck pain; b) identify and treat each co morbid state and risk factors; c) provide resources and information’s, especially about regarding use computers in dayly practice. Physical and manual treatments can be: a) physical therapy can assist to achieve early mobilization and return to daily activities; b) active physical therapy , mobilization, manipulation and exercises can assure short time relief of neck pain; c) home based exercises, as shown by this research, can significantly prolong the pain free period, in case of patients with the chronic syndrome; d) Medications, combined with the exercise program and ergonomic improvements can be effective solution for the chronic or recurrent neck pain. Intensive treatments in Neck pain syndrome are: a) Surgical and other intensive treatment (rarely indicated); b) invasive treatments includes and percutaneous radiofrequent neurotomy and cervical epidural analgesis.

L. Todorović, M. Ibisević, A. Alajbegović, Enra Suljić-Mehmedika, V. Jurisic

Bilateral retrobulbar optic neuritis in young adults are most often caused by demyelinate disease (MS). In all cases where MS was eliminated, we have used selected tests regarding to history, clinical findings and differential diagnosis. Diagnosis of Lyme disease is approved by diagnostic criteria proposed by Center for Control and Prevention of disease. In our case diagnosis of Lyme disease was established by history of illness, clinical findings and positive serlological tests.

A. Kučukalić, A. Bravo-Mehmedbašić, A. Kulenović, Enra Suljić-Mehmedika

OBJECTIVE To determine the efficacy of venlafaxine in treatment of post-stroke depression. METHODS The sample consisted of 30 adult subjects with symptoms of post-stroke depression. All subjects received treatment with venlafaxine in therapeutic dose range in the period of three months. All subjects were assessed prior to treatment and in 1 month-follow-up and 3 months follow-up using the standardized instruments for assessment of depressive symptoms (Hamilton Depression Rating Scale HAM-D-21), and for efficacy and tolerability with the Clinical Global Impressions scale (CGI). All subjects signed an informed consent form prior to entering in the study. RESULTS The results indicate a statistically significant reduction of depressive symptoms following three months of treatment with venlafaxine. The difference between three assessments with The Clinical Global Impressions scale was statistically significant. Unwanted effects were registered in two of the subjects (increased blood pressure) and they were of mild intensity. CONCLUSIONS Venlafaxine proved to be very efficient, well tolerated and safe in the treatment of depression occurring after cerebrovascular incidents to the subjects in this study.

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