26^th European Neurology Congress August 06-08, 2018 Madrid, Spain

Ara Garabed Kaprelyan graduated from Higher Medical Institute of Varna in 1988. He is a Specialist in Neurology and Health Management, PhD since 2005, and Professor since 2013. Recently, he is a Chief of First Clinic of Neurology, member of Advisory Council (Neurology division) at University Multiprofi le Hospital for Active Treatment “Sveta Marina", Varna. He is an expert in MS, PD, AD, epilepsy, and chronic pain at National Health Insurance Fund and Republican Consultant of Ministry of Health for North-East region of Bulgaria. He is Head of Department of Neurologic Diseases and Neurosciences at Varna Medical University. His Postgraduate education includes specialization in neuro-oncology, clinical immunology, otoneurology, clinical epileptology, and movement disorders. He has over 150 scientifi c publications and authorship in eight medical text-books and monographs. He is a Member of Bulgarian Society of Neurology (Board of Managers; Chairman of regional branch at Varna district), Bulgarian Association of Neuro-oncology (Vice-president), International Medical Association Bulgaria, Balkan Medical Union (Vice-president of Bulgarian branch), and EAN (scientifi c panels of neuroepidemiology and neuro-oncology). He is in the Editorial Board of Journal of IMAB and Bulgarian Neurology, as well as a Correspondent member of Bulgarian Academy of Sciences and Arts.

Background: Recent epidemiological studies reveal increasing incidence and prevalence of patients with dementia and epilepsy. Nuclear imaging techniques are modern non-invasive tools for investigation in vivo of the basic CNS biochemical processes and physiological functions. Positron emission tomography (PET) provides information about cerebral blood fl ow (CBF), permeability of blood-brain barrier (BBB), cerebral enzyme activity, as well as glucose, amino acids, and neurotransmitters metabolism. Accordingly, it is among the most useful biomarkers for evaluation of neurodegeneration in dementia. (18F)-FDG PET may uncover the disease underlying mechanisms, follow-up the progression, and predict the outcome. Also, interictal PET is used to detect the seizure onset zone and determine the lateralization of temporal lobe epilepsy, when a good concordance between MRI and EEG is missing.

 

Objective: To study the (18F)-FDG PET fi ndings in patients with dementias and epilepsy.

 

Methods: Patients with diff erent clinical forms of dementia, genetic and structural epilepsy, due to congenital or acquired brain lesions were included in the study. Detailed clinical examination, MRI and (18F)-FDG PET (Philips Gemini TF PET/CT) were performed.

 

Results: Decreased glucose metabolism, predominantly in the temporal and parietal regions was found in patients with Alzheimer’s

disease. Th e degree of hypometabolic disturbances correlated with the severity of the disease. In patients with diff use Lewy body

disease (18F)-FDG PET revealed metabolic changes similar to the AD abnormalities and additional hypometabolism in the regions

of visual cortex. In patients with FTD zones of hypometabolism in frontal and temporal lobes were illustrated. Multiple foci of hypometabolism, corresponding to the disturbances of cerebral blood fl ow were shown on scans of patients with vascular dementia.

Interictal (18F)-FDG PET demonstrated well-defi ned hypometabolic zones in accordance with the location of epileptic foci.

 

Conclusion: Based on our own notices, we suggest that (18F)-FDG PET is a useful eff ective method for early detection and precise

diagnosis of dementias epilepsy.

Birendra Kumar Bista is one of the first Neurologists of Nepal. He has been pioneering in field of Neuroscience in Nepal and established the first neuroscience center of Eastern Nepal. He completed his study from Queen Square University, UK. Through years the work of this neuroscience center has been recognized home and abroad. He shows keen interest in medical management providing state of art services to this impoverished region of Nepal. Recently he added the first stroke center in Nepal. He firmly believes in continuous updated education and its implementation in hospital practices.

Stroke alters the cerebral auto regulation as a result blood pressure is elevated in most of the stroke patients. Diff erent stroke types namely, intra cerebral hemorrhage, ischemic infarct and SAH (subarachnoid hemorrhage) each require diff erent ranges of BP

(blood pressure) optimization to maintain CPP and MAP. Inappropriate ranges of BP result as rebleed, infarct evolution and cerebraledema. The stroke types require diff erent MAP (mean arterial pressure), CPP (cerebral perfusion pressure), systolic blood pressure (SBP) and diastolic blood pressure (DBP) to maintain adequate cerebral perfusion. Blood pressure optimization is among one of the most important steps in neuroprotection. This systemic review presents the latest updates in BP management in acute stroke. It also stipulates recommended ranges of CPP, MAP, ICP (intracranial pressure), SBP and DBP, for acute stroke management. Emphasis on, injectable anti hypertensives only in acute stroke is given and commonly used IV (intravenous) agents are also listed.

 

Recent Publications : 

1. Singh S, Gan H, Marasigan S and Navarro J C (2011) Co-occurrence of intraventricular hemorrhage and total anterior

circulation infarction in an 80 year old female: A case report. Post Graduate Medical Journal of NAMS 11(1):56-58.

 

2. Singh S (2017) Phenobarbital treatment for malignant infarcts. Neuro: A Peer Review Journal of Neurology ISSN: 2392-

4462.

 

3. Abrams E M, Becker A B and Gerstner T V (2011) Anaphylaxis related to avocado ingestion: A case and review. Allergy,

Asthma & Clinical Immunology 7:12.

 

4. Singh S and Devkota U P (2016) Guidelines for early specifi c management of acute stroke. Ultimate Marketing ISBN:

978-9937-0-0480-0.

 

5. Singh S (2016) Neurocritical care a case based approach. Ultimate Marketing ISBN 978-9937-8506-3-6.