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Keynote Forum Day 1 conferenceseries.com 26th European Neurology Congress August 06-08, 2018 | Madrid, Spain Keynote Forum Day 1 Neurology Congress 2018 Page 35 Ara Garabed Kaprelyan, J Neurol Neurophysiol 2018, Volume 9 conferenceseries.com DOI: 10.4172/2155-9562-C4-069 26th European Neurology Congress August 06-08, 2018 | Madrid, Spain Ara Garabed Kaprelyan Medical University of Varna, Bulgaria (18F)-FDG PET in diagnosis of dementias and epilepsy 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 flow (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 findings in patients with dementias and epilepsy. Methods: Patients with different 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. The degree of hypometabolic disturbances correlated with the severity of the disease. In patients with diffuse 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 flow were shown on scans of patients with vascular dementia. Interictal (18F)-FDG PET demonstrated well-defined 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 effective method for early detection and precise diagnosis of dementias epilepsy. Biography 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 Multiprofile 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 scientific 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 (scientific 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. [email protected] Journal of Neurology & Neurophysiology Volume 9 ISSN: 2155-9562 Neurology Congress 2018 August 06-08, 2018 Page 36 Birendra Kumar Bista, J Neurol Neurophysiol 2018, Volume 9 conferenceseries.com DOI: 10.4172/2155-9562-C4-069 26th European Neurology Congress August 06-08, 2018 | Madrid, Spain Birendra Kumar Bista Neuro Cardio & Multispecialty Hospital Pvt. Ltd., Nepal Blood pressure optimization in different types of stroke: A systemic review troke alters the cerebral auto regulation as a result blood pressure is elevated in most of the stroke patients. Different stroke types Snamely, intra cerebral hemorrhage, ischemic infarct and SAH (subarachnoid hemorrhage) each require different ranges of BP (blood pressure) optimization to maintain CPP and MAP. Inappropriate ranges of BP result as rebleed, infarct evolution and cerebral edema. The stroke types require different 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 specific 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. Biography 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. [email protected] Journal of Neurology & Neurophysiology Volume 9 ISSN: 2155-9562 Neurology Congress 2018 August 06-08, 2018 Page 37 conferenceseries.com 26th European Neurology Congress August 06-08, 2018 | Madrid, Spain Keynote Forum Day 2 Neurology Congress 2018 Page 55 Dimitar Maslarov, J Neurol Neurophysiol 2018, Volume 9 conferenceseries.com DOI: 10.4172/2155-9562-C4-069 26th European Neurology Congress August 06-08, 2018 | Madrid, Spain Dimitar Maslarov Medical University of Sofia, Bulgaria Current therapy of Parkinson's disease arkinson's disease (PD) is a disease, which encompasses the central nervous system. Symptoms start gradually, sometimes in Pjust one hand. This condition usually is the reason for rigidity and tremor. Even though PD is not curable, some medicines could considerably improve the symptoms. Medications: PD patients possess low levels of dopamine in their brains. The idea of medication is to increase or substitute for dopamine. Levodopa-carbidopa: The drug that goes through the human brain barrier and turns into dopamine is levodopa which is combined with carbidopa. Levodopa-carbidopa infusions: Patients with advanced PD disorder can still be influenced by Carbidopa-levodopa, however their response is variable. Yet, it's administered through a feeding tube that delivers the medication in a gel form directly to the small intestine. Dopamine agonists imitate the consequences of the dopamine on the brain. They consist pramipexole, rotigotine and ropinirole. For fast alleviation can be used the Apomorphine, which is a short-acting injectable dopamine agonist. Monoamine oxidase B (MAO-B) Inhibitors contain selegiline, rasagiline and safinamide. Their function is to avoid the failure of the dopamine in the brain via constraining the MAO B enzyme of the brain. Catechol-O-methyl transferase (COMT) inhibitors – entacapone slightly extends the outcome of levodopa treatment through interlocking the enzyme which demolishes dopamine. One more COMT inhibitor is the Tolcapone, which can hardly be given to patients because of a danger of severe liver harm and liver failure. Anticholinergics: Medicines used for decades to assist the tremor related with PD. Amantadine: Amantadine alone provide short-term relief of symptoms of early PD. It could be combined with Carbidopa- levodopa treatment throughout the advanced phases of PD to regulate the dyskinesias. Surgical Procedures: In deep brain stimulation (DBS), are implant electrodes into the subthalamic nucleus or the globus pallidus interna. DBS may steady the medicine variations, to decrease or stop dyskinesias, to diminish tremor and the rigidity. Also, can prevent slowing down patients’ actions. Treatment of PD should be personalized.
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