Background: Botulinum toxin (BoNT) injection serves as the primary modality for addressing hemifacial spasm (HFS) and blepharospasm (BFS), which are prevalent movement disorders affecting the craniofacial region. However, even though the short-term effectiveness of the botulinum injection may reach over 80%, the long-term effectiveness is still a debatable point Herein, we aim to investigate whether facial self-exercise following the BoNT injection can extend the time period of effectiveness. Methods: In this study, 51 volunteers who received Onabotilinumtoxin A (BoNTA) treatment for the diagnosis of HFS or BFS, were randomized into 2 groups. A detailed instruction about the self-exercise was given by an experienced physician to the subjects in Group 1. Volunteers were asked to repeat the exercise program afterward and continue to each movement for 5 seconds, to repeat each movement 10 times with a 10-second break, every day, 3 times a week for 1 week. hemifacial spasm grating scale (HSGS) and Jankovic scales were used to assess the efficacy of the treatment. Results: Both groups are similar to each other based on demographic features and the severity of the diseases. According to HSGS and Jankovic scales, at the end of the first month, there was no significant difference between the groups. At the end of the third month, the improvement achieved in the first month remained the same in each parameter in Group 1. On the other hand, in Group 2, most of the values returned to the baseline. Conclusion: Facial self-exercise following the botulinum toxin application may extend the period of effectiveness of botulinum toxin treatment the subjects with HFS and BFS.

Parkinson’s disease (PD) is the second most common degenerative disease which may cause blood pressure abnormalities due to autonomic dysfunction. Early morning rise of blood pressure which is called morning surge is found to be related with some cardiovascular diseases when it is exaggerated. We wanted to search the relation of Morning blood pressure surge (MBPS) and inflammation in PD. Method: Ambulatory blood pressure monitoring for 24 hours, fibrinogen to albumin ratio, hs-CRP are used in this retrospective study. Fifty idiopathic PD patients and 50 age and sex matched control cases were included. MBPS, it has been defined as the difference between morning BP (measured 2 hours after awakening) and the lowest night-time BP. Body mass index (BMI) is used as an independent variable. Results: Median value of MBPS for PD group (21,63) was significantly different from the control group values (18,63) (p

Background and Objectives: Essential tremor (ET) is a common neurological disorder, typically presenting as bilateral, rhythmic, and symmetric kinetic or postural tremors. In contrast, Parkinson’s disease (PD) is a progressive neurodegenerative disorder, characterized by resting tremor, rigidity, bradykinesia, and postural instability. Although both disorders involve tremor, ET and PD differ in clinical presentation and pathophysiology: ET generally involves action tremor and has a strong familial component, while PD more commonly presents with resting tremor and a weaker family history. A subset of ET patients may develop Parkinsonian features over time, although the relationship between ET and subsequent PD remains unclear. Genetic studies have identified only a few pathogenic variants in ET, suggesting it develops as a result of multifactorial genetic and environmental influences rather than simple Mendelian inheritance. ET is also recognized as a risk factor for developing PD, although the underlying mechanisms remain poorly understood. This study aimed to clarify potential genetic overlaps and distinctions in patients diagnosed with both ET and PD. Materials and Methods: We retrospectively analyzed 40 patients with a family history of ET or PD who were initially diagnosed with ET and later developed PD. Genetic screening and clinical assessments were conducted to investigate associated variants and clinical features. Results: Among these 40 patients, 17 different mutations were detected in 16 individuals. Three pathogenic or likely pathogenic variants were identified. The clinical characteristics and treatment responses of these patients were reviewed in relation to their genetic findings. Notably, none of the identified variants had previously been reported in association with PD following ET. Conclusions: A comprehensive clinical and genetic evaluation of ET patients who develop PD may offer insights into the underlying pathophysiology and inform future therapeutic strategies. Our findings support the need for further studies to explore the genetic landscape of patients with overlapping ET and PD features.

Objectives: The study aimed to investigate the association of anticholinergic burden with polypharmacy, the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), and the modified Hoehn and Yahr (HY) staging system in Parkinson's disease (PD). Patients and methods: The cross-sectional study included 75 patients (38 males, 37 females; mean age: 65.7±9.6 years; range, 32 to 86 years) who were admitted between January 2023 and January 2024. Demographic characteristics, systemic diseases, medications, MDS-UPDRS, and modified HY were recorded. Polypharmacy was defined as the use of five or more medications at the same time. The anticholinergic burden was calculated using the Anticholinergic Cognitive Burden (ACB) scale. Patients were divided into two groups: those with an ACB risk score ≥3 (high risk) and those with a risk score <3 (low risk). Results: When analyzed according to ACB scale risk status, 41 patients with PD were found to be at high risk for anticholinergic burden (score ≥3). The presence of at least one comorbid disease was more common in the high-risk group than in the low-risk group (p3) and depression as a comorbidity in these patients. A high ACB risk score was associated with modified HY Stage 4 when adjusted for confounding factors. The anticholinergic risk might be highest in the advanced stage of PD. Therefore, patients diagnosed with PD should be questioned about their drug history and evaluated for anticholinergic drug use at every visit.

Background: Parkinson’s disease (PD) is the second-most prevalent neurodegenerative disorder, often resulting in blood pressure abnormalities due to autonomic dysfunction. The early morning rise in blood pressure, referred to as the morning surge, has been associated with various cardiovascular diseases when exaggerated. This study aims to investigate the relationship between morning blood pressure surge (MBPS) and inflammatory markers in patients with PD. Methods: In this retrospective study, we employed 24 h ambulatory blood pressure monitoring alongside the fibrinogen-to-albumin ratio and high-sensitivity C-reactive protein (hs-CRP) as inflammatory markers. The study included fifty idiopathic PD patients and fifty age- and sex-matched control subjects. MBPS was defined as the difference between morning blood pressure (measured two hours after awakening) and the lowest recorded nighttime blood pressure. Body mass index (BMI) was considered as an independent variable. Results: Our study found that morning blood pressure surge (MBPS) levels were significantly higher in Parkinson’s disease (PD) patients compared to the control group, suggesting possible autonomic involvement. Conclusions: MBPS may indicate autonomic involvement, potentially contributing to cardiovascular and cerebral morbidity and mortality in PD patients. Longitudinal studies with larger sample sizes are warranted to further elucidate this relationship.