Background and aims: Vestibular neuritis (VN) is a clinical feature, portrayed by acute and prolonged vertigo from peripheral source without associated auditory symptoms. the appearance of vestibular disease may also lead to cognitive deficits, including attention deficits. Therefore, the purpose of this mini-review is to describe the clinical characteristics, etiology, prevalence and treatment of vestibular neuritis in children.

Materials and methods: The present study was conducted in January 2021. The study was performed based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. The comprehensive search was conducted in the literature of the international databases (PubMed, Scopus, and Google Scholar) and national databases including scientific information database (SID), Magiran and iranDoc until January 13, 2021. Search keywords included "vestibular neuritis", "vestibular disorder", "balance disorder", and "pediatrics" or "children" or "adolescent" or "infants". The time limit for publishing articles was from 2010 onwards.

Results: In the initial search, 17 articles were extracted. After reviewing the title and abstract, 6 studies were excluded. In the evaluation and full-text review, 2 articles were excluded due to low quality and lack of access to the full text of another article. Finally, 9 studies were included in the present study.

Conclusion: We conclude that vestibular neuritis should always be considered in pediatric patients presenting with vertigo, and especially with nasopharyngeal viral infection, in addition to other differential diagnoses. Vestibular neuritis is one of the most common diseases in vestibular disorders in children, and different prevalence rates have been reported in studies so it needs further investigation. Once the diagnosis of vestibular neuritis is confirmed, symptomatic treatment should be started for the child.

Background and aim: Stroke is recognized as the third leading cause of death in the world and is one of the most important causes of disability in adults. Hence, strategies that can be useful in improving condition of the patients suffering are constantly investigated. One of these strategies is the precise approach to transient ischemic attacks. Accordingly, this study was overall done to Determine clinical and brain Magnetic Resonance Imaging findings in patients with repeated stereotypical transient ischemic attack (TIA).

Materials and Methods: 36 patients referred to Loghman-e-Hakim Hospital with symptoms of transient stereotypical ischemic attacks within the first 24 hours were enrolled in this study. Patients were followed up for a complete history at the time of entrance, and Brain CT was done. Cases with metabolic and toxic causes, existence of non-ischemic evidences in Brain CT, as well as prohibition of MRI, were excluded. The information was obtained by the various examinations of clinical presentation, underlying risk factors, as well as the history of medication, and it  was entered in a data collection form. MRI (Brain and cervical MRA & Brain MRI) was performed for patients up to 72 hours. EEG was also done on patients with symptoms such as paresthesia or loss of consciousness, or patients suspected of seizure. Finally, the neurologist made the final diagnosis and the data were analyzed by a statistical expert using SPSS version 24.

Result: 36 patients were enrolled in this study. According to the studied clinical symptom, 23 patients (63.8%) had hemiparesis, 5 patients (13.9%) had hemiparesthesia, 20 patients (55.5%) had dysarthria and 23 patients (63.8%) had facial palsy. among the 36 patients, 20 (55.5%) cases had DWI infarct that 14 (38.8%) cases were lacunar infarct and 6 (16.6%) cases were large infarct. among the 20 patients with infarct, the lacunar infarct of 12 (33.3%) cases were subcortical and 8 (22.2%) cases were cortical. Also, based on investigation of the artery stenosis, 18 patients (50%) had artery stenosis among which, 7 patients (19.4%) had stenosis of small vessels and 11 patients (30.6%) had stenosis of large vessels. According to the results of this study, there is a significant relationship between artery stenosis and infarct in DWI (P = 0.007). In addition, there was no significant difference between infarct size and the size of constricted arteries, in terms of DWI (P = 0.1).

Conclusion: Most patients with repeated stereotypical TIA have infarct in DWI a thrombotic cause, and anticoagulant drug can be replaced by anticoagulants.

Background and aim:

The classification of pituitary adenomas now includes an "atypical" variant, which can be defined as MIB-1 proliferative index greater than 3%, excessive p53 immunoreactivity, invasive growth pattern, and increased mitotic activity. In this study, we aimed to describe pituitary adenoma characteristics in patients referred to the Loghman Hakim hospital.

Methods:

This article is a cross-sectional descriptive study. In this study, the authors reviewed the records of 300 patients, including 250 patients with typical pituitary adenoma and 50 patients with atypical pituitary who were referred to Loghman Hakim Hospital between 2011 and 2017. Statistical analyses were performed using Fisher's exact test and Mann-Whitney.

Result:

In the APAs group, 47.8% and 52.2% of the tumors were microadenomas and macroadenomas, respectively. In the APA group, 91.3% of the patients had a Ki-67 labeling index of more than 3%, and the presence of p53 protein was observed in all the patients with APAs. The mean number of mitosis in the TPAs and APAs groups was 0.62 and 2.5, respectively. In addition, our results showed significant threshold values for mitotic index (>2 mitosis within ten high power fields). Also, there was no significant difference between the size of tumors and the type of secretion hormones in the APA and TPA groups (P> 0.05).

Conclusion:

There was a relationship between tumor size and hormone secretion with types of pituitary adenoma.

Methanol is a toxic alcohol which can cause severe bilateral visual impairment. In this study we report a case of unilateral visual loss due to methanol intoxication.

A 45-year-old man referred to toxicology department of Loghman Hakim Hospital complaining of bilateral blurred vision, vomiting, nausea. He was oriented and he had drunk about 500 cc alcohol two days ago, he underwent 4 hours of emergency hemodialysis and we also prescribed erythropoietin, Methylprednisolone, Amp folinic acid, Na/HCO3. then he was referred to ophthalmologist that reported: right eye’s acuity 7/10, left eye’s acuity 3m, RADP positive, left eye’s abducent movement and its color was disturbed and retinal examination was consistent with methanol intoxication.

Visual impairment due to methanol poisoning usually occurs bilaterally, but rare cases of unilateral vision damage have also been reported in two studies which they stated may be due to anatomical or structural variation.

A seven-month-old female infant was referred to the dermatology clinic due to several erosive cutaneous lesions. The lesions were crusted and super-infected (impetiginized), widespread on her face, trunk and, extremities. Multiple atrophic and ice-pick scars were also remarkable, especially on her face, which was attributable to previous lesions. The lesions have been appeared since one- month of age, and have been resolved on their own with atrophic scars. Hoarseness was another notable finding in her physical examination and the physical examination was otherwise normal. The hoarseness had existed since her birth. Lipoid proteinosis or Urbach- Weithe syndrome is a rare autosomal recessive disorder due to mutation in extracellular matrix protein 1  (ECM 1) characterized by the deposition of hyaline in cutaneous tissue and mucus membrane of aerodigestive tract (2). Mucocutaneous lesions including palpebral and lingual yellowish nodules, laryngeal complications such as hoarseness and obstruction, and neuro-cognitive disorders including learning difficulties, aggression, loss of fear, memory impairment, and seizures are expected in lipoid proteinosis (3-7).