We previously reported that aging process and disease progression of Alzheimer’s disease (AD) connected depressive symptoms (affective disturbance and anxiety) with psychotic symptoms such as delusion, hallucination and aggressiveness. These features are mixed state of manic state and depressive state, therefore, there might be relationship between bipolarity (BT) and psychological symptoms of dementia (BPSD) in AD. From these reports, we considered that BPSD in AD should be treated as “augmentation” (pharmacotherapy for bipolar disorder) .
In this previous article, we proposed the reasonability of prescribing the atypical antipsychotics for BPSD in AD. However, in Japan, there are currently no licensed medicines for the management of BPSD in AD patients although in case of oldest old patient antidepressant is useful for ameliorating BPSD in AD.
The Nipah virus is an important emerging infectious disease that is still included in the list of disease to be surveillance by WHO. The neurological involvement in Nipah virus infection is an important clinical manifestation. This pathogenic virus of this disease was firstly detected and reported by professor Bing from Malaysia, a Southeast Asian country. Here, the authors would like to discuss the present situation of Nipah virus infection in Thailand, a Southeast Asian country next to Malaysia. At present, Nipah virus infection is still under the closed surveillance from Thailand public health ministry.
According to a recent report on pathogen causing neurological infection, the Nipah virus is still not observed as a cause of neurological infection in Thai patients with neuro infections. Nevertheless, there are some reports on the survey of prevalence of Nipah virus in several animals, especially for bats, in Thailand. According to the survey in bats, the prevalence of Nipah virus contamination was seen in 6.29% of bats collected from several regions in Thailand. Of interest, although bat is proved to be the carrier of several pathogenic virus such rabies, the bat has never been the problem of zoonosis in Thailand.
Insomnia disorder (ID) is a common condition that includes difficulty in initiating sleep, maintaining sleep, waking up too early, and nonrestorative or poor-quality sleep, all of which are commonly associated with symptoms of daytime functional impairment. According to a WHO collaborative study in 14 countries, 16% of correspondents had difficulty falling asleep; 25% of the correspondents either experienced difficulty staying asleep or woke up too early. The prevalence is even higher in the elderly and twice as high in women as in men.
A twenty-six years old man, who had progressive atrophy of the right clavicular portion of pectoralis major muscle accompanied by pain on the right chest and shoulder for three months, was referred to our neurology outpatient clinic. He was a worker of an automotive plant. He had been working in a leaning position at a narrow place with his right arm stretched out.