relapsing polychondritis and lymphocytic meningitis with varied neurological symptoms

context. This phenomenon is called attentional boost, which is impairedin individuals with hippocampal atrophy. In this study, we examinedthe effect of l-DOPA in attentional boost. We report data from 20patients with Parkinson's disease (PD) before and after l-DOPA therapy.Participants received a letter detection task, while also viewing a seriesof briefly presented natural and urban scenes in the background of theletters. Before l-DOPA treatment (unmedicated state), the performanceof PD patients was similar to that of the controls: they exhibited higherlevels of scene recognition performance when scenes were presentedwith target letters relative to baseline (scenes alone) and distractors.After l-DOPA treatment, target-associated scene recognition wasfurther enhanced, but PD patients also improved recognition whenscenes were presented with distractor letters outperforming con-trols. l-DOPA did not affect baseline scene recognition. Changes insubthreshold impulsive traits and psychosis-like experiences (follow-upminus baseline) correlated with paradoxically enhanced scene recogni-tion at distractor letters. These results suggest that l-DOPA provides anattentional boost at both behaviorally relevant and irrelevant points oftime when distractors are presented. A behaviorally irrelevant boostmay account for subthreshold psychiatric symptoms detectable in PD.

doi:10.1016/j.jns.2013.07.628

Abstract — WCN 2013No: 889Topic: 2 — Movement DisordersRelapsing polychondritis and lymphocytic meningitis with variedneurological symptoms

R.D.-P. Duccia, F.M. Branco Germiniania, L.E. Augustin Czeckoa, E. Paivab,H.A.G. Teivea. aNeurology, Hospital de Clínicas — Universidade Federaldo Paraná, Curitiba, Brazil; bRheumatology, Hospital de Clínicas —

Universidade Federal do Paraná, Curitiba, Brazil

Background: Relapsing polychondritis is a rheumatological diseasecharacterized by bilateral auricular chondritis, vestibular compromiseand varied neurological symptoms.Objective: To report the case of a patient with relapsing polychondritisand several neurological manifestations.Patient and method: We report the case of a patient with relapsingpolychondritis with several neurological manifestations.Results: A 69 year-old male was admitted with a 20-day history ofataxia, paraparesis, tinnitus, vertigo and confusion. Two months beforehe started with bilateral auricular chondritis and arthritis ofmetacarpophalangeal joints and ankles. He had been previously seenat another hospital, where hehad been treated for herpetic encephalitis,with improvement of confusion. On examination he had downwardnistagmus, rigidity of upper limbs, paraparesis, absent reflexes, tactilehypoesthesia, dismetric movements, gross postural and action tremor,bradikynesia and truncal ataxia. He also had swelling and a purplisherythema of both ear lobes and arthritis in the metacarpophalangealjoints of the right hand. Brain and cervical MRI disclosed a mildthickening of the dura. A new lumbar puncture confirmed the presenceof elevated leukocytes and laboratory exams disclosed augmentedinflammatory activity. A diagnosis of relapsing polychondritis wasmade based on the association of chondritis, arthritis and vestibularataxia with predominant neurological symptoms. Following a course ofPrednisone 1 mg/kg qid there was major improvement of chondritis,arthritis, ataxia and paraparesis, but the tremor remained unchanged.Conclusion: Relapsing polychondritis is a multisystemic disease thatcan manifest not only with bilateral auricular chondritis andvestibular compromise, but also with varied neurological symptoms.

doi:10.1016/j.jns.2013.07.629

Abstract — WCN 2013No: 1699Topic: 2 — Movement DisordersEffects of botulinum toxin treatment on subjective visual verticalperception in cervical dystonia

K. Elwischger, G. Kranz, T. Sycha, P. Rommer, C. Müller, E. Auff, G. Wiest.Medical University of Vienna, Vienna, Austria

Background: Previous data suggest thatwemight abandon the idea of asingle “reference frame” for verticality perception. When the head orbody is tilted, otolithic and somatosensory signals can have oppositesign effects during perceiving verticality.When cervical dystonia (CD) istreated with botulinum toxin, abnormal head posture improves within3 weeks.Objective: This dynamic alteration of head posture is a unique modelto study effects of altered somatosensory and otolithic input on staticgraviceptive function.Patients and methods: Static graviceptive function was assessed bymeans of subjective visual vertical (SVV) judgement. Thirty patientssuffering from idiopathic CD and, for control, thirteen healthyindividuals were investigated. At baseline and 3 weeks afterinjection, patients were investigated at 6 different head positions(no fixation, fixed upright (0°), fixed deviation at 15° and 30° to theleft and right, respectively). The control group was investigated at 5head positions (0°, 15° and 30° to the left and right, respectively).Results: At baseline, CD's SVV judgement in habitual head position vs.control's at 0° was significantly deviated (p= 0,0166). Three weeksafter injection, there was no significant difference. Thus, diseaseseverity and SVV aberration correlated positively (Pearson correlation:0.61). We noticed a general trend of major SVV errors of CD patients incontrast to healthy subjects, and a trend of contraversive deviation ofSVV in fixed head positions (at 30°: p = 0.052).Conclusion: Verticality perception of CD differs from healthysubjects and improves after BoNT therapy. Thereby, increasedneck muscle proprioception has a major influence on verticalityperception.

doi:10.1016/j.jns.2013.07.630

Abstract — WCN 2013No: 1674Topic: 2 — Movement DisordersAnatomic localization of secondary dystonias: Analysis of21 patients

M.F. Oztekina, N. Oztekinb. aNeurology, MOH Ankara Yıldırım BeyazitEducation and Research Hospital, Ankara, Turkey; bNeurology, MOHAnkara Numune Education and Research Hospital, Ankara, Turkey

Objective: To investigate anatomical distribution, etiology andsymptomatology of secondary dystonia.Background: Although lesions of basal ganglia, especially putamenand globus pallidus are widely accepted sites for the development ofsecondary dystonias, structural lesions located in the centrumsemiovale, thalamus, brainstem, cerebellum and peripheral nervoussystem are also reported sites. Analysis of lesion localization andcorrelation of symptoms may contribute to the relation of phenotypeand pathophysiology of dystonia.Patients and methods: 21 patients with structural lesions verifiedwith magnetic resonance imaging (MRI) or computerized tomogra-phy were selected among 365 dystonic patients referred to ourmovement disorder clinic between 2001 and 2013. The patientswere classified according to age onset, distribution and etiology.Results: There were 13 patients with childhood onset and 8 patientswith adult-onset.4 patients had focal, 4 patients had segmental, 3

Abstracts / Journal of the Neurological Sciences 333 (2013) e65–e108e104