Rivista di patologia nervosa e mentale最新文献

A case of hypokalemic periodic paralysis, is reported, characterized by a positive family history and by repeated attacks of transient motor weakness since the age of 14 involving one all limbs. An induction test under ECG and EMG monitoring, carried out by infusing glucose and insulin when the patient was symptom-free, provoked motor paresis comparable to the spontaneous attacks and confirmed the diagnosis.

Three cases of tardive myelopathy were identified among more than one thousand patients treated for tumors by X-rays at the Institute of Radiology of the University of Florence during the period 1974-83. In two of these, the clinical picture was that of a partial Brown-Séquard syndrome while in the third case it corresponded to a transverse myelitis. The myelopathy of the former patients can be attributed to the total radiation dose, which was very close to the tolerance limit. The third patient's disturbance, instead, involved additional factors of individual hypersensitivity of connective vascular tissue in response to the X-ray treatment. These cases, while few in number and lacking pathological investigation, call attention to this iatrogenic disorder which, though rare now thanks to progress in limiting radiation exposure, has not yet disappeared.

Intracranial tuberculomas have become uncommon in industrial nations, while they still have a high incidence in underdeveloped countries. Four cases of intracerebral supratentorial tuberculomas are reported in this paper. Clinical findings suggestive of tuberculosis were present in only one case. The other cases were thought to be gliomas or metastases and the diagnosis was made only after surgery. The CT scan provided a good image of the lesions whose characteristics, however, were diagnostically confusing. When a tuberculoma is suspected, medical therapy alone should be administered initially. Surgery should be resorted to in cases of markedly increased intracranial pressure.

The Schalling--Sifneos Personality Scale was administered to several groups of subjects (patient suffering from chronic hepatitis or from ulcerative colitis, patients undergoing chronic periodic haemodialysis, encephalopathic patient and healthy subjects) in order to assess the presence of alexithymia in healthy subjects, in patients suffering from chronic organic pathologies and in psychosomatic patients. The results obtained permit one to distinguish the psychosomatic patients from other groups of subjects: compared to healthy subjects, patients suffering from ulcerous rectocolitis obtained higher average scores, while compared to patients suffering from other organic pathologies their scores showed a wider scatter. A distinction is therefore proposed between primary alexithymia, of a distinctive cognitive-affective kind which predisposes towards psychosomatic pathology, and secondary alexithymia which is associated with stressful situations, such as illness, and which is essentially defensive in origin.

In a 21 year-old man suffering from a post-traumatic neurotic syndrome, the cranial CT scan revealed an arachnoid cyst in the left Sylvian fissure, which had been completely asymptomatic before. The surgical emptying of the cyst modified neither the CT finding nor the neurotic syndrome. The latter disappeared once the insurance controversy was resolved. After a review of the etio-pathogenesis of arachnoid cysts, our patient's malformation was identified as the so-called "Temporal Lobe Agenesis Syndrome". On that basis, any medico-legal correlation between the head injury and the cystic malformation was excluded.

Groups of left-hemisphere damaged patients, right-hemisphere damaged patients and controls were given the facial recognition test of Benton and Van Allen. Educational level was found to be relevant with regard to the performance of the brain damaged groups, such that a difference between left and right hemisphere-damaged groups became apparent only in patients with higher (greater than 5 years) schooling. The implications of the results are discussed.

A right-handed patient with no family history of either neurological disorders or of left-handedness was affected by crossed aphasia due to a focal hemorrhagic lesion in the right hemisphere at the level of the basal ganglia. The CAT-scan revealed the site of the brain change. Our case is uncommon in that the aphasia. Assessed by neuropsychological tests, was associated with impairment of right functions such as visual and spatial cognition. Thus he does not fit the classic description of crossed aphasia, exhibiting instead language disorders similar to those following deep brain lesions. Various hypotheses were considered in attempting to explain the pathogenesis of our neurological data, none of which proved adequate to account for all the reported findings.

The case of a 64-year-old patient with a severe cerebellar ataxia of unknown origin, dating back at least three years, is described. The patient was diagnosed as suffering from hypothyroidism and after one month of replacement therapy with thyroxine there was complete remission both of the myxedema symptoms and of the cerebellar syndrome. The possible association between cerebellar ataxia and myxedema was thus confirmed. The writers stress the importance of identifying this uncommon clinical entity especially in view of the excellent results of thyroxine treatment.

An EEG and CT study was carried out on 79 patients affected by dementia (24 SDAT and 55 MID). The EEG and CT patterns were compared with those of an age-matched control group. Statistical analysis of the CT findings between the demented and normal subjects showed significant differences only for severe atrophy. As far as EEG findings are concerned, no EEG pattern indicative of a specific type of dementia was observed even though a greater number of abnormal EEGs occurred in demented patients than in the control group. Finally, a poor EEG-CT correlation was found in demented patients.