Rivista di patologia nervosa e mentale最新文献

The authors investigate the alexithymia phenomenon and the possibility of quantifying it by administering the Schalling-Sifneos Personality Scale on four groups of subjects: asthmatics, psychosomatics other than bronchial asthmatics, patients afflicted with non-psychosomatic chronic illnesses and healthy subjects. The questionnaire permits a quantitative evaluation of the alexithymia phenomenon that appears significantly more evident in asthmatics than in patients afflicted with chronic illnesses and healthy subjects. The patients afflicted with psychosomatic illnesses other than asthma attain higher scores than asthmatic patients. The authors identify certain items on the scale as being particularly associated with the alexithymia phenomenon, enough to be able to construct a partial alexithymia score, indicative in itself of the presence of alexithymia personality traits, even in the absence of particularly high total alexithymia scores. Variations in age and educational level influence scores obtained by healthy subjects and patients afflicted with chronic illnesses, while this does not occur in asthmatics and other psychosomatic patients. This seems to indicate that the higher scores of the latter are not influenced by social or statistical types of factors, but rather by illness-related factors.

The introduction of isoelectrofocusing on polyacrylamide gel followed by direct immunofixation, in the analysis of CSF proteins, emphasized the interest in transferrin examination, mainly in order to find eventual abnormalities in patients with neurological diseases. Stibler (1979), using these techniques, demonstrated the presence in CSF of two subtypes of transferrin C, called C1 and C2, transmitted by autosomal codominant inheritance, according to the C1, C2 and C2-1 phenotypes. The rather frequently occurring variant of transferrin in CSF is the C2-1 subtype: a double banded pattern, which is focused at pH 5.9, consisting of two very closely spaced bands with a pI difference of less than 0.1. This transferrin pattern is peculiar to CSF and is absent in the serum of the same subjects. This subtype of transferrin has been observed in various neurological disorders, as well as in healthy populations, by several investigators. They also found a much higher incidence of double tau-transferrin in inherited degenerative neurological diseases, such as Friedreich's ataxia and hereditary spastic paraplegia, than in neurological ailments without a hereditary component. The aim of our study is to verify the incidence of the C2-1 variant of transferrin in a control group and in a mixed group of neurological patients, with particular attention to hereditary degenerative pathologies.

Motor conduction velocity of the median and posterior tibial nerves and sensory conduction velocity of the radial and sural nerves were examined in 45 uremic patients: 15 treated by hemodialysis (HD), 15 treated by combined peritoneal dialysis (CPD) and 15 treated as outpatients with peritoneal dialysis (CAPD). Motor and sensory conduction velocity were reduced in uremic patients treated by HD more than in those treated by CPD and CAPD; there were no significant differences between the last two groups.

33 drug abusers were examined and all of them were addicts to several drugs and always to heroin. Neurological complications occurred rather frequently. One patient had subarachnoid hemorrhage and angiography showed no arteriovenous malformations nor other pathology. Polyneuropathy has been found in one case. 7 patients (21,2%) developed psychotic episodes. Epileptic attacks were found in 5 cases (15,1%). Latency between the onset of drug-abusing and occurrence of the attacks was found to be at least 1 year in two cases and 3 years in the other three. 4 cases suffered from partial complex seizures with secondary generalization and one patient had generalized tonic-clonic attacks. Fits occurred rarely in all cases; one patient had two episodes of partial status. Further research is required because there are few clinical reports in comparison with the experimental ones.

A patient affected by continuous clonus of the right half of his tongue and face with dysphasia and right hemiparesis is described. Partial continuous epilepsy of Kojewnikow was diagnosed. The CT scan showed a spreading lesion surrounded by intense oedema in the left central region, as well as a longstanding subdural hematoma complicated by osteitis. This finding lead to a diagnosis of cerebral abscess which was confirmed by surgery. In this paper it is also analyzed the cortical and/or subcortical origin of this peculiar type of epilepsia.

This paper deals with two cases of carcinomatous meningitis as metastatic reproduction respectively of a bronchial and a stomach carcinoma. In both patients (37 and 62 years) the clinical picture consisted in combined neurologic symptoms and signs of brain and spinal roots damage, while in the first one there was also a deficit of some cranial nerves. In the past history of the subjects there had been no evidence of tumours. The diagnosis remained uncertain for a long period, although several laboratory and neuroradiologic investigations had been carried out. The C.S.F. cytomorphologic study, performed with the filtration method, gave a rapid and exact identification of carcinomatous cells and, therefore, a correct diagnosis. Such C.S.F. diagnostic test should be carried out in all cases of suspected carcinomatous meningitis. If biochemical markers are used as well, this combination of tests gives additional information.

The clinical use of S.E.R. (Somesthesic Evoked Responses) from the lower limbs has peculiar prognostic value in cases of spinal pathology with clinical signs of transection, where other neuroradiological investigations are not helpful. However, in the present case of acute trasverse myelitis, persistence of an evoked response from the lower limbs was never followed by signs of recovery below the lesional level, while autopsy showed a complete degeneration of the descending spinal pathways with a good preservation of the posterior roots. The limits of this technique appear connected to the fact that the afferent volley of the S.E.R. travels exclusively along the posterior roots, not allowing a definite prognostic evaluation about function of the remainder descending pathways.

The Author describes the interest and the meaning of General Psychopathology in today's Psychiatry. The Author defines the methodological aspects necessary in psychopathology as well as their gnoseological and formative value. The "-structural constants" defined in psychopathology appear irreplaceable in the basic aspects of psychotic mind models, and other dimensions of contemporary psychiatry cannot disregard them. The Author emphasise the risk of an inaccurate and irresponsibly exhaustive use of psychopathological categories in psychiatric practice. However it seems that a conscious exercise of psychopathological methods can avoid confusion about investigatory psychiatric research, and may help recognizing basic structures of psychotic experience. These structures are not only necessary in a diagnostic field, but also for a correct pharmacotherapeutical epproach.

The new anticonvulsant drug pargypiranone was studied in different models of experimental epilepsy in cat (penicillin and Premarin cortical focus, cobalt cortical focus, penicillin generalized epilepsy). The drug proved to possess a strong anticonvulsant effect upon focal electroclinical phenomena and a poor effect on penicillin generalized epilepsy. It seems probably that pargypyranone has a valid effect on partial epileptic seizures.

Motor conduction velocities (MCV) and distal latencies (DL) of the ulnar nerve and of the external popliteal sciatic nerve have been recorded in 21 cases of multiple sclerosis. Only in 4 cases (19%) all values were found within normal limits. The maximal MCV of one or both nerves appeared to be slightly reduced in 7 cases (33%) and the minimal MCV was reduced more markedly in 13 cases (62%). The MCV alterations (both minimal and maximal) were more frequent among patients with marked hypertonus. The ulnar nerve was the most frequent site of such alterations. LD were markedly altered in 17 cases (81%), independently from the entity of pyramidal signs.