Acta neurologica最新文献

The elevation of ADA in CSF is useful as a diagnostic means for detecting tuberculous meningitis, and in other etiologies such as lymphoma, neurosarcoidosis, fulminant bacterial meningitis, cryptococcal meningitis, neurobrucellosis and AIDS. We report an increase of ADA in CSF in association with SHA. In our case the total activity of ADA was the same as that obtained in serum, which can be interpreted among the false positives of the determination.

In a retrospective case-control study of multiple sclerosis (MS), set up with the aim of verifying the role of environmental factors in pathogenesis, we included a section on dietary habits. We compared the frequency and pattern of food consumption by cases and controls. We found an association between. MS and high consumption of bread and "pasta", butter and lard, legume soup, horse flesh, coffee and tea in the period from infancy to adolescence. A different pattern of consumption of eggs, wine and mineral water between cases and controls was found during adulthood. Our results support, at least partially, the data already reported in the international literature on an association between certain dietary factors and MS. Some foods consumed at certain "critical" ages could play a causal role in the onset of MS.

44 cases (20 men and 24 women) of subarachnoid hemorrhage (SAH) of unknown origin were studied: the mean age was 54.1 yrs. Highest frequency of the disease was observed in 51-70 years old patients. There was only a slight involvement of consciousness (I-II grade of HESS and HUNT). Vascular hypertension was noticed in 45.5% of patients, but outcome did not differ in hypertensive and normotensive subjects. The CT findings showed a typical picture of SAH. 4 cases of perimesencephalic and peripontine hemorrhage were noticed. 24 patients underwent lumbar puncture. The angiographic study was normal in all patients. 14 subjects repeated four-vessel angiography. Transient hydrocephalus was found in 22.7% of patients. Approximately 70% of patients received antifibrinolytic therapy, either with or without calcium entry-blockers (nimodipine). Neither ischemic complications nor rebleeding were observed. Follow-up showed that all patients had survived 7-88 months after SAH. All subjects made a complete recovery and have since been able to resume work.

To evaluate effect of the calcium-channel blocker nicardipine in essential tremor (ET), 14 patients with ET affecting upper limbs underwent a cross-over study with nicardipine (1 mg/Kg/day) and propranolol (160 mg/day). Evaluation (baseline and 1 month after each drug) was done by using the Fahn-Tolosa-Marin scale. Two patients withdrawed nicardipine (pretibial edema and palpitations) and other 2 propranolol (dyspnea and hypotension). Both drugs improved ET, with a non-significantly higher efficacy of propranolol. These results suggest that nicardipine might be efficacious for ET.

Complex and bidirectional relationships operate between the hypothalamic-pituitary-adrenal (HPA) axis and the immune system (IS) and either in vivo or in vitro evidence supports a physiological role of the HPA axis-IS network. A part of the well-known pharmacological effects of glucocorticoid hormones (GC) as immunodepressive agents, the direct effects of many HPA axis hormones on IS functions are actually documented also in physiologic conditions. Conversely, numerous IS soluble mediators are reported to affect the HPA axis functions at various steps of HPA axis regulation, in both physiologic and pathologic conditions. Stress and aging may represent two paradigmatic conditions to show the relevance of the bidirectional network between HPA axis and IS, as in both HPA activation and IS impairment are frequently coexistent. Finally, in the context of the wide spectrum of HIV-related HPA axis abnormalities, a case of a Cushing's syndrome associated to an acquired immunodeficiency syndrome (AIDS-related complex) in a 24-year-old homosexual drug abuser is reported.

Metastases from solid tumors that seed the leptomeninges (meningeal carcinomatosis) are an important neurologic complication of systemic cancer. Recently many authors have reported that its incidence is increasing; particularly it has been demonstrated for breast cancer and small cell bronchogenic carcinoma. A cytologic examination of cerebrospinal fluid (CSF) establishes the diagnosis. Gadolinium-enhanced MRI has demonstrated superiority over other imaging with the clinical context and CSF analysis may lead to a rapid diagnosis and treatment of leptomeningeal carcinomatosis. Despite all measures, prognosis remains poor because of the presence of multiple metastases elsewhere.

A case of spinal cord cavernoma is presented. The pertinent literature is reviewed and the problems of diagnosis and management of this rare condition are discussed.

The patient is a 60-year-old man who developed numbness of the extremities, paralysis, hyperpigmentation of the skin, hypertrichosis, anasarca and chest pain at the age of 58 years. The diagnosis of Crow-Fukase syndrome was made and myeloma was not found. Prednisolone therapy was effective but chest pain reappeared every morning when prednisolone was tapered to 30 mg alternate day. Coronary arteriogram showed no stenosis but administration of acetylcholine into the coronary artery produced ST elevation in electrocardiogram, chest pain and coronary artery stenosis which were relieved by administration of nitrates into the coronary artery.

Interaction between immune cells and tumoral cells of a case of glioblastoma was studied. Tissue fragments obtained during neurosurgery from different areas of the tumor were examined before and after rIL-2 treatment in vitro. The same morphofunctional type of cells usually activated by rIL-2, which show antitumoral reactivity, was observed both in the glioblastoma imprints and in tumoral fragments cultured with rIL-2. This cytokine stimulated the proliferation of tumor infiltrating lymphocytes in vitro. This preliminary study shows that IL-2 potentiates the differentiation of HMS cells in peripheral blood which probably pass through the blood brain barrier and infiltrate the tumor.

A 21-year-old female patient with psychotic symptoms developed hyperthermia, muscular rigidity and hypertension after administration of haloperidol. A muscle biopsy showed some atrophic and necrotic fibers, and a great number of fibers with central cores in the oxidative enzyme preparations. A related syndrome, Malignant Hyperthermia (MH), is sometimes associated with central core disease. The present case shows an association of a hyperthermic syndrome related to haloperidol with central core disease.