Rivista di neurologia最新文献

In the last few years a number of studies highlighted striking similarities between Alzheimer's Disease and Down's Syndrome. More specifically, neurochemical, pathologic, genetic and clinical features of the Alzheimer's Disease were described also in the Down's Syndrome, but with some particular differences. The most significant literature reports investigating these aspects are reviewed.

We describe a case of acute stroke due to a spontaneous carotid dissection. Doppler sonography performed 12 hours after stroke and repeated in the following days suggested a dissection of the right internal carotid artery, then confirmed by angiography. The dissection could be unrecognized because of a complete normalization of the flow within the fifth day. This case shows the importance of performing an early ultrasonic examination in stroke patients.

23 patients affected by phakomatoses were studied with NMR, including tuberous sclerosis (11 cases), Sturge-Weber's disease and Von Recklinghausen's neurofibromatosis (6 cases). SE sequence was used performing T1-WIs with TR = 350-750 ms and TE = 20-30 ms and T2-WIs with TR = 1500-2100 ms and TE = 50-100 ms. Tuberous sclerosis was characterized in each case by the presence of hiperintense areas in T2-WIOs, associated in 9 cases to subependimal microcalcifications. Sturge-Weber-disease showed: cerebral or lobar emiatrophia, abnormal vascularization and cortical calcifications. Cerebral neurofibromatosis was characterized by extra-assial tumors, associated in 4 cases to gliomas of the optical pathways. The AA. conclude that NMR is the choice examination in the evaluation of phakomatoses.

We hereby report a case of manic depressive psychosis. The patient had been treated for years with lithium carbonate (600 mg/die, lithium serum concentration equal to 0.7 mEq/l) and came to us under observation for a sensorimotor peripheral neuropathy with mostly axonal degeneration. The central nervous system had not been involved. Excluding any possible causes of peripheral neuropathy and since no precipitating circumstances were ascertained, a clinical improvement was noticed after suspending the therapy.

Describing a case of acute ischemic stroke in the middle cerebral territory, seen on CT scan, the Authors discuss the TCD results.

This study concerns an analysis of outpatients seen at a Regional Clinic for Extrapyramidal and Cerebellar Disorders during the period 1974-1984. The main findings to emerge from this study are: 1) a predominance of males; 2) peak attendance figures correlated with precise factors; 3) the geographic origin of patients reflected the distance from the Regional Clinic and the relationship between local physicians and physicians at the Regional Clinic. Lastly, this epidemiological study has led to improvements in specific protocols for the management of the long-term outpatient, and to an increase in the number of patients attending the Center.

Oscillatory potentials (OP) were recorded from 24 patients with chronic renal insufficiency undergoing hemodialysis. Nobody had visual disturbances. Abnormal OP were found in 11 (45.8%) patients. Moreover the possible correlations among the abnormal OP and some biochemical and clinical parameters were studied. The Authors emphasize the usefulness of the OP to disclose the subclinical retinopathy of the patients with renal insufficiency.

Thirteen patients with essential mixed cryoglobulinemia and neuropathy were studied and followed up clinically and neurophysiologically during last nine years. All these patients had a mild distal, symmetrical motor sensory neuropathy. Few patients had a mononeuropathy. Three patients developed an acute severe tetraparesis due to overlapping mononeuritis multiplex. Neurophysiological study and nerve biopsy were indicative of axonal neuropathy. We discuss the pathogenesis of this neuropathy and the therapeutical approach.

A longitudinal clinical-electrophysiological study has been carried out on 6 leukaemic children during the treatment with vincristine. The Authors emphasize: 1) in the vincristine neuropathy the motor and sensitive fibres are initially affected in the distal segments with subsequent centripetal discussion, this agrees with the neuropathological picture characterized by distal axonal degeneration with processes dying-back type; 2) there is a relationship between dose-duration of the treatment and neurotoxic effects.

The authors studied a group of patients with ideomotor apraxia (IMA) to verify if these patients had some difficulties in gesture learning task in respect to non-apraxic patients and normal control subjects. The results show that learning difficulties are present in patients with IMA. Apraxic patients are not able to perform the gestures in the testing situation and non in everyday life; this fact would demonstrate that the motor pattern still exists in these patients but is inaccessible unless elicited by a strong stimulation.