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  • 1
    Electronic Resource
    Electronic Resource
    Epileptic laughter: Electroclinical and cinefilm report of a case (1979)
    Springer
    Journal of neurology 220 (1979), S. 215-222 
    Details
    ISSN: 1432-1459
    Keywords: Epileptic laughter ; EEG ; Cinefilm ; Partial seizure ; Laughter, epileptic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird der Fall einer dreißigjährigen Frau dargestellt, die seit ihren ersten Lebensmonaten an pathologischen Lachanfällen litt, die die charakteristischen Züge epileptischer Lachanfälle angenommen hatten. Verschiedene Anfälle wurden durch polygraphische Aufzeichnung und durch Filmen festgehalten. Die Anfälle begannen mit einem Unwirklichkeitsgefühl, verbunden mit einem gezwungenen, unwillkürlichen Lächeln, welches in eine volles Lachen überging. Die Patientin versuchte das Lachen, welches nicht mit euphorischer Stimmung verbunden war, zu maskieren. Dem Lachanfall folgten Bewußtseinsverlust und Automatismen. Das EEG, zu Beginn normal, zeigte in der späteren Phase eine anfallsartige Entladung in der rechten Hemisphäre. Aufgrund der elektroklinischen Eigenschaften und nach Durchsicht der Literatur wird der Anfall versuchsweise als ein fortschreitendes anfallsartiges Einbeziehen temporaler-dienzephaler Strukturen erklärt.
    Notes: Summary A woman, aged 30, experienced attacks of pathological laughter which began during the first months of life; they meet the qualifying criteria of epileptic laughter. Several attacks were recorded by polygraphy and cinefilm. The attack begins with a feeling of unreality associated with a forced, involuntary smile progressing to full laughter. The patient tried to mask the laughter which was not accompanied by euphoria but was followed by loss of consciousness and automatisms. Only during the latter phase of the previously normal EEG did an ictal discharge appear over the right hemisphere. On the basis of the electroclinical pattern and of a review of the literature, the seizure is tentatively explained in terms of a progressive ictal involvement of temporodiencephalic structures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00705539
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  • 2
    Electronic Resource
    Electronic Resource
    Psychotic onset of multiple sclerosis (1979)
    Springer
    Neurological sciences 1 (1979), S. 279-280 
    Details
    ISSN: 1590-3478
    Keywords: Mania ; Multiple Sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario È descritto il caso di una donna in cui la sclerosi multipla fu preceduta da attacchi acuti di tipo psicotico (maniacale).
    Notes: Abstract A case is reported of a woman in whom acute manic attacks were followed later in life by neurological signs of multiple sclerosis, thus suggesting a possible correlation between the two clinical entities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02336711
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  • 3
    Electronic Resource
    Electronic Resource
    Plasma aminoacid alterations in idiopathic generalized epilepsy: An investigation in probands and their first-degree relatives (1994)
    Springer
    Neurological sciences 15 (1994), S. 137-144 
    Details
    ISSN: 1590-3478
    Keywords: aminoacids ; epilepsy ; aspartate ; glutamate ; glycine ; taurine ; valproate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario 22 aminoacidi plasmatici sono stati determinati mediante cromatografia a scambio ionico in 16 pazienti mai trattati in precedenza e affetti da epilessia generalizzata idiopatica, e anche in alcuni dei loro parenti di primo grado (26 soggetti). I risultati sono stati comparati con un gruppo di controllo di 50 soggetti normali. I pazienti furono poi messi in terapia con acido valproico per un mese, e quindi nuovamente esaminati con le stesse modalità del tempo 0. Nei soggetti epilettici, l'analisi statistica mostrò significative alterazioni dei livelli plasmatici di alcuni aminoacidi, tra cui i quattro rilevanti per la neurotrasmissione (aspartato, glutamato, glicina, taurina). L'aspartato, il glutamato e la glicina erano anche alterati nei parenti di primo grado, mentre la terapia con acido valproico non modificò i livelli di aminoacidi. Le alterazioni qui descritte, se ulteriormente confermate, potrebbero essere considerate come un possibile marker neurochimico di epilessia.
    Notes: Abstract Twenty-two plasma aminoacids were determined by means of ion-exchange chromatography in 16 previously untreated patients with generalized idiopathic epilepsy and in some of their first-degre relatives (26 subjects), and the results were compared with those obtained from a group of 50 healthy controls. The patients were subsequently treated with valproic acid for one month and then re-examined. In the epileptic subjects, statistical analysis showed significant alterations in the plasma levels of a group of aminoacids, including the four associated with neuro-transmission (aspartate, glutamate, glycine, taurine); aspartate, glutamate and glycine levels were also altered in the first-degree relatives. Valproic acid therapy did not affect aminoacid levels. If further confirmed, these alterations might be considered possible neurochemical markers of epilepsy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02339205
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  • 4
    Electronic Resource
    Electronic Resource
    Antiepileptic drugs and mechanisms of epileptogenesis. A review (1995)
    Springer
    Neurological sciences 16 (1995), S. 217-222 
    Details
    ISSN: 1590-3478
    Keywords: antiepileptic drugs ; epilepsy ; basic mechanisms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Vengono analizzate le azioni dei farmaci antiepilettici convenzionali (fenobarbital, fenitoina, carbamazepina, etosuccimide, valproato) e di quelli appartenenti alla nuova generazione (vigabatrin, lamotrigina, felbamato) sui meccanismi di base implicati nella genesi dell' epilessia focale e/o generalizzata. I meccanismi considerati sono: (1) canali Na+ voltaggio-dipendenti e scarica ripetitiva prolungata; (2) correnti Ca2+ dipendenti di tipo L, N e T; (3) inibizione GABA-mediata; (4) eccitazione Glu/Asp-mediata; (5) iperpolarizzazione postuma. Sulla base di queste variabili, i farmaci antiepilettici possono essere divisi in due principali categorie, quelli che presentano una sola azione specifica e quelli che agirebbero in più modi. Inoltre, si è cercato di correlare gli effetti che i farmaci antiepilettici hanno sui meccanismi di base dell' epilettogenesi con la loro azione clinica sulle crisi.
    Notes: Abstract This paper analyzes the effect of conventional (phenobarbital, phenytoin, carbamazepine, ethosuximide, valproate) and some novel (vigabatrin, lamotrigine, felbamate) AEDs on some basic mechanisms involved in focal and/or generalized epileptogenesis (Na+ voltage-dependent channels and sustained repetitive firing, L-, N-, and T-type Ca2+ currents, GABA-mediated inhibition, Glu/Asp-mediated excitation, after-hyperpolarization). According to this analysis, AEDs can be divided into two main categories, those with only one specific action and those with multiple actions. A speculative correlation is proposed between AED effects on the mechanism of epileptogenesis and their known clinical effect on seizures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02282992
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  • 5
    Electronic Resource
    Electronic Resource
    A case-control study on alcohol and seizures: study design, protocol, and data collection (1997)
    Springer
    Neurological sciences 18 (1997), S. 119-124 
    Details
    ISSN: 1590-3478
    Keywords: Epilepsy ; Alcohol drinking ; Alcoholism ; Questionnaire ; Observer-variation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Abbiamo condotto uno studio per valutare se l'uso di alcool e l'alcoolismo cronico sono fattori di rischio per una prima crisi epilettica tonico-clonica generalizzata. I casi erano 278 pazienti (92 femmine, 186 maschi) con una prima crisi tonico-clonica generalizzata idiopatica o sintomatica; i controlli erano 556 pazienti accoppiati ai casi per centro, sesso, età e giorno della settimana. Casi e controlli sono stati intervistati con un questionario. Questo lavoro descrive il disegno dello studio (selezione dei casi e dei controlli), la validazione del questionario, e le modalità di conduzione dello studio (intervista, uso di “surrogati”). L'accordo tra intervistatori era ottimo per lo status di bevitore, le modalità del bere e l'assunzione delle singole bevande (si/no). L'accordo era variabile per il numero di bicchieri bevuti/settimana, ma era ottimo (r=0.91) per la misura riassuntiva del consumo giornaliero di alcool.
    Notes: Abstract We designed a multicenter case control study to evaluate whether chronic alcoholism and alcohol consumption are risk factors for developing a first generalized tonic-clonic epileptic seizure. Cases were 278 patients (92 women, 186 men), with a first generalized tonic-clonic seizure (either idiopathic or symptomatic), matched to 556 controls for center, sex, age, and weekday of the seizure. Information on risk factors was obtained through a questionnaire. This paper focuses on the study design (selection of cases and choice of controls), the validity of the instruments for data collection, and the strategies of study conduction (interviews, use of proxy respondents). Inter-rater agreement was excellent for drinking status, patterns of drinking, and broad indicators of consumption (yes/no). Agreement was variable for the number of servings/week, but was excellent (r=0.91) for a summary measure of daily alcohol intake.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01999574
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  • 6
    Electronic Resource
    Electronic Resource
    Protirelin tartrate (TRH-T) in upper motoneuron syndrome: a controlled neurophysiological and clinical study (1994)
    Springer
    Neurological sciences 15 (1994), S. 395-406 
    Details
    ISSN: 1590-3478
    Keywords: protirelin tartrate (TRH-T) ; upper motoneuron syndrome ; therapy ; pathophysiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Abbiamo condotto uno studio in cieco-singolo, randomizzato, controllato con placebo, su 20 pazienti affetti da sindrome cronica del motoneurone superiore, esito di lesione vascolare ischemica cerebrale. Il gruppo di pazienti era selezionato in funzione della massima possibile omogeneità quanto alla gravità della sindrome e trattato per 2 settimane con protirelina tartrato 4 mg IM/die. Lo studio comprendeva valutazioni cliniche semiquantitative dell'esame neurologico, con particolare riguardo all'ipostenia ed alla spasticità. A queste si affiancavano valutazioni neurofisiologiche (studio dell'onda F e dei potenziali evocati motori magnetici). Venivano effettuate estese indagini bioumorali circa i possibili effetti collaterali. I risultati indicano un miglioramento lieve sul piano assoluto, ma statisticamente significativo, della spasticità e della forza muscolare dopo protirelina tartrato, specie per l'arto inferiore. Contemporaneamente, il farmaco si dimostrava capace di modificare in senso favorevole la risposta allo stimolo magnetico transcranico nel muscolo bicipite femorale (ricomparsa, aumento d'ampiezza e diminuzione di soglia del potenziale evocato motore). Esso si dimostrava complessivamente ben tollerato.
    Notes: Abstract This randomised, single-blind, placebo-controlled study involved 20 patients with chronic upper motoneuron syndrome due to ischemic cerebrovascular lesions, selected in order to ensure the greatest possible homogeneity in terms of the severity of the syndrome. All of them were treated with protirelin tartrate 4 mg/die i.m. The study included semiquantitative clinical evaluations of neurological examinations, with particular attention being paid to weakness and spasticity. These were accompanied by neurophysiological evaluations (F-waves, magnetic motor evoked potentials). Extended biohumoral investigations of possible side effects were also carried out. The results indicate a slight but statistically significant absolute improvement in spasticity and muscular strength following protirelin tartrate, especially in the lower limbs; at the same time, the drug also proved to be capable as favourably modifying the response of the biceps femoris muscle to transcranial magnetic stimulation (reappearance, increased amplitude and a reduction in the threshold of motor evoked potentials). The drug was generally well tolerated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02339903
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  • 7
    Electronic Resource
    Electronic Resource
    Single-blind, placebo-controlled multicenter trial of vigabatrin in the treatment of epilepsy (1992)
    Springer
    Neurological sciences 13 (1992), S. 741-747 
    Details
    ISSN: 1590-3478
    Keywords: Vigabatrin ; epilepsy ; anticonvulsants ; clinical trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Centouno pazienti affetti da epilessia farmaco-resistente (nella maggior parte dei casi con crisi parziali) sono stati inclusi in uno studio policentrico con vigabatrin somministrato in aggiunta alla terapia preesistente secondo un disegno sperimentale controllato in singolo cieco. Il protocollo prevedeva 4 fasi consecutive (osservazione basale, placebo, vigabatrin 2 g/die, vigabatrin a dose individualizzata in base alla risposta clinica, sino ad un massimo di 4 g/die), ciascuna della durata di 8 settimane ad eccezione della fase di ottimizzazione della posologia che poteva essere prolungata a 16 settimane. Novanta pazienti hanno completato lo studio, mentre 11 (tra cui 1 che ha presentato stato di piccolo male e 4 che hanno riferito un aumento della frequenza delle crisi) hanno interrotto il trattamento precocemente. Nei pazienti che hanno completato lo studio, la frequenza mensile delle crisi è diminuita da un valore mediano di 16 (range interquartile 8–34) durante placebo a 5 (2–10) durante l'ultima fase di trattamento con vigabatrin (p〈0.0001). Sia le crisi parziali che le crisi generalizzate tonico-cloniche (per lo più secondariamente generalizzate) sono diminuite significativamente. Una riduzione delle crisi di oltre il 50% è stata osservata in 60 pazienti. Gli effetti collatterali più frequentemente osservati sono stati sedazione ed aumento ponderale.
    Notes: Abstract A single-blind, placebo-controlled multicenter trial of vigabatrin was carried out in 101 epileptic patients (mostly with partial seizures) refractory to conventional therapy. The study design included four consecutive periods: (i) an observation phase (run-in), (ii) a placebo period, (iii) fixed-dosage add-on vigabatrin (2 g/day) and (iv) dose titration (up to a maximum of 4 g/day) to optimize clinical response. Each period lasted 8 weeks, except for the titration phase, which could be extended to 16 weeks. 90 patients completed the trial. Eleven dropped out, one patient developing absence status and 4 cases showing an increased seizure frequency. In the patients completing the trial, the median number of seizures/month decreased from 16 (inter-quartile range 8–34) during placebo to 5 (2–10) during the last 8 weeks on vigabatrin (p〈0.0001). Both partial and generalized tonic clonic (mostly secondary) seizures were significantly reduced. A greater than 50% reduction in seizure frequency (compared to placebo) was observed in 60 patients. Sedation and weight gain were the most frequently reported adverse events.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02229159
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  • 8
    Electronic Resource
    Electronic Resource
    Assessment of autonomic disturbances in multiple sclerosis by measurement of heart rate responses to deep breathing and to standing (1982)
    Springer
    Neurological sciences 3 (1982), S. 111-114 
    Details
    ISSN: 1590-3478
    Keywords: Multiple sclerosis ; autonomic neuropathy ; deep breathing ; standing test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Le risposte del ritmo cardiaco ai test della respirazione forzata e dell'elevazione (deep breathing e standing) sono state misurate in un gruppo di pazienti affetti da sclerosi multipla (SM) e comparati ad un gruppo di controllo. Al test della respirazione forzata i pazienti con SM non mostrarono significative variazioni rispetto ai normali degli intervalli R-R, sebbene alcuni soggetti ebbero variazioni da battito a battito al di sotto del limite normale inferiore. La risposta all'elevazione fu più piatta nei soggetti con SM, con un minore aumento del ritmo caridaco e una bradicardia relativa ridotta. Questi dati dimostrano la presenza di un certo grado di denervazione autonoma del cuore nei pazienti con SM, con un danno più consistente del sistema simpatico che non del parasimpatico. La valutazione della denervazione autonoma del cuore mediante i semplici test qui descritti può essere utile corne test ausiliario non specifico nell'avvalorare la diagnosi in casi di sospetta SM.
    Notes: Abstract Heart rate responses to deep breathing and to standing were measured in a group of patients with multiple sclerosis (MS) and compared to control subjects. On deep breathing MS patients did not show significantly lower R-R interval changes than normals, although some subjects showed beat-to-beat variations below the lower normal limit. The response to standing was flatter in MS patients, with a smaller increase in heart rate and reduced relative bradycardia. These data demonstrate the presence of some degree of autonomic denervation of the heart in MS subjects, with a more damage to the sympathetic than the parasympathetic system. The assessment of autonomic denervation of the heart by means of the simple tests here described may prove helpful as a non-specific ancillary test in supporting the diagnosis in cases of suspected MS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02043941
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  • 9
    Electronic Resource
    Electronic Resource
    Neuroborreliosis: a Sardinian case with cerebellar symptoms (1992)
    Springer
    Neurological sciences 13 (1992), S. 271-274 
    Details
    ISSN: 1590-3478
    Keywords: Lyme disease ; neuroborreliosis ; cerebellar involvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Viene descritto un paziente residente in Sardegna nel quale la storia clinica, la sintomatologia neurologica, le indagini sierologiche e neuroradiologiche e la buona risposta alla terapia specifica, hanno consentito di porre diagnosi di neuroborreliosi. Viene sottolineate la rarità del coinvolgimento cerebellare in tale malattia.
    Notes: Abstract We report the case of a patient long resident in Sardinia in whom the clinical history, neurological symptoms, serological and neuroradiological investigations pointed to the diagnosis of neuroborreliosis. We emphasize the rarity of cerebellar involvement in this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02224403
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  • 10
    Electronic Resource
    Electronic Resource
    Multiple system atrophy-autonomic failure: A case with early laryngeal stridor and without orthostatic hypotension (1991)
    Springer
    Neurological sciences 12 (1991), S. 225-228 
    Details
    ISSN: 1590-3478
    Keywords: Multiple system atrophy ; autonomic failure ; laryngeal stridor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Riportiamo un caso di Multiple System Atrophy-Autonomic Failure in cui gli aspetti di maggior interesse erano costituiti dall'inconsueto instaurarsi di uno stridore laringeo in assenza di ipotensione ortostatica e dalle scelte di inquadramento clinico-nosografico delle alterazioni autonomiche rilevate. La differenziazione tra l'Autonomic Failure e la Pure Autonomic Failure e i loro rapporti con la Multiple System Atrophy sono oggetto di dibattito: in accordo con taluni Autori riteniamo che l'assenza o la presenza dell'ipotensione ortostatica possa considerarsi fattore discriminante in tal senso.
    Notes: Abstract We report a case of multiple system atrophy-autonomic failure in which the most interesting features were the uncommon onset of a laryngeal stridor in the absence of orthostatic hypotension and the clinical-nosographic possibilities for the autonomic changes found. The differentiation between autonomic failure and pure autonomic failure and their relationship to multiple system atrophy are still under discussion. We agree with the authors who consider that the absence/presence of orthostatic hypotension may be taken as discriminant for this purpose.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02337039
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