摘要:

Before 1975 the multiple sclerosis (MS) prevalence rate in Italy ranged from 4 to 21 cases per 100000 inhabitants. In more recent studies the MS prevalence rate exceeded 30 cases per 100000. We decided to perform an epidemiological survey in the province of Modena, Northern Italy, in order to clarify whether Italy should be considered as an area at high risk for MS like the countries of continental Europe. The mean annual incidence for the disease for the period 1970–1990 was 1.49 per 100000, and the prevalence rate was 38.91 per 100000 on December 31, 1990. These results indicate Modena is a high risk MS are

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02744.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

In multiple sclerosis (MS) up‐regulation of β‐adrenoceptors on peripheral blood mononuclear cells (PBMCs) has been attributed to either autonomic dysfunction, inflammation or a combination of the two. We have compared secondary progressive MS patients with normal subjects (NS) and two models of autonomic dysfunction; pure autonomic failure (PAF) and multiple system atrophy (MSA, Shy‐Drager syndrome). There was up‐regulation of β‐adrenoceptors on PBMCs in MS and PAF patients but not in MSA patients. Only in PAF patients β‐adrenoceptor up‐regulation was correlated with low plasma levels of noradrenaline (NA) and adrenaline (Ad). In addition to studies in the basal state, measurements also were made after the centrally acting sympatholytic agent clonidine. These were combined with haemodynamic and neurohormonal measurements. After clonidine, there was a fall in blood pressure in NS and MSA patients but not in MS and PAF patients; a rise in growth hormone (GH) in NS and PAF patients but not in MS and MSA patients; and an up‐regulation in PBMCs β‐adrenoceptors in NS but not in MS, MSA and PAF patients. Up‐regulation of β‐adrenoceptors on PBMCs in MS could be attributed to autonomic dysfunction but the disparity between MS and PAF patients when considering their plasma levels of NA and Ad argue against. Although the neurohormonal responses to clonidine and the physiological assessment of autonomic function in progressive MS patients, demonstrate central autonomic dysfunction resembling that of the MSA patients, the normal basal β‐adrenoceptor densities in the latter, suggests that the up‐regulation of these receptors is independent of the cent

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02745.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Neuroradiological findings are presented of 19 patients with the northern epilepsy syndrome, a recessively inherited childhood epilepsy with associated mental deterioration. The first signs of cerebellar‐brainstem atrophy already appeared in young adulthood, with atrophy tending to increase with age. Findings of cerebral atrophy were detected later: four of the seven patients under 30 years of age displayed central or cortical atrophy, while all 12 patients over 30 were affected. The degree of mental deterioration correlated well with the severity of cerebral atrophy. One half of the patients with either central or cortical atrophy were moderately to severely retarded, whereas all patients with both central and cortical atrophy were moderately to profoundly retarde

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02746.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Introduction– Psychosis is the most severe psychiatric complication after epilepsy surgery.Patients and methods– We evaluated postoperatively at 1 year the psychoses of a series of 57 adult patients with intractable epilepsy who underwent temporal lobe surgery.Results– Five patients (8.8%) developed postoperative psychosis. Two (3.5%) of these 5 revealed postictal psychotic episodes in connection with persisting seizures, both of them had had similar episodes even preoperatively. Two patients (3.5%) exhibited a definite and one patient (1.8%) a probablede novoschizophrenia.Conclusion– Our findings clearly emphasize the need for careful postoperative psychiatric follow‐up for patients with temporal

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02747.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The intracerebral distribution of intravenously injected horseradish peroxidase (HRP) in young adult DDD mice was examined. HRP‐tetramethylbenzidine reaction products were observed in the medial portions of the hippocampus, particularly the medial CA1 region and medial dentate gyrus. Reaction products were observed in the subfornical organ in mice decapitated 5 min after HRP injection, and then also progressively more caudally in the medial portions of the hippocampus as postinjection survival time increased. These findings suggest that blood‐borne macromolecules have ready access to the medial portions of the hippocampus, particularly the medial CA1 region and medial dentate gy

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02748.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Up to now the existence of “vascular parkinsonism” has been doubtful because conclusive clinicopathologic studies are lacking. The objective of the present magnetic resonance spectroscopy (MRS) study is to detect metabolic signs as a reflect of ischemic lesions which could be responsible for the clinical features of vascular parkinsonism. Proton MRS of the brain was performed in 12 patients suspected of vascular parkinsonism on clinical grounds and ischemic score, and in a control group of 15 patients with idiopathic Parkinson's disease. The MR spectra were measured in the striatum and deep white matter. MRS did not demonstrate metabolic evidence for the existence of ischemia (elevated lactate) or cell loss (decreased N‐acetyl‐aspartate levels) in patients suspected of vascular parkinsonism. Several explanations for our findings are di

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02749.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Introduction– Risk factors for aseptic intracranial venous occlusive disease are varied but only few epidemiologic studies were performed to verify the relative importance of particular factors.Patients and methods– A 2‐year hospital‐based prospective study was conducted in two hospitals to identify the clinical characteristics and risk factors of patients with confirmed aseptic intracranial venous occlusive disease.Results– 21 patients were identified, representing 0.9% of the total neurological admissions. Men were more commonly affected than women; 81% of the patients presented in a clinical picture indistinguishable from idiopathic intracranial hypertension. Risk factors included Behçet's disease in 4, the puerperium in 3, thrombophelia in 3, familial Mediterranean fever in 2, malignancies in 1, lupus anticoagulant in 1, and the contraceptive pill in 1.Conclusion– Aseptic intracranial venous occlusive disease proved to be not rare in Arabs. It should be considered seriously in the differential diagnosis of idiopathic intracranial hypertension, particularly in males. Several risk factors were

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02750.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We report clinical, neuroimaging and immunological findings in seven women with antiphospholipid antibodies (APLA) and cerebral ischemia. Two patients had systemic lupus erythematosus (SLE) and five had the antiphospholipid syndrome (APS). Autopsies were done in 3 women who died acutely with focal neurological deficits. Evidence for cerebral embolism was found in all patients: a) pathology demonstrated multiple cerebral infarctions and cerebral emboli from underlying non‐bacterial thrombotic endocarditis (NBTE) in the patients who died. b) Three patients had thickened mitral valves and embolic cerebral occlusions were identified with cerebral angiography. c) In one patient, echocardiography detected a thrombus on the posterior leaflet of a prolapsing mitral valve at the time of ictus. Our data provide further evidence to implicate valvular endothelium in the genesis of cerebral ischemia in some patients with APL

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02751.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Introduction– Despite the current interest in criteria for vascular dementia, global, as opposed to focal, cognitive change after cerebral infarction has rarely been studied.Material and methods– We documented the neuropsychological changes one to three weeks and three months post infarct in 25 unselected patients with acute, first cerebral infarcts.Results– Improvements were seen in processes thought to have a large subcortical component and in those mediated in the right hemisphere. Memory was relatively lightly affected.Conclusion– The minimal deficits seen in memory and the predominance of subcortical changes are at variance with the currently suggested criteria for vascular dementia. Further data of this kind are needed before firm criteria can be proposed for the global pattern of cognitive changes expected in vascular d

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02752.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Magnetic resonance imaging (MRI) permits efficient visualization of white matter lesions (WML). A growing body of literature deals with the correlation of WML and cognitive dysfunction with conflicting results. We studied the influence of lesion pattern as well as size by analyzing MRI and psychometric test performance in 2 patient collectives with different WML patterns. 22 patients with myotonic dystrophy (MD) and mainly subcortical WML werecompared with 39 patients with multiple sclerosis (MS) and mainly periventricular lesions. 73% of MD patients had WML, the extent of which correlated with cognitive deficits. Severely impaired patients had psychometric findings compatible with “subcortical” dementia. In MS the extent of WML alone did not correlate significantly with cognitive deficits. Significant cognitive dysfunction was observed with extension of WML to areas of white matter immediately underlying cortex, but not with exclusively periventricular lesions. Cerebral atrophy had less impact. Comparison of MD and MS indicates that WML immediately subjacent to cortex are likely to cause significant cognitive deficits, whereas extensive periventricular demyelination may cause no major dysfunction. This may relate to early disturbance of associative fibers by subcortical lesions. Our results emphasize the significance of pattern as well as total extent of WML. Myotonic dystrophy is a useful model to study the effect of subcortical lesions, due to a typical lesion pattern unusual in other conditi

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb02753.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY