Giulia Benassi

Epidemiology of headache in the Republic of San Marino.

An epidemiological survey on headache was performed in the Republic of San Marino, which is the smallest independent State in the world, located near the Adriatic Coast, within Italy. Among a random sample of 1500 inhabitants over 7 years of age the frequency of headache, severe headache and migraine in the previous year was 35.3%, 12.2%, 9.3% respectively for men, and 46.2%, 20.6%, 18% for women. The most common factors reported to provoke headache were emotional stress, physical strain, lack of sleep, particular foods or drinks and for women menstruation. Migraine patients differed from people without headache in that they had a higher consumption of coffee, more frequently reported bad sleep, allergic disease and previous appendectomy. Furthermore, migraine patients and severe headache sufferers had a higher diastolic blood pressure than non headache subjects.

Prevalence of Parkinson's disease in the Republic of San Marino

A prevalence survey on Parkinsons disease (PD) was performed in the Republic of San Marino, which is the smallest independent state in the world, and is located near the Adriatic coast, within Italy. On April 30, 1986, it had a population of 22,322. We found 34 cases of PD (17 men, 17 women). Crude prevalence ratio per 100,000 population was 152 (154 for men, 150 for women) with an age-adjusted ratio of 185 (both sexes). This study shows that the prevalence of PD in the Mediterranean area of South Europe is similar to that in North Europe and the United States.

Neurological examination in subjects over 65 years: an epidemiological survey.

The frequency of abnormal findings at neurological examination was analyzed in an unselected sample of elderly people aged 67-87 years. Absent deep tendon reflexes and impairment of proprioceptive sensation rarely occurred in the elderly. Limitation of upward gaze and convergence appear a common finding, especially in the very old. Overall, the presence of cortical disinhibition signs (primitive reflexes and paratonia) did not discriminate well between subjects without CNS disease and demented patients. Only the presence of a prominent and persistent response to the stimulus and the number of cortical disinhibition signs found in the same subject appear useful criteria to distinguish between normality and dementia.

The prevalence of lingual‐facial‐buccal dyskinesias in the elderly

We examined an unselected sample of 398 subjects aged 67 to 87 years. Only six (1.5%) subjects presented lingual-facial-buccal dyskinesias (LFBD). LFBD, therefore, are rare neurologic manifestations. They are more frequent in women than in men and in more elderly subjects. Furthermore, in three of six cases, they were associated with senile dementia. Previous studies performed on hospital-based populations probably overestimated the prevalence of LFBD.

An epidemiological study on severe mental retardation among schoolchildren in Bologna, Italy.

The prevalence, causal origin of and impairments associated with severe mental retardation (SMR) were investigated among all school‐age children (six to 13 years) living in the city of Bologna, Italy. 90 children (57 boys, 33 girls) with IQs ≤ 50 were identified. The prevalence of SMR was 4‐2 per 1000 for males, 2–5 per 1000 for females and 3–4 per 1000 for both sexes. Causal origin was prenatal for 33‐3 per cent, perinatal for 14‐4 per cent, combined pre‐ and perinatal for 5–6 per cent and postnatal for 13‐3 per cent. Another 12‐3 per cent of the children with IQs ≤ 50 had autism or childhood psychosis, while there was no evident cause of mental retardation for the remaining 21‐1 per cent. 50 per cent had at least one associated physical or neurological impairment other than mental retardation, with epilepsy and cerebral palsy predominating.

Slowly progressive ischemic stroke as first manifestation of essential thrombocythemia.

We report a case of essential thrombocythemia, the only clinical manifestation of which consisted of neurologic symptoms, including anomic aphasia, tactile and painful hypesthesia in the right hand, headache, and Gerstmann syndrome, with a relatively benign and slowly progressive clinical course. Neuroradiologic examination disclosed a large ischemic area in the left temporoparietal region. Cerebral angiography revealed an occlusion of the cortical branches of the left middle cerebral artery with total sparing of the carotid vessel. These findings are discussed in relation to the possible pathogenetic mechanisms of the vascular occlusion due to abnormal platelet function in essential thrombocythemia.

PREVALENCE OF MENTAL RETARDATION RELATED TO FRAGILE X SYNDROME AND OTHER CHROMOSOMAL ABNORMALITIES THE REPUBLIC OF SAN MARINO

The prevalence of mental retardation related to chromosomal abnormalities, including fragile × syndrome, was studied among 2735 males aged between five and 20 years living in the Republic of San Marino. Five cases of chromosomal abnormalities were found, including one case with fragile × syndrome, with partial epilepsy and a CT scan showing a large arachnoid cyst in the posterior fossa. The prevalence of mental retardation due to chromosomal abnormality was 1 · 83 per 1000, and that due to fragile × syndrome was 0 · 37 per 1000. Although these findings relate to only a small population, they are the first from a Mediterranean area.