Giulio Juvarra

Successful treatment of subacute cerebellar degeneration in ovarian carcinoma with plasmapheresis a case report

Subacute cerebellar degeneration is a rare complication of some neoplasms, and is generally resistant to therapy. A case of subacute cerebellar degeneration in a 50‐year‐old woman with a Stage II grade 3 serous ovarian adenocarcinoma is reported. The onset of the neurologic symptoms preceded the diagnosis of cancer and progressively worsened during and after four cycles of chemotherapy. A quick, partial improvement of the neurologic syndrome was documented after three weekly treatments with plasmapheresis. The contribution of circulating factors in inducing subacute cerebellar degeneration can be postulated. A trial using this new type of treatment should be performed in patients who have this therapeutically refractory clinical condition.

Polyneuropathy in Progressive External Ophthalmoplegia

A case of progressive external ophthalmoplegia (PEO) in association with peripheral neuropathy and other neural and visceral manifestations is reported. Pathological studies of the sural nerve demonstrated loss of large myelinated fibers, segmental demyelination with remyelination, and excess of zebra bodies in the Schwann cells on electron microscopy. Peripheral neuropathy in the course of PEO is regarded as a further although rare aspect of a multisystem disease.

Pseudomyotonia of the Striated Urethral Sphincter

Pseudomyotonic discharges of the striated urethral sphincter are infrequent findings. We herein report on 9 patients with dissimilar anatomical-clinical conditions. In some patients a definite neurological lesion was ascertained, whereas in the remaining patients no neurological impairment could be determined clinically and instrumentally. The possibility of spontaneous resolution of the phenomenon is an interesting clinical feature.

Hypercalcemic Encephalopathy in the Course of Hyperthyroidism

A hypercalcemic condition can be observed in association with hyperthyroidism. The case of a patient suffering from hypercalcemia and hyperthyroidism is reported. A confusional state and EEG alterations, among which diffuse monomorphic delta rhythms were remarkable, are shown. As soon as normalization of calcemia was achieved, a rapid clinical and EEG improvement took place. A hypothetical interpretation is proposed, according to which a prolonged, though inconstant, and mild hypercalcemia in the course of hyperthyroidism could determine an encephalopathy, concealing in some way thyrotoxic symptoms.

Meige Syndrome: a Clinical and EMG Study

2 patients showing oral-facial asymptomatic dyskinesia are reported. Clinically observed involuntary movements are the same as those described by Henry Meige in 1910 for the first time. An outstanding EMG feature is the recording of spontaneous potential bursts, both short and long in duration, that show synchronism when activity is registered from different facial muscles at the same time. Clinical and EMG data allow close comparison between involuntary movements in the course of Meige syndrome and idiopathic hemifacial spasm.

Myokymia in the Course of Peripheral Idiopathic Facial Palsy

5 cases of myokymia from a total of 31 patients showing peripheral ‘idiopathic’ facial palsy are reported. Myokymia began during the acute phase of palsy and abruptly disappeared during reinnervation. These findings lead us to consider damage of the facial nerve axon along its bony channel as a possible source for myokymia.