L. Bergamini

First Clinical Experience on the Antiepileptic Action of Taurine

On the basis of previous investigations showing the antiepileptic action of taurine in both acute and chronic experimental epileptogenic foci, taurine was administered intraperitoneally to 15 highly refractory patients presenting daily frequent seizures of various types. Taurine was given daily for the first 10 days and weekly during the subsequent 50-day period. In most subjects seizures disappeared and the EEG improved during the first period, while a progressive relapse to pre-taurine conditions occurred during the second period. Only in four young patients (two HHE syndromes and two primary generalized epilepsies) improvement persisted up to the end of the follow-up period. This result, besides any theoretical speculations (taurine non-specific action?), may commend use for the taurine treatment in refractory young patients having frequent seizures.

Experimental evidence for the existence of an extrarhinencephalic control of the activity of the cobalt rhinencephalic epileptogenic focus. Part 2. Effects of the paleocerebellar stimulation.

In chronic unanaesthetized and unrestrained cats with a cobalt‐induced amygdaloid or hippocampal epileptogenic focus, the effects of paleocerebellar stimulation on the cobalt focus activity and excitability were studied. The results obtained justify the following conclusions.

Diazepam binding inhibitor-like immunoreactivity (DBI-LI) in human CSF: Correlations with neurological disorders

Cerebrospinal fluid (CSF) levels of the anxiogenic neuropeptide diazepam binding inhibitor (DBI) were determined by radioimmunoassay in 281 patients who underwent evaluation for neurological problems. Serial dilution curves and reverse-phase high pressure liquid chromatography showed that the immunoreactive material in CSF behaved just as authentic DBI extracted from human brain. Furthermore in the assay there was no evidence of interference from CSF samples deprived of DBI by immunoaffinity. In 82 patients with no evidence of major lesions in the central nervous system, who acted as controls, the CSF DBI content was shown to be age- and sex-related. No correlation was observed with the CSF protein concentration. In patients with different types of dementia, the levels of CSF DBI were significantly increased in a group with normal pressure hydrocephalus. No significant differences were found between Alzheimers disease, multi-infarct dementia, or dementia with Parkinsons disease and controls. In non-demented patients with Parkinsons disease the levels of DBI were increased in a subgroup with depressive disturbances whereas no differences was observed in the non-depressed cases. The content of DBI was markedly reduced in 5 cases with olivopontocerebellar atrophy and in 4 with spinocerebellar ataxia. In all the other disorders studied the levels of DBI were similar to or slightly lower (multiple sclerosis) than those of the controls. The origin of DBI in cerebrospinal fluid is uncertain; a number of various possibilities are discussed concerning the proposed role of DBI as modulator of brain GABAergic transmission.

AN EXPERIMENTAL INVESTIGATION ON THE MECHANISMS OF INTERACTION OF ASYMMETRICAL ACUTE EPILEPTIC FOCI

In the cat the activity of two asymmetrical foci created by bilateral cortical application of conjugated estrogens (Premarin®) was compared with that of identical foci individually induced. The activity of each focus was greatly enhanced in the presence of the contralateral focus. This indicated that a facilitatory reciprocal interaction occurred between the two foci. Investigations of the pathways followed in this interaction by callosal split or cortical‐callosal isolation showed that in cats with both foci the procedures were followed by a marked increase or decrease in epileptic activity respectively. By contrast both procedures were without effect in cats affected with only one focus.

Acquired etiological factors in 1,785 epileptic subjects: clinical-anamnestic research.

This study utilizes ciinicai and anamnestic data concerning epileptic subjects (males and females) of ages ranging between 1 month and 21 years.

Long term recombinant interferon alpha treatment in MS with special emphasis to side effects

Twenty relapsing-remitting (RR) clinically definite MS patients were treated with 9 MIU intramuscular recombinant interferon alpha-2a (rIFNA) (Rof eron-A, Roche) (n=12) or placebo (n=8) every other day for 6 months and followed up for a further 6 months after stopping treatment Numbers of active lesions at MRI and of patients with clinical-MRI signs of disease activity and lymphocyte interferon gamma production, which were decreased during treatment, returned to values similar to baseline and placebos after stopping treatment rIFNA chronic therapy seems therefore needed in order to maintain drug efficacy. Side effect prof ile was monitored, too, for over 1 year in the same 20 patients plus 25 additional RR MS patients. Besides the typical side effects of type 1 interferon therapy (fever, fatigue, depression, lymphopenia, hepatic enzyme elevation), occurrence of serum autoAbs was noted in 30% patients (in 60% antinuclear and in 80% antithyroid autoAbs). In two patients rIFNA treatment was stopped, in one case for antithyroid autoAbs and hypothyroidism, in the other for antinuclear autoAbs and a five-fold increase of ALT. A careful monitoring of serum autoAbs and of signs of thyroid or liver damage must always precede and accompany longterm type 1 IFN therapy.

A Case of Status Epilepticus with Tonic Expression (so called “Reticular Epilepsy”) Physiopathological Study

A patient with status epilepticus of tonic expression had seizures characterized by clouding of consciousness, generalized hypertonia and neurovegetative changes. The following data were obtained by polygraphic and pharmacological studies.