M. G. Albizzati

TREATMENT OF HUNTINGTON'S CHOREA WITH BROMOCRIPTINE

The authors tested the effects of 2‐Br‐ergocriptine (bromocriptine, CB‐154), a drug which exerts a mixed agonist‐antagonist activity on the dopaminergic receptors, in 12 patients with Huntinton Chorea in a double‐blind crossover trial. This treatment significantly reduced the abnormal involuntary movements and the disease severity in most of the patients. Subjects who were slightly disabled showed a better response than the ones with more severe degrees of disability.

A case of lipid storage myopathy with carnitine deficiency: Biochemical and electromyographic correlations

Histochemical, biochemical and electromyographic studies were performed in a case of carnitine deficiency in serum and in muscle. Clinical features include proximal muscle weakness, predominant type I fiber impairment, excess of triglycerides and moderate glycogen accumulation in muscle. No abnormalities of palmityl CoA synthetase, carnitine palmityl transferase, carnitine acetyl transferase and lipase were evidenced. An interesting EMG decremental pattern was recorded. Correlations between electromyographic and biochemical findings are considered. A clinical improvement, a normal plasma carnitine level and a normal response at EMG repetitive stimulation were found after carnitine treatment.

F-wave velocity in motor neurone disease.

The F‐wave velocity in the central segment (axilla to spinal cord) was studied employing the “collision technique” described by Kimura (1974), and compared with the conduction velocity obtained with the the usual methods. In 25 normal subjects the F‐wave velocity increased proceeding proximally, reaching the maximum values in the central tract (64.86 ± 2.23 m/sec in ulnar nerve). In 11 patients affected by motor neurone disease and 11 patients affected by amyotrophie lateral sclerosis the F‐wave velocity decreased significantly proceeding proximally and the minimum values were found in the central tract (52.51 ± 2.15 m/see in MND and 48.64 ± 5.60 m/sec in ALS). We therefore suggest the use of F‐wave velocity as a more complete element for precise localization of the lesion in the central segment when the motoneurone is primarily involved.

Association of glycerol to dexamethasone in treatment of stroke patients

A prospective study of 93 acute stroke patients randomly selected by type of antiedema treatment given (hypertonic glicerol infusion plus dexamethasone versus dexamethasone alone) failed to elicit any statistically significant difference between the two treatments on survival rates and quality of survival 7 and 30 days after the stroke.

Acute treatment of Huntington's chorea with lisuride

The authors studied the effects of lisuride hydrogen maleate (lisuride) on the hyperkinesias of 11 patients suffering from Huntingtons chorea (HC). In all patients, acute injection of 150 micrograms of the drug induced a marked temporary improvement of the abnormal involuntary movements; the favourable drug-effect was more pronounced in the patients with a less severe degree of hyperkinesia. The antichoreic activity of the drug was prevented by pretreatment with haloperidol (2 mg) or sulpiride (400 mg), both injected intramuscularly 30 min before lisuride administration. The authors suggest the improvement of the motor disturbance induced in HC by lisuride may be explained on the basis of its preferential action on a subset of brain dopaminergic receptor.

Therapeutic experience with transdihydrolisuride in Huntington's disease

Transdihydrolisuride is an ergot derivative with mixed agonist and antagonist effects on central dopamine receptors. We gave the drug orally (1 mg daily) to 10 patients with Huntingtons disease. In seven patients, the chorea improved with no adverse effects during the study.

Encephalomyelitis with thyrotoxicosis.

SummaryA case of thyrotoxicosis associated with neuropathy and encephalomyelitis is reported which gradually improved as regards the hyperthyroidism and the neurological deficit during treatment with Tapazole. The possible role of the nervous system of an excess of thyroxine or an autoimmune factor as a cause of the involvement is discussed.

“On-off” phenomena, dyskinesias and dystonias

In this study the effects of an acute injection of lisuride and apomorphine in 12 subjects affected by dystonic‐dyskinetic syndromes of different aetiology are evaluated: 3 patients with spasmodic torticollis, 4 with tardive dyskinesia and 5 Parkinson patients suffering from “on‐off” attacks with prominent dyskinesias during the mobile phase. In the last group drugs were administered during the “on” phase. In 11 out of 12 patients both lisuride and apomorphine induced a marked improvement of the abnormal involuntary movements. In Parkinson and torticollis patients both drugs also reduced the rigidity. In comparison to apomorphine, lisuride showed a more effective and long‐lasting action. Only in one Parkinson patient did the drugs fail in showing any change.

An Investigation of the Effect on Platelet Function of Acetylsalicylic Acid, Dipyridamole and the Two Drugs in Combination in Patients with Transient Attacks of Ischaemia

Twenty patients suffering from transient attacks of ischaemia were studied. Seven received acetylsalicylic acid, six dipyridamole and seven a combination of the two drugs. No significant difference in platelet aggregation was shown in the acute phase between the three treatment groups using an adenosine diphosphate test method. Using Thrombofax platelet substitute, however, a significant difference was seen in all measures. On the seventh day following the ischaemic attack the Thrombofax values returned to normal but, in contrast, Platelet Factor 4 release was increased. Monthly testing of platelet activity during treatment shows that the combination of acetylsalicylic acid with dipyridamole was more effective in bringing about an early inhibition of Platelet Factor 4 release than either agent alone.

GANGLIOSIDES IN DENERVATION : AN EXPERIMENTAL AND CLINICAL STUDY

Publisher Summary This chapter presents an experimental and clinical study of gangliosides in denervation. In this study, the criodegeneration of soleus and EDL nerves was performed on female Sprague–Dawley rats weighing 220–250 g, subdivided into 3 groups of six animals. The first group included normal rats; the second lesioned animals; and the third rats criodegenerated and treated with gangliosides. The treatment was 50 mg/kg of brain cortex gangliosides, injected every day e.p. for 10–15–20 days. The results showed that in the normal muscle, the enzyme activities were higher in the soleus muscle than in the EDL. After cooling, in the untreated rats muscles, an increase in phosphodiesterase (PDE) and cyclase enzyme activities was observed. This increase in activity was already present at tenth day, but it joined the maximum rise at twentieth and it was higher for A–C and for G–C than for cyclic nucleotides PDE. In the gangliosides-treated rats, after a beginning increase in enzymatic activity, like that of untreated-animals, enzymatic activities came back to values close to controls at 20th day from denervation.