Marabello L

Amyotrophic Lateral Sclerosis: An Epidemiological Study in the Province of Messina, Italy, 1976–1985

An epidemiological investigation of 41 subjects with amyotrophic lateral sclerosis observed in the Province of Messina during 1976-1985 was performed. The incidence was 0.61/100,000 and the prevalence 2.48/100,000 inhabitants. The illness was found to be prevalent in males. The atrophic type occurred in 17 subjects, the bulbar type in 23 cases and the pseudo-polyneuritic form in only one patient. The mean age on the onset was 57.29 +/- 10.55 years. The duration of the illness was significantly higher in patients with atrophic type (p less than 0.01). No significant difference between occupation and development of the disease was found. Among all patients 12.19% presented evidence of trauma, but traumatic events were equally present in a control group.

Nocturnal Complex Partial Seizures Precipitated by REM Sleep

A 16-year-old patient presenting with complex partial seizures occurring in the transition from a REM period to wakefulness is described. His baseline EEG showed generalized and symmetrical slow spike and wave complexes, on a normal background activity, activated by NREM sleep. Polygraphic and videotape recordings, carried out for several nights, showed that after nearly each REM period, he would wake up briefly, presenting eye blinking followed by a burst of generalized hypersynchronous theta to start his seizures. These were characterized by moaning and autoaggressive behaviour, the ictal EEG showing generalized slow spike and wave complexes in the midst of several movement artifacts. At the end of each fit he fell back to REM sleep. Carbamazepine treatment completely resolved his symptoms, with full normalization of EEG activity.

Occurrence of uraemic autonomic dysfunction in relation to age

Abstract A battery of cardiovascular reflex tests were performed on 20 patients with chronic rena! failure on intermittent haemodialysis, to assess occurrence of parasympathetic and sympathetic abnormalities. Using age‐adjusted confidence limits, elderly uraemics showed more extensive parasympathetic and sympathetic dysfunction than middle‐aged patients. The results suggest that the autonomic nervous system in the elderly is more susceptible to uraemic toxins than in the middle aged. This should lead to better preventive and therapeutic strategies for older uraemics.

Pentylenetetrazol-induced spike wave discharges in rats: A polygraphic study

Abstract14 male Wistar rats were studied, before and after pentylentetrazol (PTZ) 20 mg/kg i.p., since a petit mal-like electroclinical pattern, either spontaneous or PTZ-induced was recently described in a breeding station where this strain is raised. In particular, surface EEG, muscular, respiratory and cardiac activities were recorded in order to detect possible clinical-electroencephalographic correlations. Spontaneous epileptic phenomena were never observed. In all the animals PTZ-induced short, usually generalized and synchronous spike wave discharges often concomitant with rhythmic twitches of the vibrissae. Epileptic bursts were related to arousal level, disappearing during motor behavior and arousing stimuli. Moreover individual discharges could be interrupted by a sudden noise. Photosensitivity was not present. Muscular tone and autonomic functions were not affected. The features of PTZ-induced generalized nonconvulsive seizures in rats are compared to those of cat penicillin epilepsy and human petit mal.SommarioQuattordici ratti maschi Wistar sono stati studiati prima e dopo somministrazione di pentilentetrazolo (PTZ), 20 mg/kg i.p., essendo stato recentemente descritto, in un allevamento di animali di tale ceppo, un pattern elettroclinico piccolo male simile sia spontaneo che indotto dal PTZ. In particolare sono state registrate l’attività elettrica cerebrale superficiale, quella muscolare, respiratoria e cardiaca. Nessuno degli animali ha presentato fenomeni epilettici spontanei. In tutti gli animali il PTZ ha indotto brevi scariche a tipo punta-onda, di solito generalizzate e sincrone, spesso associate a mioclonie ritmiche delle vibrisse. Le scariche epilettiche apparivano correlate al livello di vigilanza, non essendo evidenti durante i comportamenti motori e gli stimoli attivanti. Singole scariche potevano essere interrotte da un rumore improvviso mentre non erano influenzare dalla fotostimolazione. Il tono muscolare e le funzioni cardiorespiratorie non sono risultate alterate. Le crisi generalizzate non convulsive indotte dal PTZ sono raffrontate a quelle dell’epilessia da penicillina nel gatto e del piccolo male nell’uomo.

Wake and sleep cardiovascular reflex tests and GH profiles in diabetic patients.

SummaryFourteen diabetic patients (13 males, 1 female, 7 IDDM and 7 NIDDM) were tested during wakefulness with a battery of tests examining parasympathetic and sympathetic control of the cardiovascular system. Subsequently sleep recordings including EEG, EOG, submental, left and right anterior tibialis EMGs, ECG, nasal airflow, thoracic and abdominal respirograms, nocturnal penile tumescence, were performed in each subject. The assessment of cardiovascular functions during sleep was based on the following parameters: Rbm, R-wake, apnea index, adequate penile tumescence during phase REM. Parasympathetic and sympathetic control of cardiovascular system were both impaired during wakefulness in only one patient, who also showed a low Rbm index indicative of ascertained autonomic neuropathy. Indices Rbm sufficiently low to be considered an evidence of probable autonomic neuropathy were found in 5 patients (3 IDDM and 2 NIDDM); all but one with normal cardiovascular tests during wakefulness. Five patients showed gross deficiency upon nocturnal penile tumescence monitoring. In comparison with a control group the patients showed a significantly lower overall Rbm index (p<0.001). IDDM patients showed an increased plasma GH response to insulin-induced hypoglycemia compared to NIDDM and normal subjects. Increased GH secretion was furthermore confirmed by GH values obtained in blood samples drawn during the first REM stage of the night in IDDM patients. The evaluation of the variables taken into consideration during sleep appears to be crucial for the assessment and prevention of autonomic neuropathies and neuroendocrine dysregulation in diabetic patients.

Cerebral Atrophy in Long-Term Haemodialyzed Patients

In adult young patients on long-term regular haemodialytic treatment cerebral computed tomography (CT) scans have often revealed a high incidence of cerebral atrophy (CA), even in the absence of clear neurologic or psychiatric symptoms (1). On this basis we performed a CT investigation on a group of asymptomatic selected haemodialyzed outpatients, distinguishing between geriatric and adult subjects, in order to detect the possible incidence and severity of CA.