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Biomedical subjects

A Paggi

Publications and source records attributed to A Paggi.

At least 19 recordsLinked to original sources

Callosotomy for the treatment of drug resistant generalized seizures.

Fifteen patients have been followed for more than one year following callosotomy having presented with long standing epilepsy, no well defined focus amenable to radical excision, and severely incapacitating atonic seizures that were refractory to anticonvulsant therapy. Atonic fits have been reduced by more than 80% in thirteen patients, with two patients suffering long term sequelae (slight dysarthria in one, and dyslexia with mild visuo-spatial disturbances in another). Anticonvulsant therapy was still required post-operatively.

Adolescent

Evolution of neuropsychological changes after partial callosotomy in intractable epilepsy.

Early neuropsychological changes following partial anterior callosotomy were evaluated in 15 patients with epilepsy (10 secondary generalized and 5 Lennox-Gastaut syndromes) by comparing their performances 1 month before surgery and then 15-20 and 90-100 days postoperatively without modifying the anticonvulsant treatment. The following neuropsychological and motor functions were tested: memory, attention, visuo-motor ability, posture, motor dexterity, language, praxis and gnosis. Social behaviour was also investigated. The main results are as follows: (i) most cognitive functions showed no significant variation; (ii) motor organization was still slightly impaired at the second check-up after the surgery; (iii) improvements in social behaviour and posture were frequently observed at the final evaluation. The analysis of individual cases highlights the influence of the extent of commissurotomy, lesions related to the surgical procedure and preoperative brain damage in determining the post-surgical profile. On this basis, the short-term neuropsychological cost of partial callosotomy appears to be low and seems to depend mostly on surgical parameters and brain conditions before the operation.

Adolescent

Acute hypocalcemia enhances prolactin levels: a study before and after oophorectomy.

The effect of acute hypocalcemia on serum prolactin values was investigated in 13 female subjects before and after oophorectomy. An infusion of disodium-EDTA (50 mg/kg b.w., for 120 min) was administered to each patient. Ionized calcium, immunoreactive parathyroid hormone and prolactin serum levels were determined 15 min prior to the infusion, at the beginning of each infusion and thereafter at every 30 min interval. The decrease in serum ionized calcium induced by Na2-EDTA infusion was not influenced by surgery. Serum prolactin and parathyroid hormone values before and after oophorectomy showed a significant (p less than 0.01) increase at 90 and 120 min. The maximum serum prolactin increase was achieved at 120 min and was not influenced by oophorectomy. The results demonstrate that acute hypocalcemia increases serum prolactin levels in female subjects and suggest a possible role for parathyroid hormone and dopaminergic system, even if their interaction remains speculative.

Adult

[Ultrasonic and scintigraphic changes of the euthyroid goiter in the course of drug therapy. I].

We studied the ultrasonographic and scintigraphic changes of thyroid gland of 81 goitreous patients before and after treatment with exsiccated thyroid. About 57.8% of goitres showed a reduction of size, while no change was observed in 30% of patients; a further growth of the gland was seen in 13% of patients in spite of therapy. A difference between ultrasonography and scintigraphy in evaluating after-treatment follow-up was also noted, and a different response of nodules and diffuse hyperplasia to treatment assessed.

Adult

Callosotomy for the management of intractable non-focal epilepsy: a preliminary personal assessment.

After reviewing the data of the literature, the authors report their personal series composed of twelve cases. In evaluating the results of surgical treatment only the first ten patients are taken into account. As previously stressed in the literature, callosotomy (total in two cases and anterior in the remainder) has proved effective in abolishing or significantly reducing atonic seizures. Tonico-clonic seizures have also benefitted in some cases, while in complex partial and partial seizures the effects of callosotomy have been so far unpredictable, albeit in some patients all kinds of seizures have been abolished or definitely reduced. The most impressive EEG and neuropsychological features after callosotomy are briefly summarized. Anterior callosotomy seems to be a relatively safe procedure, its results appear to be, on the whole, gratifying even though in patients with severe mental retardation and Lennox-Gastaut syndromes remain controversial.

Adolescent

[Remarks on callosotomy in the treatment of drug-resistant epilepsy].

In this report 17 patients with long-standing non-focal epilepsy underwent callosotomy (this was total in two patients and performed in two stages, and anterior-subtotal in the remaining patients). In all patients the atonic-hypertonic seizures with sudden falls were the most disabling epileptic fits. Callosotomy proved efficient in controlling atonic fits in 10 out of 15 patients in whom surgical results are evaluated. In 3 additional patients the frequency of atonic fits was reduced by more than 50%. In the remaining two patients, no therapeutic effect was observed. Callosotomy was less effective on seizures which were not atonic. Therefore, this procedure appears to be indicated in patients in whom atonic fits are predominant. The main effect of callosotomy is to transform drug-resistant seizures into drug-sensitive ones. Neuropsychological sequels are insignificant unless the splenium is severed. However, considerable psychic and behavioral improvement was nearly always observed after surgery. Despite the fact that on a therapeutic level results were often satisfactory, a number of practical problems still remain. These concern the full spectrum of indications for callosotomy, the extent of corpus callosum section, choice of methods in severely mentally retarded patients and, finally, the age at which the operation should be carried out.

Adolescent

Ichthyosis accompanied by neurological symptoms with special reference to epilepsy.

5 patients with ichthyosis had a neurological accompaniment: epilepsy in 4, congenital palpebral ptosis, facial pain and neurosis in 1. In one patient epilepsy was combined with multiple malformations (normal dwarfism, prematurely old face, skeletal abnormalities) and oligophrenia. There was considerable variability genetically: 2 sporadic cases, 1 with X-linked transmission, 1 with autosomal dominant and 1 with apparent autosomal recessive heredity. In one case the co-existence of glucose-6-phosphate dehydrogenase deficiency provided proof of X-linked transmission. Further study of larger case-series is needed for a better definition of the nosographic and genetic aspects of non blastomatous neuroectodermatoses in which ichthyosis figures.

Adolescent

[Efficacy and side-effects of long term L-dopa therapy in Parkinsonian syndromes (evaluated by CT scan as well) (author's transl)].

The evolution of symptoms and therapeutic response in a group of have been followed parkinsonian patients 81 for a period of 4 years. Hoehn and Yahr, and Webster's scales have been used. In addition CT scan, EEG, ECG, blood and urine analyses have been carried out. Treatment was carried out with L-Dopa and decarboxylase inhibitor (benserazide for 50% of cases and carbidopa for the other 50%). Anticholinergics (esp. metixene) were often required. The initial response was satisfactory for all patients except one who had hydrocephalus (with normal pressure). Four years later, the initial improvement diminished by about 1/3. Side effects occurred in 80.24% of cases in the beginning, and in 82.50% of cases after 4 years. Dyskinesias, confusional state and "on-off" phenomenon increased with time, whereas gastric trouble diminished. CT scan were obtained in all patients and atrophic changes were found in 82.7%. There were no correlations between localization and severity of anatomical lesions on the one hand, and therapeutic response and side-effects on the other. It is suggested that the severity of the disease depends mainly on the degree of neurochemical integrity in the affected area rather then to the extent of anatomical lesions.

Adult