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Biomedical subjects

E Bortone

Publications and source records attributed to E Bortone.

14 recordsLinked to original sources

Reliability of EEG in the diagnosis of Creutzfeldt-Jakob disease.

Although EEG is generally considered a useful tool for the diagnosis of Creutzfeldt-Jakob disease (CJD), some cases have been reported where the EEG was non-specific. We reviewed a series of 15 CJD patients, observed in our institute in the period 1975-91. In 12 cases the diagnosis was confirmed on post-mortem examination. The prominent aspect of the present series was the homogeneity of clinical, neurophysiological and neuropathological data. All patients showed the presence of periodic sharp wave complexes (PSWC) and EEG reactivity to external stimuli or drugs was uniform. The EEG can give essential information for the diagnosis of CJD if 2 basic conditions are satisfied: (1) serial recordings are performed in relation to the different stages of the disease, and (2) not only the presence of PSWC is considered, but also the reactivity of EEG to dynamic events such as the response to external stimuli and drugs, and the level of consciousness.

Adult

Steadiness of amyotrophic lateral sclerosis in the province of Parma, Italy, 1960-1990.

A clinical and epidemiological study on amyotrophic lateral sclerosis (ALS) was conducted in the province of Parma, Italy, from 1960-1990. A total of 121 cases were collected from hospital records. The average annual incidence was 0.98 per 100,000 inhabitants, with a male/female ratio of 1.1. Age-specific incidence was maximal in the age group 60-69 years. No difference between rural and urban areas was found. Prevalence on October 26th, 1981 was 2.5 per 100,000. Mean age at onset was 60 years, with no significant sex difference. Mean duration of the disease was 30 (sd 21.4) months. Bulbar forms were significantly (p < 0.05) shorter than conventional forms, with a mean duration of 23.4 (sd 21.4) months. Age at onset did not influence prognosis. A comparison of three decades was made, to verify whether possible variations of the disease had occurred with time. From our data a definite stability was found in such epidemiological parameters as incidence, prevalence, mean duration and mortality of ALS in the period.

Adult

Post-anoxic theta and alpha pattern coma.

Theta pattern coma is a rare EEG finding, described in the course of post-anoxic or post-traumatic coma and interpreted as a "malignant" variant of alpha pattern coma. A case of isolated theta pattern coma, followed by alpha pattern coma is reported. Short temporal succession of such patterns would seem to confirm the hypothesis of a close relationship between them. Possible physiological mechanisms involved in the generation of the patterns are discussed.

Alpha Rhythm

Unilateral trismus caused by vertebrobasilar dolichoectasia.

Vertebrobasilar dolichoectasia is a relatively uncommon pathological entity and generally asymptomatic. We report a quite unusual case of unilateral motor trigeminal involvement with trismus, due to VD. Apart from tetanus or local morbid conditions of the mouth, trismus is often attributed to disturbed programming and co-ordination of the masticatory muscles within the mesencephalic nucleus. The possibility of truncal compression of the trigeminal motor root by vertebrobasilar dolichoectasia being responsible for masseter muscle spasm, in analogy with the pathogenetic mechanisms proposed in hemifacial spasm, is proposed as an alternative explanation in the present case.

Aged

Myokymia in the course of Bell's palsy. An electromyographic study.

Facial myokymia has been described in association with many morbid conditions, most frequently multiple sclerosis (MS) and brainstem tumors (BST). Very few reports deal with myokymia in the course of Bell's palsy, despite high frequency of the disease. A series of 88 consecutive patients with Bell's palsy is presented, in which serial EMG controls were performed in the initial phases of facial palsy. Twenty three showed myokymic activity detected by EMG, while clinically evident myokymia could be observed only in 8. EMG features did not reveal any peculiarity as compared with myokymic discharges reported in other pathological situations. Considering the high incidence of myokymic activity reported in the course of Bell's palsy, it is the authors' opinion that an occasional finding of myokymia, both clinically evident or detected by EMG, should not necessarily lead one to suspect serious aetiologies.

Electromyography

[Prevalence and incidence of multiple sclerosis in the province of Parma, 1965-1980. Preliminary data].

Recent epidemiological studies in small communities report very high prevalence rates of multiple sclerosis (MS), suggesting that Italy should be included among high risk areas for MS. Such data are not confirmed when populations exceeding 300.000 are considered. The total prevalence rate of probable MS in the province of Parma was 23.07 per 100.000 on the prevalence day Dec. 31, 1980. Up to date, very few studies deal with incidence of MS, due to the fact that in many cases it is difficult to establish the exact outburst of the disease. Yet, incidence will indicate the real risk for the disease for a given period in a more accurate manner. Mean annual incidence of MS in the province of Parma in the period 1965-80 was 1.14 per 100.000. A previous survey in the period 1950-59 reported, for the same area, an incidence rate of 1.01 per 100.000, versus a prevalence rate of 12.33 per 100.000. In our opinion, when comparison of data between two different areas, in different periods, is to be made, incidence rates for MS should be preferred to prevalence studies.

Adolescent

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.

Brain Diseases

Amyotrophic lateral sclerosis in the province of Parma, Italy: a clinical and epidemiological study in the period 1960-1980.

A clinical and epidemiological study on ALS was conducted in the province of Parma, Italy, in the period 1960-1980. A total of 78 cases was collected from hospital records. The average annual incidence was 0.93 per 100,000 with no difference between rural and urban areas. On prevalence day (October 24, 1971) a prevalence rate of 2.27 was found. Mean age at onset was 59 years, with no sex difference. In 70% of cases the onset was between 50 and 70 years, this datum being statistically significant (p less than 0.001). Mean duration of the disease was 30.4 +/- 20 months, with no difference for sex and age at onset. A comparison was then made between two decades (1961-70 vs 1971-80), in order to verify the clinical impression of a worsening of some ALS parameters in recent years. Although statistical evaluation did not show any significant data, a tendency to a worsening of some parameters of the disease may be postulated.

Age Factors

[Autoscopic occipital seizures and occipital poroencephalic lesion: considerations on a case].

Autoscopy is an hallucinatory phenomenon during which the subject see his own image. It may be caused by organic processes like migraine, vascular diseases, tumoral lesions, and exceptionally by epileptic seizure. The case of 15 years old boy is reported, affected by hemianopia, surgically treated squint, who presented occipital epileptic seizures consisting of autoscopic hallucinations, leftward conjugate eye deviation, followed by a typical major seizures. A right parieto-occipital epileptic focus was a constant finding on EEG. On CT a poroencephalic cyst in the corresponding cerebral region could be demonstrated.

Adolescent

MR findings in Meige syndrome.

A 65-year-old woman was diagnosed clinically to have Meige syndrome in the oromandibular dystonic clinical variant of Marsden. On magnetic resonance imaging a reduced signal intensity in the head of the caudate nuclei, more prominent on the right, and in both putamina was shown.

Aged

Adult postanoxic "erratic" status epilepticus.

A 66-year-old woman with posttraumatic anoxic coma after diffuse cerebral fat embolism had continuous alternating-side myoclonic jerks. Usually, this kind of myoclonic status epilepticus (SE) occurs in newborn infants. We postulate the unusual combination of diffuse cerebral anoxia plus commissural fiber damage as a possible explanation.

Aged

Transient traumatic reticular myoclonus. Case report.

Reticular myoclonus in man is a rare manifestation, generally due to uremia or post-hypoxic conditions. The case of a patient who showed transient myoclonus of sternocleidomastoid and facial muscles, immediately after direct cervical trauma, is described. Absence of paroxysmal EEG activity, topographic distribution of jerks and sequence of muscle activation suggest a reticular myoclonus. Possible physiopathological mechanisms are discussed.

Adult

The sunflower syndrome.

Some photosensitive epileptic patients show absence attacks preceded by a "seeking of a source of light" and stereotyped movements of various kinds. The common explanation is an attempt to self-induce seizures. The case reported is of a young girl who had not shown evidence of photosensitivity for many years. Alternative interpretations of this phenomenon are discussed.

Adolescent

Isolated benign cerebral vasculitis. Case report and review.

A case of isolated cerebral vasculitis showing benign outcome is presented. Review of pertinent literature suggests that isolated benign arteritis of the CNS should be considered as a distinct entity, in a heterogeneous group of vasculitides. The common features of the syndrome are as follows: 1(0) benign evolution; 2(0) sensitiveness to cortisone; 3(0) absence of CSF alterations; 4(0) constant angiographic pattern of arteritis. Early cortisone treatment is suggested in any case of cerebral arteritis.

Adolescent