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F Vassella

Publications and source records attributed to F Vassella.

At least 37 records · Page 2Linked to original sources

Intracranial lipomas.

Intracranial lipomas are very rare tumors, mostly being localized in the midline and often asymptomatic. We report on three children with intracranial lipomas (one with extension to the cervical spinal cord) diagnosed by CT and/or MR. All three had different symptoms and neurological signs. We summarize the case reports in the literature since the CT-era.

Brain Neoplasms↗

[Differential diagnosis of cerebral seizures].

Several non-epileptic disorders may cause episodic and paroxysmal symptoms that resemble epilepsy and they must be considered in the differential diagnosis. Some of these disorders are discussed in the present review: vasovagal, vasomotor and cardiac syncopes, breath holding spells. Among the sleep disorders, parasomnias, nightmares and the benign neonatal sleep myoclonus are mentioned. Migraine with aura, alternating hemiplegia and benign vertigo of childhood are probably related disorders. Benign myoclonus of early infancy, paroxysmal choreoathetoses and pseudoepileptic or hysterical seizures are further non-epileptic attack disorders to be considered in the differential diagnosis.

Child↗

[Neurological complications following tonsillectomy].

Iatrogenic neurological complications of tonsillectomy have been extremely rarely described. We report on 5 patients who developed glossopharyngeal paresis, impairment of taste on the base of the tongue, or hypoglossal paresis following tonsillectomy, and discuss the possible etiology of these isolated lesions of the cranial nerves.

Adult↗

[Variability of epileptic seizure phenomenology in infants and children].

It is well known that some patients may have two or more different types of seizures. Partial epilepsies and more than 15 different epileptic syndromes (e.g. West or Lennox-Gastaut syndrome or epilepsies with absences) can lead to the intraindividual manifestation of two or more seizure types. Among 728 children with epilepsy seen at the outpatient department 9.1% had two different types of seizures and 1.5% had more than two types of seizures. The most common association observed was between tonic-clonic seizures and absences. The most frequently observed epileptic syndromes were in decreasing order: multifocal epilepsies, epilepsies with absences, Lennox-Gastaut syndrome and West syndrome. The association of two or more different seizure types in the same patient seems to be a negative prognostic factor.

Child↗

[Prognostic value of the EEG prior to the start and the discontinuation of anticonvulsive therapy].

Opinions are divided about the prognostic value of the EEG in the course of epilepsy. We thus prospectively examined 275 children with epilepsy; in particular, we analyzed the prognostic role of the EEG. Out of these 275 children 209 (76%) have been free from attacks for more than one year. In 107 children the anticonvulsive therapy was discontinued, leading to a relapse rate of 27%. According to our results, only the focal EEG changes, up to interruption of the anticonvulsive therapy, show a statistical significance in the course of epilepsy. On the other hand, a normal EEG before or normalization of the EEG after commencement of therapy and also the absence of any epileptic activity (focal or generalized), are likely to be favourable. However, we could not find a statistically significant difference.

Adolescent↗

Partial complex epileptic seizures with ictal urogenital manifestation in a child.

Ictal sexual manifestations, like somatosensory genital phenomena, sexual emotions or sexual automatisms during a partial complex seizure, are very rare. So far the literature has above all described cases in adulthood. We report on a 6-year-old boy with partial complex epileptic seizures which led to confusion, oral and genital automatisms and the urge to urinate. During one epileptic seizure with these urogenital manifestations the EEG showed an epileptic rhythmic discharge over the left temporal region.

Automatism↗

[The treatment of juvenile migraine using flunarizine or propranolol].

The clinical efficacy of flunarizine and propranolol for the prevention of migraine attacks was assessed in 33 children in a double blind study. After a run-in phase of one month, 32 patients started the active medication. A reduction in the number of migraine attacks was observed in 75% of the flunarizine group and in 73.8% of the propranolol group. Propranolol also reduced the severity of attacks. Transient side effects were observed in 3 of 17 of the flunarizine group and in 5 of 15 of the propranolol group. The most frequent side effect was increased fatigue, which required interruption of therapy in 2 patients of the propranolol group.

Adolescent↗

[Psychomotor seizures in childhood and their differential diagnosis].

The spectrum of complex partial seizures is influenced by the criteria of selection and by the methods of documentation used by the different authors. Partial complex seizures can be observed already in infancy. 55 to 63% of the children with such seizures are males. Seizures with unresponsiveness and blank stare are seen in all age groups, but they are underrepresented in statistics based mainly on the description of the seizure in contrast to seizures recorded during videotape monitoring. The mean duration of more than one minute permits to differentiate these seizures from absences with automatisms.

Adolescent↗

Does migraine-related stroke occur in childhood?

This report concerns seven children who had at least one episode of infarct, possibly during an attack of migraine. They fulfilled the following criteria: presence of acute neurological deficit associated with headache or other symptoms characteristic of migraine attacks; a history of migraine; evidence of infarct on CT scan; and no other evident cause of the stroke. CT showed that the area of infarction was in the distribution of the posterior cerebral artery in three cases. Four of the children have been followed for at least 23 months and none has severe residual deficit. An aetiological relationship between migraine and stroke could not be demonstrated. However, epidemiological data suggest that childhood migraine can be a contributory risk-factor for strokes.

Aphasia↗

Headache in children with brain tumors.

To study the criteria for early differential diagnosis between migraine and headache due to brain tumors, we analyzed the symptoms and signs of two groups of children. The first group consisted of 67 children in whom a brain tumor had been diagnosed. The second group was composed of 600 children who had been diagnosed as migraine cases. Among the features of headache that are considered to be alarming symptoms of a brain tumor, the following were found to indicate a brain tumor with the greatest sensitivity: nocturnal headache or headache present on arising, both associated with vomiting, and increased frequency of headache. Nocturnal headache or headache present on arising, associated with vomiting, and/or progressive neurological symptoms or signs occurred in 65 of 67 children with brain tumor within 2 months of the onset of their headaches and in all 67 within 6 months.

Brain Neoplasms↗

[Psychomotor seizures in infants and young children].

off authors analyzed the ictal clinical symptoms (in 6 cases with videotape monitoring) of 12 infants and young children, who had focal epileptic discharges in the temporal regions (fig. 3, 4, 5). The average age was 1 9/12 years with a range of 3 months to 5 years. In 6 cases the seizures were typical "psychomotor" with oral automatisms, aimless movements of the upper extremities and/or tonic versive motor manifestations (fig. 2). In 5 cases the seizures consisted of staring and arrest of any movement. In another case, automatisms of the upper extremities were accompanied by a psychomotor arrest reaction. It is probable that in this age group seizures with sudden arrest of activity ("temporal pseudoabsences") are more frequently the main expression of partial complex seizures than in older children and in adults.

Child, Preschool↗

Diagnostic approach in children with severely retarded psychomotor development of unknown origin.

In infants and children with severe motor and/or mental retardation combined with a loss of acquired skills or with characteristic signs, such as e.g. a cherry red spot in the fundus, it is easy to suspect the presence of a hereditary metabolic disorder and to undertake the appropriate investigations. The diagnostic approach is, however, more difficult in retarded children with an uncertain developmental stillstand. Our goal was to devise strategies of how to deal with these patients from a diagnostic point of view. We retrospectively studied 77 children affected by severe developmental lag of unknown origin and without any clear signs of improvement or regression. A diagnosis of a hereditary metabolic disorder could be established in 12 of these children. In 5 other children a chromosomal abnormality or a structural abnormality of cerebral development was detected. Sixty children remained without any aetiological or pathogenetic diagnosis; 55 of them could be reexamined clinically after one year, and 32 of these showed then a clear improvement of their mental and/or motor performance. From the individual analysis of the 77 patients and from literature we conclude that if a child presents multiple minor malformations, investigations should concentrate on chromosomal aberrations and on possible structural brain abnormalities. Metabolic studies should be performed if the same disease already occurs in the family and where characteristic signs are present. In children without such signs the psychomotor development should be reevaluated after one year. If after this year there is an improvement, there is no reason for starting extensive investigation.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗