Biomedical subjects
Publications and source records attributed to G Cattaino.
A patient in whom transient global amnesia (TGA) led to the diagnosis of an ethmoidal meningioma is described. One year after neurosurgery, the patient showed an impairment of long-term memory, without any clinical or neuroradiological sign of relapse. We suggest that TGA may express a preexisting subclinical impairment of memory neuronal systems.
A personal series of 60 cases of transient global amnesia is reported. The main clinical characteristics and the results of ancillary examinations are presented.
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Acute cranial neuropathy followed intra-arterial chemotherapy with Cisplatin for a squamous cell cancer of the mouth. The favourable course, histological studies and local trophic impairment suggested local neurotoxicity due to Cisplatin accumulation in cranial nerves. The patient was the first to develop such a toxic effect in a series of 35 consecutive patients treated with the same therapy.
30 patients aged between 45 and 78 years and who had suffered from transient global amnesia (TGA), were seen at the Department of Neurology, Pordenone Public Hospital, in the period 1978 to 1982. 25 patients had one or more risk factors for cerebrovascular disease, such as hypertension, cardiac abnormalities, diabetes and hyperlipidemia. EEG examination revealed abnormal activity only in 7 patients. Brain Computed Tomography showed cerebral atrophy in 10 and hypodense lesions in 3 patients. 16 patients had been followed up for a mean interval of 20 months. During the follow-up period, 4 patients had recurrent TGA and one had a transient ischemic attack in the vertebrobasilar arterial system. In the follow-up group, 15 patients showed permanent memory impairment. The high incidence of risk factors for cerebrovascular disease seems to confirm that TGA is probably due to transient cerebral ischemia. The high rate of permanent memory impairment, almost always connected with the coexistence of cerebrovascular risk factors, is not in agreement with the postulated good prognosis of TGA.
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The author reports a clinical case of Isaacs-Mertens syndrome (syndrome of continuous muscle fibre activity, neuromyotonia, pseudomyotonia). A 55 years old man had increasing stiffness, painful spasms and myokymias of the peripheral muscle, associated with hyperhidrosis and absent tendon reflexes. Electromyography showed continuous electrical activity while at rest, general anaesthesia, after intravenous injection of diazepam and after peripheral nerve block. The activity disappeared after muscle infiltration of procaine and after intravenous injection of succinylcholine. After two years treatment with carbamazepine, 600 mg daily, the patient showed a normal clinical and neurophysiological picture. The etiology of the disease is unknown. The defect probably lies in the terminal motor network. A review of previous literature shows a typical uniformity of the electromyographic findings and of improvement on phenytoin and carbamazepine therapy, while there is a relative polymorphism of the clinical features.