Mollaret's meningitis or meningoencephalitis?
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Biomedical subjects
Publications and source records attributed to M Minazzi.
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A case of angioimmunoblastic lymphadenopathy with dysproteinaemia complicated by a subacute peripheral neuropathy is described. Clinically the neuropathy was mainly motor, but pain and paraesthesiae in the legs were also present. Sural nerve biopsy indicated decreased numbers of myelinated fibres, mainly the largest, without actual signs of degeneration or regeneration. However, the occurrence of denervation bands indicated that degeneration had led to loss of myelinated fibres.
Plasma L-DOPA levels in rats receiving L-DOPA by the oral route were decreased by the concomitant administration of trihexyphenidyl. Following systemic L-DOPA administration no differences were observed between control and trihexyphenidyl-treated rats. Effects similar to those of trihexyphenidyl were observed with atropine. These results indicate that trihexyphenidyl decreases L-DOPA gastrointestinal absorption probably by delaying gastric emptying. The presence in humans of this interaction between the two antiparkinsonian drugs was suggested by similar findings made either in a group of normal volunteers or in a group of parkinsonian patients. These observations suggest that at the clinical level in selected cases the concomitant administration of trihexyphenidyl to patients receiving L-DOPA may decrease the therapeutic efficacy of L-DOPA by reducing its gastrointestinal absorption.
The sural nerves of 6 patients with different signs of alcoholic neuropathy were studied qualitatively and quantitatively by electron microscopy. Myelinated and unmyelinated fibres showed degenerative changes of the Wallerian type. Concomitant involvement of the myelin appears to be secondary to axonal lesions. Regenerative processes, although frequently observed, did not balance the destruction of fibres in the degenerative phase. Quantitative studies indicated a reduced number of myelinated fibres and decreased percentage of the area covered in cross-section by myelinated and unmyelinated axons. The histograms of myelinated fibres showed a shift to the left of the peak of large and small fibres and an increased number of small-sized fibres. Similarly the histograms of unmyelinated fibres showed a shift to the left and a bimodal distribution with an increased number of small-sized fibres. Imbalance in degenerative and regenerative processes seems to be the basis of the chronic partial denervation observed in the nerves of alcoholic patients in this study.
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