PubMed Health⌕ Search

Biomedical subjects

M Morena

Publications and source records attributed to M Morena.

32 records · Page 2Linked to original sources

[Neuropathy or the brachial plexus associated with pregnancy. Report of a case].

Idiopathic neuropathy of the brachial plexus can appear in two different forms, a sporadic one and a family one, autosomic dominant, much rarer which can be associated with pregnancy. Authors report a clinical case of brachial plexus neuropathy in a patient to the seventh month of pregnancy and with no observation of hereditary disease of nervous peripheric system. Clinical, electrophysiological aspects and possible pathogenetic mechanisms are here debated. Also therapeutic strategies and psychological implications are considered.

Adult↗

[Calcification of the basal ganglia and Fahr disease. Report of two clinical cases and review of the literature].

Computed Tomography (CT) is superior to conventional skull radiographs in detecting calcifications of the basal ganglia. Basal ganglia calcification has been associated with different conditions, abnormality in the calcium-phosphorus metabolism being the most common of these associations. Some patients, without any evident disease, are well documented and called idiopathics of Fahr's syndrome; less numerous patients present familiar trait, with autosomal dominant inheritance. The correlation of neurological impairment with symmetrical calcification of basal ganglia is not so frequent. Here we present two cases of Fahr's disease, in whom CT aspects were very similar, but the neurological manifestations were different. The review of the literature shows, now, that there is no definite pathogenesis of basal ganglia calcifications.

Basal Ganglia↗

Motor and sensory evoked potentials in progressive supranuclear palsy.

Motor potentials evoked in the biceps, thenar, and tibialis anterior muscles by electrical stimulation of the scalp and of the spinal regions were recorded in 12 patients with progressive supranuclear palsy (PSP) and in a control group. Abnormalities of central motor conduction for at least one muscle were present in five patients (41.7%), characterized by a long illness duration. The central sensory conduction time of the median nerve was normal, but five patients showed a depressed frontal N30 wave. These findings support the possible occurrence of functional damage to the corticospinal tracts and to the supplementary motor area in PSP.

Aged↗

Motor evoked potentials (MEPs) in lacunar syndromes.

Motor evoked potentials (MEPs) evoked in the biceps, thenar and tibialis anterior muscles by electrical stimulation of the scalp and of the spinal regions were recorded in 32 patients with focal deficits due to minor cerebral ischemia of the lacunar type and in a control group. Somatosensory evoked potentials (SEPs) to median nerve stimulation were also recorded. The central motor conduction times (CMCTs) and the threshold intensities for eliciting MEPs in the relaxed muscles were significantly increased on the affected side. Central motor conduction, for at least one muscle, was altered in 18 patients. MEP abnormalities were related to pyramidal signs (though they could be observed also in a patient without any motor impairment) and occurred independently of a specific clinical picture or a radiologically confirmed lacunar lesion. SEPs were less frequently altered than MEPs.

Aged↗

Impaired habituation of long-latency stretch reflexes of the wrist muscles in Huntington's disease.

Electromyographic responses to sudden wrist extension were recorded from the forearm and finger flexor muscles in 10 patients with Huntington's disease (HD) and in 10 normal controls. Stretch reflexes were characterized by a short-latency (SL) and a long-latency (LL) component both in patients and controls. Latency, duration, and size of the SL component were not different in the two groups, whereas the LL component was delayed in latency and reduced in size in HD patients. Increasing the stretch repetition rate from 0.1 to 0.4 cycles/s did not affect the SL component of either group, whereas the LL stretch reflex was reduced in size and duration in normal controls, but not in HD patients. These findings suggest an impairment of the "gain" mechanisms of the sole LL component, responsible for a desaturation of this component. This study supports the hypothesis that LL stretch reflexes are mediated by a transcortical long loop, possibly damaged in HD.

Adult↗

Selective effects of repetition rate on frontal and parietal somatosensory evoked potentials (SEPs).

The effects of changing the stimulus presentation rate on early parietal (N20-P25) and frontal (P22-N30) somatosensory potentials (SEPs), evoked by median nerve stimulation, were investigated in 15 normal subjects. Stimuli were presented at 0.1, 0.4, 1.0, 4.0 and 10/sec. Only minor latency changes, mainly for the frontal P22 component, were observed when the stimulus rate was increased up to 10/sec: while the frontal P22-N30 complex was more rapidly and severely reduced in amplitude than the parietal N20-P25 complex. The differential effects of stimulus presentation rate on early frontal and parietal SEPs support the hypothesis of separate neural generators and suggest that the choice of the stimulation frequency may be critical for the interpretation of diagnostic SEP studies.

Adult↗

Somatosensory evoked potentials in lacunar syndromes.

Parietal and prerolandic somatosensory evoked potentials (SEPs) to median nerve stimulation were recorded from 40 patients with lacunar syndromes due to CT-verified lacunar infarcts. The control group consisted of 30 age-matched normal controls. Nineteen patients showed SEP abnormalities, mainly an increase of height-covariated latency of cortical components and/or of the central conduction time. Such changes occurred independently of the clinical features of lacunar syndromes, being related more to the lesion location than to its size. SEP studies may be a useful adjunct to the clinical diagnosis of lacunar infarct, possibly also when the CT scans are normal.

Adult↗

Electrical stimulation of the motor tracts in cervical spondylosis.

Motor action potentials evoked by percutaneous electrical stimulation of the scalp and of the cervical (or lumbar) vertebral region were recorded from the biceps, thenar and tibialis anterior muscles in 30 patients with cervical spondylosis. Twelve normal controls were matched for age and height. Abnormalities of central motor conduction (absence or increased central delay of cortical responses) for at least one muscle were observed in all (but one) the patients with myelopathy alone or combined with radiculopathy. An increase in latency of the responses evoked by cervical stimulation occurred in 40% of patients with radiculopathy or myelo-radiculopathy. Changes of motor conduction occurred even in the absence of abnormalities of somatosensory evoked potentials, while the opposite was never observed. Direct stimulation of the motor tracts may be of value in the functional assessment of the motor pathways in cervical spondylosis.

Adult↗

Electrophysiological analysis of motor control in patients with vascular hemichorea.

An EMG analysis of motor control was performed in 4 patients with unilateral choreic movements of sudden onset, 3 of whom presented CT scan evidence of lacunar infarcts involving the contralateral striatum. The choreic dyskinesias were correlated with EMG bursts of variable duration occurring with a random order of activation. Ballistic elbow flexion movements were performed with a normal triphasic EMG pattern, but both size and duration of the first agonist burst were increased on the affected side. Abnormalities of cerebral somatosensory evoked responses were observed in 3 patients on stimulation of the side with choreic movements.

Aged↗

Abnormalities of parietal and prerolandic somatosensory evoked potentials in Huntington's disease.

Cervical, parietal and prerolandic somatosensory evoked potentials (SEPs) to median nerve stimulation at the wrist were recorded with an earlobe reference in 24 patients with Huntington's disease (HD) and in 24 age-matched normal controls. Cortical responses of abnormal wave form and reduced amplitude were constantly observed in HD patients. SEP changes affected more severely the prerolandic (P22/N30) pattern, which could not be recognized in two-thirds of patients, than the parietal (N20/P27) pattern, which could be identified in all cases. The N20 latency and the central conduction time (N13-N20 interval) were significantly increased. The occurrence of abnormalities of central conduction and of a predominant involvement of the prerolandic SEP pattern suggests an impairment of impulse transmission along the somatosensory lemniscal pathway at subcortical, possibly thalamic, level in HD.

Adult↗

The role of mineral metabolism and inflammation on dialysis vascular access failure.

Thrombosis of arteriovenous fistula (AVF) is the leading cause of vascular access (VA) loss usually due to silent stenosis. Therefore, assessment of relevant risk factors of VA monitoring may provide insight into potential therapeutic targets for stenosis and thrombosis. The aim of this study was to evaluate the influence of cardiovascular risk factors (including inflammation and mineral metabolism dysfunctions) on the failure of internal AVF in HD patients. 128 HD patients with internal AVF were included in the study and followed up for two years. At baseline, VA morphology and function were followed by Doppler ultrasonography and serum albumin, prealbumine, C-reactive protein, orosomucoid, calcium, phosphorus, parathyroid hormone, bone-type alkaline phosphatase, osteoprotegerin and receptor activator of nuclear factor ê ê B ligand were measured. At baseline, 50 stenoses were detected but none of them required any intervention. Age and biological parameters did not significantly differ between patients with or without VA stenosis. Over the two year- follow up, VA thrombosis occurred in 19 patients. Preexisting stenosis of VA was present in 9/19 patients (47.3% of cases) (chi-square = 3.708, p = 0.0538). Despite the low rate of events, phosphorus [1.75 (0.95-2.77) vs 1.42 (0.47-3.22) mmol/L, p = 0.0416], Calcium x Phosphorus product [4.00 (2.00-5.90) vs 3.40 (1.10-6.80) mmol(2)/L(2), p = 0.0676] and parathyroid hormone [165.00 (1.00-944.00) vs 79.50 (1.00-846.60) ng/L, p = 0.0814) levels were higher in the 19 thrombotic patients whereas all other biological parameters did not significantly differ. These results, which confirm that VA thrombosis occurs more frequently upon preexisting stenosis, also demonstrate that mineral metabolism disorders, compared to inflammation, may contribute to VA dysfunction leading to thrombosis.

Adult↗