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Biomedical subjects

P Lamberti

Publications and source records attributed to P Lamberti.

At least 55 records · Page 3Linked to original sources
PubMed1991

A double blind randomized pilot trial of naloxone in the treatment of acute ischemic stroke.

Attention has focused on naloxone, an opiate receptor antagonist, because of its potential benefit in reversing neurological damage after acute cerebral ischemia. To evaluate the safety and possible efficacy of high-dose naloxone in ischemic stroke patients we planned a double blind pilot study. Between January 1989 and May 1990 24 patients were randomly assigned to the naloxone or placebo group according to age and neurological deficit. Naloxone was given in a loading dose of 5 mg/kg over 10 minutes followed by a 24-hour infusion at the rate of 3.5 mg/kg/h. 10 patients experienced minor side effects but none of them had to discontinue the treatment. 9 patients improved: 6 in the naloxone group and 3 in the placebo group, but no significant difference was found using the non parametric Mann-Whitney test. Our study suggests that naloxone is safe at the dose used, but the results do not support the planning of similar trials on a larger scale.

Acute Disease↗
PubMed1990

Botulinum A toxin treatment for eyelid spasm, spasmodic torticollis and apraxia of eyelid opening.

Botulinum-A toxin (botAtox) was used in the treatment of blepharospasm (BS), idiopathic hemifacial spasm (HFS), idiopathic spasmodic torticollis (ST) and apraxia of eyelid opening (AEO). The injection of 7.5-30 U botAtox per eye spread over 3 or 4 sites in the palpebral part of orbicularis palpebrae (OP) reduced palpebral spasm in 12/13 cases of BS and in 7/8 cases of HFS. The effect lasted for 14.5 weeks on average (range 4-30 weeks). Palpebral ptosis (lasting 1-3 weeks) was the most frequent side effect (16/107 eyes treated) but was not related to dose of botAtox or number of inoculation sites. Injection of 60-160 U botAtox into the sternocleidomastoid, trapezius and splenius capitis muscles reduced ST objectively in 1/4 patients for about 4 weeks. In the other patients the reduction or abolition of the hypertrophy of the previous hyperactive muscles was accompanied by persistence or rearrangement of the dystonia pattern, suggesting a change in the pattern of activity of the neck muscles after botAtox. 5 U botAtox per eye spread over 4 sites in the OP significantly reduced the frequency of the episodes of involuntary eyelid closure in 2 patients with AEO but not BS. The therapeutic effect lasted for 7 months after the first treatment and for 8 months after the second in a 46 year old woman with a 6 month history while the second patient (72 year old parkinsonian) has now completed her 3rd month of treatment.

Adult↗
PubMed1989

Facial dystonia: clinical features, prognosis and pharmacology in 31 patients.

The natural history and response to different treatments were assessed in 31 consecutive patients with blepharospasm (BS) and/or oromandibular dystonia (OMD). The mean age at onset was 52.4 years and there was a female preponderance of 2.5 to 1. Ocular symptoms preceded the onset of blepharospasm in more than 50% of the affected patients, whereas psychiatric and dental problems prior to the onset of focal dystonia were found in 10% and 13% of the cases respectively. Dystonia elsewhere, mainly in the craniocervical area, was found in 23% of patients and appeared to follow a somatotopic progression. The first 2-3 years of history were crucial for the spread of dystonia to other face and body parts. When OMD was the first symptom, a lower tendency of dystonia to progress elsewhere was observed. A putative cause was found in 14% of patients who showed clinical and radiographic evidence of basal ganglia or rostral brainstem-diencephalon lesions. The response to different drugs was inconsistent although transient improvement was induced by haloperidol in 6 patients, by L-Dopa plus deprenyl in 3 patients, by trihexyphenidyl in 2 patients and by clonazepam in 2 patients. One, apparently spontaneous, remission was observed. Botulinum A toxin was injected in the orbicularis oculi of 8 patients affected by BS: moderate to marked improvement lasting 5 to 30 weeks (mean 14.5 weeks) was achieved in all cases; transient ptosis, lasting 1 to 3 weeks, occurred in 3 cases.

Adult↗
PubMed1984

Hypokalemic myopathy associated with liquorice ingestion.

A case of hypokalemic myopathy with systolic hypertension due to chronic liquorice ingestion is described. The clinical features quickly receded on potassium replacement therapy and discontinuation of liquorice ingestion. The relationship between the clinical features and the blood values and instrumental data is shown. The aldosterone-like action of the active principle of liquorice is underlined.

Foodborne Diseases↗
PubMed1982

Ophthalmic herpes zoster with contralateral hemiparesis: a case report.

Herpes zoster of the ophthalmic division of the left fifth cranial nerve with contralateral hemiparesis was observed in a 30-year-old man. Left carotid angiography showed segmental constrictions consistent with cerebral arteritis, possibly provoked by direct viral infection along the intracranial part of the ophthalmic nerve. An ischaemic lesion revealed by computed tomographic scan was considered secondary to arteritis and responsible for the hemiparesis. The presence of an immune response within the blood-CSF barrier was suggested by an increase of oligoclonal CSF IgG and IgA.

Adult↗
PubMedDate not supplied

"Apraxia of eyelid opening" induced by levodopa therapy and apomorphine in atypical parkinsonism (possible progressive supranuclear palsy): a case report.

We report a female patient in whom so-called apraxia of eyelid opening (AEO) developed after the onset of possible progressive supranuclear palsy (National Institute of Neurological Disorders and Stroke criteria) and the introduction of antiparkinsonian medications including levodopa. Although parkinsonian symptoms responded poorly to levodopa, AEO worsened after increasing levodopa dosage and disappeared when levodopa was discontinued. Later, a dose of apomorphine widely accepted for acute tests had no significant effect on limb motor activity but induced AEO. Overall, these observations are grounds for thinking that AEO developing in the course of parkinsonism may be either disease- or drug-related. The possibility of manipulating dopaminergic treatment should always be considered when dealing with AEO associated with parkinsonism.

Aged↗
PubMedDate not supplied

[Facial hemispasm and anomalies of the terminal portion of the vertebral artery (author's transl)].

A revision is suggested of the concept of "essential hemifacial spasm": 23 cases have been studied in whom the facial spasm was the only symptom present, while in 8 other cases in addition to the spasm of facial muscles other symptoms were noticed suggesting a pathology of the ponto-cerebellar angle. In many cases the symptom "spasm" and other concomitant symptoms are a direct consequence of an irritation due to compression on the nerve root (and/or on other nervous structures) owing to stretch of the distal tract of the vertebral artery or of the initial segment of the basilar artery. In five cases the AA. studied the vertebro-basilar circulation and in four patients they have actually found pathological elongations of the great vessels. In 18 other cases it was only possible to assume the presence of analogous alterations. The AA. suggest a study of the vertebro-basilar circulation in all the patients with "essential hemifacial spasm".

Adult↗
PubMedDate not supplied

Intravenous administration of lisuride in the treatment of neuroleptic malignant syndrome.

The neuroleptic malignant syndrome (NMS) is a very rare but life-threatening complication of neuroleptic treatment. The mortality of NMS has been estimated at 8-30% and the most common cause of death is respiratory failure. Signs and symptoms of NMS are attributed to impairment of dopaminergic neurotransmission in the central nervous system. We describe two cases of NMS successfully treated with intravenous lisuride in combination with oral L-Dopa.

Adult↗
PubMedDate not supplied

[Plasmapheresis in neuromuscular diseases. Personal cases].

The authors used plasmapheresis to treat 8 patients with myasthenia gravis and 26 with polyradiculoneuropathy. In myasthenia the treatment was effective in 85% of the cases, as reported in other studies. Good results occurred in some 80% of the cases with acute and relapsing polyradiculoneuropathy. In all cases plasma-exchange was started in the early stage. In chronic polyradiculoneuropathy the treatment was less effective. The authors discuss the advantages, disadvantages and prospects of this kind of therapy.

Acute Disease↗