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Biomedical subjects

P Pazzaglia

Publications and source records attributed to P Pazzaglia.

At least 19 recordsLinked to original sources
PubMed1992

A double-blind comparison of valproate and lithium in the treatment of acute mania.

OBJECTIVE: This study was carried out to compare the efficacy of lithium carbonate with that of valproate in acute mania and to determine whether pretreatment clinical characteristics, such as the presence of a mixed affective state, might predict a differential response to the two drugs. METHOD: Twenty-seven patients meeting DSM-III-R criteria for acute manic episodes underwent a 3-week, randomized, double-blind, parallel-groups trial of treatment with lithium carbonate or valproate. Symptom severity was measured by using the Schedule for Affective Disorders and Schizophrenia, change version (SADS-C), the Global Assessment Scale (GAS), and the Brief Psychiatric Rating Scale (BPRS). Drug effects were compared by using repeated measures analysis of variance (ANOVA). RESULTS: At the end of the study, nine of 14 patients treated with valproate and 12 of 13 patients treated with lithium had responded favorably, as measured by changes in the SADS-C mania, BPRS, and GAS scores. Elevated pretreatment SADS-C depression scores were associated with good response to valproate. ANOVA revealed a significant interaction between drug and mixed affective state with respect to treatment response. CONCLUSIONS: Lithium and valproate were both effective in improving manic symptoms, and lithium was slightly more efficacious overall. Unlike the case with lithium, favorable response to valproate was associated with high pretreatment depression scores. Therefore, treatment with valproate alone may be particularly effective in manic patients with mixed affective states.

Analysis of Variance↗
PubMed1988

Epileptic transient amnesia.

Transient global amnesia (TGA) was formerly supposed to have an epileptic origin thought unlikely by more recent authors. Further, epileptic seizures rarely present transient memory dysfunction as prominent symptom. These particular cases of which we report here three examples were previously identified as epileptic amnesic attacks (EAA). They have uniform clinical characteristics quite different from TGA and respond favorably to antiepileptic therapy. The features differentiating these two conditions are discussed. The authors suggest that an epileptic origin should be considered in patients presenting frequent transient amnesic attacks.

Aged↗
PubMed1986

Prognostic and electroclinical features of grand mal epilepsies.

We studied the electroclinical features and prognosis of 103 patients with tonic-clonic seizures alone. Patients were classified into three groups according to seizure semiology and interictal EEG: primary grand mal, focal grand mal and indeterminate grand mal. Discriminant analysis showed that a number of other electroclinical features had no significant classificatory power. Patients have been followed for 2-10 years. At the last observation 40% of patients were free from tonic-clonic seizures and 23% had fewer than 1 seizure a year, without differences among the three groups. The appearance of 'minor' (absence or partial) seizures during follow-up occurred in 12 patients and did not change the prognosis of tonic-clonic seizures. At the end of follow-up, 96% of patients had a normal social adjustment. Grand mal epilepsies therefore appear to have a good prognosis.

Electroencephalography↗
PubMed1985

Drop attacks: an ominous change in the evolution of partial epilepsy.

We studied 16 patients with partial epilepsy and drop attacks. The drop attacks appeared 1 to 29 years after onset of epilepsy; 15 patients had these attacks weekly or daily, despite therapy. After the appearance of drop attacks, 6 patients had severe mental disorders, and social life was disrupted in 13. There was a high rate of adversive seizures, atypical absences, and diffuse spike-wave discharges in the EEG, electroclinical features that suggest a frontal origin of epilepsy. Drop attacks are ominous because they occur so frequently, resist therapy, are physically dangerous, and portend personality change.

Adolescent↗
PubMed1982

Chronic relapsing polyneuritis. A light- and electron-microscopic study.

The clinico-pathologic findings in two patients with chronic relapsing polyneuritis are reported. The patients had several attacks of diffuse polyneuritis followed by partial recovery. The tendency to persisting disability increased following relapses and in the late stages there was a progressive motor deterioration suggesting a continuing activity of nerve damage. The biopsies of peripheral nerves, obtained in the advanced stages of the disease, showed severe loss of myelinated fibers and aspects of repeated demyelination and remyelination, with formation of onion bulb complexes. Completely demyelinated axons together with remyelinating fibers as well as remyelinated fibers invested by macrophages were seen at the same time. The clinical and pathological evidences suggest that in chronic relapsing polyneuritis, at least in the late stages of the disease, besides clinical relapses, there is a continuing activity of nerve damage. Thus, due to this ongoing activity of demyelination and remyelination, the elimination of the supernumerary Schwann cells does not take place satisfactorily and hypertrophic changes of the nerve fascicles are produced.

Aged↗
PubMed1982

Classification of partial epilepsies according to the symptomatology of seizures: practical value and prognostic implications.

Among 1,000 outpatient epileptics who visited the Epilepsy Center of Bologna consecutively from 1974 to 1978, 596 cases of partial epilepsy (PE) were chosen, representing 62.9% of all cases classified according to the International Classification of epilepsies. Fifty-four of these cases (5.7%) of those classifiable) that were affected by benign infantile epilepsy with rolandic spikes were not analyzed further. The remaining cases were divided up into three groups based on the symptomatology of the seizures: (1) partial elementary epilepsy (PEE), 102 cases (10.8%); (2) partial complex epilepsy (PCE), 332 cases (35%); and (3) partial secondarily generalized epilepsy (PSGE), 108 cases (11.4%). The three groups were compared according to the parameters that distinguish recognized epileptic syndromes, in order to see whether they constitute autonomous nosographic entities. Among the three groups, significant differences did not arise with regard to the incidence of single lesional etiological factors, the age of onset of the epilepsy, the neurological context, and the general features of interictal EEG. PSGE instead differs significantly from the other two forms for the minor severity of the epilepsy at first examination and for its more favorable course: after at least 2 years of follow-up under treatment, the epilepsy appeared to be controlled in 60.6% of the cases with PSGE, in 31.6% of those with PEE, and in 37.5% of those with PCE (p less than 0.05). For those with PE, globally considered, only three parameters have a favorable prognostic value: the brief duration of the epilepsy at the first observation, the rarity of the seizures, and the presence of only one type of seizure.

Age Factors↗
PubMed1982

CT scan prediction of late post-traumatic epilepsy.

Out of 233 patients admitted for head trauma during 1977-1978, 93 had a CT scan examination within the first 48 hours. Forty-nine of these had at least one clinical risk factor for post-traumatic epilepsy. Ten of this group developed post-traumatic epilepsy. In all cases early CT scan showed focal brain damage, which was related more significantly to post-traumatic epilepsy than to risk factors.

Brain Edema↗
PubMed1980

Peripheral neuropathy due to gasoline sniffing - A case report.

A case of polyneuropathy in a 14-year-old boy, a chronic gasoline sniffer, is reported. Clinical and electromyographic examination showed a symmetrical motor involvement, mainly distally and in the lower limbs. A sural nerve biopsy showed only slight changes, both of axonal and demyelinating type. The role of gasoline toxic substances in the etiology of this rare polyneuropathy is discussed.

Adolescent↗
PubMed1978

Stiff-man syndrome associated with nocturnal myoclonus and epilepsy.

A case of stiff-man syndrome associated with primary generalised epilepsy is reported. In addition, nocturnal polygraphic recording revealed a nocturnal myoclonus. Detailed examination of the central nervous system did not show specific changes. There is no direct proof as to a spinal or supraspinal origin of the stiff-man syndrome. The absence of specific anatomical lesions may indicate a functional rather than a structural disturbance in its physiopathogenesis.

Brain↗
PubMed1976

Record in grade school of pupils with epilepsy: an epidemiological study.

In the area of Cesena, Italy, the prevalence of epilepsy was about 3/1,000 among the 13,000 children of school age, 6-14 years. Only half the epileptic pupils had a normal scholastic record. One-third were in special classes, nearly all because of mental retardation due either to birth injury or to damage in infancy. The others (17%) were behind by one or more classes, mainly because of a depressive reaction owing (in half of the intelligent epileptics) mainly to classmates' fear of seizures and to the hostility of classmates' parents after the pupil had a grand mal seizure in school. Teachers had usually not learned how to manage either seizures in the classroom or the problems of pupils with epilepsy.

Adolescent↗
PubMed1975

Clinical course and prognosis of acute post-traumatic coma.

The clinical course and prognosis of 282 cases of acute post-traumatic coma have been studied. Death occurred in 140 cases (49 percent), and, of survivors, about two-thirds achieved complete social reintegration, while one-third were partially reintegrated or not at all. The quality of survival did not depend only on the nature of the physical sequelae, but also on other factors, particularly social ones. With regard to early prognosis, the authors believe it is possible to predict the final outcome of the patient by using the indices of age, level of coma, and the nature of the intracranial lesions.

Adolescent↗