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Biomedical subjects

R Giannaula

Publications and source records attributed to R Giannaula.

13 recordsLinked to original sources
PubMed2002

[Hydrosyringomyelia in demyelinating diseases].

Spinal cord cavitation is a frequent finding in optic neuromyelitis (Devic's syndrome) (DS) but it is also, although rarely, observed in patients with multiple sclerosis (MS). The objective of our study was to compare the MRI characteristics of the syringomyelic cavities in 6 patients with DS and 3 patients with MS. All the patients with DS had a relapsing clinical form with normal brain MRI. Spinal MRI revealed unenhanced central cavities which extended more than 3 vertebral bodies and remained unchanged in follow-up studies. Two patients presented multiple cavities.MS patients suffered a relapsing remitting form of the disease, they all had hyperintense T2 enhancing lesions on their spinal MRI. Moreover spinal MRI also revealed non communicating cavities which extended less than 2 vertebral bodies. Follow-up studies in MS patients revealed a reduction of both the spinal lesions and the cavities. It is still debated whether DS represents a distinct clinical entity different from MS. These findings help distinguishing both disorders in cases when spinal cavities are present and also contribute to the therapeutic choice.

Adult↗
PubMed1999

Cerebral tumor-like American trypanosomiasis in acquired immunodeficiency syndrome.

Cerebral tumor-like American trypanosomiasis (CTLAT) is an uncommon complication of Chagas' disease, observed only in immunosuppressed patients. We assessed 10 human immunodeficiency virus-positive patients with Chagas' disease who presented with CTLAT. All patients had neurological involvement and 6 developed intracranial hypertension. Neuroimaging studies showed supratentorial lesions in 9 patients, being single in 8. One case had infratentorial and supratentorial lesions. Low CD4+ cell counts were observed in all the cases and in 6 of them CTLAT was the first manifestation of acquired immunodeficiency syndrome. Serological tests for Chagas' disease were positive in 6 of 8 patients. Trypanosoma cruzi was identified in all brain specimens and in three cerebrospinal fluid samples. CTLAT should be considered in the differential diagnosis of intracranial mass lesions in human immunodeficiency virus-positive patients and should be added to the list of acquired immunodeficiency syndrome-defining illnesses.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Neurologic complications by cocaine abuse].

Argentina is facing an increase in cocaine use by adolescents and young adults from every socioeconomic background. It is calculated that up to 10% of all cocaine passing through this country is locally sold and consumed. Nevertheless, local information describing common cocaine-related neurological events is scarce. From August 1988 to March 1993, 13 patients were evaluated with neurological disease associated with cocaine abuse. Among these 13 patients (Table 1), the mean age was 29; 70% were men. Patients most commonly used the nasal route (snorting). Concomitant abuse of other intoxicants, especially alcohol, was frequent (85%). The major neurological complications included one or more seizures (n = 7), ischemic stroke (n = 2) (Fig. 1-2), hemorrhagic stroke (n = 2) associated with arteriovenous malformation (Fig. 3a-b), memory disturbances (n = 1) and paroxysmal dystonia (n = 1). Psychiatric complaints were present in all patients. Mortality was not observed. There was no correlation between the appearance of complications and the amount of cocaine used, or prior experience with this drug. Only one of the 7 patients with seizures had a previous history of seizures. All had generalized tonic-clonic seizures, and one had concomitant absence episodes. Cocaine modulates central neurotransmitters and has direct cerebrovascular effects. The neurological complications appear to be related to cocaine hyperadrenergic effects, striatal dopaminergic receptor hypersensitivity and perhaps vasculitis. Structural changes in the brain of long-term cocaine abusers could explain the persistence of neurologic symptoms after drug withdrawl.

Adolescent↗
PubMed1993

Bruxism secondary to chronic antidopaminergic drug exposure.

Eight cases of diurnal bruxism (DB) secondary to long-term antidopaminergic drug exposure are reported. Five exhibited a grinding pattern, one a clenching form, and two a mixed type. An odontological etiology was absent throughout. EMG recordings disclosed two distinct patterns of muscle activity, one with brief rhythmic, forceful contractions and the other featuring sustained prolonged contractions. Surface EMG and EEG monitoring during a 24-h period confirmed the absence of bruxism during sleep. Several drug trials failed to provide relief. Our findings support DB as a focal tardive dystonia syndrome.

Aged↗
PubMed1989

Movement disorders and depression due to flunarizine and cinnarizine.

Over the last few years, cases of movement disorders induced by flunarizine and cinnarizine have been increasingly reported. We describe a series of 101 patients, whose ages ranged from 37 to 84 years (mean 69.1), developing abnormal movements frequently associated with depression, secondary to treatment with either or both drugs. Symptoms closely resembled those induced by neuroleptic drugs and remitted on drug discontinuance in all but five cases after 5-22 months' follow-up. Whether or not such undesirable side effects are attributable to calcium antagonism and/or dopamine receptor blockade, long-term treatment with flunarizine or cinnarizine should be discouraged, particularly in the elderly.

Adult↗
PubMed1987

Paroxysmal dystonia responsive to anticholinergic drugs.

A case of a mentally retarded patient with sporadic paroxysmal dystonia, unresponsive to anticonvulsant therapy, is described. He had a long-standing history of neuroleptic drug intake. Trihexyphenidyl in a total daily dosage of 20 mg totally suppressed the crises.

Adult↗
PubMed1987

Calcified cerebral hydatid cyst.

A 32-year-old patient with a lifelong history of epileptic attacks is described. A skull X-ray showed a round calcified nonhomogenous left frontotemporal mass. A CT scan confirmed its presence, as well as displacement of the left lateral and the third ventricles. At surgery a calcified inactive hydatid cyst was totally removed. Full recovery took place two months later. A differential diagnosis of hydatic cysts should be made when a calcified brain mass is found in patients from an endemic echinococcosis area.

Adult↗
PubMed1987

Flunarizine- and cinnarizine-induced extrapyramidal reactions.

Cinnarizine and flunarizine are selective calcium blockers that have been used to treat and prevent vertigo. We studied 15 patients who had extrapyramidal syndromes after taking these drugs. Eleven patients had parkinsonism, one with persistent akathisia as well; one had an orofacial tremor; one, acute akathisia alone; and one an acute dystonic reaction. All but one improved when the drug therapy was discontinued. Seven patients were also depressed during treatment. Cinnarizine and flunarizine must therefore be added to the list of potentially risky drugs known to induce extrapyramidal reactions and depression.

Adult↗
PubMed1985

[Piebaldism associated with cancer].

A family in which piebaldism is inherited in a dominant pattern is described. In this kindred the cutaneous signs were associated to a high incidence of cancer. Malignancy usually became apparent in the fourth decade and did not correspond to any fixed histopathologic type. Associated cutaneous alterations were: "cafe au lait" spots in two members and telangiectasias in one. A peculiar distribution of blood vessels in fundus oculi was found in one member. One patient had broad nasal bridge and low implanted ears was found in another. The initial cases were two male brothers who had central nervous system tumours. One had a pituitary adenoma and the other a grade III astrocytoma. As it is important to find biologic markers in familial cancer, we speculate, that may be in this family, the marker could be the cutaneous hypopigmentation. Numerous cutaneous syndromes associated to a predisposition to develop cancer have been described, and may be piebaldism is a new one. More observations are needed to corroborate these findings.

Adenoma↗