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R Quatrale

Publications and source records attributed to R Quatrale.

17 recordsLinked to original sources
PubMed2006

Clinical use of non-A botulinum toxins: botulinum toxin type C and botulinum toxin type F.

Botulinum neurotoxin (BoNT) serotype A is commonly used in the treatment of focal dystonia, but some patients are primarily or become secondarily resistant to it. Consequently, other serotypes have to be used when immuno-resistance is proven. In the literature, patients with focal dystonia have been treated with BoNT serotype F with clinical benefit but with short lasting effects. Recently, BoNT serotype C has been used with positive clinical outcome. An update on the clinical use of BoNT serotype F and BoNT serotype C is provided.

Adult↗
PubMed2004

Explosive-aggressive behavior related to bilateral subthalamic stimulation.

We describe a patient with Parkinson's Disease who underwent bilateral subthalamic nucleus deep brain stimulation and later presented with episodes of aggressive behavior disorder with disturbed impulse control and an inability to control anger likely related to the deep brain stimulation "switch-on stimulation". We hypothesize that increasing voltage intensity could influence neighboring passing fibers coming from basal limbic system that are involved in the regulation of affect and emotional behavior. We suggest investigating these neuropsychological disturbances considering their influence on quality of life after surgery.

Aggression↗
PubMed2003

Recovery cycle of the masseter inhibitory reflex after magnetic stimulation in normal subjects.

OBJECTIVE: To evaluate the differences in the recovery cycle of the masseter inhibitory reflex (MIR) obtained with electrical and magnetic stimulation. METHODS: In 31 healthy subjects we studied the MIR evoked by electrical or magnetic stimulation of the mental territory and the recovery cycle of this reflex with the paired stimuli technique at different interstimulus intervals (ISI), between 100 and 600 ms. RESULTS: Latency and area of the early and late silent periods (SPs) of the MIR were similar after electrical and magnetic stimulation. The recovery cycle of the test late SP was similar with the two kinds of stimulation, except for short ISIs. The main difference between the two kinds of stimulation was in the painful quality of the stimulus: the magnetic stimuli were always below pain threshold. CONCLUSIONS: As with electrical stimulation, it is possible to obtain a MIR with magnetic peripheral stimulation. The magnetic paired stimuli are equally effective in the evaluation of the recovery cycle of the MIR. The results demonstrate that magnetic stimulation is a useful tool in the evaluation of excitability of the trigeminal motoneuronal system, with little discomfort for the patient. They also confirm the unlikelihood of nociceptive afferences involvement.

Adult↗
PubMed2003

Neurophysiological study of corticomotor pathways in restless legs syndrome.

OBJECTIVE: To test the variations in cerebral motor excitability in patients with primary restless legs syndrome (RLS) by using electrophysiological techniques. In RLS patients periodic legs movements (PLMs) in sleep and wake have been described and it is hypothesised that PLMs result from a sleep-related disinhibition of descending central motor inhibitory pathways. Moreover, in primary RLS, these modifications are still debated. METHODS: In 15 patients with primary RLS, transcranial magnetic stimulation (TMS) was carried out using several paradigms, particularly paired pulse TMS with short interstimulus intervals (ISI) in abductor digiti minimi (ADM) and tibialis anterior (TA) muscles. RESULTS: Short ISI paired TMS showed a significant decrease in inhibition and increase in facilitation in ADM muscles. This result was even more evident in TA muscles of patients as compared to the controls and these modifications were more evident in the limbs which were more affected by PLM. Moreover, intracortical (corticocortical) inhibition (ICI) and intracortical facilitation (ICF) unchanged their biphasic time course. CONCLUSIONS: In our study the changes in short paired-pulse ICI and ICF revealed the presence of an altered excitability of central motor pathways, with good correlation with asymmetric distribution of symptoms.

Adult↗
PubMed2002

The role of gustatory flushing in Frey's syndrome and its treatment with botulinum toxin type A.

After parotid surgery, gustatory sweating and flushing occur more frequently, the former reportedly in 15-100% of cases, while no reliable data are available for the latter. Although botulinum toxin (BoNT) is effective in controlling sweating, little is known about its effect on flushing. In 17 patients suffering from Frey's syndrome after parotid surgery, we studied the gustatory flushing phenomenon as compared to gustatory sweating, analyzing their frequency, area, type of stimulus and response to BoNT administration. Cutaneous blood flow (CBF) was monitored by laser Doppler flowmetry (LDF) on affected and unaffected areas of the cheek in basal conditions and after meals, before and then 1 month after starting the BoNT injections. The Minor test was used to identify the sweating area. Flushing was observed in 7 of 17 patients after masticatory activity, spicy meals or citrus fruits. No clinical data correlated with any presence of flushing. Flushing regressed completely after BoNT administration and CBF reached similar values in the affected and unaffected sites. No adverse effects were observed. BoNT administration proved an effective and safe treatment for gustatory sweating and flushing in patients with Frey's syndrome.

Adult↗
PubMed1997

Hypokaliemic rhabdomyolysis associated with liquorice ingestion: report of an atypical case.

We here present an unusual case of hypokaliemic rhabdomyolysis, characterised by a sthenic deficit exclusively involving the distal muscles of the upper limbs and secondary to chronic glycyrrhizic acid intoxication, and by the absence of even ictal arterial hypertension. We discuss the etiopathogenetic bases and the risks related to the development of this secondary hypokaliemic syndrome, also in relation to other concomitant risk factors such as prolonged physical exercise and exposure to low temperatures.

Arm↗
PubMed1997

Motor evoked responses to paired cortical magnetic stimulation in Parkinson's disease.

We evaluated cortical excitability in patients with Parkinson's disease (PD) using paired magnetic stimulation. This recent technique allows to study the cortical inhibition after motor evoked potential (MEP) and its modulation at different intensities of stimulation and interstimulus intervals (ISIs). At low stimulus intensity and at ISIs of 40-75 ms we observed, in PD patients, a greater test MEP inhibition, which might be due to a lower facilitatory effect of conditioning MEP on the motor cortex. At high stimulus intensity, in PD patients, a consistent inhibition of test MEP persisted and, at ISIs of 75-150 ms, it did not reach the amplitude of conditioning MEP as in normal subjects. Some clinical and neurophysiological features, like a silent period of shorter duration, demonstrated in PD patients a decrease of the inhibitory input to the motor cortex. On the contrary, the persistence of test-MEP inhibition at high stimulus intensity could also suggest a prevalence of inhibitory activity when an effective and phasic activation of the corticospinal system is required.

Aged↗
PubMed1995

Risk factors for idiopathic generalized seizures: a population-based case control study in Copparo, Italy.

We examined the etiopathogenetic role of preperinatal risk factors in the history of epileptic patients, identified in a previous descriptive study performed in Copparo, Italy. A community-based case control study of a group of epileptic patients with idiopathic generalized seizures was performed. The population consisted of 55 patients aged < 35 years as of December 31, 1988, residing in Copparo. Symptomatic patients were not included in the present study. The control sample consisted of 165 randomly selected healthy individuals, matched with patients for sex, age, and residence in the study area. The interview for detection of history of presumed risk factors was based on the Protocol of the Italian League Against Epilepsy. Obstetric, neurologic, and neonatal hospital charts were also reviewed. A family history of epilepsy, febrile seizures, and other perinatal factors (such as continual physical stress during pregnancy, maternal age > 35 years, and birth order > 3) were significantly more common in patients as compared with controls. Our data support the hypothesis of genetic propensity for generalized and febrile seizures, which may represent early expression of a low seizure threshold that subsequently develops into epilepsy.

Adolescent↗
PubMed1994

Pattern of motor evoked response to repetitive transcranial magnetic stimulation.

The changes in motor pathway excitability, induced by pairs or trains of transcranial magnetic stimuli, were studied. The motor evoked potential (MEP) pattern depended on the interstimulus interval (ISI), the stimulus intensity and the type of coil employed. At low intensity, using either an 8-shaped or a circular coil, there was a test MEP inhibition at ISIs of 50-150 msec. During trains of stimuli, this inhibition showed a periodic trend with an interval of 250-300 msec. At high stimulus intensity we observed a progressive disappearance of test MEP inhibition which was incomplete with an 8-shaped coil and complete, reaching an MEP facilitation, with a circular coil. The inhibition observed at low intensity might be due to cortical inhibitory mechanisms. The effect found at high intensity and with the circular coil could depend on the activation of deeper and at higher threshold cortico-spinal structures. This hypothesis, however, does not explain the simultaneous delay of the test MEP latency which might depend on the activation of different cortico-spinal pathways.

Adult↗
PubMed1994

Immunogenetic heterogeneity and associated autoimmune disorders in myasthenia gravis: a population-based survey in the province of Ferrara, northern Italy.

INTRODUCTION: The well-established relationship between myasthenia gravis (MG) and HLA antigens varies among different ethnic groups. In Caucasians B8 and/or DR3 alleles have been found associated with young MG women without thymoma and with high titres of acetylcholine-receptor antibody (AChR Ab). An increased frequency of haplotype HLA-A3, B7 and/or DR2 has been observed in older MG patients with low AChR Ab levels. So far, there is no convincing evidence for an association between a specific haplotype HLA and ocular MG or MG with thymoma. MG subjects often show other concurrent autoimmune disorders suggesting a more general inherited predisposition to autoimmunity. We performed a community-based study to verify the HLA-A, B, C, DR and DQ profile on ethnically homogeneous MG patients and with the aim to estimate the frequency of concurrent autoimmune diseases and to compare HLA phenotypes to autoimmune status in different MG patients groups. METHODS: Forty-seven patients, living in the province of Ferrara, were followed-up in our neurologic department and typed for HLA Antigens. In addition a set of immunological laboratory tests was performed. RESULTS: We found a trend towards an increased B8 and DR3 frequencies in total affected population; an association between B8 allele and early onset of generalized MG sustained by thymic hyperplasia. The DR3 allele is statistically associated with the presence of additional autoimmune disorders. CONCLUSIONS: Our data support the hypothesis of a genetically-based heterogeneity of the disease and show an increased prevalence of associate autoimmune conditions in MG patients.

Adult↗
PubMed1993

A neurophysiological study on the P300 component of event-related potentials in Hakim-Adams syndrome.

We have explored the variability of P300 event-related potentials in patients affected by Hakim-Adams syndrome, with raised or intermittent intracranial pressure, treated with surgical cerebrospinal fluid shunting. The clinical utility of P300 is confirmed in the light of the improvement of neurophysiological data after the surgical procedure, parallel with amelioration of neuropsychological performances.

Aged↗
PubMed1991

Neurophysiological study of Horner's syndrome.

Sympathetic skin response from the forehead and from the hand obtained by using electric, acoustic stimuli and during deep breathing was recorded in normal subjects and in patients suffering from Horner's syndrome in order to characterize this clinical picture neurophysiologically. The reliability of the method points to its possible usefulness in the pre-postganglionic differential diagnosis also.

Adult↗
PubMed1989

Epidemiological study of myasthenia gravis in the province of Ferrara, Italy.

The only prevalence rate of myasthenia gravis (MG) so far estimated in Italy by an epidemiological study carried out in Pavia, North Italy, indicates a prevalence quite similar to that observed in other countries. The purpose of the survey was to verify the frequency of the disease in a geographically well-defined and previously surveyed community. On the basis of 39 cases, on 31 December 1987 the prevalence per million was 105.3 (102.3 if standardized for the Italian population). This is the highest prevalence figure yet found, indicating a value similar to that established in Northern Europe. According to Kurtzke this high prevalence rate reflects the high standard of the local public health service, which permitted a more intensive search for affected subjects.

Adolescent↗
PubMedDate not supplied

Neurophysiological evaluation of the muscular hypotrophy after immobilization.

Muscular hypotrophy due to arm or leg immobilization (MH) in absence of neuromuscular pathologies was tested by EMG spectral analysis, in order to identify a possible neurophysiological method able to analyze this kind of particular clinical picture. Two different groups of patients were tested. In group 1 the patients were suffering from vastus medialis muscle MH due to meniscus surgery, in group 2 the patients were suffering from biceps brachii muscle MH after humerus fracture. A significant difference between normal and pathological muscles was found and the methods may be useful in the neurophysiological evaluation of MH.

Adult↗