[The use, abuse and misuse of instrumental examinations in neurology].
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Biomedical subjects
Publications and source records attributed to R Vizioli.
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The problem of musicogenic epilepsy is reconsidered by the author in the light of a case of temporal lobe seizures with secondary generalization precipitated by any type of music. The inclusion of musicogenic epilepsy in the chapter of reflex epilepsies is discussed and critizised by the author considering that music sets in motion too many structures and cannot be reduced to crude perception of rhythm and melodies. It is considered that three levels of integration are involved in music: a sensory level (the lowest one) an emotional and waking level (the second one) and finally a highest level, allowing aesthetic appreciation. It is the opinion of the author that musicogenic epilepsy has to do mostly with the limbic brain, that is with the second level of integration. Musicogenic epilepsy therefore should be better included in the dismissed chapter of affective epilepsy of Bratz.
Any attempt to classify and to understand the basic mechanism underlying the neurological symptoms as pyramidal and/or sensitive, should start from the fundamental laws of nervous system functioning: 1) the law of reciprocal innervation of Sherrington; 2) the law of hierarchy of levels of Jackson and 3) the law of supersensitivity of deafferented structures of Cannon. Paresis on one side, Jacksonian jerks on the other side represent two opposite conditions known respectively as negative and positive symptoms of corticomotor involvement. Unluckly involuntary movements cannot be explained with these three laws. They are the clinical expression of the disorganization and disintegration of functions: a true disregulation unrespectful of laws and general principles. They must be considered as the result of conflicts of antagonist functions controlling each other, i.e. tremor, chorea, myoclonus, torsion spasm etc. The author emphasizes the clinical-descriptive aspect of the problem.
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Chronic cerebrovascular disorders (CCVD), as defined by the 1980 Ad Hoc Committee in Paris, constitute both clinically and pathogenetically an extremely complex entity, characterized by a protean symptom pattern. The effects of a daily dose of 10 mg flunarizine orally on CCVD have been evaluated with a neuropsychological methodology during a three-month treatment period in a randomized double-blind study compared with a placebo. The results confirmed the effectiveness of the drug in the improvement of neurological, amnesic, attentive and behavioural symptoms, without evident side-effects even after a long-term treatment.
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Short historical review of the interrelationships between cerebellum and epilepsy, the historical background of COOPER'S intervention. The Author's personal contribution to this fascinating topic is also reminded.
Short revaluation of present status of the concept of primary and secondary generalized epilepsy and of neurophysiopathological differences supporting such distinction.
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