Headache after lumbar puncture: failure of different preventive measures.
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Biomedical subjects
Publications and source records attributed to S Marforio.
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Two familial Italian cases of Creutzfeldt-Jakob disease are reported. Clinical picture and life history are presented and compared: 1) with the findings in familial cases reported in other countries, 2) with the findings (age at onset, disease duration) in sporadic Italian cases.
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The frequency and characteristics of cardiac involvement have been evaluated in 22 patients with Friedreich's ataxia and in 10 patients with non Friedreich's ataxia (Strumpell-Lorraine 5 cases; Pierre Marie 5 cases), classified according to the severity and the lasting of neurological disease. In a high percentage (45%) of patients with Friedreich's ataxia, the results show left ventricular hypertrophy as proved echocardiographically by an increase of the interventricular septum thickness and of the posterior wall thickness. On the contrary, no patient with non Friedreich's ataxia had left ventricular hypertrophy. In the patients with Friedreich's ataxia, left ventricular hypertrophy was of concentric type in 27% of the cases and of asymmetric type in 18% of the cases; left ventricular systolic indexes were not reduced. The left ventricular end-diastolic diameter was normal in all the patients. Furthermore, in 4 patients with Friedreich's ataxia (18% of the cases) without left ventricular hypertrophy, mitral valve prolapse has been found. No correlation exists between the severity and the lasting of neurologic disease and the presence of cardiac hypertrophy. This supports the hypothesis that the cardiac abnormality is a primary expression of a genetic defect and not a secondary manifestation of spinocerebellar degeneration. It is therefore necessary to always consider a patient with Friedreich's ataxia as affected with a cardiac disease even if it is not clinically evident.
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49 patients with multiple sclerosis (MS) were evaluated on several lines of investigation: clinical examination with disability rating scale, disease activity staging, multimodal evoked potentials and cerebrospinal fluid analysis. 24 patients were monthly re-examined and T-cell subsets were analysed in the peripheral blood. Evoked potentials were re-evaluated every 3 months in 24 patients. All paramethers were correlated in transversally and longitudinally during a 3 to 18 months follow-up. The results are discussed in the view of a methodological approach to a laboratory evaluation of disease evolution in its natural course and during therapeutic trials.
The present study deals with the characterization of peripheral blood T-cell subpopulations in multiple sclerosis (MS) patients during different stages of the disease. An indirect immunofluorescence assay was performed using monoclonal antibodies directed at lymphocyte surface antigens. Patients in exacerbation were found to have significantly (p less than 0.001) reduced OKT8+ (T-suppressor) cells and a high helper/suppressor ratio (p less than 0.001). Patients in remission showed a significant increase of suppressor T-cells compared to controls (p less than 0.02) and patients during relapse (p less than 0.001); H/S ratio was consequently low compared to acute MS (p less than 0.001) and controls (p less than 0.1). Patients with a progressive course showed an intermediate T-subset pattern. The results are discussed in the light of the most recent neuroimmunological approaches to MS.
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In 61 of 300 patients suffering from multiple sclerosis, disease onset was retrobulbar optical neuritis. Comparing the clinical data of these patients with those of the remaining 239 cases, the following typical features were observed: in patients with optical neuropathy, disease onset is more frequently acute and course, in the early years of the disease, is in fits and starts. Recurrence frequency is higher in these patients but not significantly so. Prognosis, deduced from the analysis of degrees of invalidity, does not differ substantially between the two groups. Current techniques of diagnosing multiple sclerosis in patients with retrobulbar optical neuritis are also discussed.
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A group of 47 patients (multiple sclerosis (M.S.) diagnosed according to Schumacher's criteria) with age at onset over 40 years, was studied by statistical analysis and compared with a control group (100 M.S. patients with onset between ages 18 and 38). The following features appear peculiar in this group: --the most frequent initial symptoms are motor disturbances --the onset is generally monosymptomatic --the course is generally progressive and more severe than that of controls, as seen by Kurtzke's Disability Scale, relapse rate, interval between first and second attack --the course is more severe when the onset is progressive and characterized by motor disturbances.
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