Conventional EEG in the differential diagnosis of dementia syndromes.
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Biomedical subjects
Publications and source records attributed to S Striano.
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The authors describe a case of Kleine-Levin syndrome (KLS) which in the hypersomniac period presents, together with the classical symptoms, frequent arousals accompanied by sleep terrors. Polygraphic study shows the absence of any nyctohemeral cycle and very frequent parasomnias occurring during arousals from NREM sleep. On the basis of data from the literature, the authors suggest that a disturbance of maintenance of sleep might not be exceptional in KLS, even if none of the previous reports describes such frequent parasomnias.
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The authors describe the occurrence of a sleep-induced apnea syndrome with daytime hypersomnolence in a patient suffering from Thomsen's disease. Polysomnography showed, during the whole sleep, repetitive obstructive, and rarely mixed, apneas. The patient also had daytime alveolar hypoventilation, primarily obstructive, and waking chronic hypercapnia. Long-term diphenylhydantoin therapy relieved not only myotonia, but sleep-induced apneas, daytime sleepiness and waking breathing as well. This result, together with some EMG features recorded during sleep and with daytime obstructive hypoventilation, suggests that myotonia could be one of the pathogenic factors involved in nocturnal upper airway stenosis.
Nineteen homocystinuric patients--13 children and 6 adults--were identified in the course of a selective screening for homocystinuria due to cystathionine synthase deficiency. Treatment with high doses (300-1200 mg/day) of pyridoxine was carried out in 17 patients, of whom 15 were completely responsive. In 10 patients EEG abnormalities were observed consisting mainly of a mild diffuse non specific slowing of background activity. In two sisters, with no history of seizures, focal paroxymal activity was also recorded. EEG recordings before and after B6 treatment were available in 16 patients, one of whom was a non responder, during treatment seven normal and six abnormal EEGs showed no change whereas three previously abnormal EEGs were classified as normal.
We report the case of a 4 1/2-year-old girl admitted to our Hospital because of repeated tonic convulsions. These attacks were triggered by noxious stimuli as well as by emotional stress. Since patient's history was not typical of idiopathic epilepsy, and several electroencephalograms failed to reveal any abnormality, a cardiac basis for the clinical picture was suspected. Resting electrocardiograms and 48-hour ECG recording showed a prolonged Q-T interval, usually responsible for severe cardiac arrhythmias (e.g., ventricular fibrillation or "torsades de pointe"). In our patient the neurologic paroxysmal symptomatology, wrongly considered as idiopathic epilepsy, should be interpreted being due to the underlying cardiac abnormality.
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