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Biomedical subjects

A Nalin

Publications and source records attributed to A Nalin.

At least 19 recordsLinked to original sources
PubMed1990

Psychobehavioral disturbance in epileptic children.

Psychobehavioral disturbances are frequently seen in epileptic children, but they vary in type and degree. This diversity depends on various factors: age at onset, type of epileptic syndrome and EEG pattern, and the drugs used. The early onset of an epileptic process (within the first year of life) has a profound effect on the organization of primary relational processes and on structuring of the ego. The cognitive and behavioral damage that results may become evident after just a few seizures and may persist through time when such damage is not definitive. Epilepsy with onset in childhood may be accompanied by practognosic deficits and impairment of memory, attention and analytical reasoning. These deficits occur much more frequently in the symptomatic forms. In adolescent forms of epilepsy prevalently idiopathic, disturbances of a neurotic type are relatively common. Psychobehavioral disturbances tied to drugs can be noticed mainly with the use of phenobarbital (hyperactivity, longer reaction times), phenytoin (torpor), and politherapy.

Age Factors↗
PubMed1990

The risk of convulsions: a longitudinal study of normal babies and infants with neonatal damage in the first 6 years of life.

After carefully reviewing the epidemiological literature on this subject, we assessed the risk of febrile, isolated or epileptic convulsions in normal babies and infants with neonatal damage. We considered 417 term or preterm infants with birth injury and compared them with 400 healthy full-term newborns, all born between 1978 and 1980, studying each one individually until at least the age of 6 using the chi 2 test, the risk factors in relation to the convulsive outcome in all the groups were processed. We also calculated the relative risk of outcome of both febrile convulsions and epilepsy. Our results show that as far as the onset of seizure disorders in the term infant is concerned, the predisposing factors are asphyxia, neurological syndrome, and previous barbiturate intake. In contrast with this, for premature infants the risk factors are severe apnea and severe prematurity.

Asphyxia↗
PubMed1989

State of the art of magnetic resonance (MR) in neonatal hypoxic-ischemic encephalopathy.

Magnetic resonance (MR) has begun to play an important role in neonatal neurology. Several MRI techniques have been applied to the diagnosis of hypoxic ischemic encephalopathy. Cerebral perfusion examined by intravoxel incoherent motion, a non-invasive tool, seems to be opening new inroads for detecting variations (neurophysiological modifications) in cerebral flows during hypoxic ischemic encephalopathy. MR spectroscopy allows identification of specific biochemical alteration of spectra patterns at various moments of hypoxic ischemic distress, including: (1) primary expression of metabolic disorders induced by the lack of blood and O2, revealed by a peak of the water-suppressed H1 spectrum, the earliest and most persistent-marker; (2) a secondary marker for the establishment of permanent lesions of anoxic-ischemic origin revealed that variations of the phosphocreatine/inorganic phosphorous index in the P31 spectrum are of diagnostic and prognostic significance in this phase. In relation to different neuropathological, structural lesions, MRI becomes particularly important in diagnosing the acute phase of cerebral edema and the different types of infarct. MRI is especially fruitful in monitoring the evolution of the lesion, providing an evaluation of myelinization, and defining the neuropathological outlook. Spectroscopic studies on human neonates have helped establish the therapeutic effects of mannitol in cerebral metabolism. MR studies on neonate animals seem to open new therapeutic prospect for CA antagonists.

Asphyxia Neonatorum↗
PubMed1989

Reduced cerebrospinal fluid B-endorphin levels in Rett syndrome.

Cerebrospinal fluid (CSF) levels of B-endorphin (B-EP), B-lipotropin (B-LPH) and ACTH were measured in nine girls with Rett syndrome with features of autistic behavior (3.7-12.1 years of age) and in ten children with chronic leukemia (control group). The peptides were measured by radioimmunoassay, either directly in the sample (ACTH) or after Sephadex G-75 column chromatography, in order to eliminate interfering substances (B-LPH and B-EP). The CSF B-EP patient levels (20.8 +/- 13.1 fmol/ml, means +/- SD) were significantly lower than in age-matched controls (69.1 +/- 32.6, P less than 0.01), whereas the B-LPH and ACTH levels were in the control range. No correlations were found between the clinical findings and CSF neuropeptide concentrations. These data demonstrate a decrease in central opiate activity in girls with Rett syndrome.

Adrenocorticotropic Hormone↗
PubMed1989

[Clinical aspects, differential diagnosis and evolution of visual epileptic seizures in children].

We studied 13 boys and girls, treated for ictal visual episodes, followed-up in the Center for Epilepsy of the University of Modena. In 10 cases visual symptoms (amaurosis, hallucinations, and illusions) started between 6 and 14 years, associated with occipital EEG anomalies. In 6 cases, EEG abnormalities (sharp-waves, slow waves, spikes, spike-waves) disappeared after eyes opening. In the history of half of our cases, there was no significant antecedent. Normal intelligence and behaviour were present in all cases. Only in one case, CT demonstrated bilateral occipital calcifications. In the other 9, visual ictal symptoms disappeared after antiepileptic treatment. We think that these last cases present the characteristic features of Benign Occipital Epilepsy described by Gastaut (1982-1985). On the basis of our results, we can confirm the existence of this syndrome, even if it is rare. Nevertheless, 3 of our cases with visual symptoms, don't show the typical picture of BOE, and must be diagnostically distinguished from psychiatric disorders, basilar migraine, and other partial epilepsies.

Adolescent↗
PubMed1988

Lack of clinical-EEG effects of naloxone injection on infantile spasms.

In a previous study we found depressed ACTH and normal beta-endorphin values in the cerebrospinal fluid of patients with West's syndrome, whereas normal peptide levels were present in infants with secondary Infantile spasms. This prompted us to study the effects of naloxone administration in children with West's syndrome. After informed consent was obtained from the parents, the effects of naloxone administration on clinical and EEG findings were evaluated in five infants 5-9 months old (3 males, 2 females) with cryptogenic infantile spasms and hypsarrhythmia. The infants were studied at the onset of symptomatology before therapy. An average of 5-10 groups of spasms were present per day. Naloxone (12 micrograms/kg body weight) was administered as an intravenous bolus in two cases, as a slow venous drip in another two cases, and intramuscularly in the last case. EEG and polygraphic monitoring were performed for 2 h. Naloxone did not induce any acute behavioral changes and the number of seizures remained unchanged after treatment. These data reject the possibility that endogenous opioids tonically modulate infantile spasms. Further studies are required to ascertain the involvement of POMC peptides in West's syndrome.

Adult↗
PubMed1988

Antiepileptic drugs and puberty.

This paper investigates pubertal development in 57 epileptic subjects, ranging in age from 6 to 15 years, under anti-epileptic therapy for at least 2 years. The results were compared with those from a control group of healthy volunteers. The onset of stage II puberty was significantly earlier in both male and female treated epileptics than in healthy control subjects: at this stage serum levels of 17-beta-estradiol (E2) were found to be significantly lower in treated epileptic females than in healthy control females and the serum levels of follicle-stimulating hormone (FSH) significantly lower in treated epileptic males than in control subjects. At stage III puberty, serum levels of FSH were significantly lower both in male and female treated epileptic than in healthy control subjects.

Adolescent↗
PubMed1986

Plasma endorphins in Rett syndrome: preliminary data.

Plasma levels of beta-endorphin (beta-EP) and prolactin (PRL) were measured in 5 girls with Rett syndrome and in a control group before and after giving 10 mg metoclopramide i.v. beta-lipotropin (beta-LPH) was only measured in basal conditions. Basal values of beta-EP and beta-LPH were lower than in control individuals. The responses of plasma beta-EP to metoclopramide in Rett syndrome patients were less intense than in control individuals, while the PRL increase in girls with Rett syndrome was significantly higher than in control subjects. These preliminary data suggest a derangement of the dopaminergic system.

Adolescent↗
PubMed1986

Visual orientation to the human face in the premature and fullterm newborn.

Visual orientation to the human face was studied by the method of Brazelton in 15 fullterm newborns on the 4th-5th day of life and in 21 premature newborns (gestational age 27-37 weeks) tested weekly up to 40 weeks conceptional age. No evidence of visual orientation was found before 33 weeks. Performances on a par with those of fullterm newborns were not attained until 37-38 weeks on average, though in a few cases this was achieved at 35 weeks. The quality of orientation improved gradually from 32-33 weeks to 38 weeks, but with wide inter- and intra-individual variations. Noteworthy were the discontinuity and transient worsening of visual orientation of the extremely premature subjects (gestational age less than or equal to 31 weeks) in the weeks following birth. Neurological status at the time of the test, rather than pre-and perinatal risk factors, correlated positively with the quality of the visual responses. No statistically significant differences in orientation were found between premature newborns at term age and fullterm newborns.

Age Factors↗
PubMed1980

Longitudinal study of epileptiform EEG patterns in normal children.

EEG were recorded in 3,726 children, from 6 to 13 years of age who were neurologically normal and had no history of epileptic seizures. The records were taken during wakefulness, at rest, and during hyperventilation. In 131 cases (3.54%) epileptiform patterns were found. They consisted of 3 count/sec spike and slow waves discharges (4 cases), multiple spike and slow wave complexes (37 cases), midtemporal spikes (50 cases), rolandic or parietal spikes (27 cases), occipital spikes (2 cases), and multifocal spikes (11 cases). Half of the subjects with EEG abnormalities had behavior problems and/or slight psychomotor ability disturbances. Follow-up studies over an 8 to 9 year period were performed. These demonstrated the spontaneous disappearance of the EEG abnormalities, usually within school age or, at the latest, during adolesence. Only seven individuals developed epileptic seizures of the primary generalized type which responded well to anticonvulsant drug treatment. From this study we can deduce that the epileptiform EEG patterns that often are found in children during school age have no clinical relationship to epilepsy in the great majority of cases. The relationship with epilepsy exists probably on a genetic level for the generalized discharges. The spike foci are non-epileptic in nature in all probability, especially if they emerge from a fairly normal background activity and their duration is very similar to that of the constituents of the background activity, as found in the majority of these subjects. On the contrary, it is probable that these alterations express difficulties in affective or motor adaptation during childhood.

Adolescent↗
PubMedDate not supplied

Reduced ACTH, while normal beta-endorphin CSF levels in early epileptic encephalopathies.

Since ACTH and the opioids display opposite effects on experimentally-induced seizures, cerebrospinal fluid (CSF) levels of ACTH and beta-endorphin (beta-EP) were measured in 6 children (4-8 months) affected by infantile spasms with hypsarhythmia, an idiopathic early onset encephalopathy, and in 8 age-matched controls. beta-EP levels in the patients (76.3 +/- 14.7 fmol/ml, M +/- SD) did not differ from those in controls (109.8 +/- 42.7) while babies with epileptic encephalopathy showed reduced ACTH levels in the CSF (3.8 +/- 1.5) as compared to controls (9.0 +/- 3.7, p less than 0.01). This resulted in an increased beta-EP/ACTH ratio. Another patient previously treated with ACTH showed a normal CSF level of ACTH (9.0) with a normal beta-EP/ACTH ratio while in clinical and EEG remission. These results are consistent with the hypothesis that some infantile seizures unrelated to brain injuries could originate from an ACTH deficiency at central level and/or an imbalance of neuropeptidergic pathways.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Reduced ACTH content in cerebrospinal fluid of children affected by cryptogenic infantile spasms with hypsarrhythmia.

In view of the therapeutic efficacy of adrenocorticotropic hormone (ACTH) in the treatment of infantile spasms (IS) with hypsarrhythmia, we studied the cerebrospinal fluid (CSF) levels of ACTH in 15 children (4-10 months) affected by IS with hypsarrhythmia (eight cryptogenic forms, seven secondary to perinatal distress) and in age-matched controls. Lumbar puncture was performed in all but one case before any kind of treatment. In another case, CSF was collected 3 weeks after a spontaneous remission. Both ACTH and beta-endorphin (beta-EP), the other peptide related to the same precursor (proopiomelanocortin), were measured by specific radioimmunoassay after gel chromatography. While beta-EP levels were unchanged in the two groups of patients, ACTH concentrations of cryptogenic (3.75 +/- 2.40 fmol/ml, Mean +/- SD p less than 0.05) and secondary (6.36 +/- 3.70, NS) forms were lower than in controls (10.90 +/- 5.79). On the other hand, ACTH was higher in the case studied after therapy (9.0) and in the case presenting a spontaneous clinical and EEG remission (15.0). These data indicate that in children affected by IS with hypsarrhythmia (mainly of cryptogenic type), CSF levels of ACTH are lower, while levels of beta-EP remain normal. It would therefore appear that central ACTH content may play a possible role in the pathogenesis of IS with hypsarrhythmia.

Adrenocorticotropic Hormone↗