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Biomedical subjects

C Munari

Publications and source records attributed to C Munari.

At least 91 records · Page 5Linked to original sources
PubMed1979

The use of althesin in drug-resistent status epilepticus.

The properties of Althesin (anticonvulsant activity, depression of oxygen consumption, lowering of ICP, rapid excretion) led us to use this steroid combination to treat 11 patients in status epilepticus resistant to the standard drugs (benzodiazepines and barbiturates). The administration of Althesin by slow intravenous injection was ineffective in 2 of the 3 patients thus treated. The doses used (2--10 ml) were probably too small. One only administration of a 10% solution of Althesin in 10% fructose by intravenous drip (the rate was calculated so as to obtain the burst suppression stage at the EEG) stopped status epilepticus in 7 of the 9 patients thus treated. In this group the doses used varied from 25 to 50 ml. The 2 patients in whom it was necessary to repeat Althesin administration and combine it with other drugs had both been operated on for severe brain injuries involving marked cerebral edema. In spite of the very small number of cases, the definitive arrest of status epilepticus obtained in 8 out of 11 patients first treated with other drugs is encouraging: Althesin probably may be regarded as an adjunct in the treatment of status epilepticus.

Adolescent↗
PubMedDate not supplied

[Activation with amitriptyline: electroclinical comments on 120 epileptic patients (author transl's)].

The sleep-inducing and epileptogenic effects of amitripyline (0.5 mg/kg i.m.) were studied in 120 epileptic patients. Sleep occurred in 94 p. 100 of the patients: 92 p. 100 showed stages I and II, 42 p. 100 also showed stages III and IV, but only 12 p. 100 showed REM. Major activation of inter-ictal abnormalities occurred in 41 p. 100 and seizures were provoked in 17 patients (14 p. 100). Neutral results were obtained in 23 p. 100 of cases. The results obtained and the complete absence of drawbacks recommend amitriptyline for use in studying epileptic patients, at least before turning to other pharmacological techniques which are more dangerous and probably less reliable.

Adolescent↗
PubMedDate not supplied

[The use of alfatesine in the treatment of epilepsy (author's transl)].

7 patients (aged 15 months-72 years) were treated by intravenous infusion of alfatesine in varying dose depending on age and body weight. Treatment was effective in 6 of the 7 patients, 4 of whom had previously derived no benefit from standard treatment with benzodiazepines. Intravenous injection in 2 cases only increased the interval between seizures from 3-12 minutes to 25-40 minutes. No major side-effects were observed.

Adolescent↗
PubMedDate not supplied

[Role of the amygdala in the occurence of oro-alimentary signs of during epileptic seizures in man (author's transl)].

The authors study the role of amygdala dysfunction in cases of oro-alimentary signs occuring in seizures recorded during a series of stereo-electroencephalographic investigations (S.E.E.G.) carried out for neurosurgical purposes. The patients under study have an epilepsy that is resistant to drug therapy. This work concerns 89 seizures with "oro-alimentary motor activity" recorded in 59 patients with whom it was possible to establish sufficiently rigourous anatomical - electrical - clinical correlations. This study enabled us to show that : --a seizure characterized by "oro-alimentary motor" signs (with the exclusion of swallowing movements) is related to a discharge that directly involves the amygdala. --a critical discharge affecting the anterior temporal region is expressed as : oro-alimentary activity either accompanied or not by other signs (breaking contact is exceptional). --late "oro-alimentary motor activity" also indicates disorganization of the amygdala, but offers no conclusion on the origin of the discharge.

Amygdala↗
PubMedDate not supplied

[Correlations between intracranial pressure (I.C.P.) and EEG changes during traumatic coma (author's transl)].

A total of 55 polygraphic recording (ICP, EEG, EMG, EOG, Respiration, and ECG) were made in 20 comatose patients following cranial injuries, during the week after the injury. Whenever the ICP was stable, and without waves, and whatever the mean values were, the EEG tracing was slow, monomorphic, of large amplitude, and nonreactive. Each time that ICP recordings included Lundberg's B waves, the EEG tracings showed alternating bursts of slow waves and periods of rapid activity, with or without typical sleep patterns. The ICP increases each time there is flattening of the tracing and diminishes with the reappearance (spontaneous or provoked) of slow waves. The artificial respiration is not always involved in determining these phenomena.

Adolescent↗
PubMedDate not supplied

[Correlations between E.E.G. findings and intracranial pressure (ICP) during treatment of acute post-traumatic intracranial hypertension (preliminary report) (author's transl)].

An infusion of a 10% solution of Althesin was administered for treatment of acute post-traumatic intracranial hypertension. Six comatose patients, aged from 7 to 22 years, without neurosurgical lesions, were treated with doses of the compound varying from 40 to 400 ml per day for 1 to 6 days. Daily polygrahic recordings (E.E.G, E.M.G., E.K.G., respiration and I.C.P.) were made in all patients for periods of 4 to 8 hours. Doses lower than 0.12 ml/min. caused a slight reduction in I.C.P. in two patients, without variations in the E.E.G. Doses between 0.12 and 0.36 ml/min. provoked a reduction in I.C.P. in all patients, and the appearance of burst suppression in the E.E.G. in those patients with an "alternating" tracing only. Higher doses (0.36 to 0.72 ml/min.) caused a reduction in I.C.P. less than 50% in 5 of the 6 patients. Continuous slow wave tracings and border-line tracings showed less constant modifications. The reactivity of the I.C.P. and the E.E.G. to Althesin appears earlier and is more evident in patients with an alternating E.E.G. tracing and with pressure waves of the Lundberg type b. No side effects related to the use of barbiturates were noted after interrupting treatment.

Acute Disease↗
PubMedDate not supplied

[Genital and sexual manifestations occurring in the course of partial seizures in man (author's transl)].

The literature only rarely mention the genital and sexual manifestations occurring in the course of partial seizures in man. The authors presently describe 42 seizures of this type recorded with E.E.G. and Stereo-E.E.G. techniques in 15 patients. The results of this study indicate that the genital and sexual paroxystic manifestations do have a specific semeiology, and there can be related to the initial localization of the electrical discharge which may begin in one of three different regions (perisylvian region, anterior part of the cingular gyrus and the paracentral lobule). Penile erection is observed in only one seizure starting in the central region. Orgasm occurs in the only one female patient in the course of the seizures beginning in the perisylvian region (temporal region). Early sensitive symptomatology characterizes very often the seizures beginning in the perisylvian region but also in the paracentral lobule. Post-ictal or peri-ictal true masturbation occurs at the end of the ictal discharge beginning either in the perisylvian region or in the anterior part of the cingular gyrus. The sexual dyspraxic (i.e. fondling the genitals) characterizes only the post-ictal phase of the seizures beginning in any of the three regions.

Adolescent↗
PubMedDate not supplied

Stereotactic endocavitary treatment of cysts and pseudocysts of glioma. Preliminary report.

The present study reports the results of the stereotactic treatment via endocavitary irradiation (Talaraich's method) of 50 gliomatous cysts (volume: 5-242 cm3; av.: 73 cm3) in 45 patients (M: 24; F: 21; age 3.5-57 yrs; av.: 22 yrs) in the period January 1973-January 1987. Twenty-four patients (27 cysts) were affected by a grade I glioma, 10 patients (12 cysts) by a grade II and 11 patients (11 cysts) by a grade III or IV glioma. The first step in the treatment was a neuroradiological stereotactic stereoscopical survey (tele-angiography, ventriculography, cystography) with serial biopsies and a cystic impermeability test (injection of 0.3-1 mCi of Re 186). One week later one therapeutic dose, ranging between 5 and 85 mCi of a beta-emitting colloidal radioisotope (Re 186, Au 198, Y 90), was stereotactically injected into the cyst. The stereotactic treatment was not followed by severe side effects. In high grade gliomas (grade III and IV) the benefit of the possible shrinkage and/or disappearance of the cyst was vanished by the solid tumor progression. In low grade gliomas (grade I and II) more than 50% of the cysts disappeared and 25% of them shrinked up to one third of the starting volume (follow-up: 5-168 mo.; av.: 54 mo.). At present almost only Re 186 is employed using a cyst wall dose of 400-500 Gys. The low surgical invasiveness, the absence of severe side effects and good therapeutical results induce us to propose this as a first choice treatment in inoperable low grade gliomatous expanding cysts.

Adolescent↗
PubMedDate not supplied

Long term results of stereotactic endocavitary beta irradiation of craniopharyngioma cysts.

This study concerns 33 pts (age: 3-69 yrs; m: 22) with cystic craniopharyngiomas (36 cysts) treated with stereotactic beta endocavitary irradiation (TRT). Nine patients died (3 days to 36 months after TRT) and one was lost. In 23 the follow-up varied from 12 to 126 months (m: 45 months). The disappearance of 13 cysts was appreciated 5 to 24 months after TRT: no recurrence was observed after 22-126 months (m: 61). A greater than 70% reduction of the cyst volume occurred 3-36 months after TRT and persisted at 12-71 months (m: 35 m). In one patient, the cyst volume increased. Visual acuity improved in more than 50% of survivors, while endocrine disturbances did not change and memory troubles disappeared.

Adolescent↗