Biomedical subjects
F Frediani
Publications and source records attributed to F Frediani.
[Piribedil test in cephalalgic syndromes. Diagnostic and therapeutic usefulness].
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Nimodipine versus flunarizine in common migraine: a controlled pilot trial.
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Vasculitic neuropathy in panarteritis nodosa: clinical and ultrastructural findings.
Clinical involvement of the peripheral nervous system in panarteritis nodosa is common, but the histological aspects are little known. We describe the sural nerve, muscle and skin biopsy findings in a patient with panarteritis nodosa, affected by mononeuritis multiplex. The data are compared to those reported in other types of vasculitis neuropathy.
Neurocysticercosis: clinical and therapeutic considerations. Review of Italian literature.
We describe two cases of neurocysticercosis, the first with a spinal extramedullary form, the second with hydrocephalus secondary to basal cistern and convexity arachnoiditis. Praziquantel was given without evident benefit; this therapeutic response is discussed in relation to the clinical and radiological findings. The Italian literature is reviewed.
Brainstem auditory evoked potential (BAEPs) in cluster headache (CH): new aspects for a central theory.
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Visual evoked potentials in cluster headache: central structures involvement.
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Piribedil test in migraine: neuroendocrinological aspects.
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Cryptococcal meningoencephalitis. Case report and review of Italian literature.
A case of cryptococcal meningoencephalitis, as presented by a hypertensive hydrocephalus, is described. To our knowledge, this is the 24th case described in Italy since 1953. The diagnosis was made with ventricular fluid examination: the patient was successfully treated with amphotericin B and 5-fluorocytosine, thus avoiding the risks of surgical treatment of hydrocephalus. Early diagnosis and proper therapy are necessary in order to decrease the high lethality of cryptococcosis.
Clinical usefulness of a dopaminergic agonist in headache diagnosis.
The dopaminergic system seems to be involved in pain modulation. In a 1983 publication, the administration of a dopaminergic agonist has been proposed as a test able to distinguish migraine from other cephalalgia. In the present study, 123 people were tested, 102 of them being migraine patients and the others being normal subjects. The test showed highly specificity for headache patients when compared to normal subjects, and was highly specific for migraine patients when compared to headache patients. Data are discussed considering the clinical diagnostic value, pathophysiological and therapeutic aspects.
Naloxone in cerebral ischemia: preliminary data.
The effect of the opiate antagonist naloxone was evaluated in 11 unselected patients with cerebral ischemia. Naloxone reversed neurological deficits in the 4 patients with less evident signs of vascular damage.
Brainstem auditory evoked potentials in migraine patients in basal conditions and after chronic flunarizine treatment.
BAEPs have been studied in a group of 20 migraine subjects before and after chronic flunarizine treatment. No statistically significant modifications of neurophysiological parameters have been observed. We confirm flunarizine effectiveness in migraine treatment.
Neuroendocrinological study of opioid and serotoninergic systems in migraine patients.
PRL response to morphine in a group of migraine subjects was studied in the baseline condition and after neuroendocrinological inhibition and stimulation tests. No significant differences were found in comparison with control subjects. This demonstrated the integrity of the opioid system and serotoninergic pathways in migraine subjects.
Complicated migraine in AS hemoglobinopathy.
Neurological manifestations have been rarely described in sickle cell trait carriers. Almost all the patients up to now reported are black and young of age. An adult white man is reported, with AS hemoglobinopathy, affected by complicated migraine, who developed acute occlusion of two middle cerebral artery branches, with persistent neurological deficit. The possible significance of this association is discussed.
Long-acting ergot: clinical and neuroendocrinological aspects in migraine patients.
The possible interaction between long-acting ergot and the opiate system has been studied in 12 migraine patients, evaluating the PRL releasing effect of morphine. Our data suggest the integrity of the opiate system in migraine patients and demonstrate that long-acting ergot does not interact with the dopaminergic system. We hypothesize that the effect of ergot on migraine pain may be related to the interaction with non-opiate substances with central analgesic action. Chronic treatment with long-acting ergot significantly reduces the peak of pain intensity of the migraine attack.
Clinical considerations on side-locked unilaterality in long-lasting primary headaches.
The relevance of side-locked unilateral pain (with no side shift) in diagnosing and differentiating primary long-lasting cephalgias such as tension headache and migraine is not clear. In the present study we have retrospectively examined the frequency of side-locked unilaterality in 1169 primary headache outpatients, whose pain duration was more than four hours. The cases were migraine (66%), tension-type headache (21%) and non-classifiable headache and atypical facial pain (not well defined headaches) (13%). The occurrence of side-locked unilateral pain was more frequent in migraine (17%) than tension headache (4%). However side-locked pain was found to be more frequent in patients with not-well-defined head pain (28%). Of the 1169 patients, 181 (15%) had side-locked unilateral pain: 70% of the 181 had migraine, 25% were not-well-defined head pain cases and 5% were tension-type headache cases. The high percentage of migraine cases in the side-locked unilateral group reflects the high proportion of migraine patients in the studied population.
Cluster headache: lack of central modulation?
Activation of the SPergic pathway may be responsible for the starting of both painful and autonomic symptoms during a typical cluster headache (CH) attack. We utilized Brainstem Auditory Evoked Potentials (BAEPs) and Visual Evoked Potentials (VEPs) to evaluate the possibility of underlying asymmetries in central functions in CH attacks. We studied 14 CH (7 right and 7 left cluster) and 14 normal subjects. All the CH patients showed a significant VEP asymmetry; the mean P 100 amplitude was significantly reduced on the side of the pain and I-V latency of BAEP was increased on the symptomatic side. No check was made for any significant variation underlying asymmetries in the normal subjects. We postulate that such an asymmetry in VEP and BAEP responses could suggest a neurotransmitters disorder with a different manifestation in each hemisphere.
Cardiovascular reflex responses in cluster headache patients: basal autonomic alterations.
To investigate the involvement of the autonomic nervous system in Cluster Headache (CH) patients, we compared the cardiovascular reflex responses in a group of CH subjects and a group of controls. We considered five tests: 1) deep breathing test (DB); 2) lying to standing test; 3) heart rate response to Valsalva manoeuvre; 4) blood pressure response to standing; 5) blood pressure response to sustained handgrip. Our data confirm an autonomic dysfunction in CH, particularly regarding the parasympathetic system. Alternative interpretations of these results are discussed.