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Biomedical subjects

F Micheli

Publications and source records attributed to F Micheli.

At least 55 records · Page 3Linked to original sources
PubMed1993

Bruxism secondary to chronic antidopaminergic drug exposure.

Eight cases of diurnal bruxism (DB) secondary to long-term antidopaminergic drug exposure are reported. Five exhibited a grinding pattern, one a clenching form, and two a mixed type. An odontological etiology was absent throughout. EMG recordings disclosed two distinct patterns of muscle activity, one with brief rhythmic, forceful contractions and the other featuring sustained prolonged contractions. Surface EMG and EEG monitoring during a 24-h period confirmed the absence of bruxism during sleep. Several drug trials failed to provide relief. Our findings support DB as a focal tardive dystonia syndrome.

Aged↗
PubMed1993

[The long QT syndrome: epilepsy as the form of presentation].

Prolongation of the QT interval, either on a congenital or an acquired basis, is associated with an increased likelihood of malignant ventricular arrhythmias with a high rate of morbimortality. Symptoms are variables, and patients may develop seizures, syncope and sudden death. Herein we report a young woman 17 years old with long QT syndrome, seizures and recurrent attacks of syncope; her initial diagnosis was primary epilepsy. An electrocardiogram performed 3 years after the initials symptoms was able to make the diagnosis long QT syndrome. The specific treatment controlled the malignant ventricular arrhythmias and the symptomatic status of this patient.

Adolescent↗
PubMed1992

Chronic Histoplasma capsulatum infection of the central nervous system successfully treated with fluconazole.

A 48-year-old man with a long-standing history of communicating hydrocephalus is reported. Ventriculoperitoneal shunting led to clinical improvement, but symptoms recurred despite surgical re-exploration switching the shunt to an atrial drainage. Ten months after the last surgical procedure, an acute myelopathy developed. Concomitant pharyngeal granuloma examination identified Histoplasma capsulatum (Hc) yeasts. Despite initial response to amphotericin B, Hc was isolated from cerebrospinal fluid (CSF), valve reservoir and distal catheter after two courses of therapy. Fluconazole successfully sterilized CSF, but transverse myelopathy persisted unchanged, and shunting was needed to control hydrocephalus.

Cerebrospinal Fluid Shunts↗
PubMed1991

Dopa-responsive dystonia masquerading as idiopathic kyphoscoliosis.

A 19-year-old girl with a long-standing history of kyphoscoliosis misdiagnosed as idiopathic was offered corrective surgery on several occasions but fortunately refused, since neurological examination later found evidence of mild dystonic posturing in the neck and right leg. Symptoms worsened toward evening but improved with rest. Treatment with low doses of levodopa led to total remission within a month. Our case illustrates that dopa-responsive dystonia can manifest spinal curvature as the major symptom and warrants its inclusion in the differential diagnoses of idiopathic kyphoscoliosis.

Adult↗
PubMed1991

Clenbuterol-induced tardive dyskinesia.

A 73-year-old man with a history of obstructive lung disease who received clenbuterol 20 mg b.i.d. over 5 years developed dyskinetic movements mainly of the respiratory muscles, closely resembling neuroleptic-induced dyskinesias. Despite drug withdrawal, abnormal movements persisted unchanged. Treatment with reserpine successfully controlled the dyskinetic movements. Clinicians should be aware of this potentially harmful effect of long-term clenbuterol therapy.

Aged↗
PubMed1991

Epidemiological assessment of levodopa use by populations.

This study is an analysis of the measurements of drug use by populations proposed by the Nordic Council on Medicines, conducted from an epidemiological-theoretical perspective. Particular attention is given to levodopa use (LDU). Several measurements of comparative LDU are proposed here for the assessment of levodopa (LD) consumption, from data on LD sales to well defined populations, over known periods of time. The method takes into account possible purposes of LDU evaluations, and is based on a reported model which combines information on Parkinson's Disease prevalence (PD) from surveys, gross levodopa sales, age-structure of the population, the figures for infant mortality rates (IMRs) taken as an indicator of modernization, and the average amount of LD prescribed as daily dose. The evaluation of LDU is implemented following a stepwise procedure.

Cross-Cultural Comparison↗
PubMed1991

[Spinal myoclonus secondary to the intravenous administration of iodine contrast media].

We describe a patient with a longstanding paraplegia who developed spinal myoclonus on 3 different occasions spanning one year, once after an enhanced CT scan and twice after excretory urographies, one of which was also followed by a generalized tonic-clonic seizure. To our knowledge only one case of spinal myoclonus secondary to the administration of intravenous contrast material in a patient with a spinal arteriovenous malformation has yet been reported. Taken together, the findings in these cases suggest that spinal myoclonus following intravenous iodine administration is indicative of an underlying spinal cord lesion.

Adult↗
PubMed1991

[A new levodopa benserazide preparation for Parkinson's disease with motor fluctuations refractory to standard L-dopa].

As Parkinson's disease worsens, many patients develop motor fluctuations which usually correlate directly or indirectly with L-dopa plasma levels. A new L-dopa-benserazide HBS preparation (Madopar) a control release pharmaceutical formulation which is activated when it contacts gastric fluid thus providing more stable L-dopa plasma levels, was assayed. Ten patients with a diagnosis of idiopathic Parkinson's disease and motor fluctuations otherwise unresponsive to conventional therapy were selected. The average age was 62 years and the duration of the disease 9 years. The motor status was evaluated on an hourly basis with the King's College Parkinson's disease rating scale; in addition, a nocturnal disability scale (Lees) was used. Out of the 10 patients, 2 dropped out within the first month due to worsening of parkinsonian signs, while 7 of the remainders preferred HBS preparation to the previous treatment. The number of off hours in this group was reduced by 58% and motor fluctuation became less severe. In only 3 cases was it possible to use HBS as monotherapy while in the rest standard L-dopa had to be added, specially as morning doses. The average L-dopa daily dose was increased by 36%. Unwanted effects included psychiatric disturbances in two (in one L-dopa dose had to be reduced) and epigastralgia in one. Our findings suggest that this L-dopa-benserazide control release may be considered an able therapeutic formulation in the control of motor fluctuations in Parkinson's disease.

Adult↗
PubMed1990

Blepharoclonus and parkinsonism associated with aqueductal stenosis.

A 28-year-old man with a history of congenital hydrocephalus due to aqueductal stenosis shunted at 45 days of age is presented. At age 4 years the valve had to be removed because of septicemia. Twenty-three years later he developed parkinsonian signs and abnormal, involuntary rhythmic contractions of the eyelids. The latter were elicited on gentle eye closure. Parkinsonism promptly improved after ventriculoperitoneal shunting, but blepharoclonus persisted unchanged.

Adult↗
PubMed1990

Treatment of Tourette's syndrome with calcium antagonists.

Six males and one female with chronic tic disorders, whose ages ranged from 12 to 31 years, were evaluated before treatment, after 1 month on placebo, after a single 10 mg nifedipine dose (three patients), and monthly while on flunarizine 10-15 mg (mean dose of 13 mg). None of the patients receiving nifedipine improved, but treatment with flunarizine significantly decreased both motor and phonic tic severity and frequency in all but one patient. Side effects included mild transient headaches in one patient, depression in one, and bradykinesia in two. Although a double-blind study is essential to validate our findings, results suggest that flunarizine is a useful drug in the treatment of Gilles de la Tourette syndrome.

Adolescent↗
PubMed1990

[Multifocal demyelinating neuropathy after tetanus vaccine].

A 39 year old man presenting multifocal demyelinating neuropathy (MFDN) is reported. Fifteen days before onset he had been vaccinated with 75 IU of tetanus toxoid. Although recent histories of vaccination or viral infection support the immunological hypothesis proposed for chronic acquired demyelinating neuropathies (CADN) it is reported for the first time in MFDN, suggesting that MFDN and CADN may share common pathophysiological mechanisms.

Adult↗