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Biomedical subjects

F Micheli

Publications and source records attributed to F Micheli.

At least 73 records · Page 4Linked to original sources
PubMed1989

Bacterial cavernous sinus aneurysm treated by detachable balloon technique.

We describe a patient who developed bilateral cavernous sinus septic thrombosis secondary to a suppurative lesion on the left cheek. Despite clinical improvement, left oculomotor symptoms recurred suddenly. A carotid artery aneurysm within the cavernous sinus was diagnosed by means of magnetic resonance imaging and confirmed by digital angiography. Follow-up angiograms showed an initial decrease in the aneurysm size, with subsequent enlargement. A latex contrast-filled balloon was successfully placed within the aneurysm, preserving the carotid parent artery blood flow. Our case illustrates the usefulness of the detachable balloon technique in the treatment of bacterial aneurysms of the cavernous sinus as an alternative treatment to carotid artery ligation.

Adult↗
PubMed1989

Development of parkinsonism after transient ischemic attacks.

In order to correlate the influence of cerebrovascular disorders with the appearance of parkinsonism, 115 patients aged between 32 and 84 years (mean = 65) with transient ischemic attacks were followed up for one year. They were treated with platelet antiaggregant drugs. None of them received neuroleptics, calcium antagonists or other drugs known to induce parkinsonism. During the study, 8 patients (mean = 75 years) developed parkinsonism, bilateral in all but one, who remarkably enough was the only case responding to L-dopa treatment. On comparing recorded with expected incidence, our series showed significantly greater values. Our findings suggest that cerebrovascular disorders are factors contributing to parkinsonism in the elderly.

Adult↗
PubMed1989

[Clinical and neurophysiologic tests in the normal elderly].

Clinical and neurophysiological examination was performed in 35 normal aged subjects (72 +/- 6.4; range 65-86 years). Seventeen showed abnormal ankle reflex (48.6%), one case had patellar areflexia as well (2.9%), six had malleolar appalesthesia (17%), and five revealed both areflexia and apallesthesia (14%). Electromyography and motor conduction were normal in every case. Sural nerve conduction velocity and the amplitude of the sensory evoked potential showed no differences between subjects with and without clinical abnormalities. It is concluded that a) reflex and vibration sensibility changes in the elderly are not consequence of peripheral nerve involvement and b) there is no reason to believe there is an "aging neuropathy".

Aged↗
PubMed1988

Concurrent hypnogenic and reflex paroxysmal dystonia.

A 29-year-old patient with nocturnal episodes of paroxysmal dystonia is described. In addition, attacks could be provoked by stimulation of his right foot. Treatment with phenytoin resulted in a marked reduction in the frequency of the episodes.

Adult↗
PubMed1988

Treatment of Parkinson's disease with subcutaneous lisuride infusions.

Four patients with Parkinson's disease and severe fluctuating responses to levodopa and oral dopamine agonists were treated with continuous administration of lisuride infusions, administered by means of an externally worn pump. Levodopa dosage ranged from 300 to 687 mg/day and was kept stable throughout the study. In addition increasing doses of lisuride were injected subcutaneously in the abdomen. Lisuride doses ranged from 41 to 104 micrograms/h. A marked improvement in mobility was observed in every patient while severe biphasic dyskinesais almost remitted in one of them. The most common side-effect was the presence of subcutaneous nodules appearing at the injection site. Two cases had mild hemorrhagic complications and one initially had nausea. One patient developed acute psychiatric disturbances severe enough to be excluded from the study. Our findings suggest that lisuride subcutaneous infusions can be useful in severily handicapped parkinsonian patients, however local and psychiatric side-effects may be a serious threat in the long-term care.

Aged↗
PubMed1988

Continuous dopaminergic stimulation in cranial dystonia.

Meige's disease is a distressing complaint, the treatment of which often poses a challenge to the neurologist. The patient described here had blepharospasm-oromandibular dystonia, which responded transiently to oral lisuride. On three occasions, drug holidays successfully restored efficacy but thereafter further trials proved fruitless. Continuous subcutaneous lisuride administration in 0.35 mg doses per day, by means of a portable infusion pump, led to sustained improvement for 7 months. No major side effects were observed. Our findings suggest that this treatment deserves further trials.

Domperidone↗
PubMed1988

Unusual manifestations of basilar artery ectasia.

Three patients with unusual presentations of basilar artery ectasia are described: subarachnoid hemorrhage was manifest in one and autonomic dysfunction developed in the other two. Aneurysmal rupture was the cause in the first patient, while compression of the brainstem and/or of the baroreceptor afferences of the IXth and Xth cranial nerves is postulated to be responsible for the symptoms found in the other two. Basilar artery aneurysms should be considered in cases with subarachnoid hemorrhage or autonomic dysfunction, particularly when diagnostic procedures fail to disclose other possible etiologies.

Autonomic Nervous System Diseases↗
PubMed1987

Paroxysmal dystonia responsive to anticholinergic drugs.

A case of a mentally retarded patient with sporadic paroxysmal dystonia, unresponsive to anticonvulsant therapy, is described. He had a long-standing history of neuroleptic drug intake. Trihexyphenidyl in a total daily dosage of 20 mg totally suppressed the crises.

Adult↗
PubMed1987

Calcified cerebral hydatid cyst.

A 32-year-old patient with a lifelong history of epileptic attacks is described. A skull X-ray showed a round calcified nonhomogenous left frontotemporal mass. A CT scan confirmed its presence, as well as displacement of the left lateral and the third ventricles. At surgery a calcified inactive hydatid cyst was totally removed. Full recovery took place two months later. A differential diagnosis of hydatic cysts should be made when a calcified brain mass is found in patients from an endemic echinococcosis area.

Adult↗
PubMed1987

Flunarizine- and cinnarizine-induced extrapyramidal reactions.

Cinnarizine and flunarizine are selective calcium blockers that have been used to treat and prevent vertigo. We studied 15 patients who had extrapyramidal syndromes after taking these drugs. Eleven patients had parkinsonism, one with persistent akathisia as well; one had an orofacial tremor; one, acute akathisia alone; and one an acute dystonic reaction. All but one improved when the drug therapy was discontinued. Seven patients were also depressed during treatment. Cinnarizine and flunarizine must therefore be added to the list of potentially risky drugs known to induce extrapyramidal reactions and depression.

Adult↗