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Biomedical subjects

G Lanzi

Publications and source records attributed to G Lanzi.

At least 37 records · Page 2Linked to original sources
PubMed1999

Dolicho-vertebrobasilar abnormality and migraine-like attacks.

This is a study of two children with neuroradiologically diagnosed dolichobasilar anomaly: in both cases, the diagnosis was based on magnetic resonance imaging and magnetic resonance angiography findings. We examined the first child (R., aged 6 years and 8 months) following four episodes of intense pain in the left orbit, lasting between 10 and 30 min and accompanied by photophobia and vomiting. The second child (S., aged 9 years and 2 months), suffering from Marfan's syndrome, was examined following recurrent episodes of intense pain that started above the left orbit, moving to the homolateral orbit after a few minutes. These episodes, which lasted between 20 and 30 min, took place mainly at night and were accompanied by phono-photophobia and vomiting. In both cases, the pain attacks can be interpreted as a result of compression of the root of the trigeminal nerve caused by an arterial malformation.

Anticonvulsants↗
PubMed1999

Can protrusion of the tongue stop seizures in Rolandic epilepsy?

We report the case of a child with benign partial epilepsy with centro-temporal spikes (BECT) in whom protrusion of the tongue stopped the interictal abnormalities, and describe the polygraphic EEG recording of a seizure which terminated upon voluntary protrusion of the tongue. We mention the close link between the post-central (somatosensory) cortex and pre-central (motor) cortex, and how the primary sensory area has direct access to the motor cortex. We also examine how a tactile stimulus may provoke the inhibition of an epileptic discharge.

Child↗
PubMed1998

Facial nerve palsy: which flap? Microsurgical, anatomical, and functional considerations.

In the microsurgical therapy of facial nerve palsy, the muscles most frequently utilized have been gracilis, latissimus dorsi, and pectoralis minor, this depending upon surgeons' personal experience. However, at the moment no satisfactory comparison studies are available; this work is a comparative study of the three most often used cadaver-derived muscles in surgical therapy of facial nerve palsy. The potential use of gracilis, latissimus dorsi, and pectoralis minor as free flaps has been assessed by analyzing their microsurgical, anatomical and functional parameters. Suitability has been evaluated by scoring each parameter from 0 to 3 (unsatisfactory, satisfactory, good, and excellent respectively). The results may provide the surgeon who undertakes this kind of technique with a useful data comparison.

Adolescent↗
PubMed1998

Tourettism as clinical presentation of Huntington's disease with onset in childhood.

Infantile Huntington's disease (HD) shows a wide clinical heterogeneity. Here we describe the case of a child affected by HD who showed unusual neurological features consistent with tourettism. The absence of family history and persisting normal magnetic resonance imaging (MRI) results long after the onset of symptoms delayed the diagnosis of the disease. An MRI exam performed 26 months after disease onset disclosed bilateral atrophy in the putamen, suggesting HD. The diagnosis was confirmed by genetic analysis. The present report underlines the need to consider HD in childhood cases of unusual and even unfamiliar progressive movement disorders.

Child↗
PubMed1998

Cerebral visual impairment in periventricular leukomalacia.

Infants with cerebral palsy (CP) frequently present cerebral visual impairment (CVI) often caused by damage to retrochiasmatic pathways. This is particularly true of subjects with damage to the periventricular white matter. Thirty-eight preterm infants with periventricular leukomalacia (PVL) diagnosed by MRI were examined to correlate binocular visual acuity with neuroradiological findings. Binocular visual acuity was evaluated using Teller Acuity Cards and a complete ophthalmological examination was also performed. Three infants with ROP III were excluded from the sample. The age of observation ranged from 20 months to 5 and a half years (mean 42 months). The possible involvement of the optic radiations and/or of the calcarine cortex was detected by brain MRI. Twenty-three infants (66%) presented visual impairment. Of these, 9 (26%) were totally or nearly totally blind and 14 (40%) were low vision children. The other 12 (34%) had normal (2) or near normal (9) vision. MRI findings correlated with visual acuity; a relationship was detected between the degree of visual acuity and the reduction of the peritrigonal white matter, and also between the degree of visual acuity and the extent of calcarine atrophy. This report clearly establishes a relationship between visual impairment and specific MRI findings in children with PVL. Teller Acuity Cards and MRI are useful for detecting potential visual impairment and for improving both the clinical diagnosis of these disorders and the therapeutic approach to these subjects.

Atrophy↗
PubMed1998

Biologic prognostic factors in ovarian cancer: a review.

The need of foreseeing the prognosis of ovarian cancer beyond the limits of classical methods based on clinical and histopathological staging has recently caused great interest in a large number of biologic prognostic markers. Studies concern proliferation associated proteins, suppressor genes, abnormal expressions of growth factors, cytokins, and many more. Here some of the most recent and promising factors being studied are described together with their significance for future clinical application.

Biomarkers, Tumor↗
PubMed1998

The efficacy of noninvasive mechanical ventilation on nocturnal hypoxaemia in Duchenne's muscular dystrophy.

The aim of this 2 yr follow-up study was to evaluate the efficacy of nocturnal noninvasive mechanical ventilation in a group of 10 Duchenne's muscular dystrophy (DMD) patients who desaturated during the night but had normal daytime blood gases: mean (range) age 18.3 (15-22) yrs; mean (SD) vital capacity (VC) 752.5 (460-1,308) mL; mean time in bed (TIB) with arterial oxygen saturation (Sa,O2) < 90% 22.8% of total TIB (range: 16.6-32.0); mean arterial oxygen tension (Pa,O2) 10.3 (9.3-11.7) kPa (78 (70.0-87.8) mmHg); mean arterial carbon dioxide tension (Pa,CO2) 5.9 (4.8-6.5) kPa (44.3 (36.3-48.5) mmHg). All the patients were noninvasively ventilated during the night with a bilevel positive pressure ventilation (BiPAP) devise in spontaneous mode in order to correct the episodes of nocturnal desaturation. Nocturnal Sa,O2 values normalized during nocturnal noninvasive mechanical ventilation, and daytime sleep-disordered breathing disappeared, for the entire study period. No statistically significant differences were observed between baseline and follow-up daytime blood gas values, although a slight increase in Pa,O2 was found. During the follow-up, VC declined at a rate of 79.1 +/- 25 mL.yr-1, less than that generally reported in the past in untreated patients in the same age range. In conclusion, our data suggest that patients with advanced Duchenne's muscular dystrophy with pronounced nocturnal desaturation, not fulfilling criteria for imperative ventilation, could be successfully treated with "elective" nocturnal ventilation with immediate benefits consequent to the correction of the nocturnal blood gas anomalies and with long-term benefits related to the preservation of residual respiratory function, delay of development of chronic hypercapnia and thus the requirement for imperative mechanical ventilation.

Adolescent↗
PubMed1997

Periodic syndrome and migraine in children and adolescents.

Many reports in the literature seem to confirm the hypothesis that the symptoms of periodic syndrome are precursors or the equivalent of migraine: the aim of this study was to assess the prevalence of periodic syndrome in a group of children and adolescents suffering from migraine in comparison with that observed in various control groups. We considered seven symptoms: recurrent vomiting and abdominal pain, migrating limb pain, vertigo, recurrent hyperthermia with no visible cause, sleep disturbances and eating disorders. The study involved 171 children divided into four groups; 42 migraineurs; 37 subjects with chronic nervous pathologies but no psychosomatic symptoms; 46 subjects with a known psychosomatic disease, and 46 healthy subjects. The prevalence of the symptoms in the different control groups was different, although the pattern was more similar in the migraineurs and psychosomatic patients than in the other control groups. The development continuum of the syndrome may support the view that periodic syndrome is predictive of the subsequent development of a psychosomatic pathology.

Adolescent↗
PubMed1997

Cerebral cavernous angiomas: an atypical case in infancy.

Cerebral cavernous angiomas (CCA) are rare, reportedly accounting for only 1% of all intracranial vascular lesions and 15% of all cerebral vascular malformations. Forms are sporadic or familial, and the mode of inheritance is probably autosomal dominant. We report an unusual case of an infant born at 37 weeks of gestational age following a normal pregnancy. Her birth-weight was 1560 g. The family history was negative. At 10 months of age, the child presented with the sudden onset of muscular hypotonia, motility and strength deficits, and absence of osteotendinous reflexes in the right arm. The psychomotor development of the child was normal. MRI revealed the presence of a cavernous angioma in the paramedian pontine region. The child's monoparesis quickly disappeared. This case is interesting because of the age at onset and the way in which the clinical manifestations developed.

Brain Neoplasms↗
PubMed1997

Neurodevelopmental outcome in very low birth weight infants at 24 months and 5 to 7 years of age: changing diagnosis.

We describe the long-term development of 53 very low birth weight premature infants. The children were divided into 2 groups on the basis of ultrasound scan, and classified as: group I, patients with normal ultrasound scan or with uncomplicated hemorrhage; and group II, patients with complicated hemorrhage or only parenchymal lesions. Minor and major sequelae detected at 2 years of age were compared with those observed at 5 to 7 years. Our study confirms that most severely handicapped children are identified by age 2 years. Minor sequelae are more evident at 5 to 7 years and subjects with good outcome, as expressed by a McCarthy General Cognitive Index score > 80, present a discordant cognitive profile with verbal scores higher than performance scores. Therefore, we emphasize the importance of follow-up of very low birth weight premature infants until school age and stress that neonatal ultrasound scan diagnosis of parenchymal damage represents an important diagnostic tool in terms of both short- and long-term neurodevelopmental outcome.

Brain↗
PubMed1997

Epilepsy: a study of adolescence and groups.

We report a 2-year study of 'psychological support' of a group of seven adolescents (five female and two male) with both non-symptomatic generalized and partial epilepsy with onset before puberty. Two child neuropsychiatrists, supervised by a Freudian psychoanalyst specializing in group therapy, conducted the sessions. Sessions were aimed at improving comprehension and acceptance of the condition and its consequences through comparison of thoughts, fantasies, and preoccupations regarding epilepsy, including significance of epileptic seizures and their possible effects on sexuality, pregnancy, mental state, patient resistance to drug therapy, speaking openly about illness, and social and job-related problems. Group dynamics were also examined to improve subject interaction and self-identification. This method varies from the 'self-help' type of intervention which uses an interpretative and reflective approach to interaction of group members.

Adaptation, Psychological↗
PubMed1997

Clinical characteristics and long-term outcome of migraine with aura in children and adolescents.

A population of 45 young subjects, 16 males and 29 females, affected by migraine with aura were studied prospectively. The mean follow-up was 7 years 6 months. The clinical characteristics and modifications during migraine aura attacks were evaluated. The aura propagated slowly with a pattern corresponding to a cortical pathway in the posteroanterior direction in 71% of the series, and was visual alone in 40%. Analysis of the relation between the course, and therefore prognosis, and the aura type showed that headache has a better prognosis when symptoms continue to be only visual. The International Headache Society (IHS) classification subdivides migraine with aura into six categories based on the duration of symptoms and the clinical characteristics (hemiplegic, basilar). Our results suggest that subjects with only visual aura should be considered separately, possibly as a seventh category, because they may have a more favourable prognosis.

Adolescent↗
PubMed1997

Electrophysiologic study of central motor pathways in ataxia-telangiectasia.

To date, corticospinal tract functional integrity in ataxia-telangiectasia has not been studied. Thorough evaluation of central motor pathways is also lacking in neuropathologic and clinical studies. Using electromagnetic stimulation, we assessed the integrity of the corticospinal tracts in eight patients with ataxia-telangiectasia. Cortical and peripheral compound motor action potentials were recorded from the abductor pollicis brevis muscle. Recordings of the shortest F-wave latency and of the compound motor action potential distal latency were made from the abductor pollicis brevis muscle after electrical stimulation of the median nerve at the wrist. A significant increase in central motor conduction time was observed in four patients, two of whom had clinical findings compatible with a pyramidal lesion. This study demonstrates involvement of the central motor pathways in ataxia-telangiectasia, which appears to be more frequent late in the course of the disease.

Adolescent↗
PubMed1997

Transsynaptic degeneration of lateral geniculate bodies in blind children: in vivo MR demonstration.

PURPOSE: To investigate signal alterations in the thalamic lateral geniculate bodies of blind patients compatible with transsynaptic degeneration of these nuclei caused by pregeniculate or postgeniculate interruption of the visual pathway. METHODS: Six patients were selected from a group of blind children in our care. Four had cerebral palsy caused by periventricular leukomalacia, one had infantile neuroaxonal dystrophy, and one had Chiari I malformation and hydrocephalus, which was worsened by bilateral ischemic lesions of the occipital lobes. MR examinations (obtained at 0.5 T) were reviewed retrospectively by two neuroradiologists, with particular attention to the visual pathway. RESULTS: Symmetric, focal areas of T2 prolongation were found at the precise site of the lateral geniculate bodies. CONCLUSION: Anterograde (pregeniculate) and retrograde (postgeniculate) transsynaptic degeneration of the second neurons of the visual pathway produce alterations in MR signal.

Arnold-Chiari Malformation↗
PubMed1997

[Drug-resistant epilepsy treated with ketogenic diet].

A 4-year old girl affected by intractable seizures was treated with ketogenic diet. The diet was calculated to provide appropriate protein intake for growth (1.4 g/kg body weight) and adequate calories (1600 kcal) derived from 4 parts fat and 1 part protein + carbohydrates. The child remained on the diet for 8 months and had a decrease in seizure frequency of 90%. No serious side effects were reported and it was possible to discontinue or decrease antiepileptic drugs. Our results confirm the efficacy of ketogenic diet in the treatment of epilepsy. Since it is known that 20 to 30% of all patients with epilepsy do not have their seizures completely controlled with established antiepileptic drugs, it would be useful to increase the application of this dietetic treatment in selected patients in Italy as it already happens in other countries.

Anticonvulsants↗
PubMed1997

[Eating behavior disorders. Epidemiologic study of 434 adolescents].

METHODS: An epidemiological investigation of behavior disorders in a population of 434 students (52.3% males, 47.7% females) ranging from 16 to 19 years of age has been carried out. Possible correlations between eating disturbances, drug addiction related behaviors, suicide attempts and former sexual abuses have been discussed. An anonymous self administered questionnaire, prepared by the authors, had been used. The statistical analysis was carried out with the SPSS/PC Factor software. RESULTS: This study revealed the presence of adolescents with unstable or quantitatively not adequate eating behaviors, which are expressed by borderline symptoms and not by clear syndromes. Distorted attitudes towards weight, body and food, related to disturbances of body image, were pointed out. In particular, girl seemed to be unhappy with their own body. There was a correlation between abnormal eating behaviors (borderline bulimia) and low level of selfesteem. "Anorexic behavior" and "bulimic behavior" had a significant correlation to suicide attempts. A relationship between "bulimic behavior" and use/abuse of drugs and/or alcohol was found. In our population several kinds of violence were found (2.6% sexual abuse with physical contact; 13.5% sexual abuse without physical contact; 9.4% physical abuse) experienced inside or outside families. The adolescent victims of sexual abuse showed abnormal eating behavior, mostly a tendency to a "bulimic behavior". CONCLUSIONS: This study seems to confirm that there are significant correlations and several conduct disorders. Moreover the presence of a correlation between eating disturbances, even if borderline and traumatic events of sexual nature is confirmed.

Adolescent↗