[Nocturnal sleep in the Shy-Drager syndrome].
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Biomedical subjects
Publications and source records attributed to G Macchi.
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A new case of subacute sclerosing panencephalitis with onset in adult life is reported. Clinical picture was characterized by a maculopathy, followed two years after by behavioural disturbances, psychomotor impairment, pyramidal signs and left-side myelonic jerks synchronously with the typical periodic R-complex in the EEG. CT-scan and MRI showed a wide demyelinative lesion in the right temporo-occipital area of the brain. Elevated antibody titers to measles virus in serum and CSF were present. Death occurred within 6 months while in coma. The neuropathologic findings confirmed the diagnosis of SSPE revealing widespread inflammatory lesions in the grey and white matter areas of demyelinization more evident in the right temporo-occipital regions and several Cowdry type A inclusions in glial cells and neurons.
In the history of experimental demyelination, allergic encephalomyelitis (EAE) is the most impressive experimental demyelinating disease based on an immunological mechanism. The evolution of the neuropathological process of chronic EAE is very close to that of chronic Multiple Sclerosis. On the other hand experimental inoculation of different viruses can induce various types of demyelination depending on the main target of the virus and the host response, this latter being conditioned by the age, the mechanism of immunity and the persistence of the virus in the brain. The demyelination can be induced by a viral persistent infection primarily affecting oligodendrocytes (CDV, JHM hepatitis virus) or acting through an immunomediate response against myelin (Visna, Theiler virus, human conventional viruses). The experimental demyelinating models show that also in Multiple Sclerosis a viral etiology could be the starting point of a demyelinating process based on a immunologically mediated mechanism.
It is now well established that a rich mutual exchange of information occurs between some brain regions and vegetative centres located in the brain stem and medulla. Anatomico-clinical data on suprasegmental control of the vegetative nervous system are dealt with here, by briefly reviewing information relevant to the following territories: the frontal lobe and limbic centres, which are located in the forebrain, the hypothalamus, the respiratory, cardiovascular, and micturition centres of the brain stem.
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