A perplexing case of juvenile extrapyramidal disease.
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Biomedical subjects
Publications and source records attributed to G Moretti.
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A case of transient global amnesia has been neuropsychologically assessed during the attack. Global involvement of any memory modalities and far-reaching retrograde amnesia were found. Follow-up retesting, 1 week and 6 months later, showed persistence of mild verbal memory impairment.
76 cases of cluster headache are reviewed. Besides confirming established notions, the present study calls attention to the following points: (a) the peculiar behaviour of patients during the attacks does not appear explainable in simple terms of reaction to pain; (b) the occurrence of ECG abnormalities during the attacks in addition to bradycardia; (c) the well-known tendency of cluster headache attacks to recur at the same time of day, has in our cases a very high peak at 3 p.m., and (d) when the attacks occur in sleep hours, the time relationship with REM sleep stage is confirmed in our cases which have been recorded at night.
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The Authors report the case of a 32-years-old woman taking oral contraceptives for twelve years, who developed multi-infarct dementia and motor-sensory signs as a consequence of repeated cerebrovascular episodes associated with migraine-like attacks. Neuroradiological findings suggested vascular pathologic changes. Mechanisms of cerebro-vascular diseases related to oral contraception are discussed, especially emphasizing the possibility of intrinsic vascular lesions caused by exogenous steroid stimulation. Epidemiologic and pathophysiological relationship between migraine, stroke and oral contraception are also pointed out.
The unusual association of acute confusional states with migraine was observed in three adult women. This syndrome, which was previously studied in the content of juvenile migraine, seem to have the following distinctive features: a) sudden onset of confusion and agitation in the course of violent headache attacks; b) possible close relationship with neurological deficits, suggesting basilar migraine; c) demonstration of marked electroencephalographical abnormalities in either one or both posterior quadrants; d) tendency to a rapid recovery, on both clinical and electroencephalographical standpoint. Focal edema in the vertebrobasilar arterial territory appears to be the most likely mechanism.
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110 elderly patients, 57 with and 53 without acquired neurological lesions, were examined for the presence of the grasping, snout, sucking, palmomental, glabellar and bulldog reflexes. The results were statistically analyzed by means of the chi2 method. The percentages of the positive reflex responses, although not negligible in the neurologically healthy patients, turned out far higher in the patients with organic cerebral disorders. With the exception of the sucking and palmomental reflexes, these differences appeared statistically significant. As for the neurological diagnosis, diffuse lesions proved themselves more crucial than focal ones. The conclusion is drawn that primitive reflexes should be regarded abnormal only in the context of an overt cerebral pathology.
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A 35-year-old man, sephardic jew, complains for the last eleven years of typical and frequent attacks of FMF. His liver is hypertrophic. Needle-biopsy reveals an extensive macrovacuolar triglyceride storage (60 per cent) and an active vascular congestion with erythrodiapedesis in the mild and centrolobular zone, without any necrosis, cellular infiltration nor fibrosis. Electron microscopy shows lipofuschin deposits and mild lesions of mitochondrias, endoplasmic reticulum. Blood triglycerides and apo B are rather low. After six weeks of colchicine treatment, needle biopsy shows no more active congestion nor erythrodiapedesis. Triglyceride storage lowers to 40 per cent. After seven months of colchicine treatment, triglyceride storage falls down to 12 per cent. FMF may be considered as a cause of fatty liver when there is not any cause else and only after deep decrease or disparition of triglyceride deposit by a long time colchicine treatment.