[Trophic skin disorders in peripheral neuropathies. Clinico-electroneurographic study].
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Biomedical subjects
Publications and source records attributed to L Rossi.
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The Authors examine a group of alcoholics, recording for each patients somatosensory, auditory and visual potentials, in order to check the presence in different systems of nervous fibers of subclinic alterations; they separate a group of patients with clinic polyneuropathie and a group without polyneuropathie. Subclinic alterations are confirmed in different measure in the two groups. Vit. B12 and pholic acid are also dosed in the serum.
Two asymptomatic, unusually young male patients aged 18 and 21 with ossification of the longitudinal posterior ligament of the cervical spine are presented. Geographical distribution, pathological and radiologic aspects of the disease are discussed together with those signs differentiating it from ankylosing spinal hyperostosis.
The author reports the case of 13 years old girl, who since at least three years displays very frequent partial involuntary contractions of some arm's and leg's muscles, especially on the right but also on the left side. The girl was examined with EEG and contemporary registration of the myogramm of the muscles in question and with EMG. The DD of the myoclonic syndrome, and especially between Schultze myochimie, Kny's fibrillar myoclonus and Friedereich paramyoclonus multiplex has been discussed. The conclusion was that the case under discussion, is a case of paramyoclonus multiplex of Friedereich.
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Auditory and somatosensory evoked potentials were recorded from 10 patients suffering from Friedreich's ataxia. All patients were subjected to audiological tests and EMG-ENG study. Acoustic evoked potentials recordings included brainstem acoustic evoked potentials and long latency components. Peripheral and central components of somatosensory evoked potentials were obtained by stimulating the median nerve at the wrist and elbow. Various abnormalities of the cortical components were observed in all patients for both acoustic and somatosensory evoked potentials. Analysis of brainstem acoustic evoked potentials and of the early components of somatosensory evoked potentials showed a different incidence of abnormalities. The main feature of brainstem acoustic evoked potential changes was the frequent absence of one or more waves; the greatest abnormalities occurred in patients whose disease was of long duration. Long latency components (N85) were significantly prolonged in all but one patient. There was often an absence or reduction of early somatosensory evoked potentials with normal or near normal latencies, even though cortical responses were markedly prolonged. The sensory conduction velocity between stimulation sites at wrist and elbow was normal in all patients. Clinically brainstem acoustic evoked potentials may prove to be a reliable means of monitoring the progression of the disease, while long latency components and somatosensory evoked potentials could be used as complementary procedures in early diagnosis.
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Thirteen patients affected by either dominant or recessive and/or sporadic olivopontocerebellar atrophy were studied. All patients were subjected to auditory evoked potential recordings including early and long latency components, CT scans, vestibular and EMG-ENG examinations. In nine patients somatosensory evoked potentials were also recorded. Clear-cut abnormalities in brainstem auditory evoked potentials were observed in only two patients while a slight reduction of the IV-V/I amplitude ratio was found in seven cases. N85 was increased in two patients. The main feature of somatosensory evoked potentials abnormalities was a delayed N20 in association with prolonged N13-N20 central conduction time (five patients). For all patients the CT scan varying degrees of cerebellar and brainstem atrophy. There was no clear correlation between the abnormalities revealed by neurophysiological and neuroradiological investigations and the severity and duration of the illness. It is noteworthy that auditory and/or somatosensory evoked potential changes were found in all dominant olivopontocerebellar atrophy patients.
The Authors have applied the method for determination of the H reflex, in order to measure the spasticity in a group of patients operated with chronic implantation of epidural electrodes. After a brief discussion about a clinical and neurophysiological problems of the spasticity, they refers the methodologie and results obtained by determination of H/M ratio and H1/H2 curve with double stimulus. They conclude that this method is rather uncertain and useful only at a approximative clinical level.
The Authors describe four cases of cutaneous mastocytosis observed during paediatric age. They notice that the disease presents itself with a clinical polymorphous situation which sometimes exceeds the limits of the cutaneous gambit, until the illness reveals itself a systemic serious disease. Besides they point out uncertain etiopathogenesis, the utility of a correct diagnostic approach and the utility of a therapy which is continually in evolution.
A patient affected by continuous clonus of the right half of his tongue and face with dysphasia and right hemiparesis is described. Partial continuous epilepsy of Kojewnikow was diagnosed. The CT scan showed a spreading lesion surrounded by intense oedema in the left central region, as well as a longstanding subdural hematoma complicated by osteitis. This finding lead to a diagnosis of cerebral abscess which was confirmed by surgery. In this paper it is also analyzed the cortical and/or subcortical origin of this peculiar type of epilepsia.
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The authors studies through the evoked potentials of the brain stem a group of patients affected from T.I.A. of the vertebro-basilar circulation. From the remarks of cases this examination results significant in 66%. The more characteristic remarks is the increase of absolute latency of V wave. It is also possible to follow contemporary the evolution of auditive brain pathways disease and clinical features in repeating the test.
The authors study the sensitive potential evoked from point of Erb and from cervical spine in C6-C7, obtained by stimulation of median nerve in a control group (normals) and in a greater group of 40 cases from patients affected by radiculopathie with or without discal protrusion and by myelopathie spondiloartrosic. The date supply significant informations and are (obicurred in analytique) analyzed with accuracy.
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BAEPs recordings and brain CT Scans have been conducted in 11 patients with RIAs of the vertebral-basilar system. Five patients presented recurrent transient ischemic attacks (TIAs) completely clearing in 24 h, while in the other patients a full recovery took place over a longer period, within 3 week (RINDs). Each patient underwent BAEPs recording, as well CT Scans, EEG and oto-neurological examination, 7-20 days after the last RIA, when all signs and symptoms had disappeared. Both ears were subsequently stimulated and bipolar EEG activity was recorded from Cz and the mastoid electrode ipsilateral to stimulation. At least two sets of 1500 averaged responses from each ear were added. The I-III, III-V, I-V interpeak latencies (IPLs) as well as the IV-V/I amplitude ratio were measured and compared with the values obtained in a control group. Increased IPLs were detected in 4 cases of the TIA group and in 2 of the RIND group. Amplitude ratio was always normal. Any positive information provided by CT Scan showed cerebral atrophy in 4 patients with TIAs and in 1 patient with RIND. BAEPs recording is a relatively simple, non-invasive neurophysiologic test, which can give objective evidence for brainstem dysfunction in vertebro-basilar RIAs.