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Biomedical subjects

M Onofrj

Publications and source records attributed to M Onofrj.

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

Headache in children with centrotemporal spikes.

The aim of the study was to evaluate the long-term evolution of headache associated with rolandic centrotemporal spikes (CTS). The patient group consisted of a group of 32 children who suffered from headache and presented CTS at electroencephalogram (EEG). As the control group, we selected 52 sex- and age-matched children with headache without any EEG abnormalities. During a follow-up of 5 years none of them showed epileptic seizures. The number of headache attacks decreased in the majority of patients, as in the controls. A good correlation could be identified between CTS and the number of headaches attacks both at baseline (r = 0.58, P < 0.001) and at follow-up (r = 0.64, P < 0.001). In four children (12.5%), the frequency of headache attacks increased and this increase was associated with a higher frequency of CTS. In two patients, a change in the EEG pattern was observed during follow-up, with a 'migration' of the epileptiform complex from central to parietooccipital leads. In conclusion, these findings confirm that CTS are not pathognomonic of centrotemporal epilepsy and that evolution of CTS and headache in children are statistically related.

Adolescent↗
PubMed1998

Gabapentin in orthostatic tremor: results of a double-blind crossover with placebo in four patients.

We treated four patients affected by orthostatic tremor (OT) with gabapentin in increasing doses (300 to 2,400 mg/d). OT was evaluated with patients' self-monitoring scales, tremor rating scales, electromyography (EMG) showing the 14- to 18-Hz frequencies, and EMG frequency analysis. All patients had transitory responses to clonazepam. Gabapentin induced disappearance of OT in three patients and consistent reduction in one. Crossover to placebo induced reappearance of tremor.

Acetates↗
PubMed1998

Optic neuritis with residual tunnel vision in perchloroethylene toxicity.

CASE REPORT: In a 57-year-old female owner of a dry-cleaning shop, we describe the association of severe bilateral optic neuritis with unexpectedly high concentrations of perchloroethylene/metabolites in the blood and of chloroform in urine. Visual disturbances consisted of complete blindness for 9 days in the left eye, for 11 days in the right eye, with bright phosphenes and pain on eye rotation. Only central (2-3 degrees radius) vision recovered in the following months. CONCLUSION: Although environmental concentrations of perchloroethylene were within normal limits, we measured five-fold increases in vapors emitted when ironing freshly dry-cleaned fabrics, and suggest that inhalation of perchloroethylene vapors was the cause of this case of ocular nerve toxicity, recapitulating a previous report of major perchloroethylene toxicity.

Blindness↗
PubMed1997

Recovering optic neuritis during systemic cisplatin and carboplatin chemotherapy.

INTRODUCTION: We describe bilateral optic neuropathy in a patient affected by ovarian carcinoma treated with cis-platin 160 mg/m2 and carboplatin, 640 mg/m2. The patient was followed for 1 year, when recovery appeared. The few previous descriptions of CDDP optic nerve toxicity did not report recovery. METHODS: Computerized visual field, visual evoked potentials, pattern electroretinograms, full field flash electroretinograms were recorded during follow-up. RESULTS: Optic neuritis appeared 13 weeks after cis-platin discontinuation, with right eye central scotoma; 2 days later the patient became bilaterally blind. Visual evoked potentials were initially absent, reappeared, with delayed latencies to left eye stimuli at 6 months, in both eyes at 9 months. At 1 year delayed VEPs were recorded with right eye stimuli, normal VEPs were recorded for left eye. CONCLUSION: Cis-platin can induce delayed optic neuritis, that can recover in 1 year.

Antineoplastic Agents↗
PubMed1997

Event related potentials recorded in patients with locked-in syndrome.

OBJECTIVE: To determine the possibility of recording "cognitive" event related potentials (ERPs) in locked-in patients and therefore to determine whether ERPs can have a role in differential diagnosis of coma. METHODS: ERPs to classic auditory or visual "odd ball paradigms" were recorded three to four days, seven to eight days, and 30 to 60 days after admission to the intensive care unit, in four patients affected by basilar artery thromboembolism resulting in locked-in syndrome. Two patients (one 32 year old man, one 31 year old woman) could move the eyes laterally and vertically spontaneously and on command. One patient (a 39 year old man) had a "one and half syndrome", one patient (a 40 year old woman) could only elevate the left eyelid and eye. Results were compared with data from 30 age matched controls. In the last recording session a letter recognition paradigm was applied, in which ERPs were produced by the identification of letters forming a word. Results were compared with five age matched controls. Brainstem lesions extending to the pontomesencephalic junction were found on MRI and CT. RESULTS: ERPs to the oddball paradigms were recorded in three patients in the first recording session, in all patients in the second recording session. Latency, amplitude, and topographic distribution of ERP components were inside normal limits. With the letter recognition paradigm the patients could emit a P3 component to correspond with target letters, with the same margin of error as controls. CONCLUSION: It is possible to record ERPs in patients with locked-in syndrome shortly after the acute ischaemic lesion, and therefore to assess objectively cognitive activities. Furthermore the letter recognition paradigm could be implemented to facilitate linguistic communication with patients with locked-in syndrome.

Adult↗
PubMed1996

Long echo time STIR sequence MRI of optic nerves in optic neuritis.

MRI of the optic nerves was obtained in 13 patients with acute optic neuritis and 13 with a previous optic neuritis (ON), assessed by clinical features, visual fields and visual evoked potentials. Results of the conventional short tau inversion recovery (STIR) sequence obtained with a short echo time (STE-STIR; 22 ms) were compared with those of a long echo time (LTE-STIR: 80 ms) sequence. The conventional STE-STIR sequence revealed lesions in the optic nerves in 78.5% of acute and 58.8% of previous ON. The LTE-STIR sequence showed abnormalities in 92.8% of acutely symptomatic nerves and 94.1% of nerves with previous ON. The optic nerve lesions appeared significantly longer with the LTE-STIR sequence than with the conventional STE-STIR sequences, in both acute and previous ON.

Adult↗
PubMed1996

Evoked potential (EP) alterations in experimental allergic encephalomyelitis (EAE): early delays and latency reductions without plaques.

Experimental allergic encephalomyelitis (EAE) in its chronic relapsing (CR-EAE), chronic progressive (CP-EAE) and acute (A-EAE) forms was obtained in 24 juvenile strain 13 guinea pigs. Visual, brainstem acoustic and somatosensory evoked potentials (EPs) were recorded in these animals prior to the sensitizing injection and during the course of the disease. Delays in the EPs appeared 15 days post-sensitization (dps), preceding or simultaneously with clinical alterations: electron microscopy revealed myelin stripping and vacuolation in the animals sacrificed 25 dps. Decreases in EP latency were recorded 32 dps; when electron microscopy revealed myelin layers indicating remyelination, whereas light microscopy showed only inflammatory changes. When confluent plaques were revealed by light microscopy 120 dps, the EP wave shapes were distorted or absent. The discussion reviews the literature on early myelin and conduction changes during central demyelination.

Animals↗
PubMed1996

Long time echo STIR sequence magnetic resonance imaging of optic nerves in optic neuritis.

Magnetic resonance images of optic nerves were obtained in 20 patients with acute optic neuritis (ON), and assessed by means of clinical, visual field and visual evoked potential evaluations; the imaging was repeated 1 year later. The results of the conventional Short Tau Inversion Recovery (STIR) sequence obtained using short time echo (STE-STIR: 22 msec) were compared with those of the long time echo sequence (LTE-STIR: 80 msec). The conventional STE-STIR sequence revealed lesions in 57.2% cases of acute ON and in 42.9% of the optic nerves affected by previous ON; the LTE-STIR sequence was diagnostic in 95.2% of acute ON cases and in 85% of patients with previous ON. The calculated length of the optic nerve lesions was significantly longer in the images obtained using the LTE-STIR sequence than in those obtained using conventional STE-STIR sequences.

Adult↗
PubMed1996

Are VEP abnormalities in optic neuritis (ON) dependent on plaque size? A reappraisal of the physiopathology of ON based on improved MRI and multiple-lead recordings.

Twenty patients with optic neuritis (ON) described in the previous study [23] underwent serial VEP recordings (using multiple electrode arrays) for two years. The VEPs could be correlated with the lesions revealed by MRI, Visual Field tests and other clinical findings. On the basis of their scalp distribution, they were classified as "really delayed" VEPs and "pseudo-delayed" VEPs. Real delays could be recorded at the onset of ON or shortly afterwards, and their appearance indicated the recovery of visual function and a good prognosis. Pseudo-delays indicated an alteration in the visual field and, unless a breakthrough of normal or delayed components appeared in the first three months, following acute ON, indicate a poor prognosis for the recovery of visual function. The pseudo-delayed VEPs were mainly observed in patients with longer lesions revealed by means of LTE-STIR MRI [23]; there was no correlation between VEP latency and the length of plaques. Our findings contradict previous theories on the timing of conduction alterations in ON and multiple sclerosis.

Adult↗
PubMed1996

Newborns with hyperbilirubinemia: usefulness of brain stem auditory response evaluation.

We describe brain stem auditory evoked potentials (BAEP) obtained in 48 full-term newborns (20 boys, 28 girls) presenting with high serum total bilirubin concentration (from 238 to 442 mM) without Rhesus of group A, B, O factors incompatibility. Recordings were performed on the 3rd day of life and repeated 5-7 days post-appropriate therapy with photostimulation and exchange transfusion (when bilirubin concentration had decreased below 136 mM). Supplementary recordings were performed 3, 6 and 12 weeks later in order to assess test-retest reliability of components. Mean values of BAEP latencies were compared with those obtained in 40 age-matched control subjects using the same recording procedures. At first recording session (on the 3rd day), latencies of waves III and V obtained in hyperbilirubinemic patients were significantly increased as compared with records in control subjects. Recordings performed 5 to 7 days post-therapy and during subsequent recording sessions showed no significant differences between patients and control groups. Serial neuropsychological evaluations obtained over a 3-year follow-up showed no subsequent neurodevelopmental abnormality for all patients. These findings suggest that hyperbilirubinemia can alter central neurotransmission in auditory brain stem pathways, but this modification is only transient.

Case-Control Studies↗
PubMed1996

Reappearance of event-related P3 potential in locked-in syndrome.

In a patient affected by locked-in syndrome, because of a lesion of the caudal-ventral pontine tegment, we recorded event-related potentials (ERPs) to an acoustic odd-ball paradigm. We did not record N2 and P3 components in the 50 days following the acute lesion although the patient was able to understand the task and communicate with blinking. 55 days after the acute lesion, N2 and P3 reappeared on scalp derivations. This findings suggest that brainstem structures are involved in P3 or N2-P3 generation.

Acoustic Stimulation↗