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S D'Agostini

Publications and source records attributed to S D'Agostini.

5 recordsLinked to original sources
PubMed2003

[Neuropsychological tests, MRI and SPECT in the evaluation of CNS involvement in SLE].

OBJECTIVE: To assess the agreement between presence and location of central nervous system (CNS) structural damage and neuropsychological performance. METHODS: 21 unselected SLE patients underwent a 3 hours-long battery of neuropsychological tests sampling 15 cognitive functions. A neuropsychologist hypothesized for each SLE patient the most likely site of possible involvement, according to the neuropsychological performance. Patients underwent MRI scans within 6 months (3 months before or after) from neuropsychological tests and SPECT. RESULTS: 14 of the 21 SLE patients (66.6%) were impaired in at least 1 function; among these, 7 patients (33.3%) were mildly impaired and 7 (33.3%) had more than 3 functions impaired. 10 patients (48%) had abnormal MRI scan. Negative and positive agreements between neuropsychological performance and MRI scan were detected in 15 patients (71%; ?2 with Yates' correction 6.09, p 0.007, measure K for concordance 0.44, p 0.03). All the 6 negative agreements had no records of major neurologic or psychiatric events; among the 9 positive agreements, 6 presented previous major neurologic events and 2 minor neuropsychiatric symptoms. Among the subjects with disagreement, 1 was unimpaired with positive MRI and without neuropsychiatric symptoms, 5 were mildly impaired with negative MRI. CONCLUSIONS: A detailed neuropsychological evaluation along with MRI arose as a valid method to exclude or to identify, localize and clinically interpret CNS involvement in SLE. Disagreement between MRI and neuropsychological tests was detected mainly for mild cognitive impairment that might be the expression of functional (inflammatory or ischemic) processes.

Adult↗
PubMed1990

Repetitive stimulation in myasthenia gravis: decrementing response revealed by anticholinesterase drugs.

In myasthenia gravis (MG) a typical decrementing response is frequently revealed with repetitive stimulation (RS) in clinically unaffected muscles. However, RS is unlikely to give normal results in weak muscles. In two of our patients we found a normal response in clinically affected muscles. However, a decrementing response surprisingly appeared after the administration of anticholinesterase drugs. A possible explanation for this apparently paradoxical effect is as follows: some junctions are already blocked at rest, whereas others function normally both at rest and during RS. As a consequence, the initial compound muscle action potential (CMAP) is reduced in amplitude and shows no further decrement on RS. Anticholinesterase drugs reverse some blocks, therefore causing the CMAP increase in amplitude. However, these labile junctions are more prone than normal to synaptic fatigue, so a decrementing response is produced on RS. This behavior, though not frequently encountered, can account for some negative results of RS in MG.

Action Potentials↗
PubMedDate not supplied

Pilomotor epilepsy.

The case is reported of a patient presenting pilomotor seizures as the initial symptom of a tumour of the deep temporal lobe. Six other cases had previously been reported with the same type of seizures. The responsible lesion was often a tumour in deep temporal lobe and the distribution of the piloerection attacks was almost always ipsilateral. Pilomotor seizures deserve a definite role in the nosography of partial epilepsy.

Brain Neoplasms↗