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Biomedical subjects

T Sacquegna

Publications and source records attributed to T Sacquegna.

At least 55 records · Page 3Linked to original sources

Classic migraine attack complicated by confusional state: EEG and CT study.

We report electroencephalographic and clinical observations in one attack of classic migraine, accompanied by a confusional state. The ictal EEG showed slow waves over the left hemisphere, the abnormality gradually clearing up during the four days following the attack. A brain CT scan was normal during the attack and also a few days later. A possible relationship between impairment of consciousness during the attack and left hemispheric metabolic dysfunction is discussed.

Adolescent↗

Flunarizine in common migraine: Italian cooperative trial. I. Short-term results and responders' definition.

In order to assess the effects of flunarizine in long-term prophylaxis of common migraine, 120 subjects (90 female and 30 male) were treated with 10 mg at bedtime and followed-up for two years. The effectiveness of the drug was assessed by investigating the variations of the Headache Index (HI) and of the intake of analgesics. The patients considered responders were those with an at least 60% reduction of the HI compared with the baseline value. To assess side effects, on each follow-up examination the patients were weighed and submitted to the Hamilton Rating Scale for Depression, Toulouse-Pieron test for attention, and arousal test. By the third month of therapy, the average monthly HI had decreased from a baseline value of 16.5 +/- 7.0 to 7.5 +/- 4.2. Also by the third month, 60 subjects had proved responders and 50 non-responders; 10 had dropped out of the study because of side effects or for other reasons. The only statistically significant differences between responders and non-responders were in the baseline HI, which was higher among responders, and in the baseline intake of analgesics, which was higher in non-responders.

Adolescent↗

Hormonal and metabolic changes induced by flunarizine therapy: preliminary results.

The effect of 30-days of flunarizine (5 mg/day) therapy on pituitary, B-pancreatic, gonadic and adrenal function was studied in five adolescents with common migraine. Baseline concentration of growth hormone was significantly reduced after flunarizine therapy. The response of prolactin to thyrotrophin-releasing hormone was significantly increased after flunarizine therapy. The percentages of HbA1 and HbA1c were significantly higher after flunarizine therapy. The drug had no apparent effect on gonadic and adrenal function. Further studies are needed to confirm the effect of flunarizine on the hypothalamus-pituitary axis and glucose tolerance.

Adolescent↗

Analysis of outcome predictors of migraine towards chronicity.

Long-term migraine evolution is still undefined. The poorest outcome is the transformation from episodic attacks to a pattern of daily attacks or continuous headache with intermittent attacks. We called these cases "chronic migraine". The aim of our study was to investigate whether some clinical variables contributed to migraine chronicity. We interviewed 50 patients with chronic migraine from 2 to 15 years and 90 patients with episodic migraine matched for sex and age as a control group. Univariate analysis revealed two correlations with a chronic outcome: (1) In the control group a significantly higher number of women took oral contraceptives. (2) In the group who developed chronic migraine, there were a greater number of smokers, without reaching statistical significance. The stepwise multiple logistic regression method showed that these two variables influence the prognosis with a maximum likelihood estimate of 65%, hence not much higher than random probability.

Adolescent↗

Long term prognosis after occlusion of middle cerebral artery.

Seventy patients who had developed occlusion of the middle cerebral artery confirmed by angiography between 1970 and 1980 were followed up after an average of six years. Fourteen patients had died in the acute stage of the initial stroke. In the remaining 56 patients actuarial analysis showed that the observed incidence of survival for five years was 81.8% compared with an incidence of 94.1% in a matched normal population. Six patients sustained new strokes, four of which were ipsilateral to the middle cerebral artery occlusion. The observed cumulative incidence of subsequent strokes was 2% a year for the first five years of follow up. Twelve patients developed epileptic seizures.

Adult↗

Late seizures in patients with internal carotid and middle cerebral artery occlusive disease following ischaemic events.

The occurrence of post-infarction epilepsy was investigated in 68 patients with angiographically proven internal carotid artery occlusion and in 56 patients with middle cerebral artery occlusion. Epileptic seizures occurred during follow-up in 9% of the carotid artery group and in 21.4% of the middle cerebral artery group. The different incidence of seizures in the two groups was statistically significant. The physiopathological mechanism of the late post-infarction epilepsy is discussed.

Adult↗

Propranolol and acetylsalicylic acid in migraine prophylaxis. Double-blind crossover study.

The aim of this double-blind crossover study was to compare the prophylactic effect of acetylsalicylic acid (ASA) with that of propranolol (PRP) in the treatment of migraine. Plasma concentrations of the two drugs were measured in order to investigate a possible relationship to the clinical effect. Compared to the pretreatment period, PRP and ASA reduced migraine index, frequency, duration, severity of attacks and headache days. Due to the limited number of patients, our results should be cautiously interpreted, however relevant the clinical improvement seemed. Improvement of migraine index was not related to different plasma levels of the two drugs.

Adolescent↗

"Painful legs and moving toes" associated with polyneuropathy.

Three patients showing clinical and electrophysiological evidence of peripheral neuropathy also suffered from the syndrome of "painful legs and moving toes". Polygraphic recordings during wakefulness and sleep were consistent with the hypothesis that pathological afferent discharges arising peripherally may induce, via the spinal cord, motor excitation and pain. A severe disruption of the pattern of sleep was found in all cases.

Electromyography↗

Nocturnal headache: systemic arterial pressure and heart rate during sleep.

In order to evaluate autonomic nervous system changes occurring before nocturnal headache attacks, we studied three subjects (one male, two females) suffering from chronic migraine. All three patients underwent a nocturnal polygraphic recording including continuous monitoring of systemic arterial pressure and heart rate. Two subjects showed increases and irregularities of arterial pressure before awakening with headache. These changes began during N-REM sleep and lasted during REM sleep preceding the awakening with headache. Heart rate did not change before the attacks. These findings do not support the hypothesis that autonomic instability during REM sleep represents the precipitating factor of the attacks.

Adult↗

Menstrual migraine: intermittent prophylaxis with a timed-release pharmacological formulation of dihydroergotamine.

An open study was performed on 20 women between 20 and 40 years of age in order to assess the effectiveness of a slow-release pharmacological formulation of dihydroergotamine in the prevention of menstrual migraine. Therapy was started two days prior to the expected date of menstruation and continued for five days after the onset of menstrual flow. Trial lasted for five months, four patients suspended the treatment: one because of side effects and three because of "ineffectiveness of drug". In the 16 patients who completed the study, there was a significant reduction both in intensity and duration of migraine compared to the month prior to treatment.

Adult↗

Systemic arterial pressure and heart rate changes during migraine and cluster headaches: preliminary study.

In a case of common migraine and in two cases of cluster headache we monitored the arterial pressure and the heart rate by means of polygraphic recordings before, during and after headache attacks. During migraine attacks the arterial pressure did not show significant changes; the heart rate increased. During cluster attacks the arterial pressure increased with frequent hypertensive peaks; the heart rate on average slowed down and showed marked irregularities.

Adult↗