Reversible myoclonus in a patient undergoing transcervical hysteroscopic surgery.

We describe a 58-year-old woman who underwent hysteroscopic myomectomy to treat a large submucosal leiomyoma. A hypotonic glycine solution was instilled to distend the uterus. At one hour after the distending medium infusion started for hysteroscopic resection an electrolytic imbalance developed. One hour later myoclonus developed predominantly involving the bilateral sternocleidomastoidei and abdominal muscles. The patient was alert and cooperative; jerks were spontaneous and triggered by sensory stimuli. The electroencephalographic and brain computed tomography was normal. The clinical characteristics of her myoclonus resemble reticular reflex myoclonus, a form of subcortical myoclonus originating from the lower brainstem reticular formation. Given her severe hyponatremia we conjecture that she had symptomatic metabolic myoclonus caused by electrolytic disturbance. The case report we present underlines the need to detect in time and promptly treat neurological symptoms such as myoclonus suggesting resorption syndrome, an uncommon event complicating transcervical hysteroscopic surgery and urologic procedures.

Postural responses to low-intensity, short-duration, galvanic vestibular stimulation as a possible differential diagnostic procedure.

OBJECTIVES: In this study we investigated the effect of polarity-related differences in short-duration very low-intensity galvanic vestibular stimulation (GVS), not perceived by the subject, by evaluating the minimal postural sway responses in healthy people. We also verified its possible usefulness as a differential diagnostic tool in patients with postural instability disturbances related to polyneuropathy or peripheral vertigo. METHODS: We applied bimastoid opposite polarity direct current GVS (0.7 mA for 1 s) and recorded the induced postural response with an electromagnetic head position tracker. Latency, amplitude, velocity and an asymmetry index were measured between two reverse polarity sessions. RESULTS: The postural response was easily recorded and was statistically wider in amplitude and velocity in the polyneuropathy group than in the other groups. Postural responses were asymmetric only in the group with mild peripheral vertigo. CONCLUSION: These findings suggest that even weak GVS affects vestibular excitability: cathodal polarization increases whereas anodal GVS decreases excitability. Symmetry and amplitude or velocity of the postural responses, particularly in the eyes closed condition, can differentiate the three groups of subjects tested.

[Sexuality. Cultural, social and clinical aspects]. / Sessualità. Aspetti culturali, sociali e clinici.

The deep changes in values, beliefs and behaviour, both individual and group, have been examined, referred to the sexuality, by various methods and prospects. Sexual differentiation, typical of the plast, has been rediscussed and modified. As a result of these changes we can talk about old myths, concerning the conception of sexuality in the past, and new myths that concern the present. In this work we have reviewed the different aspects of male and female roles: masturbation, the obsession abort performance, the orgasm and, not last, the sexuality in old age condition.

[Epidemiologic psychiatric investigation in the community health district of Avezzano]. / Indagine epidemiologica psichiatrica nel territorio della ULSS di Avezzano.

The aim of the epidemiological psychiatric survey carried out among the users of the Mental Hygiene Centre of Avezzano local health district was to study the socio-demographic and clinical characteristics of participants. Data for patients for the years 1979 and 1989 were collected and analysed by studying all clinical records registered during those periods. This choice reflected the need compare user characteristics and methods of using the service following the introduction of the reform decree no. 180/1978. The aim of this retrospective epidemiological survey was to obtain data and information which would serve to formulate answers which responded to the needs expressed by users. The results revealed a heterogenous territorial distribution of psychiatric cases and this provided some indication for the realisation of a complex network of psychiatric network in the Avezzano health district.

[Lumbosacral extraspinal ependymomas. Review of literature and report of an operated case]. / Ependimomi extraspinali lombo-sacrali: revisione della letteratura e presentazione di un caso operato.

The extradural lumbosacral localization represents for ependymomas an exceptional event full of interest both from an etiopathogenetic point of view and from a clinical one. Extradural ependymomas develop in two characteristic sites: with an anterior or presacral expression in the retro-rectal pelvic area; posterior in the intergluteal space below the lumbo-sacral fascia. The possibilities of a correct diagnosis are based essentially on radiographical examinations and CAT which supply useful factors, but not peculiar to the lesion. The Authors describe a case of posterior "extradural lumbo-sacral ependymomas" which is added to the 36 already reported.