Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 6 de 6
Filter
1.
Acta Neurol Scand ; 124(2): 109-14, 2011 Aug.
Article in English | MEDLINE | ID: mdl-20809902

ABSTRACT

OBJECTIVES: To assess the frequency of clinical features of Sjogren's syndrome (SS) in patients with multiple sclerosis (MS) receiving treatment with disease-modifying drugs (DMDs) or naïve to treatment and the possible association with clinical, cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) parameters. METHODS: A multicentre cross-sectional observational study was designed, based on a structured neurologist-administered questionnaire to 440 patients. RESULTS: Twenty-eight of 230 (12%) patients receiving treatment with DMDs (DMDs(+)) and 14 of 210 (6.6%) treatment-naïve patients (DMDs(-) ) showed clinical features of SS. Four primary SS were diagnosed, two of which were DMDs(+) and two were DMDs(-) . Sicca symptoms were significantly associated with higher EDSS scores (P = 0.018), a low frequency of gadolinium-enhanced MRI-positive lesions (P = 0.018) and cerebral disturbances (P = 0.001). CONCLUSIONS: Screening for the clinical features of SS should be performed in patients with MS both receiving treatment with immunomodulatory drugs and without therapy.


Subject(s)
Antirheumatic Agents/therapeutic use , Interferon-beta/therapeutic use , Multiple Sclerosis/drug therapy , Sjogren's Syndrome/drug therapy , Adult , Cross-Sectional Studies , Disability Evaluation , Female , Humans , Magnetic Resonance Imaging , Male , Multiple Sclerosis/cerebrospinal fluid , Multiple Sclerosis/complications , Multiple Sclerosis/diagnosis , Observation , Retrospective Studies , Severity of Illness Index , Sjogren's Syndrome/cerebrospinal fluid , Sjogren's Syndrome/complications , Sjogren's Syndrome/diagnosis , Surveys and Questionnaires
2.
Pain ; 143(3): 186-191, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19171430

ABSTRACT

Although many patients with multiple sclerosis (MS) complain of trigeminal neuralgia (TN), its cause and mechanisms are still debatable. In a multicentre controlled study, we collected 130 patients with MS: 50 patients with TN, 30 patients with trigeminal sensory disturbances other than TN (ongoing pain, dysaesthesia, or hypoesthesia), and 50 control patients. All patients underwent pain assessment, trigeminal reflex testing, and dedicated MRI scans. The MRI scans were imported and normalised into a voxel-based, 3D brainstem model that allows spatial statistical analysis. The onset ages of MS and trigeminal symptoms were significantly older in the TN group. The frequency histogram of onset age for the TN group showed that many patients fell in the age range of classic TN. Most patients in TN and non-TN groups had abnormal trigeminal reflexes. In the TN group, 3D brainstem analysis showed an area of strong probability of lesion (P<0.0001) centred on the intrapontine trigeminal primary afferents. In the non-TN group, brainstem lesions were more scattered, with the highest probability for lesions (P<0.001) in a region involving the subnucleus oralis of the spinal trigeminal complex. We conclude that the most likely cause of MS-related TN is a pontine plaque damaging the primary afferents. Nevertheless, in some patients a neurovascular contact may act as a concurring mechanism. The other sensory disturbances, including ongoing pain and dysaesthesia, may arise from damage to the second-order neurons in the spinal trigeminal complex.


Subject(s)
Multiple Sclerosis/pathology , Nerve Fibers, Myelinated/pathology , Pons/pathology , Trigeminal Nerve/pathology , Trigeminal Neuralgia/pathology , Trigeminal Nuclei/pathology , Adult , Age of Onset , Basilar Artery/pathology , Basilar Artery/physiopathology , Brain Mapping , Decompression, Surgical/standards , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Multiple Sclerosis/complications , Multiple Sclerosis/physiopathology , Pons/physiopathology , Prospective Studies , Retrospective Studies , Rhizotomy/standards , Trigeminal Nerve/physiopathology , Trigeminal Neuralgia/etiology , Trigeminal Neuralgia/physiopathology , Trigeminal Nuclei/physiopathology , Wallerian Degeneration/etiology , Wallerian Degeneration/pathology , Wallerian Degeneration/physiopathology , Young Adult
3.
Mult Scler ; 13(3): 343-7, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17439903

ABSTRACT

Sixty-two patients with multiple sclerosis (MS) were imaged monthly over a six-month (ie, seven monthly magnetic resonance images [MRI]) natural history period (NHP). Thereafter, patients were randomized to receive 11 or 33 mug of subcutaneously injected interferon beta 1a (IFNp-1 a) with imaging monthly for nine months and at months 12, 18 and 24 of therapy phase (TP). In the present exploratory post hoc analysis, the authors evaluated IFNbeta-1a dose effect on reducing the size of contrast-enhancing lesions (CELs). MRIs performed at months 0, 3 and 6 of NHP and at months 3, 6, 9, 18 and 24 of TP were analysed. While a significant reduction in mean number of CELs was observed in both treatment groups of patients, the mean total volume and size of CELs was reduced only in patients undergoing therapy with 33 mug of IFNbeta-1a. The latter suggests a significant dose effect exerted by IFNbeta-1a in the evolution of CELs' dimensions during therapy.


Subject(s)
Interferon-beta/therapeutic use , Multiple Sclerosis/drug therapy , Multiple Sclerosis/pathology , Adjuvants, Immunologic/therapeutic use , Adult , Age of Onset , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Humans , Injections, Subcutaneous , Interferon beta-1a , Interferon-beta/administration & dosage , Magnetic Resonance Imaging , Male , Time Factors
4.
Neurol Sci ; 28(6): 331-5, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18175081

ABSTRACT

Allgrove syndrome is a rare autosomal recessive disorder characterised by childhood onset, alacrima, oesophageal achalasia, adrenocortical insufficiency, neurological and occasionally autonomic involvement. Although the disease has been associated with mutations in the ALADIN gene on chromosome 12q13, it is genetically heterogeneous. The case we report is interesting because of its onset in adulthood, long duration of disease and prominent neurological dysfunctions. After the onset of neurological abnormalities the diagnosis went unrecognised for years until the patient presented for evaluation of dysphagia. The presence of achalasia with dysphagia, adrenal insufficiency, reduced tear production, optic atrophy and peripheral motor-sensory neuropathy with axonal loss led us to clinically diagnose Allgrove syndrome even though a genetic study showed no mutations in the ALADIN gene exons. The case we report shares many clinical features with Allgrove syndrome and, even with the limitations of a single case, underlines the variability in this syndrome and the need for appropriate investigations along with a multidisciplinary approach.


Subject(s)
Adrenal Insufficiency/genetics , Chromosome Disorders/genetics , Chromosomes, Human, Pair 12 , Esophageal Achalasia/genetics , Nerve Tissue Proteins/genetics , Nuclear Pore Complex Proteins/genetics , Adrenal Insufficiency/complications , Adult , Chromosome Disorders/complications , Dry Eye Syndromes/etiology , Esophageal Achalasia/complications , Genes, Recessive , Humans , Male , Mutation
6.
Neurol Sci ; 23 Suppl 2: S119-20, 2002 Sep.
Article in English | MEDLINE | ID: mdl-12548372

ABSTRACT

In the last two years, the environmental theory on the aetiology of Parkinson disease has acquired new data. From an experimental point of view, a new model of parkinsonism induced by rotenone, a diffuse insecticide, has been proposed, and in vitro studies have provided proof that several pesticides stimulate the formation of alpha-synuclein fibrils (one of the principal constituents of Lewy bodies). Moreover, a meta-analysis of all case-control studies so far performed showed a positive, statistically significant association between pesticide exposure and PD. In this context, we are performing a cohort study on 5575 licensed pesticide users in the province of Viterbo. After 27 years of follow-up, 4788 subjects are still alive. The aim of this study is to measure the prevalence of Parkinson's disease in a large group of workers with theoretically increased risk.


Subject(s)
Occupational Diseases/chemically induced , Occupational Diseases/epidemiology , Occupational Exposure/adverse effects , Parkinson Disease, Secondary/chemically induced , Parkinson Disease, Secondary/epidemiology , Pesticides/adverse effects , Cohort Studies , Female , Humans , Italy/epidemiology , Male , Prevalence
SELECTION OF CITATIONS
SEARCH DETAIL
...