CT and EEG investigations in 100 patients with multiple sclerosis (MS).

100 MS patients were followed up for an average of 5 years. We considered age at onset, duration of the disease, number of attacks, neurological and psychic status, CT and EEG findings and tried correlating the last two with all the previous factors. In remission the most frequent CT abnormality was diffuse atrophy. In acute exacerbations there were 3 possibilities: normality, hypodensity and, much more rarely, hyperdensity with pseudotumoral patterns. A normal CT and short duration of disease were positively correlated with a small number of attacks. There were no positive correlations between CT findings, age at onset and neurological and psychic status. EEG, like CT, may show no changes in a high percentage of cases but there is scant correlation between the two.

[Epileptic patients: work and entailing risks (author's transl)]. / Attivita' lavorativa e rischio nell'epilettico.

We made a survey of 450 epileptic patients to find out how their disability affected their jobs and what risks were involved. 60% of the patients questioned had jobs. Those who did not work had frequent attacks and neurological and/or psychiatric handicaps. About 50% of the working epileptic patients were self-employed against a figure of 35% for the self-employed population in our region. In 6.6% of the cases, accidents had occurred at work because of attacks. In half of these cases the accident was not serious and in the other of no account. There is little difference between the Italian population in general and the epileptic when we consider the risks involved at work. This may be attributed to the prudence and common sense the patients show in their choice of work (when this is possible) and in the way they perform their work. Italian law on civil disability limits the work for which epileptics may be employed. For this reason they very often hide their illness from their employer and co-workers.

[The problem of private insurance for patients with epilepsy (author's transl)]. / Il problema dell'assicurazione privata nei pazienti epilettici.

324 epileptics were questioned about their approach to private insurance. Only 9,26% of them were covered by a life or accident insurance policy: 3,70% had life insurance, 3,70% accident insurance and 1,86% both. None of the patients had declared his disability to the insurance company. In 6,17% of the 324 epileptic cases an insurance policy had been taken out by their parents. In comparison about 35% of the Italian population in general are insured. A questionnaire was sent to 20 insurance companies; only 5 of them replied, saying that as far as accidents were concerned, they considered epileptics uninsurable. As for life insurance, policies can be contracted at increased premiums, according to the individual case (including the severity of the illness). Physicians must give epileptics fuller information about their insurance plans because, if their illness is detected after an accident, they will find themselves not covered by insurance. Government intervention is called for with the setting-up of special funds for this purpose.

[The driving license and epilepsy (author's transl)]. / Il problema della patente di guida nei soggetti epilettici (Contributo clinico).

Italy is one of the few countries in Europe with no legislation specifically concerning driving licenses and epilepsy. We made a survey of 321 epileptics all over 18 years of age; 80,4% of them had epilepsy (temporal lobe). 47,7% of the 321 had a driving license, 2,8% had their license withdrawn because of epilepsy. The frequency of attacks among those with licenses was as follows: 52,9% rarely had attacks (1 every 2 years or even less often), 17,7% had attacks yearly and 29,4% had frequent attacks (1 a month, 1 a week or even daily). About 2% of the patients examined had had accidents because of attacks; none of the accidents were very serious. In spite of the lack of legislation, a high number of patients has driving license. However our investigations have shown that they were careful in their driving and scrupulous about treatment and medical check-ups. The main problem is that epileptics with a driving license may encounter serious difficulties with insurance companies if they have a car accident. It is to be hoped that in Italy appropriate measures are taken parallel to those of other European Countries.

[Institutionalized epileptic patients in the "Marche" region (preliminary data) (author's transl)]. / L'istituzionalizzazione dei pazienti epilettici nelle Marche (dati preliminari).

The purpose of this survey was to gather information about long stay epileptic patients in 16 institutions of the "Marche" region. The 203 institutionalized subjects were examined and the information fed into computer. All the patients, in addition to epilepsy, had psychiatric and or neurological handicaps, which were often more disabling than their epilepsy (with difficult social adjustment in most cases). The socio-economic level of the families was usually rather low. Ths survey showed satisfactory as well as unsatisfactory aspects of rehabilitation facilities, equipment, medical and para-medical staff, in these institutions. The deficiencies were mostly caused by the lack of coordination and programming at regional level. Each institution, in effect, acted independently.

[Efficacy and side-effects of long term L-dopa therapy in Parkinsonian syndromes (evaluated by CT scan as well) (author's transl)]. / Efficacia ed effetti collaterali della terapia prolungata con l-dopa nelle sindromi parkinsoniane (valutate anche con TAC dell'encefalo).

The evolution of symptoms and therapeutic response in a group of have been followed parkinsonian patients 81 for a period of 4 years. Hoehn and Yahr, and Webster's scales have been used. In addition CT scan, EEG, ECG, blood and urine analyses have been carried out. Treatment was carried out with L-Dopa and decarboxylase inhibitor (benserazide for 50% of cases and carbidopa for the other 50%). Anticholinergics (esp. metixene) were often required. The initial response was satisfactory for all patients except one who had hydrocephalus (with normal pressure). Four years later, the initial improvement diminished by about 1/3. Side effects occurred in 80.24% of cases in the beginning, and in 82.50% of cases after 4 years. Dyskinesias, confusional state and "on-off" phenomenon increased with time, whereas gastric trouble diminished. CT scan were obtained in all patients and atrophic changes were found in 82.7%. There were no correlations between localization and severity of anatomical lesions on the one hand, and therapeutic response and side-effects on the other. It is suggested that the severity of the disease depends mainly on the degree of neurochemical integrity in the affected area rather then to the extent of anatomical lesions.