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1.
Neurol Sci ; 27(5): 340-4, 2006 Nov.
Article in English | MEDLINE | ID: mdl-17122944

ABSTRACT

The aim of the present paper was to describe some formative projects on work integration of patients with epilepsy and mild cognitive deficits, so that similar initiatives may be promoted. The different phases of the formative projects were described: the inclusion criteria, the selection of participants, the assessment instruments, the courses themselves and the final results in terms of working experience. Thirteen participants were selected for each course. Patients were treated in different Lombardy Epilepsy departments, which addressed them to the Epilepsy Center, S. Paolo Hospital, Milan, where the selection took place. Seventy percent of the participants in the formative courses found a job in 1 year, even though most of the positions were temporary. The work integration seemed to be mainly related to the level of intelligence and to verbal memory. We stress the importance of organising similar courses in the future, in the context of wider networks. This will help more patients in acquiring both economic and psychological autonomy from their families.


Subject(s)
Cognition Disorders/etiology , Educational Measurement , Epilepsy/physiopathology , Epilepsy/psychology , Program Evaluation , Adult , Epilepsy/epidemiology , Female , Humans , Italy/epidemiology , Male , Neuropsychological Tests/statistics & numerical data
2.
Neurol Sci ; 27(6): 381-96, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17205223

ABSTRACT

In this study, a series of tests exploring long-term verbal memory (the Short Story Test), attention (a modified version of Attentional Matrices and the Trail Making Test) and frontal functions (a modified version of the Frontal Assessment Battery) have been standardised on an Italian population of 283 children aged 5-14. Raw scores for each test have been adjusted for a series of variables (child's age, years of parents' education, handedness, gender) and transformed in equivalent scores enabling direct comparison across measures. This study was promoted by LICE (the Italian League Against Epilepsy) in order to provide Italian instruments standardised on the developmental age population and to study some of the most frequently impaired cognitive functions in epilepsy.


Subject(s)
Attention , Cognition Disorders/diagnosis , Epilepsy/complications , Frontal Lobe/physiology , Memory , Neuropsychological Tests , Adolescent , Adolescent Development , Child , Child Development , Child, Preschool , Cognition Disorders/etiology , Female , Humans , Italy , Male , Mass Screening/methods , Mass Screening/standards , Neuropsychological Tests/standards , Reproducibility of Results
3.
Acta Neurol Scand ; 109(3): 232-5, 2004 Mar.
Article in English | MEDLINE | ID: mdl-14763964

ABSTRACT

We report on two siblings who presented with juvenile myoclonic epilepsy, and in whom myoclonic jerks of the right arm and hand were also triggered by writing tasks. Both patients underwent intensive video-electroencephalography monitoring, with simultaneous neuropsychological tests. In both patients, reflex epileptic myoclonus was more easily triggered by writing that required a higher degree of concentration. Conversely, other cognitive tasks, such as reading, typing, thinking, or calculation never elicited any seizures or myoclonus. Valproate was effective in controlling both spontaneous and reflex epileptic seizures. The results of this study further support the notion that 'praxis-induced' reflex epilepsy precipitated by specific stimuli occurs in the context of idiopathic generalized epilepsy. Our results also illustrate that writing tasks are more effective in eliciting seizures when they require higher levels of concentration and mental elaboration.


Subject(s)
Epilepsy, Reflex/genetics , Myoclonic Epilepsy, Juvenile/genetics , Adolescent , Adult , Anticonvulsants/therapeutic use , Attention/physiology , Electroencephalography/drug effects , Epilepsy, Reflex/diagnosis , Epilepsy, Reflex/drug therapy , Epilepsy, Reflex/physiopathology , Evoked Potentials/drug effects , Evoked Potentials/physiology , Female , Handwriting , Humans , Myoclonic Epilepsy, Juvenile/diagnosis , Myoclonic Epilepsy, Juvenile/drug therapy , Myoclonic Epilepsy, Juvenile/physiopathology , Neuropsychological Tests , Parietal Lobe/drug effects , Parietal Lobe/physiopathology , Psychomotor Performance/physiology , Temporal Lobe/drug effects , Temporal Lobe/physiopathology , Treatment Outcome , Valproic Acid/therapeutic use , Video Recording
4.
Epileptic Disord ; 3(3): 143-6, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11679306

ABSTRACT

We report on a patient with a left frontal lesion who, many years after an injury, developed non-fluent aphasia and facial myoclonic jerks triggered by speaking and listening to spoken language. At age 57, the patient first noted that he would begin to stutter when delivering lectures at conferences. The stuttering would worsen if he continued talking. The video-polygraphic EEG recording shows brief paroxysms of spikes and polyspikes, followed by a slow wave, more evident in the left fronto-temporal region. The myoclonic jerks originating from the submental area correlate with EEG abnormalities. Clinically, these jerks determined a form of stuttering. The triggering factors were reading, speaking and listening to spoken language. This case had several characteristic features: facial myoclonus was the only seizure type experienced by the patient; the seizures and language impairment had a very late onset--about 50 years after the traumatic event that produced a dramatic lesion in the left fronto-polar region. (Published with videosequences.)


Subject(s)
Epilepsies, Myoclonic/physiopathology , Epilepsy, Post-Traumatic/physiopathology , Epilepsy, Reflex/physiopathology , Speech Perception/physiology , Stuttering/physiopathology , Verbal Behavior/physiology , Aphasia, Broca/diagnosis , Aphasia, Broca/physiopathology , Dominance, Cerebral/physiology , Electroencephalography , Epilepsies, Myoclonic/diagnosis , Epilepsy, Post-Traumatic/diagnosis , Epilepsy, Reflex/diagnosis , Evoked Potentials/physiology , Facial Muscles/innervation , Frontal Lobe/injuries , Frontal Lobe/physiopathology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Stuttering/diagnosis
6.
Eur J Neurol ; 8(6): 613-20, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11784346

ABSTRACT

The aim of the study is to evaluate the correlation between subjective memory complaints and neuropsychological tests in the epilepsy population. We administered a Self Report Memory Questionnaire, based on possible everyday memory failures, two questionnaires on anxiety and depression and a battery of cognitive tests to 150 patients with epilepsy (n=100 with partial epilepsy, n=50 with idiopathic generalized epilepsy) and a control group (n=50). A discrepancy between the results of the memory questionnaire and the cognitive tests was found in the epilepsy patients: the Self Report Memory Questionnaire did not show any correlation with the psychological tests. The same discrepancy was not seen in the controls, where the memory questionnaire was related to two verbal memory tests. Furthermore, patients with epilepsy reported greater difficulties on the Self Report Memory Questionnaire than the controls (P < 0.05). It appeared that the tendency to overstate memory problems was mainly related to anxiety and depression, but was not connected with the type of epilepsy, nor with its duration (in years). Seizure frequency, on the other hand, seemed to greatly influence mood, which in turn is probably affect subjective memory perception.


Subject(s)
Epilepsy/psychology , Memory Disorders/psychology , Perception , Adult , Female , Humans , Linear Models , Male , Memory , Neuropsychological Tests , Surveys and Questionnaires
7.
Respir Med ; 94(8): 742-9, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10955748

ABSTRACT

Recently published research contends that anxiety and depression are more common in asthmatic patients than in the general population. Particular psychological profiles could even be a risk factor contributing to deaths caused by asthma. The purpose of our research was to evaluate the anxiety and depression level in a population of 80 asthmatic patients who were treated in our department, and to judge whether data collected on psychological profiles of these asthmatic patients can be of any significance when dealing with their pathology. The study consisted of 40 patients suffering from chronic viral hepatitis B or C, and 40 healthy subjects who served as a control group. Both sets of patients were homogeneous with regard to sex, age and education. All subjects were tested for anxiety and depression levels with the S.T.A.I. and Zung questionnaires. A structured questionnaire was employed to assess the daily approach to living with the disease only in asthmatic patients. The anxiety and depression levels were noticeably higher in asthmatic patients than in patients with chronic liver disease and healthy subjects. In particular, 34 asthmatic patients scored higher than the S.T.A.I. cut-off (40/80) and 27 attained the same results in the Zung questionnaire. Results from the asthmatic population and healthy subjects illustrated that women had a higher incidence of anxiety and depression compared to men, although no statistically significant relationship between sex and questionnaire results was apparent in patients with liver disease. In the year before assessment, hospitalization and emergency treatment due to asthmatic exacerbation was correlated in females with a high incidence of anxiety. Additionally, the asthmatic population's level of education is significantly related to the incidence of anxiety and depression. With higher education, incidence of depression and anxiety decreased. This result was not apparent in control groups. The results of our study were: (1) we confirmed that asthmatic pathology is associated with an increase in incidence of anxiety and depression, whose presence and seriousness should be taken into consideration in therapeutic programmes when dealing with a patient; (2) we indicated that a specific approach towards therapy is crucial when dealing with an asthmatic patient; (3) we suggested how important it is to identify categories of patients that require more care because of their psychological profile. These findings should provide for the optimal use of informational resources with important applications for educational programmes and the future treatment of the asthmatic population.


Subject(s)
Asthma/psychology , Adult , Anxiety/psychology , Asthma/physiopathology , Asthma/therapy , Chronic Disease , Depressive Disorder/psychology , Female , Forced Expiratory Volume/physiology , Hepatitis B/complications , Hepatitis C/complications , Humans , Linear Models , Male , Peak Expiratory Flow Rate/physiology , Sex Distribution , Surveys and Questionnaires
8.
Epilepsia ; 40(4): 453-61, 1999 Apr.
Article in English | MEDLINE | ID: mdl-10219271

ABSTRACT

PURPOSE: MRI volumetric measurements (MRIvol) have been proven reliable in determining mesial temporal atrophy in patients with TLE. We attempted to correlate the clinical features with different patterns of hippocampal formation (HF) and amygdala (AM) atrophy in patients with TLE without foreign tissue lesion. METHODS: We studied 65 patients with refractory TLE. They were divided into five groups according to MRIvol results: pure AM atrophy (n = 11, 10 unilateral and one bilateral), unilateral HF atrophy (n = 16), bilateral HF atrophy (n = 12), unilateral AM + HF atrophy (n = 13), and patients with normal volumes of AM and HF (n = 13). MRIvol of AM and HF were performed by using a protocol previously described by Watson et al. (Neurology 1992;42:1743-50). RESULTS: Patients with AM atrophy had later onset of seizures compared with those with unilateral HF atrophy (p < 0.01). History of febrile convulsions (p < 0.0001) and frequent secondarily generalized tonic-clonic seizures (GTCSs) were more often found in patients with HF atrophy compared with those with pure AM atrophy and those with normal volumes (p = 0.04). Prolonged postictal confusion was more often found with AM atrophy (p = 0.05). Memory impairment was more severe in patients with HF atrophy than in those with AM atrophy only or in those with normal volumes (p = 0.03). There were no significant differences among the five groups in the following parameters: age, duration of epilepsy, seizure frequency, and presence and type of aura. CONCLUSIONS: Prolonged postictal confusion appeared to be related to AM atrophy, in keeping with previous clinical observations. These patients also had a lower incidence of early febrile convulsions, older age at epilepsy onset, lower frequency of secondary GTCS, and lesser memory dysfunction compared with patients with hippocampal atrophy.


Subject(s)
Amygdala/pathology , Epilepsy, Temporal Lobe/diagnosis , Magnetic Resonance Imaging , Adolescent , Adult , Age of Onset , Amygdala/surgery , Atrophy , Biomarkers , Comorbidity , Confusion/diagnosis , Electroencephalography/statistics & numerical data , Epilepsy, Temporal Lobe/epidemiology , Epilepsy, Temporal Lobe/pathology , Functional Laterality , Hippocampus/pathology , Hippocampus/surgery , Humans , Incidence , Memory Disorders/diagnosis , Memory Disorders/epidemiology , Middle Aged , Neuropsychological Tests , Seizures, Febrile/diagnosis , Seizures, Febrile/epidemiology , Treatment Outcome
9.
Epilepsia ; 39(9): 942-51, 1998 Sep.
Article in English | MEDLINE | ID: mdl-9738673

ABSTRACT

PURPOSE: The chromosome 20 ring [r(20)] is a rare chromosomal disorder without clear phenotypical markers. We describe the electroclinical pattern in a group of patients with r(20). METHODS: We observed 3 patients (a boy, patient 1; his mother, patient 2; and an unrelated man, patient 3), performing prolonged video-EEG and cytogenetic studies and fluorescent in situ hybridization (FISH) with chromosome-specific telomeric probes. RESULTS: All 3 patients had a very similar abnormal electroclinical pattern characterized by long bursts or trains of rhythmic theta waves, which were sharply contoured or had a notched appearance (with no detectable clinical correlate), and generalized spike waves (SW) associated with seizures of probable frontotemporal origin (SFT). In all 3 patients, the cytogenetic analysis of T lymphocytes showed mosaicism with a normal cell line and a second cell line with a chromosome 20, although the latter was little represented in patients 2 and 3. A few cells with a single chromosome 20 were also found. The same cytogenetic findings were confirmed in the lymphoblastoid cell line of patient 1 and in the fibroblasts of patient 3. FISH with chromosome-specific telomeric probes and TTAGGG sequences demonstrated the integrity of the ring chromosomes. CONCLUSIONS: The clinical picture of these patients appears to be related to the instability of the r(20)-generating cells monosomic for chromosome 20 and is thus haploinsufficient for a gene. In these patients, the electroclinical pattern of theta waves (probably unrelated to epilepsy) and the SW and SFT, even with mild mental retardation (MR) or no MR and without dysmorphic features, suggest that the r(20) syndrome may be present.


Subject(s)
Chromosomes, Human, Pair 20/genetics , Electroencephalography/statistics & numerical data , Ring Chromosomes , Seizures/diagnosis , Adolescent , Adult , Chromosome Aberrations/diagnosis , Chromosome Aberrations/genetics , Chromosome Disorders , Chromosome Mapping , Epilepsy/diagnosis , Epilepsy/genetics , Humans , In Situ Hybridization , Intellectual Disability/genetics , Male , Repetitive Sequences, Nucleic Acid , Seizures/genetics , Syndrome , Telomere
16.
Int Surg ; 76(3): 149-53, 1991.
Article in English | MEDLINE | ID: mdl-1938202

ABSTRACT

Changing attitudes to animals in research and practical considerations prompted the authors to evaluate whether the pig might be a suitable substitute for dog and baboons for single left lung transplants. Twenty-nine paired pigs were used. The first transplants on 13 pairs (group 1) were done to adapt the lung transplant technique to pigs; later transplants on 16 pig pairs (group 2) were done to evaluate operative survival, and function and histological modifications of the transplanted lung in the absence of immunosuppressive treatment. Surgical and anesthetic techniques for both donor and recipient are described in detail. The survival rate in group 2 was 68%. Hemodynamic and blood gas changes were assessed during operation. PaO2 did not drop significantly after occluding the right pulmonary artery by an inflatable cuff placed around it; this suggests that the function of the transplanted lung was preserved. The pigs were put down on the third postoperative day. Vascular and bronchial anastomoses were patent and intact, but the transplanted lung was macroscopically and microscopically altered. Lung transplants can be performed in pigs and the transplanted lung seems to be capable of functioning immediately after the operation. Alteration in the lung after 3 days is probably due to rejection.


Subject(s)
Lung Transplantation/physiology , Swine , Animals , Feasibility Studies , Female , Graft Rejection , Lung Transplantation/methods , Transplantation, Homologous
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