[Type I Arnold-Chiari malformation: diagnostic considerations in a case]. / La malformazione di Arnold-Chiari tipo I: considerazioni diagnostiche su un caso.

An 18-year-old patient with a 5-year history of periodic vertigo, headache and stiff neck is reported. Routine X-ray of the skull showed a mild form of basilar impression while the CT scan demonstrated only a tri-ventricular hydrocephalus. Without using the traditional invasive techniques, diagnosis of Chiari type I malformation was nonetheless clearly pointed out by magnetic resonance imaging of the posterior fossa and spinal cord. Diagnostic problems of this clinically ambiguous and uncharacterized syndrome are discussed.

[Therapeutic effects of trazodone in the treatment of tremor. Multicentric double-blind study]. / Effetti terapeutici del Trazodone nel trattamento del tremore. Studio policentrico in doppio cieco.

A 30 days therapeutical trial with trazodone has been performed in 47 patients suffering from different types of tremor. No significant improvement was detected in patients suffering from parkinsonian syndromes, multiple sclerosis, psycogenic tremor and hyperthyroidism. After the double-blind trial with trazodone, a significant improvement (p less than 0.025) was, instead, evident in 5 out of 6 patients with essential tremor, while the score did not change in the 3 patients with essential tremor who were treated with placebo.

Therapeutic effect of lisuride in advanced Parkinson's disease.

The therapeutic effects of lisuride hydrogen maleate, a central dopamine agonist, were examined in 15 patients with advanced Parkinson's disease no longer satisfactorily responding to levodopa. A significant improvement (p less than 0.01) in the total Parkinson's disease disability score was obtained by the addition of lisuride to levodopa therapy. The clinical assessment in the follow-up was performed with 2 different disability scales that yielded a more precise evaluation of the efficacy of lisuride, an efficacy that, as with other dopaminergic drugs, showed a slight decrease in time after a mean of 3 months. No important adverse effects were noticed. The only limitation of the use of lisuride was the occurrence of reversible psychic disturbances. It is concluded from this study that lisuride is a valuable tool in the management of advanced Parkinson's disease that allows for a reduction of the side effects of levodopa therapy in the long-term treatment of the disease.

[Catamnestic findings in syringomyelia in the province of Padua]. / Rilievi catamnestici sulla siringomielia in provincia di Padova.

While performing this research, 107 patients affected by syringomyelia were found, of which 35 were from the Padova province. The epidemiological study showed a progressive decrease of the disease in the last 40 years and a higher frequency in the rural area in comparison to the urban area. The data of prevalence in the region were also evaluated and compared with previous studies in other countries. The clinical studies, including a 20 years follow-up on a group of 25 patients, showed a slowly progressive impairment of the physical capacity without complete handicap, which had occurred in 2 of the group. The Authors suggest a constant clinical survey of these patients to encourage and support their social and professional activities.

[Currency of postencephalitic parkinsonism]. / Attualità del parkinson postencefalitico.

A case of postencephalitic parkinsonism is described. The patient, 27 years old, was affected by encephalitis lethargica 15 years prior to the appearance of the extrapyramidal syndrome on the right side of his body. Based on data in the literature, the possibility is discussed that postencephalitic parkinsonism may still be present and may manifest itself sporadically.

Wernicke-Korsakoff syndrome after subtotal gastrectomy.

A case of Wernicke-Korsakoff syndrome is a nonalcoholic patient after gastric surgery provides support for the theory that nutritional deficiencies play an important part in the pathogenesis of the disease.

[Apropos of delusions of grandeur in general paresis: considerations in 1 case]. / A proposito del delirio di grandezza nella demenza paralitica: considerazioni su un caso.

Nowadays diagnosis of neurosyphilis has become an infrequent event. Furthermore, the few patients studied have a clinical picture different from that described in the past. We report the clinical evolution of a patient with general paresis who suffered from delusions of grandeur, a clinical feature almost disappeared in these times. This mental disorder did not change after prolonged phenothyazines treatment. Among possible causes that made delusions of grandeur disappear in general paresis, remarkable improvements in therapy and major changes in social life should be considered.

The Prader-Willi syndrome: neuroendocrine study of identical twins.

Identical twins with the Prader-Willi syndrome are reported. Apart from hypogonadism, hypomentia, hypotonia and obesity, they presented shorter than normal stature and the peculiar facies of this syndrome. Both twins also suffered from arterial hypertension with secondary hyperaldosteronism, an abnormality never previously recorded. The endocrinological study showed the presence of hypogonadotrophic hypogonadism in both twins. The GnRH and clomiphene tests suggested a hypothalamic disorder. Although the vast majority of cases with the Prader-Willi syndrome are isolated, the expression of this disorder in two identical twins enhances the possibility of a genetic determination.

[Course of multiple sclerosis with and without corticosteroid therapy]. / Decorse della sclerosi multipla con o senza terapia corticosteroidea.

The course of multiple sclerosis in 186 patients had been studied at the Nervous and Mental Diseases Department - University of Padua - Italy. Among the 186 patients who have been followed, 93 have never been subjected to a corticosteroid oral therapy; the 93 other patients had undertaken an oral therapy with methyl-prednisolone. The seriousness of the course and the kind of evolution have been examined valuating the clinical observation. As regards the seriousness of the disease course, statistically significant differences between the two groups of patients have not been found. More considerable differences have been found for the kind of evolution.

[Muscular diseases: epidemiology of progressive muscular dystrophies]. / Malattie muscolari: l'epidemiologia delle distrofie muscolari progressive.

Epidemiology of muscular dystrophies has been important in the prevention of these diseases. In fact the genetic counselling, after a preliminary epidemiological investigation, reduced the incidence rate of Duchenne muscular dystrophy in the Veneto Region. Furthermore the new biochemical data on dismetabolic muscular diseases revealed a future strategy in the early identification of muscular dystrophies for their epidemiology and genetic prevention as well as for the new systems of research used in the field of muscular dystrophies.

[Development of multiple sclerosis with ocular onset as compared with other onset forms]. / Evoluzione della sclerosi a placche a inizio oculare a confronto con le forme a esordio diverso.

This work is to verify if multiple sclerosis started with a retrobulbar optic neuritis has a more favourable course, compared with the cases started with any other neurological symptomatology according to a large part of AA. We considered 47 cases of M.S. started with R.O.N. hospitalized in our Clinic from 1940 to 1975, controlled with two groups of 47 patients of the Clinic with M.S. without any ocular symptomatology. Any satisfactory information result from this inquiry to prognosticate a more favourable prognosis for the cases started with R.O.N.

[Achondroplasia is also a neurologic disease]. / L'acondroplasico è anche un malato neurologico.

The achondroplasics' ossification defect produce some changes of the spinal column of such a degree to cause a medullary compression. The AA. refer two cases of neurological complication hospitalized since 1960 in the Clinica delle Mlattie Nervose e Mentali - University of Padua. The clinical evolution of the two patients is considered and compared with the cases known in the Literature; the pathogenetic mechanisms of this disease and the therapeutical perspective are discussed too.

[Prognosis of myastenia (author's transl)]. / La prognosi della miastenia.

The authors refer to a follow up study on 83 cases of myasthenia ranging from 2 to 40 years duration. Cases of only two years duration were taken into consideration since the mortality from myasthenia occurs almost totally in the first few years of the disease. A favorable response to therapy occurred in approximately 66.7% of cases; 9.8% of which presented with a complete "restitutio ad integrum" with total suspension of all therapy, the remaining 56.9% presented with objective clinical improvement with reduction in dosage of anticholinesterase drugs. Death occur in approximately 24%. The outcome of cases treated by surgical intervention (thymectomy) is a function of the absence or presence of thymic hyperplasia or a thymoma: Good results occured in 64% of the cases. The data collected confirm other reports in the literature. In view of the number of observations a more optimisitic attitude toward myasthenic patients is justified. Some doubts are expressed as to the appropriateness of the adjective "gravis" by which Jolly catagorized myasthenia yet keeping in mind the seriousness of the disease.