[Involuntary movements]. / I movimenti involontari.

Any attempt to classify and to understand the basic mechanism underlying the neurological symptoms as pyramidal and/or sensitive, should start from the fundamental laws of nervous system functioning: 1) the law of reciprocal innervation of Sherrington; 2) the law of hierarchy of levels of Jackson and 3) the law of supersensitivity of deafferented structures of Cannon. Paresis on one side, Jacksonian jerks on the other side represent two opposite conditions known respectively as negative and positive symptoms of corticomotor involvement. Unluckly involuntary movements cannot be explained with these three laws. They are the clinical expression of the disorganization and disintegration of functions: a true disregulation unrespectful of laws and general principles. They must be considered as the result of conflicts of antagonist functions controlling each other, i.e. tremor, chorea, myoclonus, torsion spasm etc. The author emphasizes the clinical-descriptive aspect of the problem.

Musicogenic epilepsy.

The problem of musicogenic epilepsy is reconsidered by the author in the light of a case of temporal lobe seizures with secondary generalization precipitated by any type of music. The inclusion of musicogenic epilepsy in the chapter of reflex epilepsies is discussed and critizised by the author considering that music sets in motion too many structures and cannot be reduced to crude perception of rhythm and melodies. It is considered that three levels of integration are involved in music: a sensory level (the lowest one) an emotional and waking level (the second one) and finally a highest level, allowing aesthetic appreciation. It is the opinion of the author that musicogenic epilepsy has to do mostly with the limbic brain, that is with the second level of integration. Musicogenic epilepsy therefore should be better included in the dismissed chapter of affective epilepsy of Bratz.

Randomized double-blind study of flunarizine versus placebo in patients with chronic cerebrovascular disorders.

Chronic cerebrovascular disorders (CCVD), as defined by the 1980 Ad Hoc Committee in Paris, constitute both clinically and pathogenetically an extremely complex entity, characterized by a protean symptom pattern. The effects of a daily dose of 10 mg flunarizine orally on CCVD have been evaluated with a neuropsychological methodology during a three-month treatment period in a randomized double-blind study compared with a placebo. The results confirmed the effectiveness of the drug in the improvement of neurological, amnesic, attentive and behavioural symptoms, without evident side-effects even after a long-term treatment.

[Discrepancies between clinical and neurophysiological findings in vigilance disorders]. / Diskrepanzen zwischen klinischen und neurophysiologischen Befunden bei Vigilanzstörungen.

In spite of the fact that animal experimentation has demonstrated the importance of the reticular formation of brain stem in the maintenance of consciousness some discrepancies still exist concerning the localization of this function in man. 40 patients suffering from intracranial tumours localized in brain stem diencephalon and basal ganglia have been reviewed by authors. From this study it could be observed that expanding lesions involving only brain stem did not show troubles of awareness which were also very seldom observed in tumours involving brain stem and neighbouring structures. A higher incidence of troubles of awareness was observed in patients with tumours involving diencephalon and basal ganglia. Troubles of consciousness seemed unrelated with increase of intracranial pressure because this increase was observed frequently in the first two groups of patients where troubles of consciousness were not present while troubles were observed in 73,4% of patients where intracranial pressure was not increased. A short review of troubles of consciousness in brain stem lesions of traumatic, vascular, and tumoral origin has been made by the authors and the discrepancies between neurophysiological data and clinical events is stressed in the light of the fact that hemispheric tumours more frequently than brain stem tumours cause troubles of consciousness. The possibility of a telencephalization of consciousness regulation in man is considered by authors.

[Parkinson's disease and epilepsy: hypothesis of biological incompatibility]. / Maladie de Parkinson et épilepsie: hypothèse d'une incompatibilité biologique.

The case of a 74-year-old woman, affected since the age of 20 by generalized convulsive fits and who began to show at the age of 63 signs of Parkinson's disease is reported. The epileptic features showed no change while Parkinson's disease got worse. Further, every convulsive fit was followed by a transitory improvement of the extrapyramidal disorders. After a review of the literature on the rare association of Parkinson's disease with epilepsy, the hypothesis of a biological incompatibility between the two diseases is considered.

[Generalized epilepsies]. / Le epilessie generalizzate

Short revaluation of present status of the concept of primary and secondary generalized epilepsy and of neurophysiopathological differences supporting such distinction.