Parkinson's disease and carotid intima-media thickness.

UNLABELLED: Reports about the impact of cerebrovascular disease (CVD) on clinical status in Parkinson's disease (PD) are rather controversial. There have been a few studies and inconsistent results regarding the coincidence of Parkinson's disease (PD) and atherosclerotic diseases, such as cerebrovascular disease. Carotid intima-media thickness (IMT) is a known marker for subclinical atherosclerosis. AIM: This study was done to investigate the carotid IMT between PD patients and controls. MATERIAL AND METHODS: A total of 54 PD patients and 50 controls were examined. The duration of Parkinson's disease, the severity of Parkinson's disease (the Hoehn-Yahr stage) and carotid IMT were examined. RESULTS: The mean Hoehn and Yahr stage was 2.78 (range 2-4). Duration of disease had a mean of 7.59 +/- 0.85 years. The left CCA mean IMT was 0.900 +/- 0.147 in Parkinson group and 0.828 +/- 0.118 in control group (p = 0.007). The right CCA mean IMT was 0.891 +/- 0.176 mm in the Parkinson group and 0.860 +/- 0.164 in control group (p = 0.360). No relationship between the Hoehn and Yahr stages or the duration of PD with the IMT were found by the Pearson's correlation test. CONCLUSIONS: The carotid IMT was higher in PD patients than in controls.

[Secondary effects of chronic treatment with levodopa in Parkinson disease]. / Efecte secundare ale tratamentului cronic cu preparate de levodopa în boala Parkinson.

We have analysed the side effects of levodopa preparations in patients suffering from Parkinson's disease. The study has begun in 1993. All the patients were initially admitted in the Neurological Clinic of the Recovery Hospital in Iasi, and then followed in ambulatory condition. We have monitorized the apparition of adverse reactions of levodopa therapy, and tried to treat them by modifying doses and patterns of administration, by associating other drugs or by replacing levodopa with other drugs. We have initially included 116 patients, of whom 30 have developed secondary effects until June 2002. The most frequent secondary effects have been coreea, dystonia, mental adverse reactions, yo-yo-ing etc. Each one of the 30 patients has developed one or more types of secondary reaction.

[Recurrent unilateral inflammatory exophthalmos]. / Exoftalmie unilaterala inflamatorie recurenta.

The issue discusses the diagnosis difficulties concerning the case of 58-years-old woman who was watched for a recurrent exophthalmos after a mild conjunctival trauma. The debut was orbital cellulite appearance, complicated by a nonaxial exophthalmos due to a dacryoadenitis. The exophthalmos is axial in the other two recurrences. All exophthalmic episodes progressed with inflammatory features associated with optic neuritis and oculomotor nerves implication without any neurological signs. The paraclinical tests (ECHO, orbital radiography, CAT) find inflammation of orbital elements: extrinsic muscles and lacrimal gland. Biochemical tests showed minimal inflammatory changes without be able to provide the positive diagnosis. Initial combined therapy (antibiotics and steroids), then steroid monotherapy had favorable response.

[Stimulation modalities in the study of visual evoked potentials]. / Modalitati de stimulare în studiul potentialelor evocate vizuale.

An evoked potentials (EPs) is an electrical manifestation of the brain's reception of and response to an external stimulus. The classification of visual evoked potentials (VEPs) depend primarily on stimulus characteristics. The visual content of a stimulus can be divided into two types: patterned and diffuse. VEPs to patterned stimuli are due mainly to the density of light and dark contrast borders; VEPs to diffuse light flashes are due to change in luminance only. Transitions between light and dark pattern elements have sharp borders in checkerboard patterns and in bar gratings. Those transitions can be represented by a spatial square wave. In sine wave gratings the change of luminance between light and dark stripes is gradual. The visual angle describes the size of the image of one light or dark element. The spatial frequency equals the number of repetitions of one light plus one dark element.

[The clinical, imaging and electrophysiological correlations in Paget's disease]. / Corelatii clinice, imagistice si electrofiziologice în boala Paget.

The work presents two cases of Paget disease with a complex neurological description. The first case, a woman of 59 years, presents a spastic paraparesis with multiple syndrome of cranial nerves. The second case, a woman of 60 years, presents a spastic tetraparesis with myoclonus. The cranial radiography stood out to both patients the thickness of the bones of the skull in the context of the existence of some grown titres of the alkaline phosphate. The examination CT to the second patient indicates an important cerebral atrophy. Auditory evoked potentials (AEPs) show to the first patient the increasing in time of the latency of the first wave and to the second patient the inequality of latency from the right to left a wave I and the growing latency of the interval I-III to the left. Visual evoked potentials (VEPs) to the second patient indicate the delay of all the component parts. If the radiological examination asserts the diagnosis, the electrophysiological probings diagnose the complications and the evolution of the disease.

[The imaging and electrophysiological correlations in lateral homonymous hemianopsia of vascular origin]. / Corelatii imagistico-electrofiziologice în hemianopsia homonima laterala de cauza vasculara.

This paper presents 7 cases of patients suffering of lateral homonymous hemianopia. This diagnosis was established taking into account both the clinical exam as well as the visual field, into the context of a vascular suffering of hemiparesis type. I worked with a Bioscript BST 2100 apparatus foreseen with flash and with its help there could have been recorded the visual evoked potentials (VEPs) with electrodes occipitally placed. The analysis of VEPs was made in the correlations with the premises and the extend of the cerebral lesion. The imaging exploration stood out lesions with the following localisations: stretched hemispherically, internal capsule, thalamus, occipitally. The VEPs recordings showed: the small N1 + leveling, the leveling of the whole tract, bifid N1 + leveling, invertit N1 + leveling, diminished N1. The study of the correlation between the lesion premises and the aspect of VEPs led to the idea that waves N1 and P1 represent different functions of the process of the visual stimulations rather than activities in distinct cortical areas.