Lifetime prevalence of Bell's palsy in rural Bolivia: a door-to-door survey.

We carried out a door-to-door survey in rural areas of the Cordillera Province, Bolivia, to determine the prevalence of the most common neurological diseases in a sample of about 10,000 inhabitants. A team of non-doctor health workers administered a standard screening instrument for neurological diseases, a slightly modified version of the World Health Organization protocol. All subjects found positive at the screening phase underwent a complete neurological examination. On screening, we found 1,130 positive subjects, of whom 909 were aged 15 years and above. After the neurological examination, we found 52 cases who had experienced Bell's palsy during their life in the population aged 15 years and above. The lifetime prevalence on November 1, 1994 was 11.1/1,000 (95% confidence interval 7.8-14.5) for the population aged 15 years and above. The prevalence was higher in women than in men (13.7 and 8.7/1,000, respectively) and increased with age, reaching a peak in the group aged 65 years or more (31.7/1,000). Only 3 cases (5.8%) had received medical therapy.

Prevalence and incidence of multiple sclerosis in Catania, Sicily.

OBJECTIVE: An epidemiologic survey was conducted to determine the prevalence and incidence of MS in the city of Catania, Sicily, Italy. Prevalence rate was calculated as point prevalence at January 1,1995, and incidence during 1974 to 1995. METHODS: The authors studied the frequency of MS in the community of Catania in a population of 333,075 inhabitants according to the 1991 census. The primary sources for the case ascertainment were the neurologic and motor rehabilitation departments, the MS Center, the Italian MS Association, private neurologists, and family doctors. All patients who satisfied the Poser criteria for clinically definite MS, laboratory-supported definite MS, clinically probable MS, and laboratory-supported probable MS were considered prevalent and incident cases. RESULTS: One hundred ninety-five patients with MS who had had the onset of disease on prevalence day in a population of 333,075 inhabitants were detected. The prevalence rate was 58.5 per 100,000 (95% CI 50.7 to 67.5). Prevalence was higher in women (62.0/100,000) than in men (54.8/100,000). The age-specific prevalence showed a peak in the group aged 35 to 44 (145.1/100,000). From 1975 to 1994, 170 subjects with MS had the clinical onset of the disease. The mean annual incidence was 2.3 per 100,000 (95% CI 2.0 to 2.6). Age-specific incidence showed a peak in the group aged 25 to 34 (6.32/100,000). Incidence for 5-year intervals increased from 1.3 during 1975 to 1979 to 3.9 during 1990 to 1994. CONCLUSIONS: These prevalence and incidence rates are close to those reported in other similar surveys carried out in Italy and southern Europe.

[Spectral analysis of EEG signals in Alzheimer's disease]. / Analisi spettrale dei segnali EEG nella malattia di Alzheimer.

UNLABELLED: Alzheimer's disease (AD) represents the most frequent cause of senile dementia in Western countries. The disease has a slow onset and gradual progress. Over the past few years considerable importance has been attributed to the diagnostic techniques of brain imaging able to highlight morphological and functional images. EEG mapping is one of the most widely used methods. METHODS: The authors evaluated the characteristics of EEG mapping in relation to frequency and amplitude in a group of elderly patients with AD and in a group of healthy elderly control subjects. The former group consisted of 10 patients with AD aged between 65 and 83 years old. The control group included 10 healthy subjects who were matched for age and sex. RESULTS: The spectral analysis of EEG signals relating to frequency and amplitude showed a slowing down of underlying activity in AD patients, with a frequency between 1 and 4 c/sec, amplitudes below 5 microW and no arrest reaction. In healthy subjects spectral analysis showed a signal percentage colocated at a frequency of between 8 and 13 c/sec in relation to frequency. CONCLUSIONS: In view of these results, the authors recommend the use of EEG mapping to complete the diagnosis of Alzheimer's disease in the aged.

[Study of mapped slow auditory evoked potentials in Alzheimer's disease]. / Studio dei potenziali evocati lenti mappati uditivi nella malattia di Alzheimer.

BACKGROUND: Alzheimer's disease affects around 500,000 persons in Italy and its diagnosis remains essentially clinical. Our aim was to contribute to the diagnosis of Alzheimer's disease by mapping auditory evoked potentials (AEP). Evoked potentials represent the electric response of the CNS to an external stimulus and can be represented as a sequence of waves. Brain mapping allows a chromotopogram to be compiled showing chromatic maps. METHODS: A group of 12 patients were studied aged between 68 and 84 years old who were referred to our attention at the Department of Geriatrics and Gerontology at Catania University and the A.O. Cannizzaro, Geriatrics Unit. All patients completed an assessment form (MM-SE, ADAS) and underwent brain NMR and AEP. RESULTS: These tests enabled us to identify two types of patients (Group A and Group B) based on the responses shown. The overall evaluation of results revealed that patients with Alzheimer-type dementia present an anomalous cortical neurogenic response to mapped AEP, and that patients in Group A showed anomalous wave morphology, latency and localisation and asymmetric impregnation. The data gathered in this study did not confirm any specific characteristics of AEP given that similar anomalies are found in metabolic dysfunction syndromes and demyelination pathologies. CONCLUSIONS: However, while it does not constitute a specific technique for screening against Alzheimer's disease, the mapping of AEP may contribute to the diagnosis of this disease.

Mapped auditory evoked potentials before and after interferon treatment.

Neurotoxicity induced by interferon (IFN) is revealed by neurobehavioral changes, such as irritability, somnolence, lack of motivation, and delayed ideation. As these side effects persist throughout IFN-alpha treatment, we studied cerebral mapped auditory evoked potentials (MAEP) in 20 hepatitis C virus antibody (HCV Ab)-positive chronic active hepatitis patients before and after administration of leukocyte IFN-alpha (i.m. 3,000,000 IU). Some of the main components of MAEP, such as morphology, latency, and power spectra, were altered before IFN injection. These parameters changed 7 h after administration as revealed by increased quality and quantity of acoustic signal reaching the brain cortex and appearance of physiologic waves in patients with mild/intermediate liver disease. These effects revealed 48 h after IFN administration.

Clinical and serological identification of 2 forms of complete heart block in children.

OBJECTIVE: To study the association of maternal antibodies to Ro(SSA) and/or La(SSB) with isolated complete congenital heart block (CCHB) in children according to the child's age at detection. METHODS: Sera from 17 mothers of 18 children with CCHB of unidentified cause were studied. Autoantibodies were measured by double immunodiffusion, enzyme linked immunosorbent assay (ELISA), Western blot, and immunoprecipitation from cell extracts. Statistical analysis used the chi 2 test with Yates' correction. RESULTS: CCHB was diagnosed in 12 children of 11 mothers before the age of 3 mo (Group A) and in 6 children of 6 mothers after the age of 17 mo (Group B). Seven Group A mothers and no Group B mother had connective tissue disorders; autoantibodies were found in 9/11 Group A and in 1/6 Group B mothers (p < 0.01). Eight Group A children needed a pacemaker and one other died of cardiac insufficiency, whereas only one of the 6 Group B children needed a pacemaker. Interestingly, this latter child was the only one from Group B whose mother's serum contained autoantibodies. Irrespective of their age at diagnosis, the children with CCHB who needed a pacemaker and the one who died were born to mothers with autoantibodies (p < 0.001). CONCLUSION: CCHB detected before the age of 3 mo is highly associated with the presence of anti-Ro(SSA)/La(SSB) in the mothers, while CCHB diagnosed later is generally not. For epidemiological studies, the former type should be considered early onset as opposed to late onset CCHB in the latter type. Establishing this clinicoserological distinction is also important for the children, since it alerts the clinician to a more severe prognosis (necessity of a pacemaker), even in the rare occurrence of late diagnosed CCHB.