- Email: [email protected]
Transcranial Doppler assessment of cerebral haemodynamics in patients with carotid occlusion
58P
SocieQ
potentials did not show any significant decrease when stimulus repetition frequency changed from 2 to 7.5 Hz. P60 showed an attenuation of the amplitude only at 7.5 Hz. Latency and scalp topographies of all cortical components examined remained unchanged for the 3 stimulus rates tested. The optimal stimulus rate for mapping of tibia1 nerve SEPs was lower than 5 Hz. The distinct recovery function of the contralateral N37-P50 and ipsilateral P37-NSO responses is one argument to show that these potentials arise from separate generators. 16.
Transcranial Doppler assessment in patients with carotid occlusion. Pellgrini, S. Milanta, D. Giorgi, ogy, Pisa)
of cerebral baemodynamics - G. Orlandi, L. LanducciR. Galli (Institute of Neurol-
Proceedings ual quantization. We programmed in Basic graphics for a Commodore, obtaining two red and green luminous targets on a TV monitor, The subject, weraing spectacles with red and green lens, has to put the varable target on the fixed one using a joystick and the TV monitor automatically shows the degree of disalignment either horizontally or verttally. With this method, it is possible to examine ocular disalignment in all the cardinal positions. We studied 20 normal subjects and 5 myasthenic patients examined in the morning, in the late afternoon and after a pharmacological test with Prosthygmin. The disalignment variability was negligible in normal subjects, while in myasthenic subjects there were important oscillations of the disalignment in different cardinal positions. 19.
Forty-three patients with unilateral carotid after occlusion were investigated and analyzed separately in 3 groups on the ground of the symptoms: I I patients were asymptomatic (Group I), 1 presented TIA (Group 2) and 15 stroke (Group 3). All the patients were investigated by means tram-Doppler (Multidop X-TCD7) in order to document eventual intracranial blood supply circles through the ophthalmic artery, the anterior communicating artery and the posterior communicating artery. Besides the mean flow velocity (MFV) values and the vasomotor activity, variations of the PaC02 induced through the apnoea test on the middle cerebral artery (MCA) were evaluated bilaterally. In the Group I all the patients showed at least two blood supply arteries that always included the anterior communicating artery; the cases the MFV values on the MCA on the same side as the occlusion was normal (>38 cm/s), whereas the MFV increase during the apnoea test was normal (>30%) in 8 patients and reduced (~20%) in 3 patients. None of the patients in Groups 2 and Group 3 showed more than two blood supply arteries for each; a simultaneous blood supply through the anterior communicating artery and the posterior artery was observed. In Group 2 the MFV values on the MCA on the same side as the occlusion were reduced (<3X cm/s) in 6 patients and normal in I1 patients, whereas the vasomotor reactivity during the apnoea test was reduced (~20%) in I2 patients and normal in 5 patients. In Group 3 the MFV values were reduced in 11 patients and normal in 4 patients, whereas in all cases a reduced vasomotor reactivity during the apnoea test was observed. Therefore intracranial blood supply efficiency and normal values for mean flow velocity and vasomotor reactivity in patients with carotid artery occlusion are related to a better clinical outcome.
The majority of cases of multiple sclerosis (MS) have a relapsing-remitting course but sometimes there is a change into a progressive course The change has a marked effect on the prognosis and there is a debate about the fact that the two entities must or not be considered distinct. Thirteen patients (mean age 39.8 + 7.4, range 2752; mean EDSS 5.1 + 1.3) suffering from secondary chronic progressive MS underwent measurement of the cerebral MRI total area of demyelination, study of motor evoked potential (MEP) and evaluation of disability with the main aim of assessing possible correlations. Tl and T2 MRI contiguous images of 5 mm thickness were obtained (Magneton Siemens 1.5 T) to measure the total number (71.3 * 35.5) and total lesion area (4747.8 & 3633.2 mm2). Central conduction time (TCC) of MEP was 13.4 + 4.6 from upper limbs and 34.2 + 12.6 from lower extremities. All the patients showed abnormal TCC from both lower limbs and at least one upper limb. The fact that there is no evidence of correlation between cerebral total demyelination area, disability and evoked motor potentials give rise to some interesting hypotheses about pathophysiology of secondary chronic multiple sclerosis. 20.
17.
Ocular movements study in Stiffman bardi, L. Caniatti, V. Tugnoli, L. Quatrale, D. De Grandis (Neurological Hospital, Ferrara Italy)
syndrome. - R. BomSalvi, R. Eleopra, R. Department, S. Anna
We analyzed ocular movements in 3 patients with Stiffman syndrome and one with leucoencephalytis and rigidity; all of them presented anti-GAD antibodies. We studied smooth pursuit and saccadic movements vertically and horizontally. We used a Commodore 64 computer connected to a TV monitor. In all the patients we noticed more evident saccadic recoveries vertically during smooth pursuit. In all patients, saccadic movements showed a diffuse slowing down without clear hypometries. A patient showed a particular movement of the superior eyelid that. especially in the vertical smooth pursuit movement. showed small rhythmic oscillations (2-3 Hz) tending to extinguish. We conclude for a repeatable recorded of ocular movements abnormalities consisting in a velocity reduction of both the saccades and the smooth pursuit. This test in Stiffman syndrome proves an important ocular motility impaument. 18.
Computer approach for diplopy quantization. - R. Bombardi, V. Tugnoli, L. Salvi, R. Eleopra, R. Quatrale, D. De Grandis (Neurological Department, S. Anna Hospital, Ferrara, Italy) The variability
of ocular
disalignment
is difficult
to follow
by man-
Comparison between MRI total lesion area, motor evoked potentials and disability secondary chronic progressive multiple sclerosis. - D. Facchetti, R. Mai, A. Micheli, R. Gasparottia, N. Marcia&‘, R. Capra”, M. Polonib (‘Clinica del Lavoro’ Foundation, IRCCS, Medical Center of Rehabilitation of Gussago, Unit of Neurophysiology. Wniv. Brescia. bIII Clinica Neurologica, Univ. Milano, Ospedale S. Paolo, Milan)
Lamotrigine in severe epilepsy: neuropsychological evaluation. M.C.E. Maschio, G.L. Gigli, M. setti, F. Placidi and G. Bernardi Tor Vergata. “IRCCS S. Lucia,
computerized EEG study and - F. Spanedda, M.G. Marciani, Diomedi, F. Pauri”, M.A. Bas(Clinica Neurologica, Univ. Rome)
Whereas the clinical efficacy of lamotrigine (LTG) is well clarified, the effects on EEG and cognitive performances are less documented. At present, 14 epileptic patients with treatment-resistant partial seizures (5 females, 9 males, mean age 26.8 years) have been enrolled in this trial in order to monitor the effect of LTG on seizure frequency, on EEG paroxysmal abnormalities and background activity and on cognitive functions. A 24-h EEG monitoring, through video-telemetry system and neuropsychological evaluation were performed before and 3 months after starting LTG therapy. Specific computer programs allowed the quantification of ictal and interictal activities. The EEG background activity was evaluated by spectral analysis. Statistical evaluation of data included the analysis of variance (ANOVA one-way). Our preliminary results show a decrease in seizure frequency of >SO% in 8/14 patients; in the remainder the decrease was ~50%. Interictal activity was decreased or unmodified. About the EEG background activity the most relevant finding was a significant increase of fast activity (B I and 82). The neuropsychological tests demonstrated a significant improvement in long-term verbal memory. The neurophysiological and neuropsychological findings show that LTG, besides its clinical efficacy, seems to have a positive influence on cortical functions,
SocieQ
potentials did not show any significant decrease when stimulus repetition frequency changed from 2 to 7.5 Hz. P60 showed an attenuation of the amplitude only at 7.5 Hz. Latency and scalp topographies of all cortical components examined remained unchanged for the 3 stimulus rates tested. The optimal stimulus rate for mapping of tibia1 nerve SEPs was lower than 5 Hz. The distinct recovery function of the contralateral N37-P50 and ipsilateral P37-NSO responses is one argument to show that these potentials arise from separate generators. 16.
Transcranial Doppler assessment in patients with carotid occlusion. Pellgrini, S. Milanta, D. Giorgi, ogy, Pisa)
of cerebral baemodynamics - G. Orlandi, L. LanducciR. Galli (Institute of Neurol-
Proceedings ual quantization. We programmed in Basic graphics for a Commodore, obtaining two red and green luminous targets on a TV monitor, The subject, weraing spectacles with red and green lens, has to put the varable target on the fixed one using a joystick and the TV monitor automatically shows the degree of disalignment either horizontally or verttally. With this method, it is possible to examine ocular disalignment in all the cardinal positions. We studied 20 normal subjects and 5 myasthenic patients examined in the morning, in the late afternoon and after a pharmacological test with Prosthygmin. The disalignment variability was negligible in normal subjects, while in myasthenic subjects there were important oscillations of the disalignment in different cardinal positions. 19.
Forty-three patients with unilateral carotid after occlusion were investigated and analyzed separately in 3 groups on the ground of the symptoms: I I patients were asymptomatic (Group I), 1 presented TIA (Group 2) and 15 stroke (Group 3). All the patients were investigated by means tram-Doppler (Multidop X-TCD7) in order to document eventual intracranial blood supply circles through the ophthalmic artery, the anterior communicating artery and the posterior communicating artery. Besides the mean flow velocity (MFV) values and the vasomotor activity, variations of the PaC02 induced through the apnoea test on the middle cerebral artery (MCA) were evaluated bilaterally. In the Group I all the patients showed at least two blood supply arteries that always included the anterior communicating artery; the cases the MFV values on the MCA on the same side as the occlusion was normal (>38 cm/s), whereas the MFV increase during the apnoea test was normal (>30%) in 8 patients and reduced (~20%) in 3 patients. None of the patients in Groups 2 and Group 3 showed more than two blood supply arteries for each; a simultaneous blood supply through the anterior communicating artery and the posterior artery was observed. In Group 2 the MFV values on the MCA on the same side as the occlusion were reduced (<3X cm/s) in 6 patients and normal in I1 patients, whereas the vasomotor reactivity during the apnoea test was reduced (~20%) in I2 patients and normal in 5 patients. In Group 3 the MFV values were reduced in 11 patients and normal in 4 patients, whereas in all cases a reduced vasomotor reactivity during the apnoea test was observed. Therefore intracranial blood supply efficiency and normal values for mean flow velocity and vasomotor reactivity in patients with carotid artery occlusion are related to a better clinical outcome.
The majority of cases of multiple sclerosis (MS) have a relapsing-remitting course but sometimes there is a change into a progressive course The change has a marked effect on the prognosis and there is a debate about the fact that the two entities must or not be considered distinct. Thirteen patients (mean age 39.8 + 7.4, range 2752; mean EDSS 5.1 + 1.3) suffering from secondary chronic progressive MS underwent measurement of the cerebral MRI total area of demyelination, study of motor evoked potential (MEP) and evaluation of disability with the main aim of assessing possible correlations. Tl and T2 MRI contiguous images of 5 mm thickness were obtained (Magneton Siemens 1.5 T) to measure the total number (71.3 * 35.5) and total lesion area (4747.8 & 3633.2 mm2). Central conduction time (TCC) of MEP was 13.4 + 4.6 from upper limbs and 34.2 + 12.6 from lower extremities. All the patients showed abnormal TCC from both lower limbs and at least one upper limb. The fact that there is no evidence of correlation between cerebral total demyelination area, disability and evoked motor potentials give rise to some interesting hypotheses about pathophysiology of secondary chronic multiple sclerosis. 20.
17.
Ocular movements study in Stiffman bardi, L. Caniatti, V. Tugnoli, L. Quatrale, D. De Grandis (Neurological Hospital, Ferrara Italy)
syndrome. - R. BomSalvi, R. Eleopra, R. Department, S. Anna
We analyzed ocular movements in 3 patients with Stiffman syndrome and one with leucoencephalytis and rigidity; all of them presented anti-GAD antibodies. We studied smooth pursuit and saccadic movements vertically and horizontally. We used a Commodore 64 computer connected to a TV monitor. In all the patients we noticed more evident saccadic recoveries vertically during smooth pursuit. In all patients, saccadic movements showed a diffuse slowing down without clear hypometries. A patient showed a particular movement of the superior eyelid that. especially in the vertical smooth pursuit movement. showed small rhythmic oscillations (2-3 Hz) tending to extinguish. We conclude for a repeatable recorded of ocular movements abnormalities consisting in a velocity reduction of both the saccades and the smooth pursuit. This test in Stiffman syndrome proves an important ocular motility impaument. 18.
Computer approach for diplopy quantization. - R. Bombardi, V. Tugnoli, L. Salvi, R. Eleopra, R. Quatrale, D. De Grandis (Neurological Department, S. Anna Hospital, Ferrara, Italy) The variability
of ocular
disalignment
is difficult
to follow
by man-
Comparison between MRI total lesion area, motor evoked potentials and disability secondary chronic progressive multiple sclerosis. - D. Facchetti, R. Mai, A. Micheli, R. Gasparottia, N. Marcia&‘, R. Capra”, M. Polonib (‘Clinica del Lavoro’ Foundation, IRCCS, Medical Center of Rehabilitation of Gussago, Unit of Neurophysiology. Wniv. Brescia. bIII Clinica Neurologica, Univ. Milano, Ospedale S. Paolo, Milan)
Lamotrigine in severe epilepsy: neuropsychological evaluation. M.C.E. Maschio, G.L. Gigli, M. setti, F. Placidi and G. Bernardi Tor Vergata. “IRCCS S. Lucia,
computerized EEG study and - F. Spanedda, M.G. Marciani, Diomedi, F. Pauri”, M.A. Bas(Clinica Neurologica, Univ. Rome)
Whereas the clinical efficacy of lamotrigine (LTG) is well clarified, the effects on EEG and cognitive performances are less documented. At present, 14 epileptic patients with treatment-resistant partial seizures (5 females, 9 males, mean age 26.8 years) have been enrolled in this trial in order to monitor the effect of LTG on seizure frequency, on EEG paroxysmal abnormalities and background activity and on cognitive functions. A 24-h EEG monitoring, through video-telemetry system and neuropsychological evaluation were performed before and 3 months after starting LTG therapy. Specific computer programs allowed the quantification of ictal and interictal activities. The EEG background activity was evaluated by spectral analysis. Statistical evaluation of data included the analysis of variance (ANOVA one-way). Our preliminary results show a decrease in seizure frequency of >SO% in 8/14 patients; in the remainder the decrease was ~50%. Interictal activity was decreased or unmodified. About the EEG background activity the most relevant finding was a significant increase of fast activity (B I and 82). The neuropsychological tests demonstrated a significant improvement in long-term verbal memory. The neurophysiological and neuropsychological findings show that LTG, besides its clinical efficacy, seems to have a positive influence on cortical functions,