European neurology
-
Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind study of bromocriptine and L-dopa in de novo Parkinson's disease. Short-term results.
The first phase of a longitudinal multicenter study comparing bromocriptine and L-dopa (as Sinemet) as de novo therapy for Parkinson's disease using a double-blind randomized design has recently been completed. Over a period of 5.5 months, bromocriptine and L-dopa were equipotent in reducing functional and neurological disability. These observations complement and extend earlier studies and suggest a role for bromocriptine as de novo therapy of Parkinson's disease.
-
Randomized Controlled Trial Clinical Trial
Effect of vigabatrin (gamma-vinyl-GABA) on visual, brainstem auditory and somatosensory evoked potentials in epileptic patients.
Visual (V), somatosensory (S) and brainstem auditory (BA) evoked potentials (EPs) were determined in 22 epileptic patients, mostly with partial seizures, who received add-on treatment with vigabatrin (1-3 g/day, stratified according to body weight) and placebo, each given for 7 weeks according to a double-blind, randomized cross-over design. At pretreatment assessment, BAEPs and SEPs were found to be within normal limits in most of the patients tested, while for VEPs several abnormal responses were found, including a marked prolongation of P100 latency values in the majority of cases. ⋯ These results support the evidence that enhancement of GABA-ergic transmission does not substantially affect the functional state of afferent sensory pathways as assessed by EP analysis. The significance of these findings with respect to the safety of vigabatrin therapy is discussed.
-
Twenty-five children with post-hemiconvulsive hemiplegia, who had had epileptiform discharges on EEG, were followed for over 5 years. Twenty-two of them developed the hemiconvulsion-hemiplegia-epilepsy syndrome. The computed tomographic (CT) findings were: marked hemispheric atrophy in 13 cases; moderate or slight hemispheric atrophy in 4; focal atrophy or porencephaly in 4, and a normal scan in 4. ⋯ Epileptiform discharges on EEG were found on the ipsilateral side (the damaged hemisphere) in 13 cases, the contralateral side (the undamaged hemisphere) in 9, and on both sides in 3. As to the correlation between CT and EEG abnormalities, 8 of 13 cases with marked hemiatrophy on CT had contralateral epileptiform discharges on EEG, and the converse was more pronounced: 8 of 9 cases with contralateral epileptiform discharges had marked hemiatrophy on CT. Contralateral epileptiform EEG abnormalities were observed in the patient with severe hemispheric brain damage.
-
A sensory disturbance limited to the hand or fingers and the corner of the mouth both on the same side constitutes the cheiro-oral syndrome (COS). Six patients with typical COS are described; in 5 of them a well-circumscribed lesion was found at different brain sites. ⋯ The pathogenetic explanation of this peculiar sensory symptom complex is a matter of debate and a new hypothesis is formulated. We advocate that when COS is encountered, especially if a history of migraine is lacking, a thorough neurological workup is called for.