Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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Letter Case Reports
Serial MRI findings in brain anoxia leading to Lance-Adams syndrome: a case report.
Although in literature almost 150 patients with Lance-Adams Syndrome (LAS) have been reported, neuroradiological evaluations were often performed in late stages and there is no serial study evaluating LAS from early stages. We herein report a serial neuroimaging study demonstrating early and transient involvement of cerebellum and thalami in a LAS patient. We may hypothesize that a transient cerebral hypoxia provoked a permanent synaptic rearrangements of the neuronal networks involved in the pathogenesis of post-hypoxic myoclonus in our patient.
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Letter Case Reports
Theta burst stimulation improves visuo-spatial attention in a patient with traumatic brain injury.
Recent studies showed that non-invasive brain stimulation methods, such as repetitive transcranial magnetic stimulation (rTMS) can improve the symptoms of neglect in stroke patients. Here, we adopted this approach to improve visuo-spatial deficit in a patient with traumatic brain injury (TBI) that showed important symptoms of visuo-spatial neglect. We found that continuous theta burst stimulation (cTBS) applied over the left posterior parietal cortex (PPC) induced a clinical improvement of cognitive disorder associated to a functional changes of fronto-parietal network as assessed by means of TMS and resting state fMRI.
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Acute basilar artery occlusion has a poor prognosis and best treatment has not been assessed yet; as for intra-arterial treatment, no "gold standard" exists. We evaluated a series of ten patients treated with intra-arterial combination of recombinant tissue plasminogen activator (rtPA) and abciximab. Partial/complete recanalisation was achieved in all patients and good outcome (1 month Modified Rankin Scale 0-2) in eight cases, while one patient had symptomatic intracranial haemorrhage and died. Such outcome appears significantly better if compared with the results of Basilar Artery International Cooperation Study, suggesting that intra-arterial administration of rtPA and abciximab may be a promising option in patients with acute basilar artery occlusion undergoing endovascular treatment.
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In the last few years several cases of headache as sole manifestation of an epileptic seizure have been reported and the term "ictal epileptic headache" has been recently proposed to identify an EEG-recorded epileptic seizure with migraine/headache-like features. Among the potential practical implications arising from these clinical observations, there is the urgent need for a revision of both International Classifications of Epilepsy and Headache disorders. We discuss these topics and provide additional comments about the physiopathological links between epilepsy and migraine.