Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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We report the case of a patient who developed notalgia paresthetica during the recovery from a neuralgic amyotrophy. A 23-year-old woman had a typical neuralgic amyotrophy (severe shoulder pain, followed by a long thoracic nerve palsy); five months after the onset of pain, when scapular winging was improving, she began to feel a burning sensation in a restricted interscapular area, on the same side. ⋯ The notalgia paresthetica disappeared shortly before the complete recovery of scapular winging. The abnormal activation of shoulder girdle and spine extensor muscles during the time of long thoracic nerve palsy may explain the association between the two disorders.
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Review
Dizziness and vertigo: an epidemiological survey and patient management in the emergency room.
Dizziness and vertigo are frequent causes of presentation at the emergency room, with an incidence in the Vimercate district, Italy, close to 3.5%. The basic management of the "dizzy" patients in the emergency room includes a detailed history and an accurate physical/neurological examination, with the aim to identify "at risk" patients who require further diagnostic procedures and/or immediate admission to the hospital.
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Intracerebral hemorrhage (ICH) occurs as a result of bleeding into the brain parenchyma and formation of a focal hematoma. Treatment for ICH is primarily supportive, and outcome remains poor. ⋯ Arterial blood pressure control is useful and requires adequate compliance to specific guidelines. Ultra-early hemostatic therapy may represent a promising tool to reduce early hematoma enlargement and to improve outcome.
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Comparative Study
The subthalamic nucleus in Parkinson's disease: power spectral density analysis of neural intraoperative signals.
To test a new tool for the neurophysiological identification of the human subthalamic nucleus (STN) during stereotactic surgery for the implantation of deep-brain-stimulation (DBS) electrodes, we analysed off-line the intraoperative signals recorded from patients with Parkinson's disease. We estimated the power spectral density (PSD) along each penetration track (8 patients, 13 sides) and determined the spatial correlation of the PSD with the target location estimated from neuroimaging procedures ("anatomical target"), and with the final target location derived from standard intraoperative neurophysiological procedures for STN localization ("clinical target"). At each step we recorded the 'on-line' signal for 120 seconds; because the PSD was estimated by calculating the periodogram for 6-second epochs of neural signal, we had 20 epochs at each step. ⋯ When the track was outside the nucleus, the PSD remained unchanged. Even on recordings with low signal-to-noise ratio, off-line PSD analysis of neural signals showed a good correspondence with the target indicated by the surgical team. On-line intraoperative estimation of the PSD may be a simple, reliable, rapid and complementary approach to electrophysiological monitoring during STN surgery for Parkinson's disease.
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We examined the potential sex-related differences in levodopa pharmacokinetics and their relation with the presence of dyskinesias in a group of 115 patients (67 men, 49 women) with Parkinson's disease. The patients were given a standard oral dose of levodopa plus benserazide (100/25 mg). The area under the levodopa plasma concentration time curve, corrected for the levodopa test dose (in mg/kg body weight), (AUC(w)) was significantly higher in women than in men, with a reduced oral clearance. No difference in the proportion of men and women experiencing dyskinesias was observed.