Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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We describe a patient treated with SSRI and Ldopa, who developed agitation, rigidity, hyperreflexia, restlessness, autonomic instability, fever and finally death. CSF examination, MRI of the brain, laboratory investigations, except for serum CK, glycemia and WBC, were normal. His condition was thought to result from an central serotonin activity. The serotonin syndrome occurs following the use of serotomimetic agents (serotonin reuptake inhibitors, tricyclic and tetracyclic antidepressants, tryptophan alone or in combination with monoamine oxidase inhibitors).
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We report the case of a 65-year-old woman who developed symptoms of spinal cord compression due to a spinal meningioma after 10 years of treatment with hydroxyurea (1000 mg/day) for essential thrombocytemia. This case provides a paradigm for the occurrence of symptomatic meningioma in course of HU therapy.
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There is no consensus in the literature on the effects of the development of hydrocephalus on survival and disability after intracerebral haemorrhage (ICH) and the benefits of external ventricular drainage (EVD). In this open, prospective study, we investigated the clinical courses, radiological findings and outcome scores of 47 consecutive patients who were admitted to our clinic with spontaneous ICH. Hydrocephalus developed in 6 (12.8%) of the 47 patients, and EVD was applied in these 6 cases. ⋯ Hospital mortality and functional outcome were not significantly different between patients with and without hydrocephalus. Our results shown that acute obstructive hydrocephalus should be anticipated if haematoma is near the ventricle or if it is opening to the ventricle. EVD is a life-saving and effective procedure that should be performed in patients who develop hydrocephalus following spontaneous intracerebral haemorrhage.
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Aretrospective hospital-based case-control study was performed with the aim to evaluate the association between exposure to anesthesia and Alzheimer's disease (AD). A total of 115 AD patients, 230 Parkinson's disease (PD) patients and 230 patients with non-degenerative neurological disease were studied. Each AD case was matched for sex, age (+/-3 years) and geographic area of residence with four controls (2 PD patients and 2 with other neurological disease). ⋯ The present study reveals a lack of association between exposure to general anesthesia and AD. Prospective epidemiological studies are needed in order to investigate levels of exposure to anesthesia, as well as any possible relationships between anesthetic exposure and genetic factors (e. g. APOEepsilon4 genotype).
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Alternative causes of optic neuritis (ON), other than primary demyelination or non-demyelinating optic neuropathies which can mimic acute ON, should be rigorously considered if a patient with presumed ON does not follow the typical clinical course or has a normally appearing brain on magnetic resonance imaging. A thorough differential diagnosis includes viral and bacterial optic neuropathies, ischemic optic neuropathies, Devic's neuromyelitis optica, compressive or infiltrative optic neuropathies, Leber's hereditary optic neuropathy and toxic and deficiency optic neuropathies. All patients should undergo a complete neuroophthalmological examination to help exclude other diseases mimicking ON. Atypical clinical cases of optic neuropathy require further specific laboratory, neurophysiological and imaging tests to make a correct and early diagnosis.