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Functional Neurology

Paolo Rossi, P Little, E R De La Torre, A Palmaro
Cluster headache (CH) is arguably the most severe pain condition that afflicts humans. The severity of the pain has earned it the nickname "suicide headache". Understanding how CH impacts on those who suffer from it is essential, because this understanding creates empathy, which is so valuable to these patients. On the occasion of Cluster Headache Day 2017, we asked CH patients from different European countries to share their experiences, in order to help people to imagine what it means to live with the condition...
January 2018: Functional Neurology
Vincenzo Raieli, E Correnti, A Sandullo, M Romano, F Marchese, C Loiacono, Filippo Brighina
It is crucial that all headache specialists receive adequate training. Considering the unsatisfactory results obtained with standard updating courses and the growing need for continuing professional education, a digital platform was developed as a training tool. The platform has been active since 1 October 2014. It is readily accessible to doctors by free registration. Users have access to all the material available on the platform, which includes scientific articles, e-books, presentations and images. Users can share their own material and clinical cases directly...
January 2018: Functional Neurology
F Bove, G Di Lazzaro, D Mulas, F Cocciolillo, D Di Giuda, A R Bentivoglio
Accelerometry is a reliable tool for gauging the occurrence, amplitude and frequency of tremor. However, there is no consensus on criteria for accelerometric diagnosis of tremor syndromes. We enrolled 20 patients with essential tremor (ET), 20 with dystonic tremor (DT), and 20 with classic parkinsonian tremor (PD-T), all meeting accepted clinical criteria. All the patients underwent dopamine transporter imaging (by means of single-photon emission computed tomography) and triaxial accelerometric tremor analysis...
January 2018: Functional Neurology
Giorgio Sandrini, A Baricich, C Cisari, Stefano Paolucci, Nicola Smania, A Picelli
The present paper provides practical guidance on the management of adult spasticity with OnabotulinumtoxinA. Advisory Board members reviewed the available evidence and discussed their personal experiences in order to address the unmet needs in the management of spasticity with botulinum toxin type A identified by the recent Italian Real-Life Post-Stroke Spasticity Survey. Stroke patients should be referred to spasticity services that have adequate facilities and multidisciplinary teams with the necessary training, competence and expertise...
January 2018: Functional Neurology
V Valentino, Alessandro Iavarone, M Amboni, F Moschiano, M Picillo, V Petretta, G Cicarelli
Apathy is a state of diminished goal-directed speech, motor activity and emotions. The prevalence of apathy in Parkinson's disease (PD) ranges from 16 to 62%. Several studies have investigated the relationships between apathy and other dimensions of PD, but little is known about possible discrepancies between self-evaluation (SE) and caregiver reporting (CR) of this symptom. The aim of this study is twofold: 1) to investigate the differences in apathy evaluations according to the point of view from which apathy is reported (SE vs CR); 2) to identify the possible relationships between each of the two evaluations (SE and CR) and cognitive and affective dimensions of PD...
January 2018: Functional Neurology
A Pascarella, S Fiorenza, O Masotta, V Tibollo, D Vella, Anna Maria Nardone, Marta Rossi, P Volanti, F Madonia, Gaetano Cstronovo, D De Cicco, Caterina Guarnaschelli, M P Achilli, C Chiapparino, M T Angelillo, M A Tommasi, F Pisano, G Grioni, G Vezzadini, G Ferriero, S Salvaderi, R Bellazzi, Anna Estraneo
Diagnostic accuracy and reliable estimation of clinical evolution are challenging issues in the management of patients with disorders of consciousness (DoC). Longitudinal systematic investigations conducted in large cohorts of patients with DoC could make it possible to identify reliable diagnostic and prognostic markers. On the basis of this consideration, we devised a multicentre prospective registry for patients with DoC admitted to ten intensive rehabilitation units. The registry collects homogeneous and detailed data on patients' demographic and clinical features, neurophysiological and neuroimaging findings, and medical and surgical complications...
January 2018: Functional Neurology
A Ferrari, M Manca, V Tugnoli, L Alberto
Three different type A botulinum neurotoxins (BoNTAs) - onabotulinumtoxinA, abobotulinumtoxinA and incobotulinumtoxinA) - are currently marketed in Europe to treat several conditions. Differences between BoNTA preparations, which depend on their specific biotypes and manufacturing processes, lead to clinically relevant pharmacotherapeutic dissimilarities. All three available products are separately recognized and reviewed in American Academy of Neurology guidelines. The neurotoxin load/100U is likewise different among the different BoNTAs, with the result that the specific potency of the 150kD BoNTA neurotoxin is calculated as 137 units/ng for onabotulinumtoxinA, 154 units/ng for abobotulinumtoxinA, and 227 units/ng for incobotulinumtoxinA...
January 2018: Functional Neurology
C Zivelonghi, S Tamburin
No abstract text is available yet for this article.
January 2018: Functional Neurology
S Juhl, G Rubboli
This study aimed to investigate the incidence of aggressiveness in patients with severe drug-refractory focal epilepsy (DRE) who started perampanel (PER) as add-on treatment, and to identify possible predisposing factors. Data on 49 consecutive patients with severe DRE who initiated PER were retrospectively collected. Twelve of the 49 patients experienced aggressiveness as adverse event related to PER treatment, one third of them on low (2-4 mg/day) PER dosages. PER was discontinued in 10/12 patients because of aggressive behaviors...
October 2017: Functional Neurology
Damiana Scuteri, B Piro, Luigi Antonio Morrone, Maria Tiziana Corasaniti, M Vulnera, G Bagetta
The Authors of this letter look at consumption of opioids and a2- ligands, also known as "gabapentinoids", in Italy, and specifically in the Provincial Health District of Cosenza, as compared with USA trends of recent decades. Access to analgesic drugs since the introduction of Italian law 38/2010 is also evaluated and possible future measures for better management of chronic pain are proposed.
October 2017: Functional Neurology
S F Castiglia, G Galeoto, A Lauta, A Palumbo, F Tirinelli, F Viselli, Valter Santilli, M L Sacchetti
The Barthel Index (BI) is widely used to determine eligibility criteria for inpatient rehabilitation and to monitor patients' recovery, irrespective of the illnesses that affect them. The culturally adapted Italian version of the Barthel Index (IcaBI) was recently validated. This paper reports the structural validity and inter-rater reliability of the IcaBI and its responsiveness to the results of inpatient rehabilitation. The IcaBI was administered to a cohort of 264 patients hospitalized in two rehabilitation centers in Rome, Italy...
October 2017: Functional Neurology
A Loffi
The first part of this paper reports an interview with the philosopher Peter Singer. In the second, we examine Singer's background: naturalism and neurophilosophy, discussing three of its theses, as presented by Patricia Smith Churchland. Finally, we go back to Singer himself, to draw some conclusions.
October 2017: Functional Neurology
Rita Moretti, R Caberlotto, R Signori
Corticobasal degeneration is a rare disorder, which usually consists of a combination of complex movement disorders, apraxia and cortical changes. Its definition is still evolving and in 2013 an international consortium tried to develop new criteria, based on a systematic literature review. Over a long period of time, we carefully selected 23 patients who fulfilled the criteria for a diagnosis of corticobasal degeneration; all had the so-called corticobasal syndrome phenotype, in accordance with Armstrong et al...
October 2017: Functional Neurology
A Zarabla, S Ungania, A Cacciatore, A Maialetti, G Petreri, A Mengarelli, A Spadea, F Marchesi, D Renzi, Svitlana Gumenyuk, L Strigari, Marta Maschio
Cytosine arabinoside (Ara-C) is one of the key drugs for treating acute myeloid leukemia (AML). High intravenous doses may produce a number of central nervous system (CNS) toxicities and contribute to modifications in brain functional connectivity. sLORETA is a software used for localizing brain electrical activity and functional connectivity. The aim of this study was to apply sLORETA in the evaluation of possible effects of Ara-C on brain connectivity in patients with AML without CNS involvement. We studied eight patients with AML; four were administered standard doses of Ara-C while the other four received high doses...
October 2017: Functional Neurology
Fiorella Bianchi, Giovanna M Squintani, M Osio, A Morini, C Bana, G Ardolino, S Barbieri, L Bertolasi, R Caramelli, F Cogiamanian, A Currà, G de Scisciolo, C Foresti, V Frasca, E Frasson, M Inghilleri, L Maderna, L Motti, E Onesti, M C Romano, U Del Carro
Neurophysiological testing of the pelvic floor is recognized as an essential tool to identify pathophysiological mechanisms of pelvic floor disorders, support clinical diagnosis, and aid in therapeutic decisions. Nevertheless, the diagnostic value of these tests in specific neurological diseases of the pelvic floor is not completely clarified. Seeking to fill this gap, the members of the Neurophysiology of the Pelvic Floor Study Group of the Italian Clinical Neurophysiology Society performed a systematic review of the literature to gather available evidence for and against the utility of neurophysiological tests...
October 2017: Functional Neurology
M Barbieri, M Maffoni, S Negro, D Maddalena, D Bosone, L Tronconi
No abstract text is available yet for this article.
October 2017: Functional Neurology
D Sattin, L De Torres, G Dolce, Francesco Arcuri, Anna Estraneo, V Cardinale, R Piperno, E Zavatta, Rita Formisano, Mariagrazia D'Ippolito, C Vassallo, B Dessi, G Lamberti, E Antoniono, C Lanzillotti, J Navarro, P Bramanti, Silvia Marino, M Zampolini, F Scarponi, R Avesani, L Salvi, S Ferro, L Mazza, P Fogar, S Feller, F De Nigris, A Martinuzzi, M Buffoni, A Pessina, P Corsico, M Leonardi
Different rehabilitation models for persons diagnosed with disorders of consciousness have been proposed in Europe during the last decade. In Italy, the Ministry of Health has defined a national healthcare model, although, to date, there is a lack of information on how this has been implemented at regional level. The INCARICO project collected information on different regional regulations, analysing ethical aspects and mapping care facilities (numbers of beds and medical units) in eleven regional territories...
July 2017: Functional Neurology
Silvia Marino, Rosa Morabito, S De Salvo, L Bonanno, A Bramanti, P Pollicino, R Giorgianni, Placido Bramanti
Gerstmann-Sträussler-Scheinker syndrome (GSS) is an inherited autosomal dominant prion disease, caused by a codon 102 proline to leucine substitution (P102L) in the prion protein gene (PRNP). We describe the case of a 40-year-old male, affected by a slowly progressive gait disturbance, leg weakness and cognitive impairment. Genomic DNA revealed a point mutation of PRNP at codon 102, resulting in P102L, and the diagnosis of GSS was confirmed. Somatosensory evoked potentials showed alterations of principal parameters, particularly in the right upper and lower limbs...
July 2017: Functional Neurology
C Geroin, G Squintani, A Morini, F Donato, Nicola Smania, Maria Giovanna Gandolfi, S Tamburin, Alfonso Fasano, Michele Tinazzi
Patients with Parkinson's disease (PD) and Pisa syndrome (PS) may present tonic dystonic or compensatory (i.e. acting against gravity) hyperactivity in the paraspinal and non-paraspinal muscles. Electromyographic (EMG) activity was measured in nine patients with PD and PS, three with PD without PS, and five healthy controls. Fine-wire intramuscular electrodes were inserted bilaterally into the iliocostalis lumborum (ICL), iliocostalis thoracis (ICT), gluteus medius (GM), and external oblique (EO) muscles. The root mean square (RMS) of the EMG signal was calculated and normalized for each muscle...
July 2017: Functional Neurology
F Crosta, Giovambattista Desideri, Carmine Marini
An association of obstructive sleep apnea syndrome (OSAS) and other sleep-disordered breathing (SDB) with Parkinson's disease (PD) has been reported in some small studies. In the present study we investigated the occurrence of SDB in a large consecutive outpatient series. This is a case-control study in subjects attending a neurological clinic where all patients were screened for SDB by means of sleep-wake history, Epworth Sleepiness Scale, and full-night polysomnography, when indicated. 3194 patients were recruited...
July 2017: Functional Neurology
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