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There are many medications that cross the blood-brain barrier affecting the central nervous system and converting the normal patterns of sleep and wakefulness. Some drugs are used to treat special sleep disorders but others can induce sleep disorders (e.g. periodic limb movements during sleep, restless leg syndrome, parasomnia, insomnia) or exacerbate them (e.g. obstructive or central sleep apnea). The most frequent classes of agents used in sleep medicine are: benzodiazepines, nonbenzodiazepines receptor agonists, melatonin and melatonin receptor agonists, antiepileptic drugs, antidepressants, atypical antipsychotics, central stimulants and dopamine agonists. [ABSTRACT FROM AUTHOR]

Since the Babylonian era up to nowadays, the large complexity of epileptic disorders made the attempt of classifying and organizing concepts one of the most challenging. The 1981 classification was a revision of the one devised by Henri Gastaut for the ILAE and published in 1970. The distinction between simple and complex partial seizures represented a significant difference. In 1989 the report of ILAE classification and terminology task force introduced the concept of epileptic syndrome. An epileptic syndrome is defined by the sum of signs and symptoms that tend to occur together, not reflecting a particular etiology and prognosis, these latter features being the hallmark not of a syndrome, but of a disease condition. Firstly, any epileptic disorder can be described as either idiopathic (primary, whose etiology is probably genetic), symptomatic (with a known or presumed cerebral pathology) or cryptogenic (with an occult cause). The epileptic diagnostic tree ramifies into four main branches in the 1989 ILAE Classification: localization-related (focal, local, or partial) epilepsies and syndromes, generalized epilepsies and syndromes, epilepsies and syndromes undetermined whether focal or generalized and special syndromes. The next important milestone in epilepsy classification was settled by ILAE in 2001, when a glossary for ictal semiology was developed and multiaxial approach of diagnosing epilepsy was proposed. The necessity of processing the new insights in epilepsy was answered by the latest ILAE Report released in february 2010, which brings awareness of and appropriately integrates the currently available data. It presents a modular approach of diagnosing epilepsy and recommends to keep a flexible vision on this topic, as every individual case requires a different prioritizing scheme. [ABSTRACT FROM AUTHOR]

Chronic inflammatory demyelinating polyradiculopathy is mainly based on clinical and electrophysiological criteria. If electrophysiological findings remain questionable for the diagnosis of CIDP and/or clinical presentation is atypical, nerve biopsy may assist the diagnosis. We present a case in which the nerve biopsy was helpful in diagnosis of CIDP and revealed the peculiar presence of tomacula. [ABSTRACT FROM AUTHOR]

Quantitative sensory testing (QST) is a potentially useful tool for measuring sensory impairment for clinical and research studies but there is still no consensus regarding the place of this evaluation in every day clinical practice. Our study included 15 patients previously diagnosed with neuropathic pain due to small fiber sensory polyneuropathy based on clinical and electrodiagnostic criteria.Variables were compared with an age matched control group of 7 healthy persons. We looked to pain severity rated on Visual Analog Scale and Pain Detect Questionnaire and we searched for correlations with sensory nerve conduction studies and parameters of quantitative sensory testing - thermotest, limits method. QST was a sensitive technique for evaluation of patients with small fiber sensory polyneuropathy. Score on Pain Detect Questionnaire has statistically significant correlation with values recorded for cooling detection threshold on QST, documenting sensory loss and A delta fibers dysfunction in the study group. [ABSTRACT FROM AUTHOR]

Diagnosis of ALS is based on clinical examination and electromyographic tests which are used to confirm the clinical suspicion and to exclude alternatives. Atypical presentations may delay the diagnostic and subject the patient to unnecessary tests and procedures. We discuss here three cases with atypical features: head dropping, highly focal weakness and amyotrophy and the last case with surgery for lumbar stenosis. [ABSTRACT FROM AUTHOR]

We depict the case of a patient who progressively develops a motor deficit and respiratory failure, which eventually proves to be botulinus intoxication, after a series of puzzling results of various investigations leading to a different diagnosis. [ABSTRACT FROM AUTHOR]

Dementia and depression are both frequent in stroke patients. Evaluation, follow-up of the severity and treatment decisions are important in such patients. Moreover, neuropsychological testing for cognition and mood interfere and various neurological deficits could further on alter the testing. The picture is even more complicated, considering that dementia can lead to depression and vice versa. In our current pilot study we evaluated patients in days 3-5 after the onset of ischemic stroke. We found no significant correlations between cognition and depression scores in our sample, result which suggests that at very short interval after stroke, cognitive disturbance is not a predictor for depression. [ABSTRACT FROM AUTHOR]