21 results on '"Brunetto D"'
Search Results
2. Le convulsioni associate a gastroenterite nel lattante: una entità clinica benigna
- Author
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FRANZONI, EMILIO, GENTILE, VALENTINA, Brunetto D, Valenti V, Cordelli DM, Iero L, Cecconi I., Franzoni E, Brunetto D, Valenti V, Gentile V, Cordelli DM, Iero L, and Cecconi I
- Subjects
GASTROENTERITI ,ROTAVIRUS ,CONVULSIONI - Abstract
Le gastroenteriti virali acute sono una delle patologie infettive più frequenti in tutto il mondo caratterizzate da un’alta morbilità (1). In età pediatrica causano frequentemente disidratazione acuta e alterazioni idroelettrolitiche (1). In questi casi può comparire sintomatologia neurologica caratterizzata da agitazione, sonnolenza o convulsioni (2). Tuttavia sono state descritti in letteratura casi di gastroenterite afebbrile, senza né disidratazione nè alterazioni idroelettrolitiche, ma associate a convulsioni. Tale entità nosografica è stata definita “convulsioni benigne infantili associate a lieve gastroenterite” (convulsions with mild gastroenteritis) (2). Si tratta di convulsioni di breve durata, autolimitanti, con tendenza alla ricorrenza nelle 24 ore e con quadro di neuroimaging ed elettroencefalografico normale (3). La prognosi è benigna e non sono necessari nè indagini diagnostiche approfondite né trattamento antiepilettico prolungato (2,3).
- Published
- 2009
3. [Complex anal fistula with a recess above the levator ani muscles: report of a case complicated by haemorrhagic colitis]
- Author
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Celi, D., Desogus, A. I., Cucinotta, A., Lucibello, L., Giordano, T., Metro, Daniela, Bonardelli, P., Cocuzza, G., and Brunetto, D.
- Subjects
Treatment Outcome ,Anal Canal ,Humans ,Rectal Fistula ,Female ,Middle Aged ,Colitis ,Gastrointestinal Hemorrhage ,Muscle, Skeletal ,Perineum - Abstract
Anal fistula surgery offers very little in the way of new developments. As early as the 14th century John of Arden defined the rules for surgical therapy. The numerous classifications adopted are often contradictory and unclear, and no clearly defined pathogenesis of the condition has been established. Complex anal fistula with a recess above the elevator ani muscles requires very careful and meticulous therapeutic treatment because of the risk of damaging the sphincter. In the case reported here the patient presented a very complex fistula which was followed by onset of severe haemorrhagic colitis without any clinical, endoscopic, radiological, or histological evidence of inflammatory bowel disease prior to surgical treatment.
- Published
- 2005
4. Clinical and Neuropsychological Considerations in a Case of Unrecognized Myoclonic Epileptic Jerks Dramatically Controlled by Levetiracetam
- Author
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Gentile, V., primary, Brunetto, D., additional, Leo, I., additional, Bonetti, S., additional, Verrotti, A., additional, and Franzoni, E., additional
- Published
- 2010
- Full Text
- View/download PDF
5. Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study
- Author
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Katia Tenore, Barbara Basile, Teresa Cosentino, Brunetto De Sanctis, Stefania Fadda, Giuseppe Femia, Andrea Gragnani, Olga I. Luppino, Valerio Pellegrini, Claudia Perdighe, Giuseppe Romano, Angelo M. Saliani, and Francesco Mancini
- Subjects
obsessive-compulsive disorder ,imagery rescripting ,memories ,criticism ,guilt ,Psychiatry ,RC435-571 - Abstract
Background and objectivesCriticism is thought to play an important role in obsessive-compulsive disorder (OCD), and obsessive behaviors have been considered as childhood strategies to avoid criticism. Often, patients with OCD report memories characterized by guilt-inducing reproaches. Starting from these assumptions, the aim of this study is to test whether intervening in memories of guilt-inducing reproaches can reduce current OCD symptoms. The emotional valence of painful memories may be modified through imagery rescripting (ImRs), an experiential technique that has shown promising results.MethodsAfter monitoring a baseline of symptoms, 18 OCD patients underwent three sessions of ImRs, followed by monitoring for up to 3 months. Indexes of OCD, depression, anxiety, disgust, and fear of guilt were collected.ResultsPatients reported a significant decrease in OCD symptoms. The mean value on the Yale−Brown Obsessive Compulsive Scale (Y-BOCS) changed from 25.94 to 14.11. At the 3-month follow-up, 14 of the 18 participants (77.7%) achieved an improvement of ≥35% on the Y-BOCS. Thirteen patients reported a reliable improvement, with ten reporting a clinically significant change (reliable change index = 9.94). Four reached the asymptomatic criterion. Clinically significant changes were not detected for depression and anxiety.ConclusionsOur findings suggest that after ImRs intervention focusing on patients’ early experiences of guilt-inducing reproaches there were clinically significant changes in OCD symptomatology. The data support the role of ImRs in reducing OCD symptoms and the previous cognitive models of OCD, highlighting the role of guilt-related early life experiences in vulnerability to OCD.
- Published
- 2020
- Full Text
- View/download PDF
6. Is the airway volume being correctly analyzed?
- Author
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Alves M Jr, Baratieri C, Mattos CT, Brunetto D, Fontes Rda C, Santos JR, and Ruellas AC
- Published
- 2012
7. 18FFDG-PET and SPM analysis role in focal epilepsy at infantile onset: An evolutive study,Ruolo della 18FFDG-PET e dell'analisi SPM nelle epilessie focali in età evolutiva
- Author
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Brunetto, D., Garone, C., Valenti, V., Gentile, V., Marchiani, V., Moscano, F. C., Cecconi, I., Duccio Maria Cordelli, and Franzoni, E.
8. VNS in drug resistant epilepsy: preliminary report on a small group of patients
- Author
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Iero Luisa, Cecconi Ilaria, Brunetto Daniela, Colonnelli Maria, Gentile Valentina, Franzoni Emilio, Moscano Filomena C, Cordelli Duccio M, and Marchiani Valentina
- Subjects
Pediatrics ,RJ1-570 - Abstract
Abstract Background In 1997 Vagus Nerve Stimulation (VNS) received approval from the US Food and Drug Administration (FDA) as an adjunctive therapy in the treatment of medically intractable partial epilepsy in people aged 12 years and older who are ineligible for resective epilepsy surgery. Although the exact mechanisms of action are unknown, the use of VNS with children has increased, including those younger than 12 years of age, or those with generalized epilepsy. Methods We describe the outcome for the first group of nine patients, aged 8-28 years, who had pharmaco-resistant epilepsy and were treated with VNS. During the follow up, we gradually and slowly increased the parameters of the stimulation in order to assess the efficacy of VNS even at parameters which would usually be considered "non-therapeutic", along with possible side effects and changes in quality of life. Results At the last follow, up 1 patient was "seizures free", 3 were "very good responders", 3 were "good responders" and 2 were "non responders". We obtained an initial seizure reduction with low stimulation parameters, the highest current reached being 2.00 mA. This observation supports the possibility that, for younger patients, lower stimulation intensities than those commonly used in clinical practice for adults can be therapeutic. We also wanted to underline the reduction in seizure frequency (~91,7%) and the reduction in seizure duration (> 50%) in the patients affected by drug-resistant absence epilepsy. Adverse effects were mild, tolerable and, in most of cases, easily resolved by adjusting the stimulation parameters. Hoarseness of voice was the most frequent side effect. The improvements in the quality of life are relevant and seem to be independent of the VNS effect in controlling seizures. Conclusions Our small experience seems to confirm the efficacy and safety of VNS in drug resistant partial and generalized epilepsy in developing age groups.
- Published
- 2010
- Full Text
- View/download PDF
9. VNS in drug resistant epilepsy: preliminary report on a small group of patients
- Author
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Valentina Gentile, Filomena Moscano, Valentina Marchiani, Daniela Brunetto, Luisa Iero, Emilio Franzoni, I. Cecconi, Duccio Maria Cordelli, Maria Chiara Colonnelli, Franzoni E, Gentile V, Colonnelli MC, Brunetto D, Cecconi I, Iero L, Moscano FC, Cordelli DM, and Marchiani V
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Adolescent ,Vagus Nerve Stimulation ,medicine.medical_treatment ,Drug Resistance ,Epilepsy ,Young Adult ,Quality of life ,medicine ,Humans ,Epilepsy surgery ,Young adult ,Generalized epilepsy ,Child ,Retrospective Studies ,business.industry ,Research ,lcsh:RJ1-570 ,Retrospective cohort study ,lcsh:Pediatrics ,medicine.disease ,Drug Resistant Epilepsy ,Electrodes, Implanted ,Treatment Outcome ,Anesthesia ,Quality of Life ,Female ,business ,Vagus nerve stimulation ,Follow-Up Studies - Abstract
Background In 1997 Vagus Nerve Stimulation (VNS) received approval from the US Food and Drug Administration (FDA) as an adjunctive therapy in the treatment of medically intractable partial epilepsy in people aged 12 years and older who are ineligible for resective epilepsy surgery. Although the exact mechanisms of action are unknown, the use of VNS with children has increased, including those younger than 12 years of age, or those with generalized epilepsy. Methods We describe the outcome for the first group of nine patients, aged 8-28 years, who had pharmaco-resistant epilepsy and were treated with VNS. During the follow up, we gradually and slowly increased the parameters of the stimulation in order to assess the efficacy of VNS even at parameters which would usually be considered "non-therapeutic", along with possible side effects and changes in quality of life. Results At the last follow, up 1 patient was "seizures free", 3 were "very good responders", 3 were "good responders" and 2 were "non responders". We obtained an initial seizure reduction with low stimulation parameters, the highest current reached being 2.00 mA. This observation supports the possibility that, for younger patients, lower stimulation intensities than those commonly used in clinical practice for adults can be therapeutic. We also wanted to underline the reduction in seizure frequency (~91,7%) and the reduction in seizure duration (> 50%) in the patients affected by drug-resistant absence epilepsy. Adverse effects were mild, tolerable and, in most of cases, easily resolved by adjusting the stimulation parameters. Hoarseness of voice was the most frequent side effect. The improvements in the quality of life are relevant and seem to be independent of the VNS effect in controlling seizures. Conclusions Our small experience seems to confirm the efficacy and safety of VNS in drug resistant partial and generalized epilepsy in developing age groups.
- Published
- 2010
10. A new case of idiopathic hemiplegia hemiconvulsion syndrome
- Author
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Caterina Tonon, Caterina Garone, Bruno De Bernardi, Daniela Brunetto, Emilio Franzoni, Valentina Marchiani, Raffaele Lodi, Franzoni E, Garone C, Marchiani V, Brunetto D, Tonon C, Lodi R, and Bernardi B
- Subjects
Male ,medicine.medical_specialty ,Neurology ,Brain Edema ,Hemiplegia ,Epilepsy, Partial, Motor ,Dermatology ,Status epilepticus ,Seizures, Febrile ,Lateralization of brain function ,Epilepsy ,Atrophy ,Convulsion ,medicine ,Humans ,Neuroradiology ,medicine.diagnostic_test ,business.industry ,Infant ,Magnetic resonance imaging ,Syndrome ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Psychiatry and Mental health ,Anesthesia ,Neurology (clinical) ,medicine.symptom ,business - Abstract
We report a new case of infantile idiopathic hemiconvulsion-hemiplegia syndrome (HH). A prolonged right-sided febrile convulsion was followed 4 days later, by right hemiconvulsive status epilepticus, documented by video-electroencephalogram (EEG) recording. The child developed an ipsilateral hemiplegia, partially improved during the first month of follow-up. Sequential cerebral magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS) at 6, 15, 30 days of follow-up showed a cytotoxic edema in the left hemisphere and a subsequent necrosis. At 1-year of follow-up, we performed MRI control because of febrile convulsion lasting few minutes that confirmed a non-progressive left hemisphere atrophy. After 2 years, the patient was seizure-free, with a mild right hemiplegia and language skills deficit. We discuss the unclear pathogenesis of HH through sequential neuroradiological evaluation.
- Published
- 2010
11. Bathing epilepsy: report of two Caucasian cases
- Author
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Paolo Balestri, Daniela Brunetto, Emilio Franzoni, Valentina Gentile, Duccio Maria Cordelli, Salvatore Grosso, Franzoni E, Gentile V, Grosso S, Brunetto D, Cordelli DM, and Balestri P.
- Subjects
reflex seizures ,medicine.medical_specialty ,Pediatrics ,Neurology ,Bathing ,water-immersion epilepsy ,CHILDREN ,Electroencephalography ,Pallor ,Epilepsy, Reflex ,WATER-IMMERSION ,Epilepsy ,Reflex Epilepsy ,reflex seizures, bathing epilepsy, water-immersion epilepsy ,medicine ,Humans ,Bathing epilepsy ,Child ,medicine.diagnostic_test ,business.industry ,Baths ,General Medicine ,medicine.disease ,Treatment Outcome ,Anesthesia ,Child, Preschool ,Female ,Neurology (clinical) ,medicine.symptom ,business ,bathing epilepsy ,Somnolence ,CAUCASIAN CASES - Abstract
Bathing epilepsy, also known as water-immersion epilepsy, refers to a rare form of benign reflex epilepsy in which seizures are precipitated by the normal process of domestic bathing. This condition has been confused with true hot water epilepsy, even though bathing in water at normal temperature is the trigger. Focal seizures predominate with a staring gaze, pallor and generalised features followed by prolonged postictal somnolence. A variable percentage of patients may also show unprovoked seizures. The prognosis is usually favourable, and modifying bathing habits may prevent further seizures. We report two Caucasian patients with bathing epilepsy. In one, seizures were provoked by water immersion. In the other, we noted an unusual triggering factor; pouring of lukewarm water over the genitalia.
- Published
- 2010
12. Teaching as a system: COVID-19 as a lens into teacher change.
- Author
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Brunetto D, Bernardi G, Andrà C, and Liljedahl P
- Abstract
In the spring of 2020, schools and universities around the world were closed because of the COVID-19 pandemic. The relative lockdown affected more than 1.5 billion learners as teachers and students sheltered at home for several weeks. As schooling moved online, teachers were forced to change how they taught. In the research presented here, we focus on university mathematics professors, and we analyze how their practice, knowledge, and beliefs intertwine and change under these circumstances. More specifically, the context of the pandemic and the relative lockdown provides us with the experimental basis to argue that the new practice affected both knowledge and beliefs of mathematics teachers and that practice, knowledge, and beliefs form a system. Being part of a system, the reactions to change in practice can be of two types, namely, the system as a whole tries to resist change, or the system as a whole changes - and it changes significantly. The research presented here proposes a model for describing and analyzing what we called a teaching system and examines three cases that help to better depict the systemic nature of teaching., (© The Author(s) 2021.)
- Published
- 2022
- Full Text
- View/download PDF
13. Microscopic reconstruction and immunohistochemical analysis of discomalleolar ligament.
- Author
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Anastasi MR, Rizzo G, Nicita F, Bramanti A, Milardi D, Macchi V, Brunetto D, Cascone P, Arco A, Nicita A, Anastasi G, and Favaloro A
- Abstract
Discomalleolar ligament represents the vestiges of the primitive lateral pterygoid muscle which penetrates in the caudal end of Meckel's cartilage; during the development of newborn, the petrotympanic fissure close almost completely leaving inside the discomalleolar ligament. After entering in tympanic cavity, some fibers of the discomalleolar ligament insert to walls of cavity, other fibers continue with the lateral margin of the anterior ligament and insert in the neck of malleus; in contrast, other Authors demonstrated that discomalleolar ligament is an independent structure inserted in proximity of the neck of the malleus. Although the discomalleolar ligament can be considered as a structure of clinical importance, it is not described by anatomy textbooks. Moreover, it is likely that important correlations between temporomandibular diseases and otological symptoms exist. We have studied discomalleolar ligament submitting the specimens to the 3D volume rendering technique, light microscopy, reconstructing a wide light microscopic fields to analyze the real connection between retrodiscal connective tissue and middle ear, and immunofluorescence methods in order to analyze the consistence of ligament. We have shown two types of connections between TMJ and ear: first, with external acoustic meatus and, second, with middle ear through discomalleolar ligament. The different insertion represents a strong support in order to demonstrate that the TMJ disorders can determine variations of tension that are transmitted on the tympanic membrane provoking tinnitus in according to clinical features. Then, we propose that it is necessary to mention, also in anatomy textbook, the discomalleolar ligament as ligament distance of TMJ., (© 2020 The Authors.)
- Published
- 2020
- Full Text
- View/download PDF
14. An interview with Lincoln Issamu Nojima.
- Author
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Nojima LI, Brunetto D, Valladares Neto J, Menezes LM, Schroeder MA, and Matsumoto MAN
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- 2019
- Full Text
- View/download PDF
15. Camouflage of a high-angle skeletal Class II open-bite malocclusion in an adult after mini-implant failure during treatment.
- Author
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Franzotti Sant'Anna E, Carneiro da Cunha A, Paludo Brunetto D, and Franzotti Sant'Anna C
- Subjects
- Cephalometry, Cone-Beam Computed Tomography, Esthetics, Dental, Extraoral Traction Appliances, Female, Humans, Malocclusion, Angle Class II diagnostic imaging, Molar, Third surgery, Open Bite diagnostic imaging, Orthodontic Appliance Design, Radiography, Panoramic, Tooth Extraction, Young Adult, Malocclusion, Angle Class II therapy, Open Bite therapy, Orthodontics, Corrective methods
- Abstract
The treatment of skeletal anterior open-bite malocclusion requires complex orthodontic planning that considers its multifactorial etiology, treatment limitations, and high relapse rates. This case report illustrates a successful treatment approach for a skeletal high-angle Class II malocclusion in an adult with a severe open bite. The treatment consisted of a high-pull headgear therapy after mini-implants failure during fixed orthodontic therapy. Adequate esthetics and function were achieved. Despite its low probability, the unexpected event of mini-implant loosening during complex treatments should be considered. Therefore, classic orthodontic mechanics should be established, especially when treating patients for whom invasive procedures such as miniplates or orthognathic surgery are not available options., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
16. Association of the mtDNA m.4171C>A/MT-ND1 mutation with both optic neuropathy and bilateral brainstem lesions.
- Author
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La Morgia C, Caporali L, Gandini F, Olivieri A, Toni F, Nassetti S, Brunetto D, Stipa C, Scaduto C, Parmeggiani A, Tonon C, Lodi R, Torroni A, and Carelli V
- Subjects
- Adolescent, Brain Diseases complications, Humans, Male, Optic Atrophy, Hereditary, Leber complications, Pedigree, Vestibular Nuclei pathology, Brain Diseases genetics, Brain Stem, DNA, Mitochondrial genetics, Mutation genetics, Optic Atrophy, Hereditary, Leber genetics
- Abstract
Background: An increasing number of mitochondrial DNA (mtDNA) mutations, mainly in complex I genes, have been associated with variably overlapping phenotypes of Leber's hereditary optic neuropathy (LHON), mitochondrial encephalomyopathy with stroke-like episodes (MELAS) and Leigh syndrome (LS). We here describe the first case in which the m.4171C>A/MT-ND1 mutation, previously reported only in association with LHON, leads also to a Leigh-like phenotype., Case Presentation: A 16-year-old male suffered subacute visual loss and recurrent vomiting and vertigo associated with bilateral brainstem lesions affecting the vestibular nuclei. His mother and one sister also presented subacute visual loss compatible with LHON. Sequencing of the entire mtDNA revealed the homoplasmic m.4171C>A/MT-ND1 mutation, previously associated with pure LHON, on a haplogroup H background. Three additional non-synonymous homoplasmic transitions affecting ND2 (m.4705T>C/MT-ND2 and m.5263C>T/MT-ND2) and ND6 (m.14180T>C/MT-ND6) subunits, well recognized as polymorphisms in other mtDNA haplogroups but never found on the haplogroup H background, were also present., Conclusion: This case widens the phenotypic expression of the rare m.4171C>A/MT-ND1 LHON mutation, which may also lead to Leigh-like brainstem lesions, and indicates that the co-occurrence of other ND non-synonymous variants, found outside of their usual mtDNA backgrounds, may have increased the pathogenic potential of the primary LHON mutation.
- Published
- 2014
- Full Text
- View/download PDF
17. Reliability of CBCT in the diagnosis of dental asymmetry.
- Author
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Ruellas AC, Koerich L, Baratieri C, Mattos CT, Alves M Jr, Brunetto D, and Eidson L
- Subjects
- Anatomic Landmarks diagnostic imaging, Cuspid diagnostic imaging, Dental Arch diagnostic imaging, Humans, Image Processing, Computer-Assisted statistics & numerical data, Incisor diagnostic imaging, Mandible diagnostic imaging, Maxilla diagnostic imaging, Molar diagnostic imaging, Nasal Bone diagnostic imaging, Observer Variation, Reproducibility of Results, Cephalometry statistics & numerical data, Cone-Beam Computed Tomography statistics & numerical data, Malocclusion diagnostic imaging, Tooth Crown diagnostic imaging
- Abstract
Objective: The aim of this study was to validate a method used to assess dental asymmetry, in relation to the skeletal midline, by means of CBCT., Methods: Ten patients who had CBCT scans taken were randomly selected for this study. Five different observers repeated 10 landmarks (x, y and z variables for each) and 12 linear measurements within 10 days. Measurements were taken in both arches to evaluate symmetry of first molars, canines and dental midline in relation to the skeletal midline. Intraclass correlation coefficient (ICC) was carried out to assess intra- and interobserver reliability for landmarks and distances. Average mean difference was also assessed to check measurement errors between observers., Results: ICC for the landmarks was, respectively, ≥ 0.9 for 27 (90%) and 25 (83%) variables for intra- and interobserver; ICC for distances was ≥ 0.9 for 7 (58%) and 5 (42%), respectively. All ICC landmarks for distances were >0.75 for both intra- and interobserver. The mean difference between observers was ≤ 0.6 mm for all the distances., Conclusion: The method used to assess dental asymmetry by means of CBCT is valid. Measurements of molars, canines and dental midline symmetry with the skeletal midline are reproducible and reliable when taken by means of CBCT and by different operators.
- Published
- 2014
- Full Text
- View/download PDF
18. A new case of idiopathic hemiplegia hemiconvulsion syndrome.
- Author
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Franzoni E, Garone C, Marchiani V, Brunetto D, Tonon C, Lodi R, and Bernardi B
- Subjects
- Atrophy, Brain Edema complications, Brain Edema metabolism, Brain Edema pathology, Epilepsy, Partial, Motor metabolism, Epilepsy, Partial, Motor pathology, Hemiplegia metabolism, Hemiplegia pathology, Humans, Infant, Magnetic Resonance Imaging methods, Male, Seizures, Febrile complications, Seizures, Febrile metabolism, Seizures, Febrile pathology, Epilepsy, Partial, Motor complications, Hemiplegia complications, Syndrome
- Abstract
We report a new case of infantile idiopathic hemiconvulsion-hemiplegia syndrome (HH). A prolonged right-sided febrile convulsion was followed 4 days later, by right hemiconvulsive status epilepticus, documented by video-electroencephalogram (EEG) recording. The child developed an ipsilateral hemiplegia, partially improved during the first month of follow-up. Sequential cerebral magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS) at 6, 15, 30 days of follow-up showed a cytotoxic edema in the left hemisphere and a subsequent necrosis. At 1-year of follow-up, we performed MRI control because of febrile convulsion lasting few minutes that confirmed a non-progressive left hemisphere atrophy. After 2 years, the patient was seizure-free, with a mild right hemiplegia and language skills deficit. We discuss the unclear pathogenesis of HH through sequential neuroradiological evaluation.
- Published
- 2010
- Full Text
- View/download PDF
19. VNS in drug resistant epilepsy: preliminary report on a small group of patients.
- Author
-
Franzoni E, Gentile V, Colonnelli MC, Brunetto D, Cecconi I, Iero L, Moscano FC, Cordelli DM, and Marchiani V
- Subjects
- Adolescent, Adult, Child, Electrodes, Implanted, Epilepsy psychology, Female, Follow-Up Studies, Humans, Male, Quality of Life, Retrospective Studies, Time Factors, Treatment Outcome, Young Adult, Drug Resistance, Epilepsy therapy, Vagus Nerve Stimulation methods
- Abstract
Background: In 1997 Vagus Nerve Stimulation (VNS) received approval from the US Food and Drug Administration (FDA) as an adjunctive therapy in the treatment of medically intractable partial epilepsy in people aged 12 years and older who are ineligible for resective epilepsy surgery. Although the exact mechanisms of action are unknown, the use of VNS with children has increased, including those younger than 12 years of age, or those with generalized epilepsy., Methods: We describe the outcome for the first group of nine patients, aged 8-28 years, who had pharmaco-resistant epilepsy and were treated with VNS. During the follow up, we gradually and slowly increased the parameters of the stimulation in order to assess the efficacy of VNS even at parameters which would usually be considered "non-therapeutic", along with possible side effects and changes in quality of life., Results: At the last follow, up 1 patient was "seizures free", 3 were "very good responders", 3 were "good responders" and 2 were "non responders". We obtained an initial seizure reduction with low stimulation parameters, the highest current reached being 2.00 mA. This observation supports the possibility that, for younger patients, lower stimulation intensities than those commonly used in clinical practice for adults can be therapeutic. We also wanted to underline the reduction in seizure frequency (approximately 91.7%) and the reduction in seizure duration (> 50%) in the patients affected by drug-resistant absence epilepsy. Adverse effects were mild, tolerable and, in most of cases, easily resolved by adjusting the stimulation parameters. Hoarseness of voice was the most frequent side effect. The improvements in the quality of life are relevant and seem to be independent of the VNS effect in controlling seizures., Conclusions: Our small experience seems to confirm the efficacy and safety of VNS in drug resistant partial and generalized epilepsy in developing age groups.
- Published
- 2010
- Full Text
- View/download PDF
20. Bathing epilepsy: report of two Caucasian cases.
- Author
-
Franzoni E, Gentile V, Grosso S, Brunetto D, Cordelli DM, and Balestri P
- Subjects
- Child, Child, Preschool, Electroencephalography, Epilepsy, Reflex diagnosis, Female, Humans, Treatment Outcome, Baths adverse effects, Epilepsy, Reflex etiology, Epilepsy, Reflex therapy
- Abstract
Bathing epilepsy, also known as water-immersion epilepsy, refers to a rare form of benign reflex epilepsy in which seizures are precipitated by the normal process of domestic bathing. This condition has been confused with true hot water epilepsy, even though bathing in water at normal temperature is the trigger. Focal seizures predominate with a staring gaze, pallor and generalised features followed by prolonged postictal somnolence. A variable percentage of patients may also show unprovoked seizures. The prognosis is usually favourable, and modifying bathing habits may prevent further seizures. We report two Caucasian patients with bathing epilepsy. In one, seizures were provoked by water immersion. In the other, we noted an unusual triggering factor; pouring of lukewarm water over the genitalia.
- Published
- 2010
- Full Text
- View/download PDF
21. Fibrosclerotic lymphedema: pathophysiology and therapy.
- Author
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Talarico F, Brunetto D, Scialabba M, Pernice I, Valenti G, Benvegna S, Mastrandrea G, and Rusignuolo F
- Subjects
- Connective Tissue surgery, Drainage, Extremities, Female, Fibrosis, Humans, Lymphatic System physiopathology, Male, Middle Aged, Posture, Pressure, Sclerosis, Lymphedema physiopathology, Lymphedema therapy
- Abstract
We describe our experience with 12 patients with severe fibrotic lymphedema treated between 1979 and 1987. Each patient initially underwent nonoperative treatment (postural drainage and pneumatic compression) and in 10 patients who required operation, these measures were continued postoperatively. Operation included excision of subcutaneous tissue (debulking), which was extensive in 8 and limited in 2 patients. Only 2 patients were satisfactorily managed by nonoperative treatment alone. Based on the extensive pathophysiologic changes that occur in the tissue microenvironment with lymph stasis, it is unlikely that at this advanced stage of lymphedema that nonoperative treatment alone or "physiologic" operations such as lymphatic-venous shunt or lymphatic collector reconstruction is satisfactory. Rather, nearly all such patients require limited or extensive excision of the fibrotic-edematous subcutaneous tissue.
- Published
- 1991
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