1,721,027 research outputs found
Elettromiografia e disordini neuromuscolari : correlazioni clinico-elettrofisiologiche ed ecografiche
No full textAllodynia in migraine: frequent random association or unavoidable consequence?
No full textAllodynia, the perception of pain induced by a non-painful stimulus, is frequently associated with migraine, especially when chronic, and mainly in the aura subtype. Among migraineurs, allodynia is thought to be caused by the headache and the activation of nociceptors with the development of central sensitization in subjects with an altered regulation of the central nociceptive pathway. The persistence of pain sensation seems to be able to induce central sensitization in the caudal nucleus of the trigeminal nerve by lowering the neuronal pain threshold. Different pathogenetic mechanisms may be involved and genetic, environmental and psychological elements should be considered. The complaint of allodynia is more frequent during the headache attack (acute allodynia) than in-between attacks (interictal allodynia). Acute allodynia is generally referred to the painful region but may diffuse to other areas, cephalic or even extracephalic. Extracephalic allodynia could not be mediated by nucleus caudalis as its neurons do not express whole-body receptive fields. The likely mechanism is thalamic sensitization. This symptom must be carefully assessed because it may be as annoying and limiting in daily activities as pain itself, and because its presence seems to reduce the efficacy of drugs used for migraine attacks. Instrumental measures may be applied, and clinical questionnaires to assess the presence of allodynic symptoms have also been developed and validated
Myotonia induced by potassium repletion in a diabetic patient with secondary hypokalemic paralysis
No full textIn a woman suffering from insulin-dependent diabetes mellitus, hypokalemic paralysis developed acutely following an episode of diabetes decompensation. During the treatment of this episode, as soon as serum potassium levels were restored to normal values, a marked increase in muscular excitability with an electromyographic picture of myotonia was observed. The patient showed signs of chronic muscle denervation that accounted for an increased sensitivity to potassium-induced depolarization and contraction and that might have been responsible for the appearance of myotonia during potassium repletion
Brain natriuretic peptide as a marker of cardiac toxicity in patients with multiple sclerosis treated with mitoxantrone
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Fluctuating position-related cognitive disturbances and recurrent cerebral ischemic attacks as presenting symptoms in a patient with platypnea-orthodeoxya syndrome
Full text linkPlatypnea-orthodeoxia syndrome is a condition of dyspnea and hypoxia whilst in the upright position, which improves in the recumbent position. We present a case of platypnea-orthodeoxia due to a fenestrated atrial septal aneurysm that induced recurrent strokes and a recent condition of fluctuating confusion and cognitive impairment, modified by position, associated with rapid variations of O2 saturation position related. The suspect of platypnea-orthodeoxia syndrome may be hypothesized in case of patients with recurrent cerebral ischemia and fluctuating cognitive disturbances induced by change of position. In those cases a careful echocardiographic evaluation and O2 saturation determination in up and downright position are required
Sleep and headache : a bidirectional relationship
No full textSleep and pain perception are two phylogenetically well-conserved functions, strictly influenced by environmental and psychological factors, and are able to interact reciprocally both in physiological and pathological situations. Sleep and head-pain perception share the involvement of several structures, such as the thalamus, the hypothalamus and brainstem nuclei, including the locus coeruleus and raphe nuclei. There ais clinical evidence indicating that sleep disorders can precede the appearance of certain headaches and that head pain, especially when frequent, can, in turn, affect sleep quality. In the present work the anatomy, physiology and pathology of sleep and head-pain perception will be reviewed with the aim of highlighting the points of contact and possible unifying treatment strategies
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