1,721,076 research outputs found
Promuovere le potenzialità degli studenti con DSA. Scuola secondaria e università a 10 anni dalla Legge 170
No full textEye-closure-triggered paroxysmal activity and cognitive impairment: a case report
No full textPURPOSE: To study the neuropsychological status of an epileptic patient presenting with epileptic activity triggered by eye closure in a 14-year follow-up period.
METHODS: The patient was studied at 12 and 26 years of age; during this period he underwent periodical clinical evaluations and EEG investigations; brain magnetic resonance imaging (MRI) was performed at 12 years of age. A neuropsychological assessment was carried out both at 12 years of age (T0) and at 26 years of age. At T0 and T1, neuropsychological tests (digits and words span, graphoestesia, reactions time to auditory stimuli, sentences repetition, words repetition, digital gnosis, backward counting [i.e.,100-0]) were performed during video-EEG monitoring either with eyes closed or with eyes open, to evaluate possible transitory effects related to ongoing epileptic activity. Moreover, at T0 the patient underwent Wechsler Intelligence Scale for Children-Revised, and at T1 to Wechsler Adult Intelligence Scale-Revised.
RESULTS: EEG recordings showed continuous epileptic activity triggered by eye closure, disappearing only with eyes opening, both at T0 and T1 (in this latter case, anteriorly predominant). The results of neuropsychological assessment during eyes closed as compared to performances with eyes open did not show significant differences, at T0 as well as at T1. Wechsler Intelligence scales showed a deterioration of performances at T1 with respect to T0; in addition, at T1, attention and short-term memory abnormalities, impairment in facial recognition and block design, and defective results in Continuous Performance Test and Wisconsin Card Sorting Test were observed.
CONCLUSIONS: Lack of differences between the results of neuropsychological tests performed with eyes closed as compared to the eyes open condition suggests that in our patient epileptic activity did not cause transitory cognitive abnormalities. Deterioration of Wechsler Intelligence Scales in the follow-up period might be interpreted as the result of a disruption of cognitive processes possibly related to the persistence of a continuous epileptic activity during eye closure over the years. We speculate whether a dysfunction in posterior cortical areas involved in visual processing might be related to the impairment in face recognition and block design tests as well to eye closure sensitivity
I tic e la sindrome di Tourette. Dalla pratica clinica alla gestione quotidiana a scuola
No full textLa sindrome di Tourette è un disturbo caratterizzato da tic motori e fonatori multipli cui spesso si associano disturbi comportamentali, dell’umore e della personalità. Tale sfaccettatura pone sfide importanti circa le strategie terapeutiche da utilizzare allo scopo di migliorare la qualità di vita dei pazienti. Questo vademecum, rivolto ai clinici, ma anche a insegnanti, educatori e genitori, permette di meglio comprendere il profilo funzionale di bambini o ragazzi con tic e sindrome di Tourette e fornisce indicazioni sui percorsi di diagnosi e cura, per meglio indirizzare le famiglie e gli specialisti per una presa in carico tempestiva ed adeguata, e indicazioni operative sulla scelta degli obiettivi didattici e delle metodologie di lavoro per veicolare gli apprendimenti scolastici. In appendice, è riportata la scala C&A-GTS-QOL sulla qualità della vita per soggetti con sindrome di Tourette, in forma di intervista, per i bambini dai 6-12 anni, e di questionario autosomministrato, per gli adolescenti dai 13 ai 18 anni
Emerging treatment strategies in Tourette syndrome: what's in the pipeline?
No full textTourette syndrome (TS) is a neurodevelopmental disorder characterized by multiple motor/phonic tics and a wide spectrum of behavioral problems (e.g., complex tic-like symptoms, attention deficit hyperactivity disorder, and obsessive-compulsive disorder). TS can be a challenging condition even for the specialists, because of the complexity of the clinical picture and the potential adverse effects of the most commonly prescribed medications. Expert opinions and consensus guidelines on the assessment and treatment of tic disorders have recently been published in Europe and Canada. All pharmacological treatment options are mere symptomatic treatments that alleviate, but do not cure, the tics. We still lack evidence of their effects on the natural long-term course and on the prognosis of TS and how these treatments may influence the natural course of brain development. The most commonly prescribed drugs are dopamine antagonists, such as typical (e.g., haloperidol, pimozide) and atypical neuroleptics (e.g., risperidone, aripiprazole), and α-2-adrenoreceptor agonists (e.g., clonidine). However, several studies have investigated the efficacy and tolerability of alternative pharmacological agents that may be efficacious, including the newest atypical antipsychotic agents (e.g., paliperidone, sertindole), tetrabenazine, drugs that modulate acetylcholine (e.g., nicotine) and GABA (e.g., baclofen, levetiracetam), tetrahydrocannabinol, botulinum toxin injections, anticonvulsant drugs (e.g., topiramate, carbamazepine), naloxone, lithium, norepinephrine, steroid 5α reductase, and other neuroactive agents (buspirone, metoclopramide, phytostigmine, and spiradoline mesylate). As regards nonpharmacological interventions, some of the more recent treatments that have been studied include electroconvulsive therapy and repetitive transcranial magnetic stimulation. This review focuses primarily on the efficacy and safety of these emerging treatment strategies in TS
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