Diagnostic delay and prognosis in primary central nervous system lymphoma compared with glioblastoma multiforme.

Glioblastoma multiforme (GBM) and primary central nervous system lymphoma (PCNSL) are malignant cerebral neoplasms associated with poor prognosis. Early diagnosis and subsequent planning of adequate treatment strategy are relevant to improve survival and reduce neurological deficit. Two groups of patients affected by GBM and PCNSL were compared to identify: (1) factors influencing the time necessary to obtain a correct diagnosis; (2) the influence of the interval time from clinical onset to diagnosis on the prognosis.

Features and predictors of activity limitations and participation restriction 2 years after intensive rehabilitation following first-ever stroke.

Background: Although stroke-related disability has been extensively studied, only few studies have investigated Participation restriction in chronic stroke survivors.

Aim: To identify features and predictors of Activity limitation and Participation restriction in the chronic phase of a first-ever stroke.

Design: Cross-sectional observational study.

Familial hemifacial spasm and determinants of late onset.

The role of hypertension in the late onset of hemifacial spasm (HFS) is evaluated in a family, spanning four generations. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) revealed a variable anatomical relationship between nervous and vascular structures in the symptomatic cerebello-pontine angle. In one case, showing neurovascular conflict (NVC), microvascular surgical decompression was followed by clinical resolution of HFS.

Long-lasting benefits of botulinum toxin type B in Parkinson's disease-related drooling.

Purpose: To investigate the safety, efficacy and effectiveness of botulinum toxin type-B (BTX-B) injections into the parotid glands to reduce drooling in Parkinson's disease (PD) subjects.

Methods: A double-blind, randomised, placebo-controlled study enrolled 36 advanced phase PD subjects who complained of disabling drooling. Patients received either 4000U BTX-B or placebo.

Botulinum toxin type A for drooling in Parkinson's disease: a double-blind, randomized, placebo-controlled study.

To investigate the safety and efficacy of botulinum toxin type A (BoNTX) treatment to reduce sialorrhea in Parkinson's disease (PD), a double-blind, randomized, placebo-controlled study enrolled 32 PD patients complaining of excessive drooling. Patients received either 50 U Botox in each parotid gland or placebo without using ultrasound guidance. Subjects treated with BoNTX experienced a reduction in both drooling frequency and familial and social disability (TimexGroup effect: P<0.

Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: technical improvements.

Background: Wrist blockage of median and ulnar nerves before treatment of palmar hyperhidrosis with botulinum toxin (BTX-A) reduces discomfort and improves accuracy of BTX-A injections, but can be associated with mechanical/chemical injury.

Objectives: We sought to compare locoregional anesthesia of median and ulnar nerves using conventional 25-G x 0.50 x 13 mm gauge needle with short 30-G x 0.

Quality-of-life assessment in patients with hyperhidrosis before and after treatment with botulinum toxin: results of an open-label study.

Background: Patients with hyperhidrosis, a disorder characterized by increased sweat production, experience substantial functional and emotional problems. Botulinum toxin type A (BTX-A) has been shown to be useful in the treatment of hyperhidrosis; however, few studies have considered the effects of treatment on patients' quality of life (QOL).

Objectives: The objectives of this study were to assess QOL in patients with focal hyperhidrosis; to investigate whether the impairment in QOL in these patients is related to the type of hyperhidrosis or the number of sites involved; and to compare the changes in QOL and the response to BTX-A treatment in patients with axillary and palmar hyperhidrosis.

Influence of early high-dose steroid treatment on Bell's palsy evolution.

The objective of this double-blind, randomized, placebo-controlled study was to test the efficacy of high-dose prednisone, administered as early as possible, in modifying the natural progression of Bell's palsy. Sixty-two consecutive patients, enrolled within 72 hours of facial palsy onset, were assigned to high dose intravenous prednisone in combination with intramuscular polyvitaminic therapy (group A) or polyvitaminic therapy alone (group B). Clinical grading of facial muscle strength and length of absence from work were evaluated.

Post-stroke spasticity management with repeated botulinum toxin injections in the upper limb.

Objective: Although the botulinum toxin A (BTX-A) treatment has proved effective in spasticity management, no information is available with regard to the effects of repeated injections over time.

Design: To evaluate the effects of BTX-A on moderate or severe upper limb spasticity, an exploratory investigation was performed on 28 stroke patients treated for 2 yr or longer and observed for 3 yr. Every 3 to 5 mo, each patient received BTX-A injections in upper limb muscles.

Transcranial Doppler sonographic monitoring during cerebral aneurysm embolization: a preliminary report.

Background And Purpose: The wide application of embolization in the treatment of aneurysms has created the need for an intraprocedural means to anticipate a poor outcome by monitoring hemodynamic changes in the brain.

Methods: Transcranial Doppler sonography was used to monitor flow velocity in the middle cerebral artery (MCA) in 23 patients undergoing embolization with Guglielmi detachable coils (GDCs) of either incidental or symptomatic intracranial aneurysms. Sonographic values were recorded from the ipsilateral MCA at the beginning, middle, and end of the interventional procedure and 24 hours afterward.

Low-dose botulinum toxin with ankle taping for the treatment of spastic equinovarus foot after stroke.

Objective: To evaluate the efficacy of a combined treatment for spastic foot using selective injections of botulinum toxin (BTA) into the tibialis posterior muscle followed by ankle taping, and to compare it with current BTA treatment procedure.

Design: Single-blind randomized control trial. Three-month follow-up after treatment.

Reproducibility of normal facial motor nerve conduction studies and their relevance in the electrophysiological assessment of peripheral facial paralysis.

To determine the intra-examiner intertrial reproducibility of normal facial motor nerve conduction studies (FNCS) and their relevance in electrophysiological assessments of peripheral facial paralysis, 52 patients with acute unilateral Bell's palsy were examined on two separate occasions 1 months apart. Three electroneurographic methods were assessed. On the unaffected side of the face, FNCS are reliable when performed by a single examiner over time.

Diabetic retinopathy and cerebral hemodynamic impairment in type II diabetes.

Purpose: To assess whether a screening method based on transcranial Doppler (TCD) examination could detect signs of brain hemodynamic impairment in non-insulin-dependent diabetic patients with retinal microangiopathy of varying severity, asymptomatic for cerebrovascular diseases.

Methods: We studied 86 patients stratified according to the presence of proliferative diabetic retinopathy (PDR: 29 cases), background retinopathy (BDR: 32 cases) and no diabetic retinopathy (NDR: 25 patients). TCD was performed to record mean flow velocity and pulsatility index values in the middle cerebral (MCA), anterior cerebral (ACA) and ophthalmic arteries (OA), at rest.

Electrically evoked long-latency responses in human forearm, arm and shoulder muscles.

Little is known about electrically evoked long-latency responses (LLR) in muscles other than hand muscles. We obtained LLR in forearm, arm and shoulder muscles by ipsilateral homonymous and heteronymous mixed and pure cutaneous electrical stimulation of the median or ulnar nerve in healthy subjects and in patients with focal unilateral Central Nervous System lesions. Our results point out the important role played by hand afferents in the sensorimotor coordination of multiarticulate upper limb movements.