A sex-dependent hemispheric difference in MV in the left MCA at rest (females>males) in the younger population subgroup was identified. These data support recent observations on anatomical differences between sexes, referring a proportionally larger Broca area in females compared to males.
We studied the three most commonly used rating scales in Parkinson’s Disease (Hoehn and Yahr Clinical Staging, Webster Rating Scale, Columbia University Rating Scale) in order to examine the agreement between observers. Six neurologists, experts at using such scales, evaluated 48 patients suffering from the idiopathic form of Parkinson’s Disease. Reliability using the K index was moderate, although a slight superiority was found with the Columbia University Rating Scale. Analysis of the various items used has suggested that scales of disability could be a valid alternative to those examined.
The authors studied a group of 36 patients with idiopathic Parkinson's disease by electro-oculographic examination in order to evaluate the most frequent vestibular and oculomotor findings. Vestibular alterations were detected mainly in caloric nystagmus (82.9%). Hyperreflectivity was the most frequent evidence, but it does not necessarily represent the sign of a lesion. The occurrence of spontaneous and evoked nystagmus was not significant. Oculomotor findings were more interesting, as they were altered in two-thirds of the cases. Particularly, saccadic eye movements presented a "multiple step" morphology in 58.3% of the series. This saccadic disarrangement was scarcely found in neurological patients with brainstem and/or cerebellum pathology (7.7%). Moreover, in Parkinson's disease patients no other saccadic alterations typical of brainstem or cerebellum involvement were found. Such observations suggest a possible non-cerebellar origin of "multiple step". Vestibular and oculomotor findings were not significantly correlated with the clinical features of the patients.
A simple self-administered questionnaire was mailed to a population sample of 8,626 (40–65 years old) to identify transient ischemic attacks (TIAs) that occurred in the previous 12 months. This study was conducted in a well-defined, medically controlled geographic area. 75.4% of the questionnaires were returned. The procedure identified 52 TIA cases (43 definite and 9 uncertain). The 12-month period prevalence for TIAs was 6.6 per 1,000 (95% confidence limits of 4.8–8.9) among the respondents. The annual incidence rate for first TIAs was 3.1 per 1,000 (95% confidence limits of 1.9–4.7). Our results differ from those reported in hospital series or in population surveys based on clinical records, with higher incidence and prevalence rates, female preponderate and higher frequency of vertebrobasilar attacks.
Testing the reliability and usefulness of disability scales in Parkinson''s disease has been the object of a study carried out by 4 neurologists on 48 patients using 2 rating scales – Hoehn and Yahr staging and Columbia University Rating Scale – and 2 disability scales – Northwestern University Disability Scale and Extensive Disability Scale, a new scale conceived for this purpose, which is more accurate in examining in a different way the physical incapacity and handicap of parkinsonian patients in their daily living. The examiners worked in pairs and did not discuss their rating scores before the end of the study. As far as interobserver agreement is concerned, the results of the disability scales are better than those of the rating scales. The Northwestern Disability Scale and the new scale are similar in reliability and consistency; however, the Extensive Disability Scale has proved to be a better indicator of the functional status. We suggest a more extensive employment of disability scales in clinical studies.
Patients with panic disorder, both during the acute phase of the illness and after clinical recovery, show an exaggerated drop in CBF during tilting. Since these findings are similar, although attenuated in intensity, to those which are observed in dysautonomic illnesses, one possible interpretation is that of panic disorder as a subclinical form of autonomic dysreactivity.
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