Subacute cerebellar degeneration is a rare complication of some neoplasms, and is generally resistant to therapy. A case of subacute cerebellar degeneration in a 50-year-old woman with a Stage II grade 3 serous ovarian adenocarcinoma is reported. The onset of the neurologic symptoms preceded the diagnosis of cancer and progressively worsened during and after four cycles of chemotherapy. A quick, partial improvement of the neurologic syndrome was documented after three weekly treatments with plasmapheresis. The contribution of circulating factors in inducing subacute cerebellar degeneration can be postulated. A trial using this new type of treatment should be performed in patients who have this therapeutically refractory clinical condition.

A case of progressive external ophthalmoplegia (PEO) in association with peripheral neuropathy and other neural and visceral manifestations is reported. Pathological studies of the sural nerve demonstrated loss of large myelinated fibers, segmental demyelination with remyelination, and excess of zebra bodies in the Schwann cells on electron microscopy. Peripheral neuropathy in the course of PEO is regarded as a further although rare aspect of a multisystem disease.

A clinical and epidemiological study on ALS was conducted in the province of Parma, Italy, in the period 1960-1980. A total of 78 cases was collected from hospital records. The average annual incidence was 0.93 per 100,000 with no difference between rural and urban areas. On prevalence day (October 24, 1971) a prevalence rate of 2.27 was found. Mean age at onset was 59 years, with no sex difference. In 70% of cases the onset was between 50 and 70 years, this datum being statistically significant (p less than 0.001). Mean duration of the disease was 30.4 +/- 20 months, with no difference for sex and age at onset. A comparison was then made between two decades (1961-70 vs 1971-80), in order to verify the clinical impression of a worsening of some ALS parameters in recent years. Although statistical evaluation did not show any significant data, a tendency to a worsening of some parameters of the disease may be postulated.

A hypercalcemic condition can be observed in association with hyperthyroidism. The case of a patient suffering from hypercalcemia and hyperthyroidism is reported. A confusional state and EEG alterations, among which diffuse monomorphic delta rhythms were remarkable, are shown. As soon as normalization of calcemia was achieved, a rapid clinical and EEG improvement took place. A hypothetical interpretation is proposed, according to which a prolonged, though inconstant, and mild hypercalcemia in the course of hyperthyroidism could determine an encephalopathy, concealing in some way thyrotoxic symptoms.

Pseudomyotonic discharges of the striated urethral sphincter are infrequent findings. We herein report on 9 patients with dissimilar anatomical-clinical conditions. In some patients a definite neurological lesion was ascertained, whereas in the remaining patients no neurological impairment could be determined clinically and instrumentally. The possibility of spontaneous resolution of the phenomenon is an interesting clinical feature.