Mioclono Canafoglia, Laura; Granata, Tiziana; Franceschetti, Silvana
Terapia delle malattie neurologiche
Book Chapter
Il mioclono costituisce un particolare disordine del movimento che può derivare da diversi generatori del sistema nervoso, avere modalità di comparsa variabile ed eziologie eterogenee.
Neurological derangement has been reported in haemodialysed patients receiving intravenous desferrioxamine (DFO) for aluminium-related disorders. The possible direct effects of desferrioxamine on EEG ...recordings were investigated in ten haemodialysed patients who underwent a DFO test 2 h after the end of dialysis. According to a commonly accepted protocol, 40 mg/kg body-weight of desferrioxamine was infused in 60 min. EEG recording was continuously performed, starting 30 min before and stopping 30 min after the desferrioxamine infusion. Besides visual inspection, EEG records were digitised, tapered, and spectrally analysed with Digital PDP 11/73 microcomputer. Basal EEG recording was normal in all patients. In three patients a progressive EEG slowing was detected by visual inspection during desferrioxamine infusion; in these cases automatic analysis revealed a 50% increase in power of slower frequencies 30 min after starting the infusion, when no changes in plasma aluminium concentrations are detected; a complete recovery was observed 30 min after desferrioxamine withdrawal. In one patient bilateral paroxysms of slow waves appeared, so we stopped desferrioxamine infusion. Two of the three patients who developed EEG abnormalities also had an increased aluminium body burden (positive DFO test). Results indicated that desferrioxamine per se can modify EEG in haemodialysis patients and that its effect is not mediated by acute increases of plasma aluminium concentrations. The finding of a positive DFO test in two of three patients with EEG changes may suggest that an aluminium-induced blood-brain barrier derangement could have played a role. However, prompt recovery after ceasing desferrioxamine infusion strongly suggests a direct role of desferrioxamine in the induction of EEG changes.
Responsiveness to visual, acoustic and somesthesic stimuli was studied in 260 units recorded within the associative thalamic nuclei of the cat (pulvinar-lateralis posterior complex and posterior ...group). Of the 123 units responding to one or more stimuli 41 (corresponding to 15% of the total) showed multisensory convergence. Bimodal, visual-somesthesic convergence was the most common finding, occurring in 33 units. Visual-somesthesic inhibitory interaction was observed only in the pulvinar nucleus, suggesting a peculiar synaptic organization of multisensory input to this nucleus.
