Nonsurgical lumbar radiculopathies treated with ultramicronized palmitoylethanolamide (umPEA): A series of 100 cases

In this clinical/observational study we have reported the administration of Palmitoylethanolamide (PEA) in patients suffering from radicular lumbar spinal pathology, who had no indication for surgical treatment. We analyzed a series of 100 cases retrospectively, all undergoing clinical and diagnostic investigations, which had shown the presence of abnormalities of the vertebral body and intervertebral discs, mainly degenerative, such as spondyloarthrosis, spondylo-discarthrosis, disc protrusion, excluding disc herniation, which fell within surgical cases. We then administered ultramicronized PEA (umPEA) to these patients, in combination with paracetamol and codeine, obtaining interesting results regarding the improvement of pain symptoms of the spine pathology, in the various checks carried out, through the administration of pain assessment scales. We also noted its safety due to the total absence of adverse effects. The obtained results encourage the use of PEA in degenerative spine pathologies

Discrepancy between clinical-neurophysiological-neuroimaging examinations in lumbar spine degenerative disease: To the neurosurgeon the choice

Background: Degenerative lumbar spinal surgery is preceded by diagnostic investigations, like clinical, radiological, neurophysiological ones. The presurgical evaluation is made easier by the concordance of the diagnostic investigations. In a percentage of cases, however, there is a discrepancy, especially with regard to the correlation between electromyography and neuroimaging. It is the case of a normal EMG and a CT or MRI showing the presence of a protrusion or a herniated disc. Material and methods: Our study covers 30 subjects suffering from herniated disc pain and undergone surgery. 15 patients presented with lumbar pain, with CT and MRI showing herniated disc, but normal electromyographic results. Despite this discordance, all patients underwent surgery. Results: The results were satisfactory. The results of this study highlighted the possible discrepancy between neurophysiological, neuroradiological and clinical examinations but the surgeon's decision to intervene was appropriate since the 5-year follow-up showed the resolution of the disc pathology, with disappearance of pain. Conclusions: The discrepancy between the diagnostic examinations is a problem creating for the purpose of the preoperative evaluation, whereby the decision to intervene is entrusted to neurosurgeon, who will choose the better option for surgery. Keywords: Herniation disc, Lumbar spine, Neuroimaging, Elecromyograph

Median occipital fossa: is it really a sign of crime or simply an anatomical variant?

Anatomical variants are alterations of the form, thickness, length, width, position of organs and anatomic structures that can cause problems of a functional nature. They can be vascular, bony, muscular and more. They represent anomalies that may cause disturbances or do not cause changes in functions. The criminologist Cesare Lombroso had correlated the anatomical variations to the criminal tendency. The most emblematic case was that related to the alleged brigand Villella, on which Lombroso, performing the autopsy, found in the skull the so-called medial occipital fossa or a third dimple. He stated that the median occipital dimple was considered a sign of atavism, the expression of the criminal. In fact all the anatomical variants described by Lombroso are variations of normality. No one ever said that anatomical variants were a sign of crime. In conclusion, anatomical variants cannot be related to crime tendency, therefore the debated median occipital fossa is only and simply an anatomical variant

Comparison of post surgical results in medial and lateral lumbar spine herniated discs: Own case series experience

Abstract Lumbar disc herniation is a frequent condition. It causes radicular pain with irradiation along a lower limb or localized to the back. Disc herniation can be lateral or medial, with different clinical features. Medial disc herniation is more frequent, characterized by immediate good outcome after surgical treatment. Lateral disc herniation shows a greater delay in improvement on pain after surgical treatment, especially in the elderly. Some factors affect the surgical outcome, such as old age, alterations of the vertebral body, ligaments, intervertebral level. Our study is in line with these data, highlighting the better outcome, immediately after the surgical treatment in patients with medial disc herniation, while results has not been immediate in patients with lateral disc herniation, Finally, there was disappearance of the pain for both groups, as demonstrated in the long-term follow-up, after the surgical treatment

Focus on the Endogenous Cannabinoid System in Migraine

Migraine prophylaxis represents a better choice than symptomatic drugs, both for safety and for effectiveness. Today, drugs such as calcium channel blockers, beta-blockers, and topiramate are still used to treat migraine with and without aura, often with satisfactory results but in some cases with adverse effects, thus limiting their use. A new class of drugs in migraine prophylaxis are endocannabinoids, substances which modulate the mechanisms of neuroinflammation that cause migraine pain. Anandamide and palmitoylethanolamide have proven useful in migraine prophylaxis, suggesting their influence in neuroinflammatory processes and opening the way for new therapeutic perspectives

Cortical neuromodulation for neuropathic pain and Parkinson disease: Where are we?

Cortex neuromodulation is promising approach for treatment of some neurological condi-tions, especially neuropathic pain and Parkinson's disease. Effects of non-invasive corticalstimulation are short lived; transcranial direct current stimulation (tDCS) and transcranialalternating current stimulation (tACS) may be useful to assess the suitability for invasivecortical stimulation. Direct cortical stimulation (DCS) is the method able to provide longlasting effects in treatment of neuropathic pain and some symptoms of Parkinson's disease through the use of totally implantable systems that ensure a chronic stimulation

New-onset hemodialysis-related headache presenting as migraine aura

Hemodialysis headache (HDH) is an infrequent new-onset symptom, occurring mainly in old uremic patients. Type of pain is nonspecific, occurs during hemodialysis treatment, assuming features similar to tension-type headache and representing a problem, also as regards the therapy to be taken. International Headache Society (IHS) has placed this form of headache among the headaches disorders of homeostasis. We found a case of new-onset HDH in old uremic man, presenting with migraine aura features. A similar case has not been reported in literature, placing us some questions: why and how does this happen? What are the mechanisms involved? Role of trigeminal-vascular system and cortical spreading depression as regards the aura could be considered, through the activation of neuroinflammatory events, lastly causing migraine aura. Moreover, the administration of flunarizine strongly improved migraine symptoms in our patient, as happens in migraine syndromes. Definitely, this case leads us to think that some mechanisms involved in headaches will need to be further clarified

DOWN AND DIRTY LOMBROSO’S BORN TO CRIME, THE MORPHOANTHROPOLOGY AND THE IGNORED HUMAN NEUROPHYSIOLOGY: A CRITICAL REVIEW ON A HISTORICAL CONTEXT

Lombroso\u27s theories, in 1800s, gave a strong shock in the international scientific community , regarding the correlation between the human morphology and its tendency to crime. They were followed, especially out of the Europe, and still are being discussed. But, in that century, they were enriched researches on human neurophysiology, which then would be further down to our time and that they denied sharply the Lombroso concepts. In short, the ignored neurophysiology, to the detriment of hypothesis which theorized the tendency to crime as an expression of the physical features of the individual, the whole body, from the face, limbs, ears, the shape of the skull. In this review, are made some critical remarks about Lombroso concepts, on \u27atavism, the people considered inferior on the basis of their physical appearance, in other words what was called morphoanthropology. At the same time, this work emphasizes instead the \u27importance of neurophysiological aspects of\u27 individual tending to crime, that are the basis of abnormal acts against the society \u27and that are related to the dysfunction of certain brain areas, such as the frontal cortex and limbic cortex, under the influence of genotype and environmental factors