Accelerated forgetting of real-life events in Transient Epileptic Amnesia.

addresses: Cognitive and Behavioural Neurology, Peninsula Medical School, University of Exeter, Exeter, UK.types: Journal Article; Research Support, Non-U.S. Gov'tCopyright © 2010 Elsevier. NOTICE: This is the author’s version of a work accepted for publication by Elsevier. Changes resulting from the publishing process, including peer review, editing, corrections, structural formatting and other quality control mechanisms, may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Neuropsychologia, 2010, Vol. 48, Issue 11, pp. 3235 – 3244 DOI: http://dx.doi.org/10.1016/j.neuropsychologia.2010.07.001Transient Epileptic Amnesia (TEA) is a form of temporal lobe epilepsy associated with ictal and interictal memory disturbance. Some patients with TEA exhibit Accelerated Long-term Forgetting (ALF), in which memory for verbal and non-verbal material is retained normally over short delays but fades at an unusually rapid rate over days to weeks. This study addresses three questions about ALF in TEA: (i) whether real-life events undergo ALF in a similar fashion to laboratory-based stimuli; (ii) whether ALF can be detected within 24h; (iii) whether procedural memories are susceptible to ALF. Eleven patients with TEA and eleven matched healthy controls wore a novel, automatic camera, SenseCam, while visiting a local attraction. Memory for images of events was assessed on the same day and after delays of one day, one week, and three weeks. Forgetting of real-life events was compared with forgetting of a word list and with performance on a procedural memory task. On the day of their excursion, patients and controls recalled similar numbers of primary events, associated secondary details (contiguous events, thoughts and sensory information) and items from the word list. In contrast, patients showed ALF for primary events over three weeks, with ALF for contiguous events, thoughts and words over the first day. Retention on the procedural memory task was normal over three weeks. The results indicate that accelerated forgetting in TEA: (i) affects memory for real-life events as well as laboratory stimuli; (ii) is maximal over the first day; and (iii) is specific to declarative memories

[Computed tomography in the preoperative staging of gastric cancer].

In gastric cancer patients, CT can demonstrate wall lesions, tumor spread to adjacent organs and metastases. Since the disease is often diagnosed in an advanced stage, some authors used CT to stage the tumor and to avoid surgery in the patients with unresectable lesions. We compared CT staging results with surgical findings in 22 gastric cancer patients. After fluid-filling and hypotonization of the stomach, CT detected gastric wall thickening in all cases. In 4 patients neoplastic nodes 1.5 cm which had been considered as metastatic were negative at histology. Overall CT accuracy in diagnosing nodal involvement was 73\%. The lack of fat plane used as the evidence of direct invasion of adjacent organs exhibited 45\% overall accuracy for hepatic involvement and 82\% accuracy for pancreatic involvement. Seven cases (32\%) were mis-staged by CT: 4 patients (18\%) were under-staged and 3 (14\%) were over-staged. Since it does not always show the real extent of the disease, in the staging of gastric cancer CT is to be considered a complementary tool to surgical staging, even though it is often necessary to choose between radical or palliation surgery

Cefalee primarie:aspetti patogenetici

Le cefalee primarie sono patologie complesse, altamente disabilitanti. La fisiopatologia del dolore è comune a tutte le forme di cefalea primaria e trova il suo correlato neurobiologico nel sistema trigeminovascolare. Le strette correlazioni fra tale sistema e altre aree del troncoencefalo e della corteccia determinano molti aspetti della sintomatologia correlata al dolore cefalico nelle diverse forme di cefalea. L’emicrania e la cefalea a grappolo così come altre cefalee autonomiche trigeminali (TACs) hanno molti aspetti fisiopatologici comuni e sono considerate cefalee neurovascolari. Non esiste a tutt’oggi una teoria unificante sulla fisiopatologia delle cefalee primarie. La complessità del quadro sintomatologico suggerisce che in soggetti geneticamente predisposti, una disfunzione del troncoencefalo e di alcune aree corticali sia responsabile dell’attivazione nocicettiva nonchè di una facilitazione delle informazioni nocicettive delle strutture craniche innervate dal trigemino e responsabile della sensazione dolorosa che nell’uomo è la cefalea.Primary headaches are complex and highly disabling disorders. Pathophysiology of pain is shared by all types of primary headaches and the neurobiological correlate is the trigeminovascular system. Bidirectional connections between trigeminovascular system and key structures of brainstem as well as cortex of human brain may explain the majority of symptoms observed in migraine and other headaches. Migraine and cluster headache as well as other trigeminal autonomic cephalalgias(TACs) are considered neurovascular headaches.The complex picture of symptoms in primary headaches suggests that, in genetically susceptible patients, a primary disfunction of brainstem and other cortical areas is responsible of activation and facilitation of nociceptive informations from cranial structures innervated by trigeminal nerve that, finally, determines the cephalic pain called headache in humans

Cluster Headache in Childhood: Case Series From a Pediatric Headache Center

Childhood-onset cluster headache is an excruciatingly painful and distressing condition. A retrospective study was conducted on charts of patients referring to our Headache Center. Those diagnosed as cluster headache were selected. We identified 11 children (6 males and 5 females). The mean age of cluster headache onset was 10 years (range: 5-16). All children had episodic cluster headache. All children had unilateral orbital pain; 7 patients had throbbing pain, whereas 4 children complained stabbing pain. The mean duration of the attack was 86 minutes (ranging from 30 to 180 minutes). The frequency of episodes was between 1 and 4 per day. All children had the typical cluster headache autonomic features, such as lacrimation, conjunctival injection, ptosis, and nostril rhinorrhea. Steroids showed a good clinical efficacy in interrupting cluster headache recurrence. As symptomatic drugs, acetaminophen as well as ibuprofen were ineffective; indomethacin was effective in 1 case