In this study we describe the frequency of eating disorders (EDs) in a group of bipolar (BP) patients. We evaluated a sample of 51 outpatients, diagnosed as having BP I disorder on the basis of the Structured Clinical Interview for DSM-IV (SCID). Each of these subjects was administered the Binge Eating Disorder Clinical Interview (BEDCI) to determine the presence of binge eating disorder (BED) or bulimia nervosa (BN). Of the 51 BP patients, 14 (9 BED, 5 BN) met criteria for an ED. Most patients developed binge eating coincident with the first episode of BP disorder or after the onset of it. This was true for those who developed BED as well as BN, and involved both manic and depressive phases. All BN patients were women (5/5), and family history of binge eating was present in 80% of BN subjects, but only in 22.2% of BED and 29.7% of non-ED BP patients. We found a high frequency of concordance between BP illness and binge eating problems in our sample of BP patients. Given the temporal sequence of the mood disorder, which generally preceded the ED, we suggest a model in which the ED evolves due to modulation of emotions with food, as well as use of medications to treat BP disorder that disrupt hunger and satiety mechanisms. Given differences in gender distribution and family history, cultural and familial influences may also be significant in the minority of BP binge-eating patients who develop BN.

Background: In this study, we investigate the affective temperamental characteristics in a sample of ED (eating disorder) patients. Methods: 49 ED patients diagnosed by the SCID (Structured Clinical Interview for DSM-IV), were divided into two groups on the basis of the presence or absence of Binge Eating (restricting-anorexia nervosa [R-AN]= 16; Binge Eaters= 33). All patients were administered the TEMPS-I (Temperament Evaluation Memphis Pisa Semistructured — Interview), to assess affective temperament. A third group of controls (N= 1010), derived from a study with the TEMPS-I on normal subjects, was included for comparison. Results: A full affective temperament was not found in patients of the restricting group. By contrast 24% of the binge eating group had a full affective temperament of one of three types. Comparing the three temperaments for the three groups, only cyclothymic temperament proved to be significant, with higher levels in the binge eating group (p<0.01). Conclusions: In this study, people with R-AN do not show a full affective temperament. However, people with binge eating, had depressive and hyperthymic temperament, and displayed higher level of cyclothymic temperament than the normal population. The findings of this study add to a growing literature on temperament in people with ED; particularly, they add to the view that may be various paths leading to R-AN, and these may differ from those of binge eating.

Increasing evidence indicates that inflammation has a substantial role in the pathogenesis and progression of AD. RDW, a measure of heterogeneity in the size of circulating erythrocytes, is associated with inflammatory markers in many numerous diseases. Present study was undertaken to assess the interrelationships between RDW and AD. A total of 197 patients with AD (male/female: 96/101, mean age 76.2 ± 6.9) and 133 patients as controls with normal cognitive function (male/female: 72/61, mean age 71.68 ± 5.3) were enrolled in this cross-sectional study. RDW values of all participants were measured. Mini-Mental State Examination (MMSE) and clock drawing tests were performed for cognitive assessment. DSM-IV and NINCDS–ADRDA criteria were used for diagnosis of AD. The mean RDW values were significantly higher in AD group (13.93 ± 1.1 vs. 13.24 ± 1.2; p < 0.001) and also a negative moderate correlation between RDW and MMSE was identified (r: −0.453; p < 0.001). After adjusting for confounders, RDW has the strongest association with AD (odd ratio (OR) 1.51, CI = 1.10–2.07). In present study RDW levels were significantly increased in patients with AD. Whereas elevated RDW value is usually considered as a novel biomarker of inflammation, the results of our study may support the role of inflammation in pathophysiology of AD. Furthermore the correlation of RDW with poorer cognition status suggests that it may be used as a marker of AD severity.

Background Axis I comorbidities are prevalent among patients with severe bipolar disorder but the clinical and psychopathological implications are not clear. Aims To investigate characteristics of four groups of patients categorised as follows: substance abuse only (group I), substance abuse associated with other Axis I disorders (group 2), non-substance-abuse Axis I comorbidity (group 3), no psychiatric comorbidity (group 4) Method Consecutive patients with bipolar disorder with psychotic features (n=125) were assessed using the Structured Clinical Interview for DSM–III–R – patient version, and several psychopathological scales. Results By comparison with group 4, group I had a higher risk of having mood-incongruent delusions, group 2 had an earlier age at onset of mood disorder, a more frequent onset with a mixed state and a higher risk of suicide, and group 3 had more severe anxiety and a better awareness of illness. Conclusions Substance abuse, non-substance-abuse Axis I comorbidity and their reciprocal association are associated with different characteristics of bipolar disorder.

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Impairment in sexual function is frequent and underestimated in patients with mental disorders, particularly in those with mood disorders. Few studies have examined the relationship between sexual dysfunctions and the clinical characteristics of mood disorders.The aim of the present study was to explore the frequency of sexual dysfunctions in patients with bipolar I disorder (BD) and unipolar depression (UD) with respect to control subjects, as well as their relationship with suicidality.Assessments included: the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (SCID‐I/P), the 24‐item Brief Psychiatric Rating Scale and the Mood Spectrum Self‐Report, a questionnaire exploring lifetime mood spectrum symptomatology including symptoms of sexual functioning and suicidality.A consecutive sample of 142 patients (60 BD and 82 UD) and a comparison group of 101 control subjects were recruited in a multicenter study involving 11 academic departments of psychiatry.Lifetime impairment in the sexual response cycle, including desire, excitement, and ability to achieve orgasm, was significantly more common in patients with mood disorders compared with control subjects. Increase in sexual activity and promiscuity were significantly more common in patients with BD vs. the other two groups.Lifetime dysfunctions in all three phases of the sexual response cycle explored were significantly associated with lifetime suicide attempts in patients with BD and with thoughts of death in patients with UD. In BD patients, the lifetime presence of periods with frequent changes of sexual partners was significantly associated with thoughts of death.Our findings suggest the importance of assessing sexual dysfunctions in patients with either BD or UD, as they may be clinically helpful in identifying phenotypes of mood disorders characterized by high suicidality. Dell'Osso L, Carmassi C, Carlini M, Rucci P, Torri P, Cesari D, Landi P, Ciapparelli A, and Maggi M. Sexual dysfunctions and suicidality in patients with bipolar disorder and unipolar depression.

Over recent years, endovascular occlusion of the carotid artery has become a valid alternative to its more traditional surgical ligation in the treatment of cavernous giant aneurysms. The authors report two cases treated with balloon occlusion in two patients with clinical signs of cavernous sinus syndrome. The procedure consisted of occluding the aneurysm and the carotid by means of detachable balloons. This was preceded by a 30-minute clinically monitored occlusion test aimed at evaluating the functioning of Willis' circle. The treatment was carried out under neuroleptoanalgesia, so optimal control of the neurological condition of the patient was possible. Partial symptom regression was obtained in both cases.

We describe a case of a sexually active woman who presented acute urinary retention associated with herpes genitalis infection and with few other neurological signs. The outcome of the disease was positive. We stress the utility of a careful CSF examination.

The Authors present a case of post-anoxic coma accompanied by myoclonic status. They describe the clinical picture and instrumental data. The outcome seems to be determined by the serious anoxic-pathological damage rather than the myoclonic jerks. They discuss the problem concerning preventive treatment by use of thiopental sodium (T.P.S.) in such cases.

Cavernous angiomas and venous angiomas may be discovered as associated lesions in the same patient. Most Authors report that Venous angiomas are not true vascular malformation; they should be considered as variant of normal venous drainage, consisting of tortuous medullary veins converging into a dilated draining one. By rule, they are quite asymptomatic, and very rarely bleed. On the other side, cavernous angiomas are true vascular malformations, usually angiographically occult. Their association is relatively rare, but it is important because of the possibility of bleeding, which should be related to the presence of the cavernous malformation. We report the cases of three patients studied by Computed Tomography, Magnetic Resonance and Digital Angiography in our Neuroradiologic Department.

We describe a 55 years old man affected by eyelid ptosis, mild ophthalmoplegia externa and severe dysphagia owing to pharyngoesophageal dyskinesia. Skeletal and eyelid constrictor muscles EMG showed myogenic alterations. Muscle histological findings of ragged red fibers and oxidative histochemical alterations, together with ultrastructural investigation clue for mitochondrial myopathy diagnosis. This, considering the unusual clinical aspects of the case, confirms as mitochondrial disease can widely vary in their phenotypical expression.

We accomplished polygraphies in two groups of infants: 1) preterm infants born before 33 weeks CA, and recorded between 33 and 48 weeks CA; 2) full term infants, recorded between 39 and 48 weeks CA. We compared in each group of infants: 1) the development of behavioral states organization; 2) the maturation of cortical bioelectric activities; 3) the development of concordance between behavioral states and EEG pattern; 4) sequences of behavioral states and EEG pattern when the babies fall asleep. In all the aspects considered, we describe some developmental changes, to understand how, through these changes, the newborn sleep-wake ultradian cycle is replaced by 24 hr-cycle, typical of the infantile period. This basic process is expression of maturation of the central nervous system because it is related to CA and not to extrauterine experience. The EEG-polygraph usually used in clinical practice allow us to follow these extraordinary transformations very closely.

Report of a case of hydrocephalus secondary to stenosis of the aqueduct with associated parkinsonian syndrome. The suggested etiopathogenesis: damage to the striatal system favored by underlying weakness of the basal ganglia.

Gynecomastia developed in two epileptic patients some months after the addition of oral fluoresone 750 mg daily to the phenobarbital and phenytoin already being administered. The common systemic diseases that may give rise to gynecomastia were excluded. One of the patients presented hyperprolactinemia and a raised estrogen/androgen ratio but the hormone levels were not raised in the other. The onset of symptoms after fluoresone in both cases is highly suggestive, although the pathogenetic mechanism is not clear.

A critical review of the therapeutic measures available to neurologists in a Vaquez disease emergency in the light of the physiopathology of the disease and its complications.