Prevalence of diabetic neuropathy with somatic symptoms: a door-to-door survey in two Sicilian municipalities. Sicilian Neuro-Epidemiologic Study (SNES) Group.

In a door-to-door survey conducted in two municipalities of Sicily, we ascertained the prevalence of diabetic neuropathy. Our case-finding was restricted to subjects with somatic symptoms. During phase 1, we administered a screening instrument for peripheral neuropathy to 14,540 persons residing in Santa Teresa di Riva (Messina Province) and Terrasini (Palermo Province). During phase 2, neurologists evaluated those subjects who had screened positive. Diagnoses were based on clinical criteria only, and were reviewed by an adjudication panel. We found 39 persons (27 women, 12 men) affected by diabetic neuropathy. The crude prevalence, as of November 1, 1987, was 268.2 cases per 100,000 population. The prevalence increased with advancing age for both sexes and was consistently higher in women. The most common type was distal symmetric polyneuropathy. The median time between diagnosis of diabetes mellitus and onset of diabetic neuropathy was 8 years, and almost all identified persons with diabetic neuropathy were under treatment for diabetes mellitus.

Prevalence survey of major neurological disorders in Sicily. Results of a pilot study.

A pilot study on the prevalence of neurological disorders in Sicily was carried out with a protocol never previously used in Italy. A screening questionnaire was administered to 1,601 subjects of a community, designed to identify patients with cerebrovascular diseases, epilepsy, extrapyramidal syndromes, peripheral neuropathies, migraine and intracranial neoplasms. Of 262 subjects who were identified as likely to be suffering from neurological illness, 248 (94.6%) were examined by a neurologist. Of these, 8.9% were found to be normal, 46.8% were suffering from non-neurological diseases, 44.3% had one or more neurological diseases (prevalence of 6.8%). This pilot study proved to be a good starting-point for a future major survey.

Fahr's syndrome: local inflammatory factors in the pathogenesis of calcification.

Three cases of Fahr's syndrome are described. All patients had disturbances of calcium metabolism and had had a meningoencephalitis in childhood. It is suggested that gliovascular changes, induced by cerebral inflammation, can later facilitate the occurrence of calcification of the striopallidodentate system when abnormality of calcium metabolism develops.

Functional hyperthermia due to central dopaminergic impairment.

The clinical cases described are characterized by rigidity, mutism and hyperthermia, with cutaneous pallor and diaphoresis. This symptomatology marks the "malignant neuroleptic syndrome" and can be found, at times, in parkinsonians on "drug holiday". The cases described, which comprehend patients with both disorders, lead us to a single pathogenetic hypothesis: a central dopaminergic impairment. Hyperthermia, secondary to functional hypothalamic deficiency, is maintained by defective heat dispersion due to the lack of cutaneous vasodilation.

Serum thyroid hormones and thyroid hormone binding proteins in patients with completed stroke.

Thirty euthyroid patients hospitalized for completed stroke had serum thyroxine, triiodothyronine, thyroxine-binding globulin and thyroxine-binding prealbumin levels significantly decreased (p less than 0.01 to p less than 0.001) compared with 70 age- and sex-matched healthy controls. Admission serum thyroxine levels gave the best correlation with mortality (T4 less than 65 nmol/l = 100% mortality; 65-77 nmol/l = 38%; 78-90 nmol/l = 9%; greater than 90 nmol/l = 0%). In general, during hospitalization a progressive decrease in serum concentrations of these parameters was observed in the 11 patients who subsequently died, while there was a progressive increase in the 19 survivors. However, the most sensitive index of clinical recovery appeared to be prealbumin, since a decrease in prealbumin levels was observed in all subjects who died, and an increase in prealbumin was found in all survivors.

Incidence and lifetime prevalence of Bell's palsy in two Sicilian municipalities. Sicilian Neuro-Epidemiologic Study (SNES) Group.

INTRODUCTION: In a door-to-door two-phase survey of common neurologic diseases conducted in two Sicilian municipalities, we investigated the incidence and the lifetime prevalence of Bell's palsy (BP). MATERIAL & METHODS: During phase I, we administered a screening instrument for facial palsy to 11,901 adult persons. During phase 2, study neurologists using specified diagnostic criteria evaluated those subjects who screened positive. RESULTS: We found 73 subjects who had experienced BP during their life. The lifetime prevalence as of November 1, 1987, was 642.8 cases per 100,000 population age 15 years and above. The prevalence increased with age and was similar in men and women. Eighteen episodes of BP occurred in the three years preceding the prevalence day. The average annual incidence rate was 52.8 new episodes per 100,000 population age 15 years and above. Incidence increased with age. CONCLUSION: Comparison with other incidence studies suggests some geographic variability.

Prevalence of lumbosacral radiculopathy in two Sicilian municipalities. Sicilian Neuro-Epidemiologic Study (SNES) Group.

OBJECTIVES: As part of a door-to-door survey of neurologic diseases, we investigated the prevalence of lumbosacral radiculopathy (LR) in two Sicilian municipalities (N = 14,540, as of November 1, 1987). MATERIAL & METHODS: During phase 1, we administered a brief screening instrument to subjects in the study population. In phase 2, study neurologists using specified diagnostic criteria investigated those subjects who screened positive. Our case finding was restricted to subjects who manifested symptoms of LR in the six months preceding the prevalence day. RESULTS: We found 143 subjects affected by LR (112 definite, 31 possible) yielding a crude prevalence of 9.8 cases per 1,000 population. Age-specific prevalence was generally higher in men; it increased to a peak at age 50-59 years and decreased steadily thereafter. At the peak, prevalence was higher in factory workers, housewives, and clerks compared to workers in other occupations. CONCLUSIONS: LR is a common neurologic disease in the general population.

Neuroepidemiological survey on Sicilian population. A feasibility study.

This research was designed as a pilot study in order to determine the feasibility and the reliability of a major door-to-door neuroepidemiological survey to be performed in the near future in 3 Sicilian towns with a total population of 30,000 inhabitants. 1,601 subjects were investigated by means of a questionnaire for the prevalence of stroke, epilepsy, parkinsonian syndromes, peripheral neuropathies, intracranial neoplasm and migraine. This preliminary study proved to be a good starting point, but some difficulties were identified in the questionnaire, in data collecting instruments and in diagnostic criteria.