Computerized analysis and topographical mapping were performed on the EEGs of 28 migraine patients (17 without and 11 with typical aura) and an age and sex-matched control group of 28 subjects. Traditional visual EEG analysis revealed only a slight diffuse slowing of theta band in eight patients (28.6%), and computerized analysis revealed significant changes in eleven (39.3%). The most frequently altered parameters were an increase in the relative power of the slow bands and/or a decrease in that of alpha band. These variations appeared to be particularly significant in the posterior regions. No significant inter-hemisphere asymmetry was revealed. Comparisons between the patient and control groups showed that the only statistically significant difference was a bilateral increase in theta power in the parieto-occipital regions of the patients. We conclude that the role of topographical EEG mapping in the clinical diagnosis of migraine is still limited.

The objective of this study was to evaluate temporal changes of stroke in an Italian community by comparing the present incidence rates with those reported in the same area for 1989. The two studies were conducted by the same research group and met almost all the criteria proposed for an "ideal" stroke incidence study. The annual incidence rate per 1000 inhabitants increased (p < 0.01) by 29%, from 2.23 (95% CL, 1.96-2.50) in 1989 to 2.89 (95% CL, 2.58-3.20) in 1997. No statistically significant change was found when these rates were adjusted to the 1991 Italian population. The overall incidence rate was 2.40 (95% CL, 2.14-2.66) in 1989 and 2.65 (95% CL, 2.39-2.91) in 1997. The thirty-day case fatality rate declined dramatically (p < 0.001) from 31% (95% CL, 26-36) to 20% (95% CL, 16-24) between 1989 and 1997. Ageing of the population and better identification of cases could explain the high incidence rate, whereas the decrease of fatality rate may be due to a general improvement in acute care and inclusion of milder cases.

Background. There is scant population-based information regarding predictors of stroke severity and long-term mortality for first-ever ischemic strokes. The aims of this study were to determine the characteristics of patients who initially presented with first-ever ischemic stroke and to identify predictors of severity and long-term mortality. Methods. Data were collected from the population-based Cerebrovascular Aosta Registry. Between 2004 and 2008, 1057 patients with first-ever ischemic stroke were included. Variables analysed included comorbidities, sociodemographic factors, prior-to-stroke risk factors, therapy at admission and pathophysiologic and metabolic factors. Multivariate logistic regression models, Kaplan-Meier estimates, and Cox proportional Hazards model were used to assess predictors. Results. Predictors of stroke severity at admission were very old age (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.75–5.06), female gender (OR 1.73, 95% CI 1.21–2.40), atrial fibrillation (OR 2.76, 95% CI 1.72–4.44), low ejection fraction (OR 2.22, CI 95% 1.13–4.32), and cardioembolism (OR 2.0, 95% CI 1.36–2.93). Predictors of long-term mortality were very old age (hazard ratio [HR] 2.02, 95% CI 1.65–2.47), prestroke modified Rankin scale 3–5 (HR 1.82; 95% CI 1.46–2.26), Charlson Index ≥2 (HR 1.97; 95% CI 1.62–2.42), atrial fibrillation (HR 1.43, 95% CI 1.04–1.98), and stroke severity (HR 3.54, 95% CI 2.87–4.36). Conclusions. Very old age and cardiac embolism risk factors are the independent predictors of stroke severity. Moreover, these factors associated with other comorbid medical conditions influence independently long-term mortality after ischemic stroke.

Minor neurologic and intellectual impairments have been described in some congenital hypothyroid (CH) children in spite of early detection by neonatal screening. The aim of our study was to assess cognitive functions as well as neurophysiologic parameters in hypothyroid children and to compare children detected by neonatal screening (group A) versus hypothyroid patients clinically diagnosed before the beginning of the screening program (group B). Group A consisted of 15 children (13 girls, mean age at the beginning of treatment 33 d). Group B consisted of 11 patients (7 girls, mean age at the start of treatment 10.1 mo). Twenty age-matched healthy children were studied as a control group for neurophysiologic tests. Neurophysiologic tests (Auditory P 300, long latency somatosensory evoked potentials (LL-SEP) were performed along with IQ evaluation. Abnormalities of neurophysiologic tests were detected in 82% of clinically diagnosed hypothyroid children. Surprisingly, 47% of the children detected by neonatal screening, having normal mental development index, showed at least one abnormal neurophysiologic test. LL-SEP latencies were found significantly increased in both groups of CH patients compared with controls. Our data are suggestive for a prenatal or perinatal CNS damage in some children with congenital hypothyroidism, despite early treatment.(Pediatr Res 37: 736-740, 1995) Abbreviations CH, congenital hypothyroidism LL-SEP, long latency-somatosensory evoked potential WISC-R, Wechsler Intelligence Scale for Children-Revised T,, thyroxine ANOVA, analysis of variance Neonatal screening programs and subsequent early replacement treatment have been successful in reducing the most severe effects of CH on neuropsychologic development (1-6); however, early treated CH children with normal IQ may show slight psychomotor abnormalities, such as deficit in motor skills (particularly in relation to balance), fine motor disorders, clumsiness, learning difficulties, and behavior problems (1, 5). All of these disorders are suggestive of minimal brain damage.Neurophysiologic studies on CH patients have been concerned primarily with stimulus-related potentials (short latency components) that analyze the integrity of the primary sensory pathways (7). The LL-SEP and the event-related potentials can give information about CNS stimulus processing and about the integrity of sensory information processing within the cerebral cortex (8). Only one group, however, reported results of short latency somatosensory evoked potential examinations in CH newborns (9). The aim of the present study was to evaluate the effect of replacement therapy onset on CNS and its relationship with IQ determinations. For this purpose we studied both neuropsychologic development and neurophysiologic changes (using LL-SEP and event-related potentials) in 15 CH patients, detected by neonatal screening, who began replacement therapy within the first 2 mo of life, and 11 CH patients, clinically diagnosed in prescreening period, who started the replacement therapy ...