Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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Comparative Study
MMPI personality profiles in patients with primary chronic daily headache: a case-control study.
We assessed the psychological profile of a large sample of patients with chronic daily headache (CDH) seen in tertiary care. We used a case-control design to study 791 patients who fell into the following categories: ARH group, chronic migraine with analgesic overuse (analgesic rebound headache, ARH), n=399; CM group, chronic migraine (CM) without analgesic overuse, n=158; and new daily persistent headache (NDPH) group, n=69. These groups were compared to two control groups: 1, migraine, n=100; 2, chronic posttraumatic headache (CPTH), n=65. ⋯ ARH and CM groups had significantly higher T-scores for scale 7 alone. NDPH showed T-scores < or =40 in scale 9 when compared to both control groups. We conclude that: (1) psychopathological factors are common in CDH patients, and appear to be a consequence of the chronification process; (2) low scores on scale 9 (hypomania) may relate to the development of NDPH; (3) psychopathological profiles differ among the subgroups of CDH and the MMPI-2 is reliable in identifying such patterns; and (4) psychological assessment is an essential step in the evaluation and treatment of patients with CDH.
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Fatigue is a recognized problem in Parkinson's disease and other clinical conditions. We characterized this symptom in 19 patients and 19 age- and sex-matched controls, using the Multidimensional Fatigue Inventory (MFI) and the Geriatric Depression Scale. Fatigue may be an independent symptom in Parkinson's disease, frequently associated with depression. Our analysis showed the usefulness of the MFI in discriminating between different dimensions of fatigue for a better therapeutic approach.
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We examined the potential sex-related differences in levodopa pharmacokinetics and their relation with the presence of dyskinesias in a group of 115 patients (67 men, 49 women) with Parkinson's disease. The patients were given a standard oral dose of levodopa plus benserazide (100/25 mg). The area under the levodopa plasma concentration time curve, corrected for the levodopa test dose (in mg/kg body weight), (AUC(w)) was significantly higher in women than in men, with a reduced oral clearance. No difference in the proportion of men and women experiencing dyskinesias was observed.
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Comparative Study
Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy).
We assessed the sensitivity and the positive predictive value (PPV) of the ICD-9 codes in identifying ischemic strokes. The study involved the cross-sectional comparison between patients with an ischemic stroke diagnosis made by neurologists and patients with the 434 or 436 discharge codes. Sensitivity of the codes (all diagnostic levels and first level respectively) was 82% and 76%; PPV: 71% and 76%. ⋯ Our results disclosed inaccuracy in use of the ICD-9 codes in the diagnosis of ischemic stroke in the general hospital of Lugo di Romagna, Ravenna Province, Italy. The misdiagnosis of patients could be influenced by the degree of severity of clinical features. Epidemiological data and cost-analysis forecasts based only on the ICD-9 system must be considered with caution.
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In the International Headache Society (IHS) classification of 1988, chronic daily headache (CDH) forms are not exhaustively categorized. The forthcoming revision of the classification will include a number of CDH forms that had been reported prior to 1988 or have been identified after that date. ⋯ Hypnic headache will be included in Group 4 ("Other primary headaches"). No additions will be made to the new IHS classification for forms such as new daily persistent headache (NDPH) and cervicogenic headache as proposed by Sjaastad.