flunarizine and Mental-Disorders

In 1890 four cases of headache associated with visual symptoms and hysterical disorder were described by the French neurologist Babinski as migraine ophthalmique hystérique, or hysterical ophthalmic migraine. Since that time this association has seldom been described, and the possibly high frequency previously reported still remains to be established. This paper has reused Babinski's description and it tries to rehabilitate the syndrome described by the French semiologist across the relatively frequent experience of this type of patients in a public hospital. Also it analyzes the reason of the oblivion of his description.. This study presents a series of 43 cases of headache of the migraine type associated with other symptoms, most consistent with basilar-type migraine according to IHS criteria. Diagnosis of conversion disorder (hysteria) was grounded in the criteria set forth in the DSM-IV.. All patients exhibited one or more manifestations of hysteria (conversion symptoms) during migraine attacks, and some did in the intervals between attacks as well. Details of the headaches, associated symptoms, and hysterical manifestations are discussed. Most patients improved with antimigraine medication. Altered consciousness may have contributed to the onset of hysterical symptoms.. The basilar type migraine associated with conversion symptoms described of systematized form by Babinski, it is not a rare entity. Similar pictures have been described along the history of the medicine. The later silence possibly is due to the historical difficulty in defining accurately the conversión disorders. The Babinskís migraine is a certain well entity and must be recovered for the clinic.

Topics: Adolescent; Adrenergic beta-Antagonists; Adult; Aged; Anti-Anxiety Agents; Anticonvulsants; Antidepressive Agents; Conversion Disorder; Diagnostic and Statistical Manual of Mental Disorders; Electroencephalography; Family; Female; Flunarizine; Hemiplegia; Humans; Hysteria; Male; Mental Disorders; Middle Aged; Migraine Disorders; Pain Measurement; Positron-Emission Tomography; Propranolol; Retrospective Studies; Tomography, X-Ray Computed; Young Adult

In an open trial the antiepileptic effects of flunarizine were studied in 64 patients with intractable epilepsy, and the following results were obtained: 1. Seizures disappeared completely in 2 cases, with a 50% decrease in 6 cases. 2. Of the 25 patients who had accompanying psychiatric symptoms 8.0% showed an improvement in these symptoms. 3. While no marked side-effects were observed, some cases showed an increase in frequency of seizures and the trial was stopped for 8 cases. 4. "Global evaluation" showed an overall improvement rate of 9.4%. In 47 cases, in which changes in frequency of seizure were confirmed and dosage of flunarizine was subsequently changed, improvement rate was 12.8%. 5. The above results suggest that the effectiveness of flunarizine in this open trial was very low.

Topics: Adolescent; Adult; Electroencephalography; Epilepsy; Female; Flunarizine; Humans; Male; Mental Disorders; Middle Aged; Multicenter Studies as Topic; Time Factors

Four patients presented symptoms of a dementia syndrome. A man aged 67 showed gradual aggravation of disorders of memory and gait, as well as subcortical infarctions. A man aged 65 had disorders of concentration non compatible with the infarctions on the MRI scan, which disappeared after discontinuation of use of flunarizine. A woman aged 55 and a man aged 52 had changes of character and infarctions in the frontal lobe. Vascular dementia is, contrary to what most criteria suggest, often a subcortical syndrome. The relationship between cerebrovascular pathology on CT and MRI scans and cognitive and behavioural disorders is often hard to establish. If the criteria for vascular dementia are applied blindly, other causes of the subcortical dementia syndrome can be missed. The present criteria offer almost no room for detecting the subtle cognitive and behavioural disorders of cerebrovascular pathology. It is important to recognize the early changes of a threatened brain, because treatment and prevention might be effective in preventing further damage.

Topics: Aged; Brain; Calcium Channel Blockers; Cerebral Infarction; Cognition Disorders; Dementia, Vascular; Depressive Disorder; Diagnosis, Differential; Fatal Outcome; Female; Flunarizine; Humans; Magnetic Resonance Imaging; Male; Mental Disorders; Middle Aged; Neurologic Examination; Neuropsychological Tests; Tomography, X-Ray Computed