Poster Abstracts Friday, November II, 2005 $505

about epilepsy. Mandatory reporting was opposed by 79% while 76% endorsed reporting recalcitrant patients. 75% favoured licences displaying prominent advice to self-report. 63% promoted pharma- ceutical industry responsibility to identify treatment related driving implications. 73% championed public safety over individual rights. There was discrepancy between reported attitude and action with < 30% regularly reporting recalcitrant patients. 98% supported report indemnification, 89% claiming to advise patients of such intention. 78% encouraged subsidised transportation for disqualified drivers. Specific seizure and epilepsy related criteria were identified relevant to driving fitness decisions. 94% fostered different standards for private and commercial drivers. Only 52% repudiated epilepsy as a greater risk than illnesses such as sleep apnoea. Commentary identified: enhanced conservatism amongst experienced epileptologists; advocacy for advisory boards; unified national laws; and potential to coerce treating neurologists for lettiency. Neurologists supported shorter seizure-free periods titan stipulated in the guidelines and disagreed regarding definition of "controlled" epilepsy. Conclusion: This is the first representative survey of Australian Neurologists regarding epilepsy and driving. It confirms a range of opinions, often reflecting lack of consensus and discrepancy between promoted opinions and deeds.

1593 Modulatory effects of Centrophenoxine on different regions of ageing rat brain

Bhalla, P~, Neh~u, B 1. 1Department of Biophysics, Panjab University, Chandigarh, India

The debilitating consequences of age-related brain deterioration are widespread and extremely costly in terms of quality of life and longevity. The major cause of age related destruction of neuronal tissue is toxic free radicals. This is largely due to high energy requirements, high oxygen consumption, high tissue concentration of iron and low of antioxidant enzymes. Supplementing such a state of brain to an external source of free radical scavenger would greatly benefit in ameliorating the free radical damage. In the present study, an important nootropic agent Centrophenoxine, which has an easy access to brain, has been administered to aged animals (14 months old). Our study indicates an increased activity of Catalase, Superoxide Dismutase, Glutathione reductase as well as an increase in tile reduced, oxidized and total glutathione content thus resulting in an altered redox state. Whereas, following Centrophenoxine administration (100 mg/Kg body weight/day, injected i.p) alterations in the activities of Superoxide dismutase, Ghitathione reductase as well as in the reduced and oxidized glutathione content was reported in aged rat brain.

1594 Permanent M C A O in sheep - a new large animal model of Focal Cerebral Ischemia

Boltze j 1 Gille, U 2, Waldmin, D 2, Ftrschler, A 3, Ionita, J-C 4, Egger, D 5, Ferguson, j4, EumlMeh, F 1 and Zimmer, C 3. 1Institute of Clinical Immunology and Tran,fusion Medicine, University of Leipzig, Germany; ~Institute of t:eterinary Anatomy, University of Leipzig, Germany; 3Departmen t of Neuroradiology, Clinic of Diagnostic Radiology, University of Leipzig, Germany; 4Clinic of Large Animal Surgery, University of Leipzig, Germany; sVITA34 AG, BBZ, Leipzig, Germany

The efficiency of experimental cell therapies has been shown recently in stroke models by using rodents. However, transfer to clinical application requires close-to-pracfice models, i.e. large animal models of focal cerebral ischemia. Currently available primate models are cost intensive, restricted to highly specialized breeding facilities and limited by ethical considerations. Tilerefore, we devel- oped a cost effective stroke model in sheep with reproducible

neurological dysfunctions and lesion size and with the option of either proximal or distal occ.hision of the middle cerebral artery (MCAO) according to its origin. 18 Merino sheep weighting 35 to 48 kg were randomly assigned to one of four groups: proximal (n - 5) and distal (in -- 3) MCAO, sham operation (n - 5) and control (in - 5). Ataimals undergoing tile surgical procedure were deeply anaesthetised. Following exposure of the MCA, the vessel was occluded or sham- operated by electrocoagnlation. After suture, animals underwent an analgefic and antibiotic treatment. Neurological and N M R investiga- tions were performed before and after MCAO (3, 7, 14 and 30 days). Proximal MCAO results in a large cortical lesion and neurological dysfunctions including absent/delayed startle reflexes, atactic move- ment, circling and torticollis. Distal MCAO causes a smaller cortical lesion and reduced functional deficits. Sham operated animals and controls did not show sensomotoric disabilities or indications of ischemia in MRI. In the ongoing study, we will investigate the efficiency of autologous, allogeneic and xenogeneic stem cell therapies in this sheep model to prepare for future clinical trials.

1595 Repetitive Transcranial Magnetic Slhnulation (rTMS) modulation of Visual Coxlex of healthy subjects undergoing light deprivation: a human ulodel to study Pathophysiology of Migraine

Brighina, F 1, Francolini, M 1, Giglia, G 1, Palermo, A 1, Scalia, S 1, Fierro, B :. ~University Of Palermo, Italy

Background: We reported visual cortical facilitation by 1 Hz rTMS in raJgraineurs with aura and interpreted these results as due to inefficiency of tile inhibitory circuits, unable to be up-regulated by low-frequency rTMS. Light- deprivation (LD) is known to increase visual corical excitability through down-regulation of GABA-circuits. Here, we investigated r I M S modulation in normal subjects under- going LD to explore further the effects of LD on visual cortex excitability and to evaluate if in a condition of reduced inhibition such as LD, healthy subjects show paradoxical effects like those reported in migraineurs. Methods: Six healthy subjects reporting reliable phosphenes by occipital TMS underwent 60 minutes of complete LD. Phosphene threshold (PT) was measured before (T0), after 45 min. (T1) and 60 min. (T2) of LD, and then every ten minutes after light re-exposure until recovery to T0 values, rTMS (at 1Hz or 10 Hz) was applied in separate sessions in tile last 15 min of LD. Results: PYs significantly decreased after 45 rain of LD. 1 Hz rTMS significantly prolonged the time to recover TO PT values after light re-exposure. By contrast, 10 Hz rTMS significantly increased PT and tile time to recover T0 PT values after light re-exposure was shortened. Tiffs study shows that modulatory effects of different rTMS fre- quencies on visual cortex critically depend on tile pre-existing excita- bility state of inhibitory and facilitatory circuits. Indeed, during LD healthty subjects behave like migraineurs and this could provide a useful human model to study pathophysiology of migraine.

1596 Ulfilateral musical hallucinations in tile elderly: a ease report with a Neurops~ychological and Neuroimaging analysis in a patient with right Temporal Lobe Infarction

Bud, G ~, Pinna, M ~. 1Neurology Service andAlzheimer's Unit, Policlinico Sassarese S.p.A., Sassari, Italy; 2Psychologist, Polidinico Sassarese S.p.A., Sassari, Italy"

Background: Unilateral musical hallucinations (UMH) are a rare phenomenon with heterogeneous etiology. There is not an accepted theory on the etiology and pathophysiology of these symptoms that occur in neurological and psychiatric patients. Method: Tiffs is a case report study. We describe a patient with U M H in the left ear that was admitted to tile hospital for a general

$506 Friday, November 11, 2005 Poster Abstracts

evaluation. We performed an extensive neuropsychological assessment with MRI, CI', SPECT, EEG and an audiological study. Results: a patient with a mild depression experienced U M H and the neuropsychological evaluation showed a mild cognitive decline and language impairment. Neuroradiological studies showed a cortical atrophy with asimetry on the right temporal lobe and the presence of infarction in the fight middle temporal gyrus. Audiometry showed mild hearing loss. Conclusion: U M H are rare and not well known. We describe a case report with an extensive neuropsychological and neuroradiological study and we assmne a correlation with an infarction in the right temporal area and this symptom, giving the opportunity to review different mechanisms to explain UMH.

1597 Behavioural Improvement, Reactive Gliosis anti Lesioned area in rodent model of Cerebral Isdieiilia following stein cell treahnent

Bulawina, L z, Boltze, j i , Kamprad, M i, Hfirtig, W 2, Paulke, B-R 3, Grosche, j2, Arendt, T a and Elrmlrich, F ~. 1Institute of Clinical Immunology and Transfusion Medicine, University of Leipzig, Germany; 2Paul Flechsig Institute of Brain Research, University of Leipzig, Germany; 3Fraunhofer Institut Angewan&e Polymerforschung, Golm, Germany

It was shown recently that stem/progenitor cell subpopulations may be beneficial for a treatment of different neurological disorders, including stroke, although the mechanisms of a therapeutic effect are not well knowll yet. Middle cerebral artery occlusion (MCAO) in male spontaneously hypertensive rats (SHR) was investigated as a model of permanent focal cerebral ischemia. Different stem/progenitor cells subpopulations from human umbilical cord blood and SHR bone marrow mononuclear cells, a T cell clone (irradiated and unable to divide) and a control (physiologycal saline) were alternatively injected ( lx l06 cells) into the tail vein 8-10 hours following MCAO. Therapeutically benefit was detected via behavioral testing (RotaRod, beanl walk and nlNSS). Iamllunotfistochemistry and digital measure- ment of lesioned area were performed after a perfusion of the animals on day 29 following stroke onset. Reactive astrocytes were detected by GFAP staining. In the group with strong behavioural benefit less glial reactivity and reduced extent of lesion were observed, while in the groups with little behavioural recovery (control T cells) reactive astrocytes were much more numerous, and the area of lesion was more extensive. It was also shown by fluorescence microscopy that in successfully treated animals the processes of the reactive astrocytes are shorter and GFAP fluorescence is less intensive as compared the to control groups. Micro- and astroglial reactions were shown by multiple fluorescence labelling and confocal laser-scamting microscopy already by day 2 after MCAO. In sunmmry, behavioural benefit in stem/ progenitor cell treated MCAO rats is associated with size reduction of the areas of lesion and less numerous reactive astrocytes indicating remodelling by reduced gliosis.

1598 World trade centre nightmares of Del~nestrafion and Suicidal Ideation following Eletriptan intake

Hart G a, Chermann J F ~, Sereni C a. 1Hdpital L~opoldBellan, Paris, France

We present a case-report of a 28 year-old female migraineur treated with eletriptan. One hour following the first administration of eletfiptan she experienced suicidal ideation with impulses of defenestration persisting for two hours accompanied by complete resolution of the migraine. Ten days later she experienced a further migraine and took eletriptan prior to sleep. Three hours later she was awakened by a nightmare during which she assisted the defenestration of people within the enflamed world trade centre. The patient had no personal or family history of psychiatric illness. The eletriptan was

subsequently replaced my almotriptan with no further recurrence of suicidal impulsions or images of defenestration at one year follow-up. In addition, the patient was treated with topiramate as migraine prophylaxis. We propose that the emergence of the suicidal ideation may be influenced by the enhanced lipophJlicity of eletriptan in comparision to almotriptan. We also suggest that the presence of topiramate may have potentialised these CNS side effects.

1599 TranSient Neurological Focal Symptoms not considered Transient Isdlemic aflacks in rural and urban Northern Portugal: incidence, risk of death and risk of stroke in a community-based study

Correia M ~, Silva M R a, Magalhges R 3, Silva MC ~. 1Servi:o de Neurologia, Hospital Germ de Santo Antdnio, Porto, Portugal," 2 Servi:o de Neurologia, Hospital de S. Pedro, tq'la Real, Portugal," 3Departa- mento de Estudos de Populaldes, lnstituto de Cidncias BiomJdicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal

Background: There are no community-based studies on the incidence of Transient Neurological Focal Symptoms not classified as Transient Ischemic Attacks (TNFS). This study was designed to determine the incidence of TNFS in rural and urban populations in Northeru Portugal. Methods: All suspected first stroke, TIA and TNFS occurring between October 1998 and September 2000 in 18677 residents in rural municipalities and 86023 living in the city of Porto were entered a population-based registry. TNFS not TIA were defined as acute symptoms and signs presunled to be caused by a non ischaemic focal dysfunction of the central nervous system, and lasting less than 24 hours. Comprehensive sources of infomlation were used for identification of patients that were followed-up at 3 and 12 months after the event. Results: During a 24-month period 513 first TNFS patients were registered, 73 in rural and 440 in urban areas. The crude annual incidence was 1.95 (95%CI, 0.94-3.76) and 2.56 (95%CI, 1.93-3.33) per 1000 for rural and urban populations, respectively. The global TNFS nicidence standardised to the World S~gi population was 1.58 (95% CI, 1.14-2.19). The 28-day risk of death was 0.6% (95%Cf, 0.2-1.8) and of stroke 0.4% (95%Cf, 0.1-1.6); the 12-month risk was 4.1% (95%CI, 2.6-6.3) and 2.5°,5 (95%CI, 1.4-4.4), respectively. Contusions: The incidence of TNFS is higher than that reported for TIA in conmlulaJty-based studies. The importance and clinical meaning of these conditions can only be ascertained by an adequate long-term follow-up of these patients.

1600 Giant cell arterifis a rare but hnportant cauSe of headache with C5 cervical radiculopathy

Woolmore, J A a, Leonnard, A a, Davies, M B ~. 1Department of Neurology, University Hospital of North Staffordshire, Stoke on Trent, United Kingdom

Background: Giant cell arteritis is a common, treatable cause of head- ache increasing in incidence with age. Case report: A 72 year old female presented with a month 's history of headache and diplopia. Five days before presentation the patient awoke with weakness of the right arm and inability to abduct both shoulders. Detailed clinical examination showed a bilateral radicular pattern of weakness involving C5 and C6 predominantly on the right. The ESR was raised at l l3mm/Hr and CRP at 105mg/L. A chest radiograph showed a raised fight hemidiaphragm. MRI of the brain and cervical spine, echocardiogram, electrocardiograph, lumbar puncture and blood screening were unremarkable. Temporal artery biopsy showed histological findings consistent with giant cell arteritis. Electrophysiology witlfin 10 days of symptom onset was normal. Both headache and neurological impairment improved with steroid therapy and recovery was full.