As the polls turn, Silvio comes out swinging

Facing sliding approval ratings and the prospect of humiliation in regional elections this weekend, Prime Minister Silvio Berlusconi has begun lashing out in all directions, including an astonishing verbal assault on the physical attractiveness of a female opposition politician.

The Italian leader was banking on a wave of public sympathy after he was attacked by a mentally unstable man before Christmas and his People of Freedom party (PDL) had privately hoped to wrest at least five of the 13 regions up for grabs from the centre-left's control. But Mr Berlusconi's approval ratings are at an all-time low of 44 per cent and his party look like winning only one region – Calabria– with even that gain cancelled out by losing Lazio.

And so the Prime Minister has gone on the offensive. His tirades against a judiciary and a media he believes to be pursuing a personal vendetta against him have the familiarity of a broken record. But eyebrows were raised in Turin on Tuesday night, when he opened both barrels on Mercedes Bresso, the bespectacled, centre-left governor of the northern Piemonte region.

"You know why Bresso is always in a bad mood?" the 73-year-old chortled. "Because in the morning when she gets up, she looks at herself in the mirror to put her make-up on – and sees herself. And so her day is already ruined."

Ms Bresso, 65, hit back immediately at the permatanned leader, who has admitted to succumbing to the plastic surgeon's knife. "I'm always in a good mood. And regarding make up, I don't use much; I don't need it as much as Berlusconi. I'm young, in good shape and haven't had a facelift."

It is not just the centre-left giving Mr Berlusconi headaches. Polls released before the pre-election blackout suggest the Northern League, the anti-immigrant rabble-rousers in his ruling coalition, could garner more than 10 per cent of the vote nationwide. Pundits are also predicting that the League could take control of Piemonte and Venice, and even the Prime Minister's stamping ground of Lombardy may be at risk. And that will trigger a power struggle within the coalition.

"The Northern League will be the beneficiaries of the cabinet reshuffle that will follow the election," said James Walston, a political analyst at the American University of Rome. "And this is seriously rattling Berlusconi."

The League's pugnacious leader, Umberto Bossi, has already labelled the premier's party as "amateurs out of their depth" following a debacle in Lazio, the region that surrounds Rome. The PDL failed to register its candidates on time because the designated official was on a sandwich break. They then made heavy-handed efforts to get their candidates back on the ballot paper, which were swiftly blocked by the Italian courts. A poll published in Corriere della Sera found that 17 per cent of voters had decided not to cast a ballot, or were changing their vote, as a result of the pre-election chaos.

Faced with the growing popularity of Purple People, the Prime Minister held his own Rome rally last weekend under the banner "Love always wins over envy and hatred". However, despite his party paying for bus and train tickets, the turnout was far below expectations. And crucially, Mr Berlusconi's key ally, Gianfranco Fini, did not attend, claiming his obligations as speaker of the house precluded it.

Another blow to Mr Berlusconi will come tonight, when Sky Italia, owned by Rupert Murdoch, broadcasts a political talk show that usually airs on state broadcaster RAI. Annozero, hosted by Michele Santoro, and all political TV was banned from state airwaves in the run-up to the election. So Mr Murdoch's Italian channel stepped in. Il Giornale, a paper owned by the Berlusconi family, vented its ire. "This shows the under-handedness of Santoro, who instead of broadcasting facts is waging political war against the government," it said.

It is against this backdrop of alleged conspiracy that Italians will cast their ballots on Sunday and Monday. Franco Pavoncello, a professor of political science at John Cabot University in Rome, predicted a weak performance by Mr Berlusconi's party would increase speculation about his succession. "Berlusconi's not going to go anywhere right now," he said. "But as a result of this election I think we might start seeing a discussion about where the right is going."