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Biomedical subjects

C Confavreux

Publications and source records attributed to C Confavreux.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Ineffectiveness of hyperbaric oxygen therapy in multiple sclerosis. A randomized placebo-controlled double-blind study].

Seventeen patients with definite and progressive multiple sclerosis entered a double-blind randomized placebo-controlled therapeutic trial of hyperbaric oxygen (HBO). Exposure in monoplace chamber was 90 minutes long each time, 5 days a week, for 4 weeks. The treatment and placebo groups received 100% oxygen at 1.5 bar constant pressure or normal air at 0.1-0.2 bar, respectively. The clinical status of the patients in both groups were compared until one year after treatment. There was no benefit of HBO versus placebo according to the Kurtzke disability status scale. A lesser proportion of patients with deterioration of bowel/bladder function 12 months after therapy was the only benefit of HBO versus placebo according to Kurtzke functional systems scales. On the whole however, HBO is useless in the management of progressive forms of multiple sclerosis.

Double-Blind Method↗
PubMed1986

Plasma cells in cerebrospinal fluid and multiple sclerosis: diagnostic yield and clinicobiological correlations.

Cerebrospinal fluid (CSF) cytocentrifugation was performed for plasma cells' demonstration in parallel with white cell count (WCC) and quantitative protein assays. Over a 5-year period, 154 consecutive multiple sclerosis (MS) patients were studied and compared to 28 other inflammatory neurological disease, 85 non-inflammatory neurological disease and 29 non-neurological disease cases. CSF cytology was easy to perform, gave definitive results within 2 h and was abnormal in 80 MS patients, 26 of whom had a normal WCC. Its sensitivity in MS was 0.57, i.e. higher than for WCC (0.45) but lower than for IgG index (0.70) and IgG synthesis rate (0.71). Its specificity was 0.86, not significantly different from specificity of WCC, IgG index and IgG synthesis rate. Plasma cells demonstration in MS CSF was neither a disease activity nor a prognosis marker. It was significantly correlated with pleiocytosis and intrathecal IgG synthesis. If these morphologically defined plasma cells are actual B cells, they could represent circulating individuals of the lymphocyte clones active in MS plaques and have a pathogenetic significance.

Adult↗
PubMed1986

Oligoclonal "fingerprint" of CSF IgG in multiple sclerosis patients is not modified following intrathecal administration of natural beta-interferon.

The IgG pattern in CSF was studied in 11 patients with multiple sclerosis who exhibited an oligoclonal banding upon thin-layer polyacrylamide gel isoelectric focusing followed by silver stain of unconcentrated CSF. Each patient received beta-interferon intrathecally during a 2 month period. No modification was observed over a 6 month period. In addition, the oligoclonal pattern was remarkably unique for each individual representing a typical "fingerprint" which allowed the identification of any single CSF.

Electrophoresis, Polyacrylamide Gel↗
PubMed1986

[Paralysis of downward gaze and chronic global amnesia as a result of a bilateral thalamo-subthalamic lesion].

A 47 year-old male was found in coma and upon awakening 36 hours later, he showed a selective paralysis of downward gaze and convergence associated to an intellectual impairment. He was euphoric, unconcerned, poorly attentive, and had a severe amnesia for both anterograde and retrograde material. CT scan and NMR demonstrated a bilateral lacunar lesion of thalamic and subthalamic paramedian region. Over the 5 years follow-up, behavioral, personality and amnestic changes remained. On the other hand, supranuclear gaze paralysis improved as documented by EOG recordings with persisting limitations in voluntary down movements amplitude and dramatic reduction of fast components velocity.

Amnesia↗
PubMed1985

The acute deafness of definite multiple sclerosis: BAEP patterns.

Of 705 patients with or suspected of multiple sclerosis who underwent evoked potential recording during a 5 year period, 12 patients with definite multiple sclerosis experienced an acute hearing loss during a relapse of the demyelinating disease. Hearing loss was unilateral in all of the 12 cases but one; tinnitus was associated with hearing loss in 9 of the 12 patients. Deafness is an unfrequent symptom in the course of multiple sclerosis, being estimated to be no more than 3% in large series of multiple sclerosis. Brain-stem auditory evoked potentials were recorded in all 12 patients, during the relapse with acute hearing loss in 4 of them, after the relapse with hearing loss in the 8 others. During the relapse with hearing loss, BAEP abnormalities were present ipsilateral to the hearing loss in all 4 patients, wave I being absent in 2 of them. BAEPs were drastically improved when recorded after the relapse with hearing loss in 2 of the 3 patients in whom repeated records were made. BAEPs were abnormal on the side of the previous hearing loss in 5 out of the 8 patients recorded after the relapse with hearing loss. Clinical and BAEP data suggest that, in accordance with the anatomical organization of the auditory pathways, the lesion causing unilateral hearing loss in multiple sclerosis could be situated in the cochlear nerve or close to its entry zone in the brain-stem. However, dissociation between unilateral hearing loss and a normal peak I and I-III interval may occur.

Acoustic Stimulation↗
PubMed1985

A Markov model of the natural history of multiple sclerosis.

Prior research into multiple sclerosis prognosis has produced conflicting results. This paper presents an original approach in which the disease course is described by the movements of patients through well-defined disease states. A Markov model is proposed to describe these movements and to evaluate the effect of prognostic factors on transitions from state to state. The feasibility and applicability of this model is determined using data on the course of disease in 278 diagnosed patients from Lyon. Patients with older age at onset, females, and those with monosymptomatic onset are found to be at a higher risk of transition to a worse disease state.

Adult↗
PubMed1984

[Multiple sclerosis. Current etiopathogenic concepts].

The pathogenesis of multiple sclerosis is still poorly understood. Clearly, exogenous factors and genetic susceptibility combine to induce the disease, but studies on twins have shown that the genetic part is of minor importance. The immunological abnormalities observed do not fit easily into a coherent system. Derepression of antibody production in the central nervous system has been postulated and ascribed to failure of suppressor T-lymphocytes, but this is an over-simplification and the possibility that immunological abnormalities merely reflect a genetic predisposition cannot be dismissed. For many years, a viral origin has been suspected, yet the measles virus, at the top of the black list, must probably be discharged. Although the auto-immune theory remains attractive, the target antigen is still unknown in spite of numerous studies, and the signs of auto-immunity found in multiple sclerosis might well result from destruction of the nervous tissue instead of being the cause of the disease.

Antibody Formation↗
PubMed1983

[Course of obstructions of the carotid artery in the neck. 69 cases].

This study involved 69 patients with occlusion of the internal carotid artery in the neck confirmed by angiography. Ten patients were operated upon and 59 were treated medically. The clinical course was roughly the same in both group. Of the 62 patients who survived the initial stroke, 50 could be followed-up for a mean period of 57 months at the end of which 12% had died, 16% remained with a major degree of functional impairment and 72% had little or no residual symptoms. All but one deaths were of non-vascular origin. New cerebral vascular accidents occurred in 16% of the cases, always in the territory of the occluded artery. The long-term benefits of surgical cerebral revascularisation are discussed in the light of these findings.

Arterial Occlusive Diseases↗
PubMed1983

[Utilization behavior during the course of progressive multifocal leukoencephalopathy].

A particular semiologic feature of a case of progressive multifocal leukoencephalopathy was the existence of utilization behavior as described by Lhermitte. The affection developed in a patient with myeloid leukemia treated by cytotoxic drugs. Multifocal low density areas were shown by CT Scan examination. The course of the disease was not altered by isoprinozine therapy.

Adult↗
PubMed1983

[Study of 213 cases of multiple sclerosis treated with azathioprine from 1967- to 1982].

Effects of azathioprine, 150 mg per day on average, were studied in 213 patients with multiple sclerosis. Thirty-eight case reports were excluded from the final analysis due to lack of continuous treatment (22 cases) or of complete data (16 cases). The 175 patients followed up regularly for a mean of 10 years had received the drug for from 6 months to 15 years (mean approximately 4 years). The treatment was generally well tolerated and there were no irreversible side effects. Results for the different parameters studied, when compared with those in untreated controls, showed the following features: for patients with the remittent form of MS: a statistically significant increase in cases showing no further progression, a reduced frequency of attacks (increased during spontaneous evolution of the affection), a significantly lower incidence of cases that became progressive in nature, and a general improvement in disability score at the end of follow-up. The course of the disease appeared to be more severe before treatment than in untreated cases. In patients with the progressive form of MS (47 cases) the ratio of total disability scores to number of years of observation was reduced in treated when compared with control patients, whereas this ratio was similar in both groups before treatment. General improvement in scores was therefore definitely related to treatment. These findings are in agreement with those of our 1978 study (Aimard, Confavreux et al.) and of others using the same protocol (Oger et al., and Rosen).(ABSTRACT TRUNCATED AT 250 WORDS)

Azathioprine↗
PubMed1982

[Contribution of lumbar puncture to the diagnosis of cephalalgia].

The authors have reviewed the records of 50 patients hospitalized for treatment of isolated cephalalgia and in whom lumbar puncture was the only investigatory procedure that initially provided some information. In 12 cases, CSF abnormalities reflected a progressive tumoral, vascular or inflammatory intracerebral lesion undetectable by the usual methods (fundus oculi, radiography of the skull, EEG), or by less common examinations (arteriography, scintiscans, CT scans). In 12 other cases, lumbar puncture provided evidence of a minimal meningeal inflammatory process. In 26 cases, the only biochemical change was an excess of CSF proteins which in 7 cases developed in a dome-shaped curve suggesting an independent disease, the significance of which is discussed.

Adult↗
PubMed1982

[Intracranial arteriovenous angioma in adults. A review of 100 medico-surgical cases (author's transl)].

The most frequent clinical presentations were haemorrhage (36 cases) and epilepsy (33 cases). Among the 68 subjects operated upon, 55 benefited from total removal of the angioma. The mortality rate was 10%. The long-term outcome was favourable in 75% of patients. Excision suppressed the risk of bleeding, but its efficacy on epilepsy was more limited. The clinical course in patients not operated upon was less favourable. However, only 4 of them died, and only one recurrence of bleeding was noted.

Adult↗
PubMed1982

Course of visual evoked potentials in multiple sclerosis: electroclinical correlations and pathophysiological considerations in 25 patients.

Twenty-five MS patients had VEPs recorded at 1-year interval. Abnormal VEPs were observed at least once in 21 patients. They were the only means of assessing the lesional dissemination in nine patients. Their contribution in the diagnostic classification is such that the proportion of "definite" cases rises from 44 to 80% of the 25 cases. The degree of abnormality of the VEPs had no relation to the disability status or to the whole severity of the disease. The main feature was the variability of the VEP latencies at a 1-year interval: they seem to follow the remittent progressive course of the disease whether visual pathways are clinically affected or not. These results are interpreted in light of the pathophysiological data of the disease. In the cases with improvement of normalization of the second VEPs, in plaque edema may be an important mechanism, sometimes free of demyelination so that perfect restitutio ad integrum may occur.

Adult↗