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Biomedical subjects

C Lebrun

Publications and source records attributed to C Lebrun.

At least 55 records · Page 3Linked to original sources
PubMed1999

Nonconvulsive status epilepticus of frontal origin.

OBJECTIVES: To determine the electroclinical characteristics and causative factors of nonconvulsive status epilepticus (NCSE) of frontal origin. METHODS: The authors conducted a 5-year prospective study. RESULTS: Ten patients were studied (seven men, three women; mean age, 56.4 years). Six patients did not have previous epilepsy. The mean diagnostic delay was 48 hours (range, 3 to 96 hours). Two types of frontal NCSE were identified. In type 1 (n = 7), mood disturbances with affective disinhibition or affective indifference were associated with subtle impairment of cognitive functions without overt confusion. EEG showed a unilateral frontal ictal pattern and normal background activity. In type 2 (n = 3), impaired consciousness was associated with bilateral, asymmetric frontal EEG discharges occurring on an abnormal background. Ictal and postictal 99mTc hexamethyl propylene amine oxime (HMPAO) SPECT was performed in five patients and showed unilateral or bilateral frontal HMPAO uptake that aided localization, especially in type 2 NCSE of frontal origin. Etiologies included a focal frontal lesion in six patients (three of which were tumors), neurosyphilis, and nonketotic hyperglycemia. Eight patients did not respond to initial IV benzodiazepine (BZ), but IV phenytoin controlled six patients successfully. The immediate outcome was favorable in all patients. There was no long-term recurrence of SE in seven patients. CONCLUSIONS: NCSE of frontal origin is a heterogeneous syndrome. Some cases are best described as simple partial NCSE, others as complex partial SE, and there are forms that overlap with absence SE. Emergency EEG and neuropsychological assessment are diagnostic, and SPECT may be useful. Many patients may not respond to IV BZ.

Adult↗
PubMed1999

[Neurologic complications of chemotherapy].

INTRODUCTION: Neurotoxicity can be induced by the synergistic or additive effects of cytotoxic treatments, and nervous system exposure is related to routes and doses. CURRENT KNOWLEDGE AND KEY POINTS: The improvements in treating systemic malignancy have been accompanied by reports of neurologic toxicity, which has an important impact on the quality of life and may even limit the use of the treatment. PERSPECTIVES AND FUTURE PROJECTS: It demands out a continuous clinical evaluation to detect their appearance. When neurological complications are diagnosed later, they are rarely reversible. Neuroprotective agents are still being evaluated.

Antineoplastic Agents↗
PubMed1999

[Brain metastases and chemotherapy].

INTRODUCTION: The epidemiology of brain or central nervous system metastases is poorly documented. Retrospective studies based on autopsies that were aimed at investigating the incidence and prevalence of brain metastases have revealed the shortfalls in tumour registers. The exact role of cerebral metastases has not been addressed within the scope of cancer considered as a public health issue. CURRENT KNOWLEDGE AND KEY POINTS: The prognosis of brain metastases should not be considered either on general or a priori basis as being poorer than that of other metastatic sites. Evaluation of the role of focal radiation therapy and chemotherapy is still in progress. Appropriate use of therapeutical strategies directed at brain tumors generally improves the condition of most patients. It also usually increases survival and enhances the quality of life. FUTURE PROSPECTS AND PROJECTS: The role of chemotherapy in current therapeutical strategies has not yet been defined and should be investigated and developed.

Antineoplastic Agents↗
PubMed1999

Leukoencephalopathy in multiple myeloma: two case reports.

BACKGROUND: No case of leukoencephalopathy has been reported associated with multiple myeloma. PATIENTS: We report on two patients with a very rare association of leukoencephalopathy and multiple myeloma revealed by cognitive impairment. RESULTS: Chemotherapy has improved neurological and biological signs. Radiological abnormalities have been stabilized. CONCLUSION: The authors suggest that leukoencephalopathy is probably a direct cerebral expression of malignant gammopathy.

Aged↗
PubMed1998

[Epilepsy and cancer].

INTRODUCTION: Seizures are common in patients presenting with intracranial tumors. Nevertheless, the incidence of cancer is not higher in patients with seizures. We attempted to summarize situations that can lead to the diagnosis or treatment of seizures in patients presenting with cancer. CURRENT KNOWLEDGE AND KEY POINTS: Focal neurological signs on clinical examination when seizures occur for the first time in patients with cancer lead to brain imaging. As a result of recent advances in neuro-imaging techniques, the presence of a tumor is now more frequently observed in patients with seizures. PERSPECTIVES AND FUTURE PROJECTS: As it may have irritating effects on the cerebral cortex, chemotherapy is able to either increase or induce seizures in patients presenting with cancer. Potential pharmacological interactions between antiepileptic and cytotoxic drugs thus require close surveillance in patients with cancer.

Anticonvulsants↗
PubMed1998

[Tyrosine kinase: implications in tumor pathology and therapeutic perspectives].

The tyrosine kinase family includes growth factor receptor and cytoplasmic enzymes. It plays a key role in normal cell division and abnormal cell proliferation and differentiation. The most common tyrosine kinases are the epidermal-growth factor (EGFR) and platelet-derived growth factor (PDGF) receptors, and a chromosome Philadelphia product, the Bcr-abl oncogene. Many studies have attempted to correlate clinical evolution of tumors with tyrosine kinase expression. However, clinical application of these new prognostic factors has not yet been demonstrated. More recently, tyrosine-phosphorylation inhibitors (tryphostin) have been developed in phase I studies. Results that were obtained show some objective responses in patients with glioblastoma and polymetastatic cancer. Another approach to block tyrosine kinase expression is the use of monoclonal antibodies. Trials using such antibodies have shown interesting preliminary results.

Antibodies, Monoclonal↗
PubMed1998

[Germinal tumor metastases. Case report].

Germinoma is the most frequent type of intracranial germ-cell tumor initial presentation is usually acute intracranial hypertension. MRI investigations are non-specific. Most of the time, only stereotactic surgery is performed before treatment. Metastases are rare but germ cells can disseminate both by infiltration and via ventricular and subarachnoid pathways. Abdominal and pelvic metastases occur in 10 p. 100 of patients who have received ventriculosomatic shunting. Since germinoma is well known to be a very radiosensitive tumor, patients are usually given radiation therapy. Chemotherapy seems to be an interesting alternative treatment.

Adult↗
PubMed1998

[Orthostatic hypotension revealing vitamin B12 deficiency].

Neurological manifestations of cobalamin deficiency are well known and various. We describe an uncommon clinical setting where major orthostatic hypotension was the primary symptom. Recovery was rapidly and completely stabilized with parenteral cobalamin substitution. There was no clinical or electrophysiological signs of neuropathic disorder. This entity is rare but few cases are described in literature. All of them were reversible with vitamin substitution treatment.

Aged↗
PubMed1997

[Hyponatremia during treatment with cisplatin].

BACKGROUND: Cisplatin is one of the most widely used agents in cancer treatment. Cisplatin regimens can lead to a more or less pronounced hyponatremia in 4 to 10% of cases due to salt wasting with hypomagnesemia and normokaliemia. Functional and renal failure and orthostatic hypotension can be observed. CASE REPORT: A 54-year-old woman with brain metastases of a non-small-cell lung cancer was given a chemotherapy regimen containing cisplatin. Hyponatremia with confusion occurred after each cisplatin perfusion. The diagnosis retained was cisplatin-induced salt wasting. The patient was given salt prolonged supplementation and carboplatin was substituted for cisplatin in the chemotherapy regimen. DISCUSSION: Hyponatremia frequently occurs in cancer patients. Cisplatin-induced hyponatremia requires specific management. Treatment is based on sodium intake which sometimes takes several months to replete stores. Carboplatin can be used instead of cisplatin in case of major hyponatremia.

Antineoplastic Agents↗
PubMed1997

Solitary meningeal plasmacytomas.

BACKGROUND: Solitary extramedullary plasmacytoma (SEP) represents a rare separate clinical pathological entity; it is radiosensitive, curable, and unrelated to myeloma. Only 15 cases have been reported. PATIENTS AND METHODS: Authors report two well documented cases of dural plasmocytomas mimicking meningiomas. This paper points out differences between plasmacytomas, with very different initial presentation, and other meningeal tumors including extensive radiological investigations. Diagnostic options and outcomes are discussed. CONCLUSION: With solitary plasmacytomas, radiological diagnosis is difficult to assess. Serum is generally free of monoclonal protein. The importance of the most recent techniques in ruling out other pathological entities is stressed. Histopathological examination is required to document a monoclonal type of plasma cell tumor. Treatment includes surgery and radiotherapy. Differential radiological diagnosis will be discussed.

Adult↗
PubMed1995

Angiotensin receptors in the brain.

Angiotensin receptors have recently become a focus of scientific interest due to the recent development of specific receptor ligands which allow to distinguish between various angiotensin II receptor subtypes, notably the angiotensin II type 1 receptor (AT1) and angiotensin II type 2 receptor (AT2). Although both receptors belong to the seven transmembrane domain receptor family they feature less than 35% homology and differ in their signal transduction mechanisms and in the effects mediated. In the brain, both angiotensin receptor types and probably some further subtypes are present and have been localized in distinct regions. In the adult brain, the AT1 receptor dominates by far and is responsible for most of the known central actions of angiotensin peptides, for example blood pressure increase, release of vasopressin from the pituitary gland, natriuresis, drinking and induction of immediate early genes in distinct brain areas. Some of the AT1 receptor-mediated effects have been shown to be enhanced by blockade of AT2 receptors in the brain suggesting that the central AT2 receptor can exert an inhibitory control on AT1 receptor-mediated actions in the brain.

Angiotensins↗