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Biomedical subjects

D Laplane

Publications and source records attributed to D Laplane.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Benign cerebral angiopathies and phenylpropanolamine].

Heroin, cocaine, amphetamines, sympathomimetic drugs can cause cerebral angiopathy. We report 2 patients with cerebrovascular disorders after ingestion of a nasal vasoconstrictor containing phenylpropanolamine (P.P.A.). The first patient had two acute repetitive attacks of severe headache and vomiting, occurring after a daily treatment with 180 mg of P.P.A. during 6 weeks. The second patient had an intracerebral hemorrhage, occurring some hours after taking for the first time 120 mg of P.P.A. In both cases, cerebral angiography, performed in the next week, demonstrated segmental narrowing and dilatations of medium-size intracranial arteries. None of the usual causes of cerebral vasculitis were present. The outcome was favorable and follow-up angiograms showed the disappearance of the beading pattern. P.P.A. is widely used over the counter in diet pills and stimulants. Cerebral vascular complications have been rarely reported, always hemorrhagic and often associated with cerebral vasculitis. They are unrelated to duration or dosage of treatment. The mechanism is unclear but could result from several factors: chronic or paroxystic high blood pressure, immuno-allergic vasculitis, arterial spasm, direct "toxic" effect of the P.P.A. on the arterial wall may be increased by other drugs and caffeine.

Adult↗
PubMed1988

[Loss of psychic self-activation and stereotyped mental activity caused by a frontal lesion. Relation of the obsessive-compulsive disorder].

A case of frontal lobe lesions is reported, its interest being that it is similar to a syndrome that we have previously described as the consequence of lenticular nucleus lesions. This syndrome includes primarily a loss of psychic self-activation (psychic akinesia) and compulsive or pseudo-compulsive activities. In the present case the lesions involved the deep white matter of the prefrontal cortex on both sides, and were most extensive in the depth of the middle frontal gyrus. This similitude brings further support to the notion that subcortical damage of the lenticular nuclei can induce a frontal-like syndrome. The similitude with some of the behavioural aspects or depressive of hebephrenic states is emphasized. The occurrence of stereotyped mental activities is the basis for a discussion of the relationships with some features of obsessive-compulsive neurosis.

Activities of Daily Living↗
PubMed1987

Prevalence of asymptomatic internal carotid artery stenosis.

The prevalence of internal carotid artery stenosis was studied with continuous wave Doppler and Duplex scanning in 526 subjects aged 45-84 years of age. They were devoid of any cerebrovascular symptoms or signs and were not referred to us because of risk factors or manifestations of atherosclerosis. The prevalence of stenosis, whatever the grade, was low in both sexes aged under 65 years: 2.4% in males aged 55-64 years. It increased sharply with age, reaching 30.3% for stenosis of less than 50% and 6.1% for stenosis of greater than 50% in males aged 75-84 years. The prevalence of minimal lesion (plaque with less than 15% diameter reduction) was high: 32.1% in males aged 45-54 years and 48.5% in the 75- to 84-year age range.

Aged↗
PubMed1986

[Chloroquine neuromyopathies: 4 cases during antimalarial prevention].

Four cases of chloroquine neuropathy presented two points of particular interest: 1) these were all young women with strictly prophylactic doses of chloroquine (100 mg/24 h); two patients showed pronounced loss of weight; 2) signs of myogenic lesions were apparent in only one patient whereas clinical and electric signs of neurogenic involvement were observed in all 4 cases. Biopsy in 3 patients (muscle in one and muscle and nerve in two) failed to show characteristic vacuoles; in one case mild segmental demyelinization was present. A favorable course was obtained in all cases after discontinuation of chloroquine, with dramatic recovery from the motor deficit. Pharmacokinetic studies in 1 patient showed abnormally high chloroquine levels at initial assay with slow elimination after its discontinuation.

Adult↗
PubMed1986

[Intracranial artery stenoses 44 years after craniofacial radiotherapy].

A 58 year-old patient experienced several ischemic strokes in the carotid arteries territories. History revealed a nasal epithelioma, for which he had received, at age 14, an irradiation through an anterior field (5500 rads), and two lateral fields (4550 rads each). He had a nasofacial atrophy as apparent sequellae. Angiograms showed stenoses of the cavernous portion of both internal carotid arteries and of the proximal portion of the left anterior cerebral artery. The ophthalmic arteries were narrowed and irregular. Despite the very long delay and the patient's age (that of common atherosclerosis) and the lack of specificity of the lesions, the relationship between the arterial lesions and radiotherapy was accepted: the site of the arterial lesions corresponded to that of irradiation; other carotid segments, and particularly the bifurcations of the common carotid arteries, appeared normal on angiograms. The X-rays dose delivered in the region of the Willis arterial circle had been very high. A review of the rare reported cases of intra-cranial post-irradiation arteriopathy is presented.

Brain Ischemia↗
PubMed1986

[Motor neglect of thalamic origin].

The clinical picture of thalamic motor neglect is identical to those of motor neglect in general, the major symptom of which being an underutilization of one side of the body in the absence of sensory-motor defect. Several thalamic nuclei can be implicated on the grounds of pathological and experimental data, most frequently the ventro-lateral nucleus. The prevalence of left neglect is not so obvious in the case of thalamic than in the case of other sites of lesions. Motor neglect appears as a disorder in the triggering of the brain structures network which program and prepare movement in several circumstances; attentional tasks are only a particular circumstance. Some thalamic nuclei are the site of hypoactivity in the case of frontal motor neglect in the monkey, as shown by anatomical and functional studies; this emphasizes the strong participation of thalamus to the motor network, the dysfunction of which can induce a motor neglect.

Attention↗
PubMed1985

[The anterior interosseous nerve syndrome. A rare lesion of a median nerve branch in the forearm. A case].

Apparently spontaneous and isolated lesions of the anterior interosseous nerve--a purely motor branch of the median nerve in the forearm--are extremely rare. Their clinical manifestations are fairly stereotyped, consisting of paralysis restricted to the long flexor muscle of the thumb, the deep flexor muscle of the index finger and the quadrate pronator muscle, without sensory disorders. The diagnosis is confirmed by electromyography. The syndrome may caused by traumas of the forearm or may develop spontaneously, although underlying anatomical abnormalities which may act as predisposing factors are not infrequently found in this case. The natural outcome may be favourable, but surgery may be required to release the nerve.

Adult↗
PubMed1985

[Side effects of antiepileptic therapy. Study of 197 cases].

A study of 197 epileptic outpatients consecutively observed by one Neurologist allowed a prospective study of the side effects of antiepileptic drugs. This study shows essentially that a clinical improvement comparable to that generally reported can be obtained with side effects limited in their number and intensity. The main principle is the routine search of these effects which are not always spontaneously mentioned by the patients, especially intellectual slowness and loss of sexual activity. The detection of the side effects through history and physical examination is far more fruitful than are plasma concentrations of drugs which can be doubly misleading: some plasma concentrations lower than recognized therapeutical levels are efficient however while others are higher and nevertheless necessary and well tolerated. Among the side effects specific to certain antiepileptic drugs, shoulder-hand syndrome due to phenobarbital was noted in 10 per cent of the cases. Furthermore, the frequency of scapulo-humeral periarthritis was significantly higher in the epileptic group than in the controls. Dupuytren's disease was less frequent (8 per cent) and the difference with the controls was not significant. Among the non-specific side effects, nystagmus is a somewhat useful sign in treatments by phenytoin but as with drugs dosages, it must be weighed within the whole clinical picture.

Adolescent↗