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Biomedical subjects

D Laplane

Publications and source records attributed to D Laplane.

At least 73 records · Page 4Linked to original sources
PubMed1984

Pure psychic akinesia with bilateral lesions of basal ganglia.

Three patients showed dramatic psychic akinesia after recovery from toxic encephalopathy. They had no or only mild motor disorders. The spontaneous psychic akinesia was reversible when the patient was stimulated, as if there was a loss of self psychic activation. Intellectual capacities were normal. Two patients had stereotyped behaviours resembling compulsions. In all patients CT cans showed bilateral lesions in the basal ganglia, mainly within the globus pallidus.

Adult↗
PubMed1984

[Study of plasma androgens in women with autoimmune diseases].

The exact significance of a reported androgen deficiency in women with lupus has not yet been determined. The authors decided to study plasma androgen concentrations not only in lupus, but also in other auto-immune diseases as well as non-auto -immune diseases. 43 patients (rheumatoid arthritis (RA): 10; systemic lupus erythematosus (SLE): 11; multiple sclerosis (MS): 11; patients without auto-immune disease: 11) were compared to 13 normal women. The age and the hormone concentrations of these different groups were compared by analysis of variance and by the Kruskal-Wallis test. A statistically significant reduction in androgen levels was only detected in the women with lupus. It therefore appears that the androgen deficiency is not a non-specific consequence of any disease, that it does not represent a predisposing factor for auto-immune disease in general, but that it is specific for lupus.

Adolescent↗
PubMed1984

[Unusual disorders of body image caused by peripheral deafferentation].

Two cases are presented. One concerned a patient with anosognosia of left plexus paralysis. The other was a patient with a massive alcoholic neuropathy, with bilateral severe deafferentation, during the course of which two almost delusional phantom limbs developed, both of which sprang from the left armpit. Some degree of mental confusion, no doubt partly responsible for these body image disorders, existed in both cases. These patients form the basis for a discussion which emphasizes the importance of elevation of functional levels of multimodal association areas in the organization of awareness of the physical self. Peripheral afferent stimuli probably partly contribute to this elevation. The hypothesis of the role of right hemispheric dominance for attention to provide an explanation for negligence does not appear valid in the first case, and another hypothesis in proposed in which a left hemispheric dominance is involved in the awareness of the physical self.

Afferent Pathways↗
PubMed1984

[Pure spinal cysticercosis. Note on the cerebrospinal fluid].

A patient from Benin experienced bilateral sciatic pain, followed by a progressive sensori-motor defect of the lower limbs. Five years after, he displayed symptoms and signs of a thoracic spinal cord compression, but no definite level could be determined. Myelography showed numerous intrathecal cysts from the cauda equina to the cervical cord. The diagnosis of cysticercosis was made by examination of the cysts removed after lumbar laminectomy. The search for another localisation of the parasite was negative. Repeated examination of cerebrospinal fluid (CSF) showed the presence of eosinophils, a high protein concentration, and a local synthesis of immunoglobulin G with an oligoclonal profile on electrophoresis. An accidental cyst punction revealed a fluid with protein migration in the alpha, beta and gamma ranges and a local synthesis of immunoglobulin A. Treatment with Praziquantel was uneffective.

Cysticercosis↗
PubMed1983

Motor neglect.

Motor neglect is characterised by an underutilisation of one side, without defects of strength, reflexes or sensibility. Twenty cases of frontal, parietal and thalamic lesions causing motor neglect, but all without sensory neglect, are reported. It is proposed that the cerebral structures involved in motor neglect are the same as those for sensory neglect and for the preparation of movement. As in sensory neglect, the multiplicity of the structures concerned suggests that this interconnection is necessary to maintain a sufficient level of activity. Predominance of left sided neglect by right sided lesions suggests that the left hemisphere is dominant for deliberate activity; hemispheric dominance could be applied to sensory neglect where conscious awareness would play the role of deliberate activity.

Brain Ischemia↗
PubMed1983

[Cerebral blood flow and oxygen extraction in lacunar hemiplegia. Semi-quantitative study using oxygen 15 and emission tomography].

The oxygen 15 non invasive continuous inhalation technique coupled with positron emission tomography (P.E.T.) allows the local study of cerebral blood flow and oxygen metabolism. Recent P.E.T. studies have demonstrated the frequent occurrence of widespread metabolic depression remote from the site of middle cerebral artery territory infarct per se, especially over the cortical mantle and thalamus ipsilaterally, and over the cerebellar hemisphere contralaterally. These phenomena have been taken as indicative of transneural depression (i.e. diaschisis). We thought it interesting to study the possible occurrence of such abnormalities in patients with lacunar syndromes. We have applied the (15)0 technique to six patients (2 with pure motor hemiplegia, 4 with ataxic hemiparesis) for whom no large causal ischemic lesion could be demonstrated on CT scans; in only one patient was a lacunar lesion, presumably responsible for the clinical deficit demonstrated. Compared to a set of 19 patients without brain disease, the semi-quantitative results (analyzed in terms of asymmetry indices between homologous brain regions) in our patients did not disclose any pathophysiologically significant abnormality. More specifically, no evidence of physiological dysfunction similar to that reported in internal carotid artery territory infarcts, was detected over the cerebral or cerebellar cortices. These findings are commented upon in view of the presumably small size and the uncertain topography of the causal lesion.

Aged↗
PubMed1982

[Motor neglect of thalamic origin: report on two cases (author's transl)].

Two cases of thalamic lesions with motor neglect are presented. The syndrome of motor neglect was complete in those cases with a) underutilization of left limbs, but good utilization upon verbal orders, b) loss of placement reaction, c) weakness of movement when hand was approaching the target, d) weakness of motor reaction to nociceptive stimuli. Those cases confirm that motor neglect exists after thalamic lesions and bring pathologic clues for topographic discussion. Motor neglect seems to be a particular case of partial unilateral neglect throwing some doubt on the hypothesis of a global trouble of hemispheric activation. Prevalence of left motor neglects suggests some linkage between propositional motility and language. One may suppose that in the right hemisphere language is able to have a vicarious action when spontaneous activation is lost; at the opposite, in the left hemisphere language and motility would be too linked to let this dissociation be generally possible.

Brain Neoplasms↗
PubMed1982

[Loss of psychic self-activation. Compulsive activity of obsessional type. Bilateral lenticular lesion (author's transl)].

After a carbon monoxide intoxication with coma of short duration, a 25 years-old man sustained a demential state and during the first weeks, a mild extrapyramidal syndrome. One year later, the mental state had progressively improved, although with a severe anterograde amnesia but the clinical picture had become unique. Let without external stimulation, the patient remained inert without any activity, often lying on his bed but not sleeping. He had lost any initiative. At the opposite, if he was stimulated, his physical, intellectual and affective performances were nearly normal, verbal fluency remaining however poor. Psychic self-activation appeared to be lost but psychic possibilities after external stimulation were nearly normal. When inactive, the patient was occupied with a mental compulsive activity. C.A.T. showed bilateral necrotizing lesions in the globus pallidus. The present case is very similar to a previously reported one. (D. Laplane et al., Rev. Neurol., 1981, 137 : 269-276) in which bilateral lenticular lesions produced the same syndrome. The pallidal area seems to play a determinant role in the processes of self-activation of psychic life.

Adult↗
PubMed1981

[Polyradiculoneuritis associated with plasmocytoma. Recovery following radiotherapy (author's transl)].

A new case of extensive subacute polyradiculoneuritis associated with a costal plasmocytoma secreting IgG lambda is reported. Radiotherapy of the rib, resulted in remarkable neurological improvement and haematological cure, which have now persisted for more than 5 years, though treatment was discontinued 3 years ago. By its distinctive haematological features, this case illustrates the lack of clear-cut distinction between "solitary" plasmocytoma and multiple myeloma. It also emphasizes the need for systematic testing for plasma cell proliferation when confronted with a subacute or chronic neuropathy of obscure origin.

Adult↗
PubMed1981

Bilateral infarction of the anterior cingulate gyri and of the fornices. Report of a case.

A 70-year-old woman had complex behavioural changes of sudden onset. The symptoms consisted of indifference, docility and inappropriate urination, but predominantly in a lack of attention. She was unable to maintain the attention necessary to perform a goal-directed activity and she was distracted by any stimulus, such as a sound, an object, or a word, which might induce behaviour irrelevant to the preconceived activity. She also exhibited confabulatory-amnestic syndrome. Neuropathological examination of the brain revealed infarcts in th territories of both anterior cerebral arteries. The rostral part of the anterior cingulate gyrus (Acg), small areas of the adjacent medial prefrontal cortex, and the underlying white matter were destroyed bilaterally. Infarction involved the deep territory of the left anterior cerebral artery, with a bilateral lesion of the fornices. This cingulate damage was more restricted than the Acg lesions reported in some cases of akinetic-mutism, which extended more caudally, but was presumably larger than the lesions created in psychosurgery. The impairment of attention was analyzed according to the possible roles of the cingulate and of the fornix lesions as causing a dysfunction between the frontal lobes and the hippocampal formations.

Aged↗