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Biomedical subjects

F Lhermitte

Publications and source records attributed to F Lhermitte.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Double-blind treatment of 49 cases of chronic multiple sclerosis using hyperbaric oxygen].

Forty nine patients with a chronic form of multiple sclerosis (MS) [progressive or stable] were treated with hyperbaric oxygen (HO) in a double blind trial. Patients were divided in three groups: the first group (group I) received a course of 2.3 ATA HO with diazepam (5 mg); the second group (group II) received a course of 2 ATA HO; the third group (group III) was the control group. Each patient breathed an adapted gaseous mixture in high pressure. Each patient received 20 sessions of this procedure during 4 weeks. Patients were evaluated with clinical, neurophysiological and immunological parameters. Clinical examination consisted in the evaluation of the Kurtzke's Disability Status Scale (DSS) and Functional Status Scale (FSS). This evaluation was done in the week before the procedure, the week following the treatment, then in the third and sixth month. The neurophysiological study was a comparative analysis from the variations of visual, somesthesic and brain stem auditory potentials. The immunological study was the analysis of the lymphocyte populations (OKT4/OKT8 ratio). Each examination was carried out the week before, then the week following the procedure. We found no amelioration into three groups. Subjectively, some patients thought to be better, but this was true in the two treated groups (I, II) and in the control group (III). There was not an FSS significant variation. We also found no significant variation of evoked potentials and OKT4/OKT8 ratio. We observed some incidental effects of the treatment, particularly in group I, in which patients were treated with a higher pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗
PubMed1986

[Myoclonic cerebellar dyssynergia (Ramsay-Hunt syndrome) and cerebellar telangiectasia].

A 8 year-old girl presented with generalized epileptic seizures followed by the progressive onset of myoclonic jerks, sometimes associated with willed movements, and a static and kinetic cerebellar syndrome without conspicuous intellectual impairment. Death occurred 10 years after the onset of the disorders. There was no family history. Neuropathological studies showed lesions confined to the cerebellum. Diffuse and bilateral telangiectases were present in the cerebellar white matter. They were associated with patchy cortical alterations of the distal parts of some folia involving mainly the granule-cells ans sparing the Purkinje cells. No Lafora bodies and no abnormal lipofuscin storage were observed. The dentate nuclei, superior cerebellar peduncles and red nuclei were normal as were the inferior olives and inferior cerebellar peduncles. The spino-cerebellar tracts were unaffected. This case confirms the hypothesis that dyssynergia cerebellaris myoclonica corresponds only to a clinical entity. It may be encountered in various degenerative or metabolic disorders involving the cerebellum and/or its pathways. To our knowledge the association of a Ramsay Hunt syndrome with a vascular malformation has not been previously reported.

Adolescent↗
PubMed1986

[Complete human Klüver-Bucy syndrome after encephalitis caused by herpes simplex type 2].

A case of complete Klüver-Bucy syndrome is reported. A 42 year-old man developed Herpes Simplex type II (H.S.V.II) encephalitis. Good sparing of language functions allowed thorough neuropsychological testing. The troubles usually described in Klüver-Bucy syndrome as psychic blindness, colour agnosia, prosopagnosia, auditive and tactile agnosia were present. The authors theorize that these symptoms are mainly correlated with the amnestic syndrome, which is constantly reported in human Klüver-Bucy syndrome. Unfortunately, after 8 weeks, the encephalitis recurred and the patient was left demented and untestable.

Adult↗
PubMed1985

Unilateral visual neglect and wave P 300. A study of nine cases with unilateral lesions of the parietal lobes.

Wave P 300 was studied in nine patients with parietal lobe lesions who had visual neglect but no hemianopia. Stimulation of the hemispace contralateral to the lesion showed a lengthening in latency and a decrease in amplitude of P 300, specifically related to visual stimulation. Comparison with results obtained in 14 normal subjects and four patients with localized hemispheric lesions without visual neglect showed that changes in P 300 were specifically related to visual neglect. The parietal lobe lesions may disturb cerebral processes involved in discrimination and visual stimulus evaluation required to perform a task, inducing disturbance of the system responsible for P 300.

Adult↗
PubMed1985

Value of multiple sclerosis diagnostic criteria. 70 autopsy-confirmed cases.

We have evaluated the sensitivity of the most recent and most frequently used criteria for the diagnosis of definite multiple sclerosis by the retrospective study of the clinical files of 70 pathologically confirmed cases. For each case, the date of diagnosis was determined separately using different sets of criteria. The delay of diagnosis was then calculated. The diagnosis was made significantly earlier when certain criteria were used. This was more marked in the earlier years of the disease. We also found that cases of multiple sclerosis with progressive courses were diagnosed later than cases with other courses, whatever the criteria used. This was statistically significant only for a single criterion.

Autopsy↗
PubMed1985

Late onset multiple sclerosis. A clinical study of 16 pathologically proven cases.

In 70 pathologically proven MS cases, we found 16 cases with onset after 45. Sex ratio (3/1) was the same in the late onset cases and early onset control group. There was no positive family history of MS. The diagnosis was more frequently never considered in late onset cases (3/16) than in control cases (3/54). Mean duration of the disease was 8.6 +/- 6 years (8.1 +/- 6 in female patients). This was significantly shorter (P less than 0.05) than in the control group. In addition, in remittent-progressive courses and in progressive courses, it appeared that the duration of the disease was shorter in late onset MS - although this was not statistically significant. Progressive courses (8 cases) and acute courses (4 cases) were more frequent (P less than 0.05) than in control cases. Initial signs and symptoms were not significantly different from those of control cases. The length of the evolution of the disease was higher in cases with vestibular-cerebellar onset. New signs and symptoms occurred at the same rate in the late onset cases as in the control cases. Although motor, sensory and bladder disturbances were more frequent in the late onset cases than in the control cases, this was not statistically significant. Amyotrophy was more frequent in late onset MS; on the contrary optic neuritis, vestibulo-cerebellar disturbances and nystagmus were less frequent in late onset MS than in the control group (P less than 0.05).

Brain↗
PubMed1985

[Spinal forms of multiple sclerosis. Value and criticism of examination by cerebral magnetic resonance. Apropos of 4 cases].

Four observations of spinal forms of multiple sclerosis (MS) have been studied by Magnetic Resonance Imaging (MRI) (Magniscan Thomson CGR 0,15 and 0,5 T). They concerned 3 females and 1 male, aged between 29 and 60. Evolution of MS varied between 1 year and 9 years. There were no familial story of neurological illness; there were no signs and symptoms of visual, oculo-motor, labyrinthic and cerebellar disorders in the past. VEP were abnormal in 2 cases (no 1, 3), BAEP in 1 case (no 2). CSF examination showed increased gamma globulins with an oligoclonal pattern in 2 cases (no 3,4). CT Scan performed with iodine contrast injection was normal in 3 cases (no 2,3,4). In all the cases, MRI using T2 weighted-SE sequences, showed high signal lesions in the white matter of the brain and/or the cerebellum, and periventricular patchy white matter lesions. It seems to be no relationship between the duration of MS and the number of abnormal high signals areas, but more important series are necessary to confirm or not such a result. These lesions seem to be without aetiological specificity. They have to be discussed according to the clinical biological, electro-physiological data and sometimes others neuroradiological procedures.

Adult↗
PubMed1985

[The L-dopa test in Parkinson's disease].

Seventy parkinsonian patients (mean age: 59.6 +/- 1.2 years; duration of disease: 9 +/- 0.6 years) with severe fluctuations of disability under L-Dopa treatment received a single dose of L-Dopa (200 mg + benserazide, a peripheral decarboxylase inhibitor) after 24-72 h interruption of treatment. The delay and duration of action of a single dose of L-Dopa, and the percentage of improvement of the parkinsonian symptoms were 39 +/- 2 and 162 +/- 6 minutes, and 57 +/- 2 p. 100 respectively. Estimation of the difference between the basal parkinsonian score and the score during maximum clinical improvement under levodopa treatment, and the score under levodopa treatment may reflect the severity of dopaminergic and of non dopaminergic lesions in the brain respectively. Modification of the treatment to obtain continuous clinical improvement can be performed according to the delay and duration of action of a single dose of L-Dopa.

Aromatic Amino Acid Decarboxylase Inhibitors↗
PubMed1985

[Late syringomyelobulbia complicating spinal cord injury. Improvement after syringoperitoneal shunt].

A patient suffered from paraplegia of T-10 level at age 29, and he complained of new symptoms in the upper limbs at age 42. Gradual ascending worsening occurred, and the diagnosis of post-traumatic syringomyelobulbia was made 23 years after the initial accident. CT scan with metrizamide transit at the medulla level confirmed the diagnosis. Definite clinical improvement was seen after syringo-peritoneal shunting. Clinical, radiological and therapeutic aspects are briefly discussed.

Adult↗
PubMed1985

[Nerve and muscle microvasculitis: 50 cases].

Fifty consecutive cases of nerve and muscle microvasculitis (MV) seen on nerve and muscle biopsies were studied. These were observed in a 5 years period, among 1076 nerve and/or muscle biopsies performed in adult patients in the Laboratoire de Neuropathologie Charles Foix. The systemic necrotizing vasculitides, in which the arteries of diameter greater than 70 microns are involved, acute polymyositis, sarcoidosis and acute polyneuritis were not considered in this study. Mononuclear cell infiltration was the rule. It was associated to leukocytoclasis in 2 cases. No fibrinoid necrosis was seen. These changes were highly diagnostic when seen in the nerve or the connective tissue of the epi or perimysium. The etiology of these microvasculitides was mainly connective tissue diseases (42 p. 100) and, overall, panarteritis nodosa (16 p. 100), or malignancies (28 p. 100) which comprise 7 solid tumors and 4 lymphomas. Other cases were related either to systemic diseases (thromboangiitis obliterans, monoclonal dysglobulinemia, cholesterol embolus) or to local trauma. The relationship between MV and peripheral neuropathy was less obvious in 3 cases of mononeuritis multiplex associated with diabetes mellitus and in 3 cases of acute idiopathic and regressive mononeuritis multiplex. In 5 cases, no cause was found.

Adult↗
PubMed1985

[Clinical analysis of 70 neuropathologic cases of multiple sclerosis].

A retrospective study of clinical files of 70 pathologically confirmed cases of Multiple Sclerosis (MS) (53 women and 17 men), selected from the records of the Laboratoire de Neuropathologie Charles Foix (Hôpital de la Salpêtrière) was performed. The following data were recorded and analysed by a computer program (HP 85): sex, age of onset of disease, clinical course (classified into Remittent, Remittent-Progressive, Progressive and Acute) and the date of each new neurological symptom or sign. The mean age of onset was 36.8 +/- 12. In women, the disease began earlier (34.6 +/- 12) and the duration was longer (17.4 +/- 12). In men the age onset was 40.6 +/- 11 and the duration was 12.5 +/- 6. In remittent courses, the mean age of onset was 30.8 +/- 13 and the duration was 21 +/- 10. In progressive courses, the age at onset was 45 +/- 10 and the duration was 2. In women, progressive courses began significantly later (42.3 +/- 9.2) and were shorter (15 +/- 8) than remittent courses which began at 26.8 +/- 8.2 and lasted 23 +/- 10. The histogram of the duration of clinical courses showed three groups: acute courses (8 cases less than 5 years long), intermediate courses (41 cases, between 5 and 20 years long), and long courses (21 cases longer than 20 years). Women were more often affected with acute (7/8 cases) or long courses (20/21 cases). The mean duration of the disease was the same when the symptoms and signs at onset were motor weakness, sensory disturbances, optic neuritis or diplopia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Monocular blindness with preserved direct and consensual pupillary reflex in multiple sclerosis.

A 22-year-old woman with definite multiple sclerosis had right-eye blindness with preserved direct and consensual pupillary reflex to light. The anatomy of the fibers inside the optic nerve did not give a satisfactory explanation of this phenomenon. On the other hand, this case appeared to support the idea of biochemical differences between the myelin of visual pathways and that of reflex pathways. Studies are necessary to confirm this hypothesis.

Adult↗
PubMed1984

Neuropsychological analysis of ruptured saccular aneurysms of the anterior communicating artery after radical therapy (32 cases).

We examined 32 patients between 12 and 50 months after they had undergone clipping of ruptured aneurysms of the anterior communicating artery. The patients benefited from diagnosis by means of computed tomography scan and angiography, accurate timing of operation, deep hypotension, and, in all cases, occlusion of the neck of the aneurysm by clip, which was performed under the operating microscope. Tests and a questionnaire administered to the patients indicated excellent recovery of mental and amnesic capacities as well as recovery of former personality. A total of 84% returned to work. These results and those that have been reported by other authors over the last 20 years illustrate the constant improvement in neurosurgery.

Adolescent↗