Acute polyradiculoneuropathy after amitriptyline overdose.
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Amitriptyline↗
Biomedical subjects
F Pasquier
Publications and source records attributed to F Pasquier.
"Hemicrania continua": the first bilateral case?
The patient reported had had a continuous headache involving the whole skull for 7 years. Many drugs had failed to relieve the pain, but with indomethacin the headache completely disappeared within 3 days. Nine months later the treatment was discontinued without any relapse. This variety of headache, not previously reported, was quite similar to the "hemicrania continua" except for its localization.
Adult↗
Possible revelation of latent myasthenia gravis by labetalol chlorhydrate.
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Female↗
[Benign choroid plexus papilloma. 2 local recurrences and intraventricular seeding].
The authors report a case of choroid plexus papilloma developped in the fourth ventricle. After complete surgical resection, two local recurrences of the tumor occurred, and required new surgical procedures. Eight years after the first operation, a papilloma of the right lateral ventricle was resected. The histological examination showed benign choroid plexus papilloma after each operation. Recurrence and seeding of benign choroid plexus papillomas are infrequent in the literature. For this reason, a long-term follow-up, by clinical examination and CT scan, is necessary for those patients.
Adult↗
[Multiple or multicentric cerebral glioma. Diagnostic and prognostic problems].
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Adult↗
Decreased morbidity from acute bacterial spinal epidural abscesses using computed tomography and nonsurgical treatment in selected patients.
We describe 5 patients with spinal epidural abscesses in whom computed tomographic scanning confirmed diagnosis without the use of myelography. One patient required urgent surgery because of rapidly deteriorating neurological status, but the other 4 were treated nonsurgically. The medical treatment of these patients and 9 others described in the literature consisted of antibiotics administered parenterally for a minimum of 8 weeks, followed by oral antibiotic therapy. Early diagnosis with computed tomographic scanning and a benign neurological state at the onset of treatment were associated with good results.
Abscess↗
Melanotic meningioma. Report of a case and review of the literature.
Melanotic tumours of the central nervous system constitute a group of expanding lesions whose prognosis is variable, depending upon their histopathological nature. The report of this case of melanotic meningioma finds its interest in the exceptional nature of this type of tumour and in the difficulty of ascertaining whether it is benign or malignant.
Adult↗
[Chiasmatic tuberculoma. 2 cases].
The authors report two cases of chiasmatic tuberculomas. They emphasize that diagnosis is still difficult despite CT scan if a picture of tuberculous meningitis is lacking. Surgical approach may be justified when diagnosis remains uncertain, especially as tuberculoma is sometimes responsible for recurrent meningitis.
Adult↗
[Myositis disclosing systemic scleroderma].
A 61 year old patient presented with muscular atrophy and weakness, predominant at the shoulder girdle, as the first manifestation of a progressive systemic sclerosis with the signs of the CREST syndrome: subcutaneous calcinosis, Raynaud phenomenon, esophagus disorders, sclerodactyly, telangiectasia. The histological features were consistent with polymyositis. In spite of corticotherapy, total recovery was not obtained. The nosological relationships with Mixed Connective Tissue Disease is discussed. Myositis is infrequent in progressive systemic sclerosis and corticosteroid therapy is discussed.
Calcinosis↗
[Dorsal interapophyseal arthropathy and spinal cord compression in syringomyelia].
A dorsal spinal cord compression by exuberant arthropathy and osteophytes of the articular processes occurred in a 61 years old patient with syringomyelia. The clinical symptoms were related to postero lateral cord involvement and rapidly appeared after syringo-peritoneal shunting. C.T. scan precisely displayed the pathological process and the cord compression. Surgery enabled a definite amelioration of secondary sensory deficits. It was to our knowledge the first description of such an involvement of articular processes in syringomyelia.
Adult↗
[Close genetic relation between determinants coding for the HLA-D region, detected by the technique of mixed primary and secondary lymphocyte culture and by serology of B lymphocytes].
In this study we report that: 1. Li determinants serologically detectable or closely linked structures are more associated to secondary responses than HLA-D specificities defined by HTC testing; 2. Other determinants from loci, MHC linked, or cross reactivity between Li determinants must be postulated to explain discrepancies between secondary responses and B serology; 3. Li determinants have an effect on the intensity of the reaction in primary allogenic proliferation.
Adult↗
Sundowning syndrome in demented patients without neuroleptic therapy.
Characterisation of sundowning syndrome, defined as 'an exacerbation of symptoms indicating increased arousal or impairment in late afternoon, evening or at night, among elderly demented individuals', is complicated by neuroleptic therapy and frequent failure to specify the nature of the associated dementia. Screening by a memory disorders unit of an institutionalized population of 30 neuroleptic-free demented patients revealed 8 sundowners, with diagnoses of probable Alzheimer's disease (n = 5), frontal lobe dementia (n = 1), Lewy body disease (n = 1), and sequelae of herpes encephalitis (n = 1). Sundowners did not differ from non-sundowners in age, Mini Mental State score, degree of temporal and spatial disorientation or perceptual delusion. Sundowning was related to restlessness (P < 0.0001), sleep disorder (P < 0.003) and a history of hypotension lipothymia (P < 0.08). These results provide further evidence for a chronobiological explanation of sundowning syndrome.
Journal Article↗
Perception of emotion in frontotemporal dementia and Alzheimer disease.
Frontotemporal dementia (FTD) is the second cause of degenerative dementia. Behavioral changes occur before the cognitive decline and remain the major feature. A poor perception of emotion could account for some behavioral symptoms. The aim of this study was to assess the perception of emotion in patients with FTD and to compare it with that of patients with Alzheimer disease (AD). Fifty subjects performed the tests: 20 patients with probable AD, 18 patients with FTD, and 12 matched controls. The two patient groups did not differ in age, sex, severity of dementia, duration of the disease, and language tests. Subjects had to recognize and point out the name of one of seven basic emotions (anger, disgust, happiness, fear, sadness, surprise, and contempt) on a set of 28 faces presented on slides. The three groups were equally able to distinguish a face displaying affect from one not displaying affect. Naming of emotion was worse in patients with FTD than in patients with AD (correct answers 46% vs. 62%; p = 0.0006) who did not differ significantly from controls (72%). Anger, sadness, and disgust were less recognized in FTD than in AD patients who did not differ from controls, whereas fear and contempt were poorly recognized in both groups of patients compared with controls. These findings argue for different neural substrates underlying the recognition of various basic emotions. Behavioral disorders in FTD may be partly due to an impaired interpretation of the emotional environment.
Aged↗
Vascular dementia: the role of cerebral infarcts.
Although vascular dementia (VaD) is the second most frequent cause of dementia after Alzheimer disease (AD), the concept remains controversial in terms of delineation. The objective of this review is to investigate, from available literature, the role of cerebral infarcts in the pathogenesis of VaD and to identify areas of interest that need further evaluation and research. The incidence of new onset dementia is increased after stroke. Stroke subtypes, total volume of cerebral infarction and functional tissue loss, and location of the lesions are probably the major determinants of VaD. Any cause of stroke can lead to VaD. In some circumstances the causal relation between stroke and dementia is clear: (1) in young patients who are unlikely to have associated Alzheimer pathology; (2) when the cognitive functioning was normal before stroke, impaired immediately after, and does not worsen over time; (3) when the lesions are located in strategic areas; and (4) when a well-defined vasculopathy known to cause dementia is proven. However, several issues remain unsolved in VaD: lack of specificity of the diagnostic criteria; influence of white matter changes and associated Alzheimer pathology; influence of preexisting cognitive status; possibility of having VaD without stroke and the clinical relevance of silent infarcts to VaD; and best therapeutic strategy to be used to prevent VaD and to prevent stroke in patients with VaD. These questions form the basis for proposals for future research.
Cerebral Infarction↗
Explicit memory in frontotemporal dementia: the role of medial temporal atrophy.
In our memory clinic experience, memory impairment differs widely in patients with frontotemporal dementia (FTD). We searched for a correlation between explicit memory disturbance assessed with the Grober and Buschke test and medial temporal atrophy on CT scan in 22 consecutive patients with FTD. Five of the 22 patients had a medial temporal lobe (MTL) atrophy. There was no significant difference between the two groups for the demographic characteristics. Free recall, cued recall and the learning curve were significantly better in patients without MTL atrophy. The patients with MTL atrophy made more intrusions. We found a positive correlation between total recall and cued recall and the mean of medial temporal lobe measurement. These results are in agreement with the role of the hippocampal formation in the memory process. In our group, the ratio of patients with MTL atrophy is similar to the ratio of Pick's disease in frontotemporal dementia. In histological series more severe hippocampal atrophy are reported in Pick's disease. Therefore MTL atrophy on CT scan could be a marker of Pick's disease in FTD.
Aged↗
Epidemiology of vascular dementia.
Although epidemiological studies are limited by diagnostic uncertainties, they suggest that stroke increases the risk of dementia. The mortality rate is higher in vascular dementia (VaD) than in Alzheimer's disease (AD). Community-based studies have provided several consistent findings: (i) age dependence with prevalence rates doubling every 5 years, (ii) a higher frequency in men and (iii) nation-to-nation differences. The prevalence of VaD ranges from 2.2% in 70- to 79-year-old women, to 16.3% in men >80 years. One sixth of acute stroke patients have preexisting dementia. The incidence of VaD has been studied much less extensively than that of AD, and substantial variations in the incidence rates have been observed: annual incidence rates (per 100,000) range from 20 to 40 between 60 and 69 years of age and from 200 to 700 over 80. The incidence rate of VaD declined over the last 2 decades, probably as a consequence of effective stroke prevention. It is generally assumed that risk factors for VaD are those of stroke, with arterial hypertension as leading factor, followed by atherosclerotic disease, low education level, alcohol abuse and heart disease. Stroke characteristics, such as lacunar infarction and left-sided hemispheric lesions, are major determinants of VaD. The cerebrovascular lesions are likely to be the only cause of dementia in strategic infarcts, in lacunar state, in hereditary cystatin C amyloid angiopathy and in CADASIL. However, white matter changes, and associated Alzheimer pathology, which are both frequent in this age category, may also contribute to the cognitive decline.
Aged↗
Is there a typical pattern of brain SPECT imaging in Alzheimer's disease?
The identification of new nosological forms such as Lewy body disease (LBD) requires a re-evaluation of the patterns observed in brain functional imaging in the various forms of dementia. We studied 60 demented patients, divided into three groups and fulfilling the clinical criteria for Alzheimer's disease (AD), LBD and frontotemporal dementia (FTD), using Tc-HMPAO and a brain-dedicated SPECT system. After normalisation we applied a cut-off at two levels according to previously established criteria. We reaffirmed the already established data concerning FTD (mainly a bilateral frontal decrease) and for LBD (a severe diffuse decrease in the frontal regions and also in the posterior association cortex). In contrast, the decrease in AD was strictly limited to the parieto-occipital cortex, irrespective of the severity of the cognitive decline. We hypothesise that the major simplification concerning the pattern observed in AD can be explained by the fact that patients suffering from LBD have previously been included in the groups of AD patients.
Aged↗
The use of SPECT in a multidisciplinary memory clinic.
We tested the interobserver reliability of visual rating of HMPAO-SPECT imaging in 271 outpatients referred to a memory clinic, and followed over 1 year. The clinical diagnoses were Alzheimer's disease (n = 156), frontotemporal dementia (n = 47); vascular dementia (n = 21), senile dementia of Lewy body type (n = 12), anxiety/depressive disorders (n = 14) and miscellaneous memory disorders (n = 21). The interobserver agreement was good (k = 0.68). However, the heterogeneity of the patterns-independent from demographic data, age at onset and duration of the disease- and their lack of sensibility and specificity limited the contribution of SPECT for diagnostic purposes in routine practice.
Aged↗