Biomedical subjects
F Regli
Publications and source records attributed to F Regli.
Migraine stroke.
Because the cause of stroke during migraine is not known, we studied 22 (17 females, 5 males; mean age, 32.7 years) classic migraine sufferers who had an ischemic stroke during an attack of migraine, with CT, Doppler ultrasound, cerebral angiography, and two-dimensional echocardiography. We found no cardiac or arterial lesion in 91% of the patients, as compared with 9% of age- and sex-matched migraineurs with stroke remote from a migraine attack and 18% of age- and sex-matched nonmigraineurs with stroke (p less than 0.00001). Mitral valve prolapse, arterial dissection, and vasospasm were not significant causes of stroke during migraine. These patients had longer previous attacks of migraine and their infarct was more frequently in the territory involved during the attacks than the controls, supporting the hypothesis that a prolongation of the migrainous process beyond usual limits may explain most migraine strokes.
Thalamic infarcts: clinical syndromes, etiology, and prognosis.
We studied forty patients with CT-proven thalamic infarcts without involvement of the superficial territory of the posterior cerebral artery. The delineation into four arterial thalamic territories (inferolateral, tuberothalamic, posterior choroidal, paramedian) corresponded clinically to four different syndromes. The most common etiologies were lacunar infarction, large artery atherosclerosis with presumed artery-to-artery embolism, cardioembolism, and migrainous stroke. We found no risk factor other than age or oral contraceptive use in six patients. One patient died in the acute phase. During follow-up (45.6 months), the stroke or death rate was 7.4% per year. Delayed pain developed in three patients and abnormal movements in three. Late disability was mainly secondary to persisting neuropsychological dysfunction (thalamic dementia).
Response-to-next-patient-stimulation: a right hemisphere syndrome.
Eleven of 134 patients with a right hemisphere stroke responded to stimuli directed at other patients as if the stimuli were directed at them. The stroke was severe in all 11 patients. Associated disturbances included hemineglect, anosognosia, motor impersistence, disorientation (sometimes with agitated confusion), and somatosensory delusions and allesthesia. This form of perseveration seems specific to acute right hemispheric stroke.
[Zona and post-zoster pain: therapeutic approach].
Explore the source record for details and available documents.
[Primary lymphoma of the nervous system following radiculoneuritis caused by Borrelia burgdorferi: study of a case].
A 50-year-old man had a primary lymphoma of the central nervous system one year after a tick bite and a radiculoneuritis secondary to Borrelia burgdorferi infection. Determination of antibodies against Borrelia burgdorferi revealed increasing IgM and IgG titers, and the autopsy showed a primary B-cell immunoblastic lymphoma of the brain without evidence of extraneural lymphoproliferative disorder. Lymphoma of the brain is a rare type of central nervous system cancer, and sporadic cases appear without predisposing features such as immunosuppression or viral infection. The controversy surrounding the histogenesis of this neoplasm is reviewed: an unknown agent or a cofactor should provoke cellular proliferation and the formation of a lymphoma.
Ischemic stroke as the presenting manifestation of localized systemic cancer.
A cerebral infarct due to a thrombosis of the left pericallosal artery was the first manifestation of an ovarian adenocarcinoma in a 42-year-old woman. A paraneoplastic origin was suggested by the observation that this patient had chronic intravenous coagulation and subsequently developed migratory thrombophlebitis (Trousseau's syndrome) despite high dose vitamin K antagonists therapy. This was supported by the fact that all manifestations of the hypercoagulable state disappeared following surgical cure of the cancer. Because cerebral infarction can be the first manifestation of a potentially curable cancer, patients with a cerebral infarct of an unknown etiology should be investigated for a malignant process, if there is laboratory or clinical evidence od disseminated intravascular coagulation.
[Inability to voluntarily close the eyes. Discussion of supranuclear disorders in palpebral closure based on 2 cases, with a review of the literature].
We studied 2 cases of supranuclear palsy of eye closure in patients who were unable to close their lids under command, but still conserved the possibility of closing them by syncinetic or reflex stimulations as well as during the sleep. The first patient had bilateral infarcts in sylvian watershed zones of fronto-parietal lobe and the second patient had a right cortico-subcortical superficial sylvian infarct. None of the 2 cases had an evolution towards motor impersistence of lid closure. We made a review of the literature and exposed the most debated hypothesis about this phenomenon, i.e. apraxia of lid closure or liberation of "grasping" phenomenon on the face. We expose the possibility of a disconnexion syndrome between motor supplementary area of the right hemisphere, supposed to be dominant for lid closure, and the premotor cortex area, based on reconstructions from CT Scan.
Guillain-Barré syndrome following Campylobacter jejuni enteritis. Report of three cases and review of the literature.
We describe three cases of Guillain-Barré syndrome (GBS) associated with Campylobacter jejuni enteritis and review the data from eight other cases described in detail in the literature. The recent recognition of this association is probably due to improved stool culture technique. In comparison with GBS associated with respiratory infections, the delay between the first symptoms of infection and the development of GBS is somewhat longer, an observation in accordance with GBS associated with gastrointestinal symptoms of unidentified etiology. The clinical picture and the outcome do not seem to differ from those of GBS associated with other disorders. Campylobacter jejuni appears to be a pathogen capable of triggering GBS and will probably become increasingly recognized if appropriate culture and serologic tests are performed.
[Neurological syndromes of the upper limb with acroparesthesia and pain].
Explore the source record for details and available documents.
[Acute cerebral vascular accidents. General results of the first 1000 cases in the Lausanne neurology registry].
Explore the source record for details and available documents.
[Neuro-AIDS and other neurological complications of acquired immunodeficiency syndrome].
Explore the source record for details and available documents.
[Cerebral microangiopathies, lacunae and leuko-araiosis].
Explore the source record for details and available documents.
[Indirect cervical trauma: long-term adverse prognostic factors].
Explore the source record for details and available documents.
[Diffuse cerebral angiopathy with ergotism and persistent neurological disorders].
Explore the source record for details and available documents.
[Paralysis of the trapezius muscle in HIV infection].
Explore the source record for details and available documents.
[Insulinoma: 12 surgical case reports].
Explore the source record for details and available documents.
[Neurologic complications accompanying acquired immunodeficiency syndrome (AIDS): study of a group of 8 cases].
Eight patients with acquired immune deficiency syndrome (AIDS) presented complications affecting the nervous system. The complaints were headache, seizure, confusion or hallucination. Neurologic manifestations included meningitis, focal deficits, cranial nerve palsy, and dementia. Cerebrospinal fluid exhibited a decrease in the percentage of T helper lymphocytes with an inverted helper-to-suppressor cell ratio. The neurologic manifestations of AIDS may depend on multiple factors, such as HIV infection of the central nervous system, concomitant infections with other agents or meningeal invasion by systemic lymphoma or Kaposi's sarcoma. Many patients develop a diffuse encephalopathy which characteristically begins with impaired concentration and mild memory loss, and progresses to severe global cognitive impairment and dementia. Perivascular infiltrates and scattered microglial nodules, consisting of aggregates of microglia and astrocytes, are the most common findings in these patients.