[Does astasia-abasia of parietal origin exist?].
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Aged↗
Biomedical subjects
G Aimard
Publications and source records attributed to G Aimard.
Sulfate and glucuronide conjugates of 3-methoxy-4-hydroxyphenylglycol (MHPG) in urine of depressed patients: central and peripheral influences.
A number of arguments support the hypothesis that changes in urinary levels of MHPG sulfate and MHPG glucuronide respectively reflect central and peripheral norepinephrine metabolism (NE) in man. In this line, the daily excretion of both conjugates was determined in 36 depressed women comparatively to 23 healthy women in order to assess the extent and the central or peripheral location of their possible NE dysfunction. About 80% of the patients suffering from depression (6 endogenous, 19 neurotic, 11 reactive depressions) exhibited a central NE defect, as evidenced by low MHPG sulfate, and many of them had probably also diminished sympathetic activity, as suggested by low MHPG glucuronide. Clinical symptoms possibly related to the psychic state (mood alteration) or associated to sympathetic changes (anxiety, motor activity) respectively altered sulfate or glucuronide excretion. Sulfate (S) and glucuronide (G) MHPG excretions were significantly correlated in healthy subjects (r = 0.53, p = 0.01), thus supporting the concept of the functional link between central NE activity and sympathetic function. Such a correlation was not found in depressive patients. However the lack of significant changes in the mean ratio S/G in the patient sub-groups suggests that as in normal subjects, central and peripheral NE activity are linked in depressed patients, but other factors may also modify sympathetic function. Taken together our data show that the separate assay of sulfate and glucuronide MHPG provides a better picture of NE dysfunction in depression than total MHPG measurement.
Adjustment Disorders↗
Acute acquired toxoplasmosis causing neuroptico-meningoencephalitis in an immunocompetent boy.
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Adolescent↗
[Spatial delusion: sign of lesions of the non-dominant hemisphere].
Two cases with respectively an ischemic and a tumoral lesion of the right hemisphere showing a striking and isolated delusional belief to be relocated elsewhere are reported. Delusion had the remarkable intrinsic coherence of a paranoid delirium but was limited to the localization in space. In contrast these patients had no mental clouding or hallucinations and were well orientated for time and persons. Associated findings were a misrepresentation of space in drawing in the first case, and a left hemiparesis, a left sensory extinction, a left hemianopsia, a left visual neglect, a constructional apraxia and a misrepresentation of space in the second case. Such a spatial delirium has been described after severe head injury but rarely after unilateral cerebral lesions. The latter involve constantly the right hemisphere, either in the frontal, temporo-parietal or thalamic region. Usual neurobehavioral correlates in these cases were a disorder of visual memory, a topographical disorientation, a lack of representation and use of visuospatial data, and an anosognosia. The putative role of a 'release' of the left hemisphere is discussed.
Aged↗
[Pseudo-optic neuritis as a manifestation of craniopharyngioma (2 cases)].
In two case of cystic craniopharyngioma the initial presentation was misleading and suggested acute retrobulbar optic neuritis: 1) isolated and unilateral drop of visual acuity of recent onset; 2) total remission in a few weeks, then a relapsing and steroid-sensitive course; 3) increase of C.S.F. gammaglobulins content in one case, normal CT scan in the second one. The diagnosis was corrected 36 and 18 months respectively after the onset of the clinical disorders.
Adult↗
[Plea for monoamine oxidase inhibitors. Retrospective study of 350 cases].
The case-records of 350 outpatients treated with monoamine oxidase inhibitors have been reviewed. All patients presented with depression, obsessions or phobias. About two-thirds benefited from the drugs, particularly after other treatments (including psychotropic drugs, seismotherapy, psychotherapy and internment) had failed. With the moderate doses administered (iproniazide: 50 mg/day; nialamide: 100 mg/day) side-effects were uncommon and mild and no incident was noted in 32 general anaesthesias given for surgical operations. These findings should help in lifting the ban on this category of drugs. Monoamine oxidase inhibitors are effective, useful and sometimes indispensable after failure of other antidepressants.
Adult↗
[Parkinson's disease. Retrospective study of 302 clinical case records].
This retrospective study of the case-records of 302 patients with Parkinson's disease shows that the condition begins earlier in males and that loss of weight during the first years of the disease is of poor prognosis. It also provides some arguments in favour of low-dosage L-dopa and suggests that no time should be wasted in administering this treatment.
Female↗
[Neuropathy with contractures evoking the stiff-man syndrome. Latent solitary plasmacytoma].
A further case of apparently primary sensorimotor neuropathy is reported. The patient, a 31-year-old man, developed the syndrome after a 4-year history of a solitary vertebral plasmocytoma revealed by post mortem examination. Circulating monoclonal immunoglobulin and specific anomalies on nerve biopsy were absent. The condition became progressively worse, with initial and predominant autonomic nervous system anomalies. After 3 years, contractures of the limbs and paravertebral muscles, with painful paroxysmal attacks suggestive of the stiff-man syndrome appeared. Pathology confirmed the severity of the root lesions with diffusion to the cranial nerves. Reflex tests could not be conducted but the semiologic characteristics and the efficacity of baclofen were distinctive of continuous muscle fiber activities reported in some peripheral neuropathies. This case was comparable to some reported ones of interneuron rigidity.
Adult↗
[Encephalopathy during distomiasis].
A patient with Fascioliasis developed polyradiculoneuritis and encephalopathy. The diagnosis was confirmed by an eosinophilia associated with positive serial serology tests. The disease regressed spontaneously. The immuno-allergic mechanism is discussed.
Brain Diseases↗
[Course of obstructions of the carotid artery in the neck. 69 cases].
This study involved 69 patients with occlusion of the internal carotid artery in the neck confirmed by angiography. Ten patients were operated upon and 59 were treated medically. The clinical course was roughly the same in both group. Of the 62 patients who survived the initial stroke, 50 could be followed-up for a mean period of 57 months at the end of which 12% had died, 16% remained with a major degree of functional impairment and 72% had little or no residual symptoms. All but one deaths were of non-vascular origin. New cerebral vascular accidents occurred in 16% of the cases, always in the territory of the occluded artery. The long-term benefits of surgical cerebral revascularisation are discussed in the light of these findings.
Arterial Occlusive Diseases↗
[Utilization behavior during the course of progressive multifocal leukoencephalopathy].
A particular semiologic feature of a case of progressive multifocal leukoencephalopathy was the existence of utilization behavior as described by Lhermitte. The affection developed in a patient with myeloid leukemia treated by cytotoxic drugs. Multifocal low density areas were shown by CT Scan examination. The course of the disease was not altered by isoprinozine therapy.
Adult↗
[Familial paroxysmal ataxia responsive to acetazolamide].
From their early twenties, a 56 year-old french woman and her 33 year-old son suffered from paroxysmal attacks of gait ataxia, incoordination of both hands, dysarthria and nystagmus. These attacks lasted from one to three hours and occurred at the rate of one to seven per week. On examination between attacks, there was only a bilateral horizontal and upward-beating gaze nystagmus. This was documented by E.O.G. Biological investigations were normal with the exception of a mild elevation of glucose blood level. Treatment with acetazolamide 250 mg daily, completely abolished the attacks in both patients. These cases meet the criteria of familial paroxysmal ataxia, a disorder only described in the United States up to the present. Although rare, this disease should be recognized because of its dramatic response to acetazolamide.
Acetazolamide↗
[Study of 213 cases of multiple sclerosis treated with azathioprine from 1967- to 1982].
Effects of azathioprine, 150 mg per day on average, were studied in 213 patients with multiple sclerosis. Thirty-eight case reports were excluded from the final analysis due to lack of continuous treatment (22 cases) or of complete data (16 cases). The 175 patients followed up regularly for a mean of 10 years had received the drug for from 6 months to 15 years (mean approximately 4 years). The treatment was generally well tolerated and there were no irreversible side effects. Results for the different parameters studied, when compared with those in untreated controls, showed the following features: for patients with the remittent form of MS: a statistically significant increase in cases showing no further progression, a reduced frequency of attacks (increased during spontaneous evolution of the affection), a significantly lower incidence of cases that became progressive in nature, and a general improvement in disability score at the end of follow-up. The course of the disease appeared to be more severe before treatment than in untreated cases. In patients with the progressive form of MS (47 cases) the ratio of total disability scores to number of years of observation was reduced in treated when compared with control patients, whereas this ratio was similar in both groups before treatment. General improvement in scores was therefore definitely related to treatment. These findings are in agreement with those of our 1978 study (Aimard, Confavreux et al.) and of others using the same protocol (Oger et al., and Rosen).(ABSTRACT TRUNCATED AT 250 WORDS)
Azathioprine↗
[Contribution of lumbar puncture to the diagnosis of cephalalgia].
The authors have reviewed the records of 50 patients hospitalized for treatment of isolated cephalalgia and in whom lumbar puncture was the only investigatory procedure that initially provided some information. In 12 cases, CSF abnormalities reflected a progressive tumoral, vascular or inflammatory intracerebral lesion undetectable by the usual methods (fundus oculi, radiography of the skull, EEG), or by less common examinations (arteriography, scintiscans, CT scans). In 12 other cases, lumbar puncture provided evidence of a minimal meningeal inflammatory process. In 26 cases, the only biochemical change was an excess of CSF proteins which in 7 cases developed in a dome-shaped curve suggesting an independent disease, the significance of which is discussed.
Adult↗
[Intracranial arteriovenous angioma in adults. A review of 100 medico-surgical cases (author's transl)].
The most frequent clinical presentations were haemorrhage (36 cases) and epilepsy (33 cases). Among the 68 subjects operated upon, 55 benefited from total removal of the angioma. The mortality rate was 10%. The long-term outcome was favourable in 75% of patients. Excision suppressed the risk of bleeding, but its efficacy on epilepsy was more limited. The clinical course in patients not operated upon was less favourable. However, only 4 of them died, and only one recurrence of bleeding was noted.
Adult↗
Course of visual evoked potentials in multiple sclerosis: electroclinical correlations and pathophysiological considerations in 25 patients.
Twenty-five MS patients had VEPs recorded at 1-year interval. Abnormal VEPs were observed at least once in 21 patients. They were the only means of assessing the lesional dissemination in nine patients. Their contribution in the diagnostic classification is such that the proportion of "definite" cases rises from 44 to 80% of the 25 cases. The degree of abnormality of the VEPs had no relation to the disability status or to the whole severity of the disease. The main feature was the variability of the VEP latencies at a 1-year interval: they seem to follow the remittent progressive course of the disease whether visual pathways are clinically affected or not. These results are interpreted in light of the pathophysiological data of the disease. In the cases with improvement of normalization of the second VEPs, in plaque edema may be an important mechanism, sometimes free of demyelination so that perfect restitutio ad integrum may occur.
Adult↗
[Silver stain of unconcentrated cerebrospinal fluid. Preliminary results in multiple sclerosis and other neurological diseases].
The authors present a new technique for the analysis of the cerebro spinal fluid (C.S.F.) proteins: silver stain after isoelectric focusing with possibility of immunofixation. This technique is simple and results are obtained after six hours only after sample deposition. If immunofixation is used a further 24 hours washing is necessary. It is highly sensitive and bands containing 25 ng of proteins can be clearly distinguished so that small volumes (10 microl. at mean) of unconcentrated C.S.F. can be used. With this technique abnormal distinct bands of IgG specificity are seen in the majority of central and peripheral nervous system inflammatory disorders. No distribution of these bands, particularly in the more cathodal zone, seems to be specific of any disease including multiple sclerosis (M.S.). The abnormal IgG bands in M.S.C.S.F. seem to have their counterpart in the serum. These results need further verification. The usefulness of this technique for research purposes is stressed. The protein pattern obtained must be interpreted in the light of the concepts of genetic polymorphism, microheterogeneity and heterogeneous mode of antibody production.
Cerebrospinal Fluid Proteins↗