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Biomedical subjects

J Lapresle

Publications and source records attributed to J Lapresle.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Scleroderma with progressive facial hemiatrophy and atrophy of the other side of the body].

The authors report the case of a 28 year old woman suffering from a chronic polyarthritis with a linear sclerodermia and presenting a crossed atrophy involving the left side of the body and the right side of the face and neck. The polyarthritis began at age 6, with signs of systemic illness, resulting early in important joint disability and proceeding with exacerbations and remissions. From the onset of this polyarthritis the patient experienced in the left side of the body highly painful and frequent muscular cramps which became rarer with the occurrence and progression of atrophy on the same side. At age 15, the patient experienced similar cramps in the right face, followed by progressive right hemiatrophy. At age 28, examination showed crossed atrophy involving the left side of the body and the right side of the face, tongue and neck, associated in these territories with several atrophic plaques on the skin, circumscribed alopecia, as well as numerous joint sequella. The laboratory date yielded immunologic abnormalities. On the CT scan the brain was normal but the right facial hemiatrophy involving orbital region and pharynx was visible. On the muscular biopsy there were inflammatory changes in the atrophic territory. Skin biopsies were consistent with sclerodermia. Two clinical points should be emphasized. Firstly, the remarkably crossed topography of the atrophy: the upper limit of the left body atrophy corresponded with the lower limit of the right face and neck atrophy; secondly, the unusual features of the muscular cramps. The relationship between sclerodermic facial hemiatrophy and Parry Romberg syndrome are then discussed: the study of this case and the literature do not provide sufficient criteria to allow description of two separate entities. Finally, the pathogenesis of localized sclerodermia is considered; in this case the association with the immunologic abnormalities and chronic polyarthritis is in favor of the hypothesis of a systemic disorder.

Adult↗
PubMed1980

[Metastatic infectious encephalitis (author's transl)].

The authors report two cases of multiple microabcesses disseminated to the brain. The diagnosis was confirmed by anatomical findings in the first case and the discovery of septic emboli on fundus examination in the second case. In such conditions, there is no space occupying lesion which might raise the question of a surgical procedure. Due to the widespread vascular dissemination of the infectious process, these cases may present as an encephalitis. The authors stress the importance of recognizing this type of central nervous system bacterial infection which may be treated appropriately.

Adult↗
PubMed1980

[Trigeminal sensory involvement in Bell's palsy (author's transl)].

Trigeminal sensory involvement was noted in 14 out of 24 cases of Bell's palsy. The authors describe its characteristics and its chronology with regard to the facial paralysis. Then they propose a vascular mechanism for this association on the basis of two kinds of data. First it is known that there is a common arterial supply of the VIIth and Vth cranial nerves through the middle meningeal vascular system. Secondly some exceptional complications of embolisation within that system have included involvement of both VIIth and Vth sensory nerves. These facts support the vascular basis of Bell's palsy and present an example of a vascular territorial pathology in cranial nerve involvement.

Adolescent↗
PubMed1980

[Persistence of herpetic inflammation of the central nervous system four years after an episode of acute encephalitis (author's transl)].

A patient was followed up for four years after an acute episode of encephalitis attributed to herpes because of the clinical and EEG features, the high serum antiherpetic antibody titers, the temporofrontal site of the lesions as shown by CT Scan. The clinical sequelae were non evolutive and the serum antiherpetic antibody titers remained at the same level (1/128) from the 10th day on. The CSF showed continuing pleiocytosis and slight elevation of protein with an increased proportion of IgG; moreover, four years later, the CSF antiherpetic antibody titers were elevated (1/16). These findings suggest that local production of antibody within the CNS may persist after acute herpetic infection.

Antibodies, Viral↗
PubMed1980

[Transitory paralysis of cranial nerves IX, X and XII as well as the left VII after angiography. Contribution to the ischemic pathology of the cranial nerves].

The authors report the case of a 28 year old woman who presented, after cerebral angiography performed for a transient hemispheric ischemic attack, a regressive paralysis of the IXth, Xth and XIIth as well as the VIIth left cranial nerves. The involvement of these nerves and the sparing of the XIth is explained by the normal disposition of their arterial supply. Such paralysis has previously been encountered after therapeutic angiography. This case is compared to similar ones involving paralysis of the lower cranial nerves in general disease such as diabetes or apparently idiopathic as reported by Edin et al (1976). This study should be seen in a context which also includes preceding ones performed by two of the authors: A. Annabi, P.L. and J.L. (1978) concerning the IIIrd, and J.L., I. Fernandez Manchola and P.L. (1980) concerning the VIIth and Vth cranial nerves. These observations demonstrate the existence of a vascular territorial pathology in cranial nerves involvement.

Adult↗
PubMed1980

[Morphological studies of peripheral nerves for a better understanding of Charcot-Marie-Tooth atrophy and Roussy-Lévy hereditary areflexic dysstasia].

The author beings with preliminary remarks concerning the role played by the electron microscope in the correct interpretation of onion bulb formations which are, when observed in sufficient number, characteristics of hypertrophic neuritis. As a result of such studies, certain entities initially considered as closely related to spinocerebellar degenerations are now attributed to this type of peripheral nerve pathology. Discussed first is Charcot-Marie-Tooth atrophy, mainly characterized by its topography and considered to be of neurogenic origin. However, there is disagreement concerning the site of the primary lesions thus bringing into question the individually of this entity. It has now been demonstrated that this disease belongs, at least partly, to the large group of disorders defined as familial or primary hypertrophic neuritis. The same conclusion may be applied to the Roussy-Lévy disease since it has been recently demonstrated that the original family upon whom the description was based is suffering from hypertrophic neuritis. Thus, there exists a relationship between these two disorders which may be additionally linked by the present of a tremor. Finally, as a result of pathological nerve studies, the field of disorders due to hypertrophic neuritis has enlarged at the expense of spinocerebellar degenerations. This nosological reappraisal should provide better direction for future research.

Ataxia↗
PubMed1980

[Congenital and sporadic atrophy of the granular layer of the cerebellum with secondary pontocerebellar degeneration (author's transl)].

The primary interest of the case reported here of congenital atrophy of the granular layer of the cerebellum (Norman type) lies in the presence of an associated pontocerebellar degeneration, interpreted to be secondary (transsynaptic and retrograde) to the granular involvement and due to the length (42 years) of the evolution. Secondly, the sporadic character of this case is not in favor of a genetic disorder. By analogy with Herringham and Andrewes cat ataxia due to a perinatal virus infection (Margolis and Kilham), it can be hypothesized that granular cerebellar atrophy in man is related to an injury incurred at a "favorable" moment in histogenesis, that is, between the 3rd and 6th month of fetal life.

Adult↗
PubMed1979

[Giant aneurysm of the intracavernous carotid, complicated by subarachnoid haemorrhage. Emergency treatment by occlusive balloon and thrombosis in situ (author's transl)].

A 15-year-old adolescent developed a painful ophtalmoplegia and a subarachnoid haemorrhage secondary to fissuration of a giant intracavernous aneurysm. The choice of therapeutic abstention was not retained due to the dissuration. The site excluded any direct approach and ligation of the common carotid was not adopted because of its complications. The method chosen consisted of in situ coagulation of the aneurysmal sac, induced by injection of thrombin after occlusion of the internal carotid by a double-lumen balloon catheter. In case of emergency and when direct approach is impossible, this technique may be useful on the condition of close cooperation between clinicans and radiologists.

Adolescent↗
PubMed1979

Rhythmic palatal myoclonus and the dentato-olivary pathway.

The anatomical basis of palatal myoclonus and related rhythmic skeletal myoclonus is described. The most constant lesion is a special type of degeneration with hypertrophy of the olivary nucleus of the medulla oblongata, on the side opposite to the myoclonus when it is unilateral. This degeneration is usually secondary to a primary lesion located either in the ipsilateral (to the hypertrophied olive) central tegmental tract or in the contralateral dentate nucleus. To link these data, Trelles (1935, 1943) suggested a dentato-olivary pathway from the dentate nucleus to the contralateral inferior olive via the superior cerebellar peduncle and the central tegmental tract after crossing the midline. The existence of this pathway was demonstrated by Lapresle and Ben Hamida (1965-1971), first by showing a topistic relationship between dentate nucleus and contralateral inferior olive, then by delineating this pathway in the vicinity of the red nucleus at the crossing of the superior cerebellar peduncle and the central tegmental tract. The significance of these lesions with their ensuing symptoms is discussed. It is considered as a transsynaptic degeneration which probably reveals an archaic phenomenon, submerged but not lost through evolution.

Cerebellar Nuclei↗
PubMed1979

[Paralysis of the 3d cranial nerves in diabetes and common oculomotor vascularization].

The purpose of this paper is to present explanations for various patterns of IIIrd cranial nerve involvement in diabetes mellitsus, based on its vascularisation. Three clinical cases of diabetes with numerous attacks of IIIrd nerve paralysis are reported. The following patterns were observed: (1) isolated; (2) associated with Vth nerve involvement and; (3) associated with invovlement of the Vth, IVth, VIth, and occasionally IInd and VIIth nerves. An anatomical study of IIIrd nerve vascularisation demonstrates three territories which could correspond to the 3 patterns of clinical expression. The arterial branches to the IIIrd nerve give off no collaterals in the posterior region of the circle of Willis. In the supra-cavernous region, vascularisation of the IIIrd nerve may be associated with that of the IVth. Eventually, vascularisation of the IIIrd nerve in the intracavernous region is associated with that of the Vth, IVth, VIth, and occasionally IInd and VIIth cranial nerves. Thus, a painless paralysis of the IIIrd nerve (isolated or associated only with an involvement of the IVth) would predictably be related to a vascular disturbance limited to the first or second portion of this nerve, whereas a painful paralysis of the IIIrd nerve, without or with associated involvement of other cranial nerves, would relate to a vascular distrubance in the intra-cavernous region. The anatomo-clinical relationships that have been presented: (1) support the vascular basis of IIIrd nerve paralysis in diabetes; (2) explain the various clinical patterns of IIIrd nerve involvement in that disorder and; (3) act as a model which can be applied to the study of ischemic pathology in other cranial nerves and other etiologies.

Aged↗
PubMed1979

Olivopontocerebellar atrophy with velopharyngolaryngeal paralysis: a contribution to the somatotopy of the nucleus ambiguus.

The authors report a case of olivopontocerebellar atrophy (OPCA) with velopharyngolaryngeal paralysis. The cerebellar syndrome appeared in a 66 year-old woman and ran its course until her death at 75. The velopharyngolaryngeal paralysis occured two years after the beginning of the cerebellar symtomatology and was limited for 6 months to a Gerhardt syndrome. Postmortem examination showed typical lesions of OPCA, and on serial sections of the medulla a massive loss of neurons in the lower two thirds of the nucleus ambiguus, bilaterally. The association of OPCA with velopharyngolaryngeal paralysis is exceptional. The anatomical findings in this case contribute to the somatotopy of the nucleus ambiguus in man by demonstrating the location of the velopharyngolaryngeal centers in this formation. The upper third plays only an accessory role in the velopharyngolaryngeal functions, and in the two lower thirds one finds, from the oral to the caudal extremity, first the velopharyngeal, then the laryngeal centers.

Aged↗
PubMed1978

[Trigeminal involvement as the presentation of syringomyella and of an abnormality of the occipito-vertebral junction (author's transl)].

Trigeminal involvement in syringomyelia or in a malformation of the occipito-vertebral junction may rarely be the presenting feature of the disorder. Two cases are reported: in the first, recurrent pruritus of the side of the nose due to sensory involvement of CN V was the presenting feature of syringomyelia; in the second, a malformation of the occipito-vertebral junction presented with refractory and painful trismus by irritation of the motor part of the trigeminal nerve.

Cervical Atlas↗
PubMed1978

[Anton-Babinski syndrome with recognition of the left upper limb on visualization in a mirror [author's transl)].

A patient presenting with an Anton-Babinski syndrome accompanied by a delusional conviction recognised her left upper limb with the aid of her right hand, but immediately denied its existence when she viewed it directly. In contrast, when placed in front of a mirror, she recognised this upper limb perfectly, recognition disappearing again when direct vision was associated with vision in the mirror. The authors suggest the possibility of a resurgence in adult life of the duality of the visual body image, direct or reflected, such as is normally experienced in childhood and, more prolonged, in identical twins.

Agnosia↗
PubMed1978

[Syncope and transitory amaurosis during mastocytosis].

In a 70-year old man who has been suffering for 20 years from mastocytosis, a syncope followed by a transitory amaurosis occured. Neurological complications of mastocytosis are exceptionnal. Syncope is the most frequent, secondary to a drop in arterial pressure due to an inappropriate discharge of histamin.

Aged↗