Search PubMed⌕ Search

Biomedical subjects

M Devic

Publications and source records attributed to M Devic.

At least 55 records · Page 3Linked to original sources
PubMed1981

[Isolated tonic ambulatory flexion of the foot (author's transl)].

A tonic ambulatory foot response developed one year after clamping of an aneurysm of the contralateral carotid artery in a young adult. No motor deficiency was noted during the postoperative period, but spasm of the carotid bifurcation branches were present on arteriograms. Clinical examination and deep reflexes tests excluded pyramidal lesions. Cortical somatesthetic evoked potential recordings confirmed the absence of sensory disturbances. CT scan suggested the presence of an infarct in the territory of the anterior choroidal artery. The present findings are compared with previous reports. The etiological data and CT scan results in the present case allow reconsideration of the physiopathology of tonic ambulatory foot response in the light of current knowledge of locomotor function in animals. The tonic flexion, an "extension" dystonia of the toes, electively provoked by walking, occurring one year after the neurological accident without any pyramidal signs, could arise from a coordination synkinesis due to lesions limited to the efferent extrapyramidal system.

Adult↗
PubMed1980

[Primary postural hypotension. Physiopathological study of 8 cases (author's transl)].

Physiological tests showed that both branches of the baroreflex arc-vagal cardiomoderator and, predominantly, sympathetic vasoconstrictor--were affected. There was no rise in serum and urinary noradrenaline levels in standing position, and adrenaline concentrations were rarely increased under induced hypoglycaemia. Dopamine beta-hydroxylase activity and reactivity of the renin-angiotensin-aldosterone system remained normal in most cases. Physiopathologically, the two clinical forms described (i.e. with and without central nervous symptoms) cannot be differentiated.

Aged↗
PubMed1980

[Anatomo-clinical study of a case of topographic confabulation (or delusion)].

The authors report an observation of a fixed monothematic and long-termed topographical confabulation associated to a topographical disorientation, without mental confusion. Different factors leading to such a confabulation are discussed (alteration of topographical memory, anosognosia of the ambulatory defect, age of the patient). The favourable effect of neuroleptics permit to regard the continuity between confabulation and delirium. Anatomical data prove an isolated right parieto-temporal infarct.

Aged↗
PubMed1980

Course and prognosis of multiple sclerosis assessed by the computerized data processing of 349 patients.

The information of 349 cases of multiple sclerosis, seen in a neurological department over a twenty-year period and followed up for a mean of nine years, was analysed by computerized data processing. The mean age at onset was 30.0 years for the remittent onset types (82 per cent cases) and 37.3 years for the progressive onset types (18 per cent cases). During the course of the disease the age of the 'pure relapse' stage was 29.2 years, of the relapse with sequelae stage 33.9 years and of the progressive phase 38.0 years. The interval between the first two relapses in the remittent-progressive type was important, the shorter the interval the sooner the progressive phase occurred. The relapses tended to increase in frequency before the progressive phase started. Using an actuarial graph, 50 per cent of cases could be expected to be moderately disabled (still ambulatory) in six years, and severely disabled (not ambulatory) in eighteen years and dead in thirty years. Combining a disability score and the duration of the disease prognostic factors could be studied. A late onset of the disease, a short interval between the first two relapses and the occurrence of the progressive phase were associated with a poor outcome. Sex of patient, the symptomatology of the initial relapses, and the constituents of the CSF had no prognostic value.

Adult↗
PubMed1980

[Non-hemorrhagic forms of intracranial arterial aneurysms].

Thirty eight consecutive cases of intracranial arterial aneurysms collected during the last decade in the same department of neurology are reported, the aneurysms being revealed by a non hemorrhhagic semeiology, i.e. without clinical meningeal syndrome. In 31 cases, the aneurysm seemed to be related to the clinical manifestation: in 14 cases, it was an acute headache, characterized by its suddenness, immediate maximum intensity, spontaneous and fastly regressive course. It occurred without any symptoms (6 cases) or associated with an epileptic seizure (1 case), or an ophthalmoplegia (7 cases). The course was often relapsing. In 8 cases, it was a cerebrovascular accident of ischemic type; in 6 cases, a pseudo-tumoral syndrome; in 2 cases, an epilepsy; in 1 case, a migraine. For the further 7 cases, the aneurysm was diagnosed fortuitously when investigating a non related disease. The present series shows: the high incidence of the non hemorrhagic forms of aneurysms since they account for 40 p. 100 of the aneurysms cases detected during the same period in our neurological department. The various clinical manifestations are already well-known, mainly the acute headache and the pseudo-tumoral forms. The aneurysm-related cerebrovascular accidents seem to be relatively frequent; 2 cases of the present series give the opportunity for a discussion about the relations between a spontaneous thrombosis and a definitive anatomical cure of the aneurysm. Finally, other cases lead to suspect aneurysms as a possible cause of epilepsy or of migraine. The prognosis of these non hemorragic forms of aneurysms is much better than that of ruptured aneurysms. The direct intracranial surgical cure of the lesion gives on the whole excellent results. Such a treatment must be advocated whenever possible for any unruptured symptomatic aneurysm, as the risk of their rupture or clinical relapse is far from being negligible. The strategy is more difficult to define for asymptomatic unruptured aneurysms as the actual risk of subsequent rupture or other clinical manifestations is not sufficiently known.

Adult↗
PubMed1979

[Encephalitis and acute amnesic encephalopathies. Retrospective study of 16 cases (author's transl)].

A retrospective study was conducted on sixteen cases of encephalitis or acute amnesic encephalopathies, only one of which was confirmed by pathological examination, seen over the last fifteen years. The amnesic syndrome was always associated with a very marked anterograde deficiency and the absence of severe disturbances of other higher functions. Its onset was always acute, was secondary to disturbances of consciousness or associated with epilepsy, and in half of the cases presented as a severe infections disorder with high fever. The mood and behavioural disorders, and the temporal epilepsy, were evidenced clinically as a pure or predominant hippocampic lesion. The diversity of the progressive nature of the disorders, and the etiological environmental factors, enable divison into three groups : a group of six cases of postencephalitic Korsakoff's syndrome, probably of herpetic origin, and associated with a stable amnesic syndrome which remained as a sequela ; a group of 5 patients with non-herpetic but probable viral "curable amnesic encephalitis" ; another group of 5 patients with "acute amnesic encephalopathy" with various etiologies and with obvious encephalitic lesions.

Acute Disease↗
PubMed1978

[Surgically treated supratentorial gliomas in the adult. Favourable action of a podophyllin derivative (VM 26) administered alone (author's transl)].

The action of VM 26 on cerebral glioblastomas was suggested by studies of phase II or protocols in which the drug was used in association. The randomised protocol presented here, involving 10 treated subjects and 11 controls, showed that VM 26 was active in terms of the duration of survival of patients undergoing surgery for a glioblastoma. The mean survival was 16.4 months as against 9.6 months in the controls (statistically significant difference at p less than 0.05). This activity would tend to characterise the drug as one of the essential factors in the chemotherapy of all malignant gliomas, in particular since it is itself free of all haematological complications, even at high doses, and causes scarcely any allergic problems.

Brain Neoplasms↗
PubMed1977

[Treatment of a case of grave orthostatic hypotension (Shy-Drager's syndrome) by an association of L-dopa and mono-amine-oxidase inhibitor (author's transl)].

The authors report a case of grave orthostatic hypotension (Shy-Drager's syndrome) with major postural disturbances. The biological test confirmed a catecholaminergic deficiency. After several drugs were tried unsucessfully, an association of L-Dopa and fractionated doses of mono-amine-oxydase inhibitor was proposed. The increase blood pressure was sufficient to block the diturbances of postural adaptation, without inducing hypertensive jerks. The functionnal result have been stable for three years, while the parkinsonian syndrome have shown little progression.

Aged↗
PubMed1977

[Brachial diplegia--a post ECC neurological complication of a specific type].

Five cases of neurological disorders occurring after extra-corporeal circulation are presented owing to the singular nature of the clinical picture made up by the essential element of a progressive brachial diplegia, free from any sensory disorder. The topography of the lesion--single medullary lesion or bilateral encephalic--is discussed. An anatomic document enables the elimination of any médullary involvement in one of the cases, thus pointing to a bilateral central lesion. The physiopathological problems are looked at.

Adult↗
PubMed1976

[Multiple sclerosis with reduced and with normal levels of complement in the blood. Clinical and genetic correlation].

The authors describe the results of immunological assay of complement factors C3, C4 (the usual path of activation of complement) and of B factor (the alternate path of activation) in 61 multiple sclerosis patients not receiving corticoids, 52 normal controls and 217 patients with other neurological disorders. Hypocomplementaemia (fall in factor C3 related to a fall in total haemolytic activity) was found in 29.5 p. 100 of the patients not on corticotherapy at the first assay, and in 36 p. 100 of the patients when repeated assays were carried out. Hypocomplementaemia is significantly more frequent in multiple sclerosis than in the normal population (0 p. 100) and in neurological patients (9.6 p. 100). In 13.1 p. 100 of the multiple sclerosis patients there was a decrease in B factor: 50.3 p. 100 of the multiple sclerosis patients exhibited no quantitative abnormality of the main factors of complement (normocomplementary multiple sclerosis). The group of multiple sclerosis patients with hypocomplementaemia was characterized by the incidence of other abnormalities in the complement system: cleavage of the C3 factor and a fall in B factor in 60 p. 100 of the cases. A more frequent increase in IgE and measles antibodies was found also while the normocomplementary multiple sclerosis patients more frequently had higher levels of IgA. Genetically, the group with hypocomplementaemia is related to a significant increase in the incidence of the HL-A W18 group while the normocomplementary multiple sclerosis patients appear closely related to the HL-A7 group. Familial investigations show that hypocomplementaemia is usually present in the ascendents and collaterals and that it seems to be transmitted with the HL-A haplotypes. Four families gave evidence of transmission with the W18 group. This transmission sometimes occurs together with transmission of an increase in IgE and/or of measles antibodies. In two pedigrees, one of the ascendents carried in his serum an activator of the alternate path of complement. There does not appear to be any prognostic difference between the two groups. In multiple sclerosis with hypocomplementaemia, the facts suggest a complex immunological abnormality, transmitted genetically to the subject and existing prior to the illness, comprising both elements of deficient and excessive immune response. The recognized presence of a gene of immunological reactivity and of genes of synthesis of complement on the 6th chromosome, in proximity with genes of histocompatability (HL-A and M.L.C.) provides a theoretical basis for this supposition.

Adult↗
PubMed1976

[Amyotrophic lateral sclerosis occuring befor the age of 40 years. Remarks apropos of 25 cases].

Twenty-five cases of amyotrophic lateral sclerosis occurring before the age of 40, collected between 1963 and 1973 in the Neurological Hospital, Lyons, have prompted the authors to make the following observations. -The incidence of disease seems to have been on the increase during this period both in absolute terms and relatively speaking (relative to the total number of patients hospitalized and to the total number of patients hospitalized for amyotrophic lateral sclerosis after the age of forty). -The 25 cases involved mostly women--the opposite of what was found in cases of amyotrophic lateral sclerosis occurring after forty. -Only one was possibly familial. -The onset is mostly with purely pyramidal features or of the topographically circumscribed peripheral type. Development appears to take longer than the average for amyotrophic lateral sclerosis. It would be worth while confirming these findings by analysis of other similar groups.

Adult↗
PubMed1975

[Pure (dynamic ?) agraphia of frontal origin. Apropos of one case].

A case of pure graphic disorder without any disorder of speech, reading or praxis is described. The conditions under which it occurred after surgery for frontal oligodendroglioma would seem to confirm that a single frontal lesion is involve affecting in particular the foot of F2. This case is compared with similar ones which have appeared in the literature and are classified within the wider category of kinesthetic disorders caused by frontal lobe lesion.

Agraphia↗