The authors report the case of a 2-year-old infant who presented with paroxysm and short changes characterized by acute drowsiness, cold sweats, ocular reversion, facial cyanosis, and bradycardia. Between these attacks, the condition was normal, suggesting diencephalic seizures. Over 2 months five fits were observed by the parents when some to-and-fro bobbing of the head onto the trunk appeared during drowsiness. One electroencephalogram was normal without a slow background or spikes discharges. As the skull radiographs showed erosion of the jugum and chronic intracranial hypertension features, a CT scan was performed and showed hydrocephalus associated with a congenital suprasellar cyst. The cyst was opened into basal cisterns with cystoperitoneal shunt. The histological examination revealed that it was an arachnoid cyst. Six months later, the infant was free of diencephalic seizures and head bobbing. Thus, we can assert that there was a direct relationship between this cyst and the diencephalic seizures. From this case, the authors make a review of the clinical features of diencephalic epilepsy, and their different causes and show that both diencephalic epilepsy and suprasellar arachnoid cysts are not common.

Child, Preschool↗

PubMed1988

[Treatment of status epilepticus by sodium valproate].

The authors studied the action of valproate with single loading dose of 25 mg/kg, by oral or rectal way, in the treatment of a status epilepticus occurring in 22 patients: 12 patients with generalized status epilepticus, 2 patients with myoclonic status, 2 patients with absence status and 6 patients with motor partial status. In 8 cases, an EEG was performed during the treatment. Results were satisfactory: the status was controlled in 16 cases (73%) in a mean time of 19 min. Plasma levels of valproate approached 55 mg/l at the 20th min after the loading dose. In 6 cases (27%), the status was not controlled, with a plasma level of 33 mg/l at the 20th min. No side effect was observed. This work shows that, for the treatment of status epilepticus, a loading dose of valproate by oral or rectal way is therapeutically equivalent to diazepam and clobazam.

Administration, Oral↗

PubMed1988

[Cardio-respiratory anomalies in disseminated sclerosis].

A case of acute pulmonary edema without cardiac failure, infectious or toxic cause, revealing a Multiple Sclerosis (M.S.), one case of bradycardia during a bout in a known M.S. and one case of orthostatic hypotension without change of cardiac frequency, during a bout of a known M.S. are reported. The common point of these 3 cases is that during their autonomic failure, there were disorders pointing to the medulla oblongata: swallowing difficulties, rotatory nystagmus, vestibulo-cerebellar syndrome, sensory and motor defect of upper limbs. A plaque of M.S. in the medulla oblongata, particularly near the tractus solitarius could explain these cardio-pulmonary abnormalities unusual in M.S.

Adult↗

PubMed1988

Altered peripheral nerve conduction in HIV-patients.

An electrophysiological study on peripheral nerves conduction was performed on HIV-seropositive patients without neurological signs on clinical examination. Eight of the 28 patients (28%) had an infraclinical neuropathy, which was myelinic or axonal and rather distal than proximal. The mechanism of these involvements is not known, but their early existence could justify an early treatment even for asymptomatic patients.

AIDS-Related Complex↗

PubMed1988

[Incidence of cerebrovascular accidents in a medium-sized French town].

Beginning in 1985, the Dijon Stroke Registry has identified every case of stroke occurring in this city of 140,000 inhabitants. The systematic use of a CT scan and multiple other sources of information ranging from hospital doctors to general practitioners make it possible for us to have virtually exhaustive data on stroke incidence. The gross incidence was 170 per 100,000 among men and 126 per 100,000 among women. Specific incidence by age and sex shows female predominance up to 30 years of age, and male predominance among victims from 30 to 80 years old. Beyond 80, rates were identical for both sexes. In 68% of the cases, the strokes were caused by infarct; in 12%, by lacunae; in 15%, by cerebral hemorrhage; in 5%, by subarachnoid hemorrhage. Significant differences existed in this distribution according to age, with a clear predominance of young people among those having subarachnoid hemorrhage, while, for those over 40, cerebral hemorrhages were frequent; the proportion of infarct increased with age for both sexes. A peak of incidence for infarct appeared during winter, while transient ischemic accident was more frequent in summer. Cerebral hemorrhage had a similar incidence throughout the year. Mortality was high during the first month (12.5% during the first week, 21.5% during the first month), and reached 30% during the first year. These results are comparable to those generally observed among white occidental populations. They confirm the limited incidence of hemorrhages (contrary to what has been observed in Japan), emphasize the important and often underestimated role of lacunar syndromes, and the seasonal variations specific to each mechanism.

Adolescent↗

PubMed1988

[Parkinsonian syndrome caused by traumatic hematomas in the basal ganglia].

A 61 year old man, without neurological history, has a coma after a facial concussion. While the consciousness is improving, parkinsonism feature is observed with tremor at rest, rigidity and bradykinesia. From the radiological point of view, hematoma of right and left basal ganglia is observed on C.T. Scan performed 6 hours after cranial trauma. The authors study the role of these 2 hematomas in genesis of parkinsonism through literature data and they bring a mean piece in pathophysiology of parkinsonism reported in boxers.

Basal Ganglia Diseases↗

PubMed1988

[Neurophysiological study of peripheral nerves in newborn infants with congenital hypothyroidism. Value in the surveillance of replacement therapy].

The authors studied prospectively with electrophysiological means, peripheral nerve maturation of 18 neonates with congenital hypothyroidism compared to 18 controls. Before replacement therapy, a large reduction of sural nerve action potential amplitude and of Hoffmann's reflex was observed. It was accompanied by a moderate reduction in nerve conduction velocity. These results imply a myelinic and even more an axonal pathology. It is related to the anatomical type of hypothyroidism and to serum T4 deficiency. It is transient and disappears after 6 months of hormonal replacement therapy. In conclusion, this study gives new informations on the consequences of congenital hypothyroidism on peripheral nerves.

Congenital Hypothyroidism↗

PubMed1988

[Dystonia caused by putamino-capsulo-caudate infarction in a child].

Three cases of stroke in childhood are reported. In the 3 cases, an infarct involved the territory of the striato-lenticular arteries. Clinically, there was a pure motor hemiplegia and a dystonia which appeared while the hemiplegia was disappearing. The dystonic syndrome due to stroke appears only if an ischaemic lesion involves the putaminal-capsular-caudate territory, and more often in childhood.

Caudate Nucleus↗

PubMed1987

[Infraclinical neuropathies in HIV+ patients].

Explore the source record for details and available documents.

HIV Seropositivity↗

PubMed1987

[Hyperglycemia in the initial phase of cerebral vascular complication. Index of bad prognosis].

The short-term prognostic value of hyperglycemia in acute stroke has been evaluated from the results of the first year of activity of the Stroke Registration unit in Dijon. In 188 patients admitted to hospital for acute hemiplegia blood glucose levels were measured on admission and daily for 7 days thereafter, and a CT scan was performed within a fortnight. Mortality was significantly higher in hyperglycemic patients (more than 2 g of glucose per litre) than in normoglycemic patients. In hyperglycemic patients the increase in blood glucose level was correlated with the initial disturbances of consciousness, the severity of hemiplegia and the presence at CT of an haemorrhage or an infarct with oedematous reaction. Thus, hyperglycemia in acute stroke is related to the severity of the cerebral damage. As a factor of bad prognosis, it is as sensitive as disturbances of consciousness or severe brain lesions at CT.

Aged↗

PubMed1987