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Biomedical subjects

P Trouillas

Publications and source records attributed to P Trouillas.

At least 19 recordsLinked to original sources
PubMed1991

[Nuclear oculomotor nerve syndrome and ocular tilt reaction caused by mesencephalic hematoma].

A 78-year-old man had a midbrain hemorrhage, documented by CT scan and MRI, resulting in a mild cerebellar syndrome predominant on the left upper limb, lateropulsion, and a complex ocular motor syndrome. The latter was associated with right nuclear oculomotor nerve palsy, gaze paresis to the left for voluntary saccades, and a tonic ocular tilt reaction. Pathophysiological mechanisms are discussed.

Aged↗
PubMed1991

[Neurologic manifestations in the vertebro-basilar system revealing pregnancy toxemia].

We report a case with focal neurological deficits suggesting vertebro-basilar system ischemia, in the course of pre-eclampsia. An early CT scan showed a large hypodensity throughout the midbrain. Brainstem auditory evoked potentials initially showed an abolition of III and V pikes suggesting brainstem injury. Two days later both neurological examination and brain stem auditory evoked potentials returned to normal. A CT scan performed three weeks after the onset was normal. These findings suggest a vasospasm which may have been due to sympathomimetic agents given two weeks before the onset of toxemia for preterm labor.

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

Hypocomplementaemic and normocomplementaemic multiple sclerosis. Genetic determinism and association with specific HLA determinants (B18 and B7).

Seventy-five patients with multiple sclerosis (MS) were treated for complement components C3, after factor B, C4, and tested for HLA-A and B-determinants. Levels of IgG, IgA, IgD, IgE and titres of measles antibodies were also determined. Correlations between these immunological values and HLA determinants could be obtained in siblings, parents and/or children of the patients in 13 families. B18 frequency is strongly associated with the hypocomplementaemic group (x2 = 8.9). An association of B18 with the population of cases with low B levels is also found (x2 = 8.02). Familial data showed that low C3 and/or low B levels are associated with the HLA haplotyes, especially with those containing B18. A "complement abnormality susceptibility gene", linked to the HLA genes, is postulated. Infections are significantly more frequent in families of hypocomplementaemic MS, the existence of a genetic immunodeficiency affecting the synthesis of the complement components, linked to the HLA determinants. In 1 case studied in this article, a heterozygous C2 deficiency linked to HLA-A10, B18 was found and might confirm this hypothesis.

Antibodies, Viral↗
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↗
PubMed1975

[Epidemiological study of primary tumors of the neuraxis in the Rhone-Alps region. Quantitative data on the etiology and geographical distribution of 1670 tumors].

The authors present a retrospective study of 670 histologically verified tumours of the neuraxis collected over 90 months in the Neurological Hospital, Lyons. The main facts concerning histological type, topography of the tumour, date of diagnosis, address, profession, O.B.O. and Rhesus groups, age and sex were codified for feeding into a computer and processed by sophisticated statistical methods. This analysis shows the homogeneity of topographical distribution in the brain of the different types of glioma, the special genetic code of meningiomas (predominance of A and B genes of the A.B.O. group), absence of the same factors for glioblastoma. Sex ratio analysis shows the contrast between definitely masculine tumours--glioblastomas and astrocytomas--and meningiomas and spongioblastomas. Analysis of the "age specific rate" separates tumours prevalent in the young, where incidence is a decreasing function of age (spongioblastoma, medulloblastoma, cerebellar astrocytoma) and tumours prevalent in adults which are mainly meningiomas and glioblastomas whose incidence is an increasing exponential function of age. Epidemiological analysis shows the difference in geographical distribution of glioblastomas and meningiomas. As far as glioblastomas are concerned, it would appear that on to the general rule of constant tumourincidence over the area as a whole, is superimposed another of high incidence in particular districts of the Beaujolais and Maconnais regions. The aetiological implications of these various findings are discussed.

Adult↗