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Biomedical subjects

R Benrabah

Publications and source records attributed to R Benrabah.

13 recordsLinked to original sources

[Unexplained bilateral optic disk edema. So-called idiopathic intracranial hypertension of drug origin should be suspected].

In 2 clinical cases of bilateral optic disk oedema, the optic disk oedema was part of a so-called benign, or rather idiopathic, intracranial hypertension. Aetiological investigations were unable to detect any intracranial or systemic anomaly, except the fact that both patients had been on a long-term treatment. The first, a 35-year-old man, was taking Roaccutane (isotretinoin) for acne, for at least 5 years, Supradyne (containing vitamin A) minimum 1 pill per day. The second patient, aged 16 years, had also been treated for acne with Roaccutane and Mynocine (minocyclin) for several months. Minocyclin and vitamin A, contained in these substances, are likely to have induced the idiopathic intracranial hypertension, and consequently the optic disk oedema. Indeed, discontinuing the treatment and rachicentesis led to a significant resolution of symptoms. A good history of the clinical cases thus remains a key-element in the process of diagnosis-making and should be strictly conducted in cases with bilateral optic disk oedema, particularly when seen in young patients.

Adolescent

[Ocular myasthenia: an etiology to consider in unexplained oculomotor paralysis].

Three cases of ocular myasthenia gravis were observed. The first patient, a 74-year-old man was found to have complete left ophthalmoplegia and ptosis unchanged at examination on month after onset. The second patient, a 42-year-old man, developed incomplete right ophthalmoplegia with pseudoanterior internuclearis ophthalmoplegia, then ptosis two days later. The third patient, a 70-year-old man, presented with sudden onset complete right palsy of the third nerve. Diabetes mellitus or intra-cranial lesions were suspected in all three patients although laboratory tests, tomodensitometry, nuclear magnetic resonance imaging, or arteriography gave no confirmation. Ptosis was relieved and eye movement was improved after the intravenous edrophonium test, but electromyography was negative. The three patients were treated with anticholinesterase agents and showed unequivocal improvement. The second patient underwent thymectomy. Clinicians should inform patients of the contraindications of drugs in this disease. The diagnosis of pure oculomotor forms of myasthenia gravis is sometimes difficult to establish and should be suspected in cases of unexplained oculomotor palsy.

Adult

Abnormal cerebral vasodilation in aneurysmal subarachnoid hemorrhage: use of serial 133Xe cerebral blood flow measurement plus acetazolamide to assess cerebral vasospasm.

A patient with cerebral vasospasm following subarachnoid hemorrhage (SAH) was investigated by serial measurement of cerebral blood flow (CBF) using the xenon-133 emission tomography method. The CBF was measured before and after acetazolamide injection. On Day 2 after SAH, there was early local hyperperfusion in the middle cerebral artery (MCA) territory, ipsilateral to the left posterior communicating artery aneurysm. The regional CBF of this arterial territory decreased slightly after acetazolamide injection, probably because of vasoplegia and the "steal" phenomenon, and thus surgery was delayed. A right hemiplegia with aphasia and disturbed consciousness occurred 4 days later (on Day 6 after SAH) due to arterial vasospasm, despite treatment with a calcium-channel blocker. The initial hyperemia of the left MCA territory was followed by ischemia. The vasodilation induced by acetazolamide administration was significantly subnormal until Day 13, at which time CBF and vasoreactivity amplitude returned to normal and the patient's clinical condition improved. Surgery on Day 14 and outcome were without complication. It is concluded that serial CBF measurements plus acetazolamide injection are useful for monitoring the development of cerebral vasospasm to determine the most appropriate time for aneurysm surgery.

Acetazolamide

[Computed x-ray tomographic aspects of intra-orbital hydatid cyst. Apropos of 10 cases].

Echinococcus taenia occurs in human accidentally after contamination by infected dust of dog. Although it may localize in all parts of the body as a hydatic cyst, liver, lung and kidney are the most frequent sites. Intra-orbital localization is rare since all statistical studies estimate it to be one per cent of orbital tumours. Using computerized axial tomography (C.A.T. Scanner) ten cases of intra-orbital hydatic cyst originating from Algiers, Tunis Hospitals and C.N.O. des Quinze-Vingts of Paris were studied. The inclusion of C.A.T. scanning in the orbital evaluation enables more positive preoperative diagnosis and facilitates the choice of the most efficient surgical approach.

Adult