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Biomedical subjects

R Marteau

Publications and source records attributed to R Marteau.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Amnesic syndrome caused by infarction in the area of the left anterior choroidal artery].

A case of infarction in the left anterior choroidal artery territory presenting as a regressive amnestic syndrome, associated with the usual syndrome, is reported. This amnesia had the same characteristics as that found in the left posterior cerebral artery territory infarction. The anterior choroidal artery supplies the medial part of the temporal lobe, the amygdaloid nucleus, part of the hippocampus, uncal gyrus, and the mamillary body. Therefore, an amnestic syndrome can occur together with an infarction in the AChA territory. To our knowledge this is the first report of that occurrence.

Aged↗
PubMed1988

[Spinal dural arteriovenous fistulae: exacerbation after myelography with metrizamide].

Metrizamide dorsal myelography was performed in two patients with minor to moderate sensorimotor paraparesis. Direct and indirect myelographic signs of spinal arteriovenous aneurysm were seen and spinal cord angiography showed thoracic dural arteriovenous fistulae (AVF) in both cases. Within 24 hours following myelography, clear neurological worsening occurred, associated with cephalalgia, nausea and transient diplopia in one case, leading to paraplegia in a few days. Paraplegia was complete six months after surgery in one case, and had resolved after embolization of fistula in the other patient. The mechanism of neurological worsening may include: substraction of cerebrospinal fluid, sitting position during and after myelography and local increase of metrizamide concentration secondary to impaired resorption caused by the fistula. Water-soluble myelography is of invaluable aid in the diagnosis of dural AVF and must be followed by early angiography, thus allowing prompt therapeutic embolization.

Adult↗
PubMed1987

Adult adrenoleukodystrophy: a sporadic case?

This is a report of a case of the adult cerebral form of X-linked ALD. The 27-year-old patient presented with psychiatric disturbances. NMR was performed and compared to CT scan to define cerebral demyelination. The level of hexacosanoate was found to be increased in the patient's serum. Biochemical analysis of the patient's mother's serum and cultured fibroblasts and of serum samples from 10 other members of the family who could have been carriers of this X-linked disease, produced negative results. Hence, it is most likely that this case has occurred sporadically. HLA determination revealed the DR2 antigen which is often associated with multiple sclerosis.

Adrenoleukodystrophy↗
PubMed1987

[Treatment of progressive and severe forms of multiple sclerosis using a combination of antilymphocyte serum, azathioprine and prednisone. Clinical and biological results. Comparison with a control group treated with azathioprine and prednisone only. 4-year follow-up].

45 patients were treated by combined application of antilymphocyte serum, azathioprine and prednisone: a control group of such 22 patients was besides treated by azathioprine and prednisone only. The treatment by antilymphocyte serum included a four weeks initial treatment, and one year continuous treatment one infusion per week. Azathioprine and prednisone were given every day during the same time. Azathioprine only was given during the three following year. The two groups were followed up during four years. This treatment was well accepted by patients under strict technical survey conditions. Serum sickness was noted in 11 p. cent of the cases. The equine antiglobulin antibody titre, increased during the initial treatment, was connected with serum sickness or, when the treatment was continued, with the inefficacy of the treatment. Rosettes titre decreased in ten cases, no clinical correlation was possible. The complement, immune complexes, were normal before treatment with most of the observed patients. The delayed hypersensitivity skin tests were negative after a month in 80 p. cent of the cases. The cerebrospinal fluid analysis, for the elements as well as for the rate of proteins and gammaglobulins, showed no significant variations before and after the treatment. The comparison with the control group showed a significant statistical difference as too the number of aggravated and improved patients after the first year. When grouping together stable and improved patients, the difference was statistically significant after the third year. The difference was not significant in years "two" or four. No difference in the frequency of the relapses could be noted, in the first year or the following three years. In spite of inconsistent results comparison showed favorable data after three years. The good results seemed due to the additional use of antilymphocyte serum. Such a treatment associating antilymphocyte serum to azathioprine and prednisone is beneficial in evolutive, remittent and recent multiple sclerosis. Through the length of the treatment remains difficult to determine, we conclude that it is really beneficial for such patients.

Antilymphocyte Serum↗
PubMed1987

[Recurrent acute dyskinesia as the sole manifestation of phenytoin poisoning].

A 20 year-old epileptic female patient was admitted because of recurrent dyskinesias of 3 months duration. She was receiving phenobarbital, phenytoin (PHT) and clonazepam. PHT dosage had been increased 4 months earlier. Clinical examination and CT scan gave normal results. PHT plasmatic levels were 42 micrograms/ml on admission and there were no other symptoms of PHT toxicity. PHT-induced dyskinesias usually occur together with severe encephalopathy and/or clinical or paraclinical evidence of basal ganglia damage and/or other evidence of PHT toxicity, none of which were present here.

Adult↗
PubMed1987

[Cerebral cysticercosis: 4 cases].

Four cases of cerebral cysticercosis are reported, occurring in an immigrant population. Two patients presented with periodic epileptic fits and cerebral calcifications. One patient presented with an acute hemiparesis associated with lymphocytic meningitis and cerebral calcifications; the fourth patient had chronic meningitis with epileptic fits. Three patients were treated with praziquantel: an acute reaction occurred during treatment in two cases with an increase in the titres of the immunological reaction of hydatid cyst disease in one case. The authors suggest classifying this condition in three types: acute (parenchymatous or subarachnoid), chronic (chronic meningitis, hydrocephalus, progressive dementia), and sequelae (epilepsy with or without headaches). This classification seems the most appropriate way of summarizing the variable clinical presentation of this condition which is rarely observed in France. The most valuable diagnostic investigation is CT brain scanning. Immunological reaction to hydatid cyst (CSF and blood) are sometimes negative. Treatment with praziquantel often causes an acute reaction with a rise in antibody titres; this is a clinically benign reaction, and it could be used as a diagnostic test.

Adolescent↗
PubMed1986

Early onset multiple sclerosis. Clinical study of 12 pathologically proven cases.

Among 70 pathologically proven MS cases, we found 12 cases with onset before 25. Only females were affected. There was no positive familial history of MS. In every case the diagnosis was considered during life. Mean duration of the disease was 29.1 +/- 12.5 years. This was significantly longer (p less than 0.001) than in the control group (58 pathologically proven cases with onset after 25). There were no acute courses. Progressive courses (1 case) and remittent courses (5 cases) were less frequent than in the control group (p less than 0.001 and p less than 0.01, respectively). The frequency of remittent-progressive courses (6 cases) was similar in both groups. The length of remittent-progressive courses (30.2 +/- 16.2) and remittent courses (28.6 +/- 9.7) was longer than that of control group (p less than 0.001). The symptomatology of onset was similar in both groups and had no predictive value for prognosis. The overall frequency of signs and symptoms was not statistically different in both groups. For each sign, the percentage of affected patients, throughout the course of the disease, was always smaller in early onset MS than in control group, except for optic neuritis which was as frequent in both groups. However, this was statistically significant only for ocular motricity and nystagmus.

Adult↗
PubMed1985

Value of multiple sclerosis diagnostic criteria. 70 autopsy-confirmed cases.

We have evaluated the sensitivity of the most recent and most frequently used criteria for the diagnosis of definite multiple sclerosis by the retrospective study of the clinical files of 70 pathologically confirmed cases. For each case, the date of diagnosis was determined separately using different sets of criteria. The delay of diagnosis was then calculated. The diagnosis was made significantly earlier when certain criteria were used. This was more marked in the earlier years of the disease. We also found that cases of multiple sclerosis with progressive courses were diagnosed later than cases with other courses, whatever the criteria used. This was statistically significant only for a single criterion.

Autopsy↗
PubMed1985

Late onset multiple sclerosis. A clinical study of 16 pathologically proven cases.

In 70 pathologically proven MS cases, we found 16 cases with onset after 45. Sex ratio (3/1) was the same in the late onset cases and early onset control group. There was no positive family history of MS. The diagnosis was more frequently never considered in late onset cases (3/16) than in control cases (3/54). Mean duration of the disease was 8.6 +/- 6 years (8.1 +/- 6 in female patients). This was significantly shorter (P less than 0.05) than in the control group. In addition, in remittent-progressive courses and in progressive courses, it appeared that the duration of the disease was shorter in late onset MS - although this was not statistically significant. Progressive courses (8 cases) and acute courses (4 cases) were more frequent (P less than 0.05) than in control cases. Initial signs and symptoms were not significantly different from those of control cases. The length of the evolution of the disease was higher in cases with vestibular-cerebellar onset. New signs and symptoms occurred at the same rate in the late onset cases as in the control cases. Although motor, sensory and bladder disturbances were more frequent in the late onset cases than in the control cases, this was not statistically significant. Amyotrophy was more frequent in late onset MS; on the contrary optic neuritis, vestibulo-cerebellar disturbances and nystagmus were less frequent in late onset MS than in the control group (P less than 0.05).

Brain↗
PubMed1985

[Late syringomyelobulbia complicating spinal cord injury. Improvement after syringoperitoneal shunt].

A patient suffered from paraplegia of T-10 level at age 29, and he complained of new symptoms in the upper limbs at age 42. Gradual ascending worsening occurred, and the diagnosis of post-traumatic syringomyelobulbia was made 23 years after the initial accident. CT scan with metrizamide transit at the medulla level confirmed the diagnosis. Definite clinical improvement was seen after syringo-peritoneal shunting. Clinical, radiological and therapeutic aspects are briefly discussed.

Adult↗