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T De Broucker

Publications and source records attributed to T De Broucker.

35 records · Page 2Linked to original sources
PubMed1994

[Unilateral paralysis of the lower cranial nerves caused by lesion of the internal carotid artery].

We report two cases of unilateral, isolated lower cranial nerves (IX, X, XI and XII) palsy: both were due to a lesion of the internal carotid artery in the para-pharyngeal space (a dissection and a pseudoaneurysm). The diagnosis was based upon magnetic resonance imaging and selective angiography. The normality of the external carotid artery on angiography led to the hypothesis of a direct compression of the lower cranial nerves in the para-pharyngeal space, rather than an ischemia of these nerves.

Carotid Artery Diseases↗
PubMed1994

[Painful ophthalmoplegia caused by chronic sphenoid sinusitis. Contribution of imaging].

Sphenoid sinusitis is a rare, often misdiagnosed, potentially lifethreatening infection. We report two cases of chronic sphenoid sinusitis presenting as painful ophthalmoplegia. We emphasize the difficulty of the diagnosis due to the deep-seated position of the cavity. The availability of CT and MRI should allow an early diagnosis. Attention has to be paid to the sphenoid sinus on every cranial image. In the chronic as well as in the acute form, the treatment is an emergency. Surgery procedures should be considered when antibiotics are inefficient. Sphenoid sinusitis must be considered in the diagnosis of painful ophthalmoplegia.

Adult↗
PubMed1990

Diffuse noxious inhibitory controls in man: involvement of an opioidergic link.

In man, heterotopic painful thermal conditioning stimuli induce parallel decreases in the spinal nociceptive flexion (RIII) reflex and the concurrent sensation of pain elicited by electrical stimulation of the sural nerve at the ankle. Such phenomena may be related to the diffuse noxious inhibitory controls (DNIC) which were initially described in the rat and subsequently documented in humans. In nine subjects in the present study, a 2-min application of a moderately noxious temperature (46 degrees C) to the contralateral hand strongly depressed the RIII reflex elicited in the biceps femoris muscle by electrical stimulation of the sural nerve at 1.2 times the reflex threshold. These depressive effects were maximal during the 2nd min of the conditioning period, showing an almost complete inhibition of the RIII reflex which gradually recovered its baseline value 6-9 min after the end of the conditioning period. Using a double-blind, cross-over design, it was found that these inhibitory effects were completely blocked 5 min after naloxone hydrochloride administration (0.4 mg i.v.) whereas the administration of saline was totally ineffective. The lifting of the inhibitions was compatible with the short duration of the pharmacological effects of naloxone in that the inhibitions were observed again 50 min after the naloxone injection. During all the experimental sessions, heart and respiratory rates remained stable at their control levels. It is concluded that the loop subserving DNIC which ascends from--and redescends to--the spinal cord involves an opioidergic link in man as in experimental animals. Possible implications for hypoalgesia based on the principles of counter-irritation or elicited by naloxone are discussed.

Adult↗
PubMed1990

Gadolinium-DTPA enhanced MR imaging in tuberous sclerosis.

Ten patients with clinical tuberous sclerosis were examined with CT and MR imaging, before and after IV contrast in order to determine the role of Gd-DTPA. Gd-DTPA enhancement occurred in eleven subependymal nodules which did not enhance on CT after IV contrast. As illustrated by previous CT and pathologic observations and related to the histologic similarity of the subependymal nodules and giant-cell astrocytomas, these hyperintense nodules could represent active lesions with the potential to evolve. Four giant-cell astrocytomas were detected both with CT and Gd-DTPA-enhanced MRI; tumor conspicuity and size assessment were improved by postcontrast MRI in two cases. No cortical tuber or heterotopic cluster enhanced; T2-weighted sequences therefore remain necessary for their detection. If pre and post-Gd-DTPA T1- and T2-weighted imaging is negative, CT is clearly the most sensitive modality in the detection of the small calcified subependymal nodules.

Adolescent↗
PubMed1990

Diffuse noxious inhibitory controls in man. Involvement of the spinoreticular tract.

In normal subjects, heterotopic painful stimuli induce simultaneous and parallel decreases in the sensation of pain and in the spinal nociceptive flexion (RIII) reflex evoked by electrical stimulation of the sural nerve. This inhibition of the RIII reflex is not seen in tetraplegic patients with clinically complete spinal cord transection, suggesting that supraspinal structures are involved in this type of inhibition, mediated through 'Diffuse Noxious Inhibitory Controls' (DNIC). In the present study, the effects of heterotopic nociceptive stimuli on the RIII reflex were examined in 3 patients with unilateral thalamic vascular lesions and in 3 with Wallenberg's syndrome (WS). In the former, as in normal subjects, nociceptive electrical conditioning stimuli applied to the analgesic hand produced a profound inhibition of the RIII reflex followed by long-lasting after-effects. No inhibition was observed in the WS patients. The same conditioning procedure applied to the nonanalgesic hand of the WS patients resulted in inhibition and after-effects similar to those observed in normal subjects. The fact that noxious but nonpainful stimuli triggered DNIC in the patients with thalamic lesions excludes the possibility that masking of pain by a second painful focus is mainly due to attentional processes. It is also concluded that lemniscal and spinothalamic pathways are not involved in the triggering of DNIC in man and it is suggested that the brainstem and probably the spinoreticular tract are key neuronal links in the loop subserving DNIC in man.

Adult↗
PubMed1990

[Improvement of Joseph's disease with sulfamethazole-trimethoprim].

A case of Joseph's disease characterized by spasticity in all 4 limbs, dystonia and disorders of ocular motility was considerably improved by cotrimoxazole, which confirms a recently published case. Further studies are required to establish this therapeutic effectiveness.

Adult↗
PubMed1989

Encoding of nociceptive thermal stimuli by diffuse noxious inhibitory controls in humans.

1. It has previously been shown that, in normal humans, heterotopic painful thermal conditioning stimuli induce parallel increase in the thresholds of a spinal nociceptive flexion reflex (RIII reflex) and the concurrent sensation of pain elicited by electrical stimulation of the sural nerve. On the basis of analogous animal studies, we proposed that such phenomena could be related to diffuse noxious inhibitory controls (DNIC), which have been described in the rat. The present study, which was carried out on normal volunteer subjects, was particularly concerned with the extent and temporal characteristics of the depressive effects of DNIC triggered by painful thermal stimuli on RIII reflex activity. In addition, because it was possible that these depressive effects could have resulted from a direct postsynaptic inhibition of motoneurons, a second part of the study was aimed at determining whether or not the heterotopic noxious thermal stimuli also affected the excitability of alpha-motoneurons, as monitored by the monosynaptic Hoffmann reflex (H reflex) technique. 2. In the 11 subjects under study, application of moderate, nonnoxious temperatures (40-44 degree C) to the contralateral hand (via a thermoregulated and agitated waterbath) did not modify the RIII reflex nor the associated sensation of pain. By contrast noxious temperatures clearly depressed the RIII reflex and the concurrent sensation of pain, both during and after the conditioning procedure (CP), in a direct linear relationship to the temperature of the waterbath in the 45-47 degree C range; the maximal depressive effect was observed with the highest conditioning temperature. A significant relationship was also found between the extent of the RIII depression during the CP and that during a 10-min period of post-CP observation. 3. The depressive effects observed on both the RIII reflex and pain were not associated with clear change in autonomic functions. Respiration remained stable during the sessions, with no significant relationship between the temperatures of the waterbath and respiratory rate. Heart rate was slightly but significantly increased during the immersion of the hand in the 46 or 47 degree C waterbaths; this increase, however, ceased with the end of CP. 4. Application of thermal conditioning stimuli produced a slight but nonsignificant increase of the monosynaptic H reflex during the first minute of CP, no matter what was the temperature of the waterbath. However, there were no subsequent variations during the 6-min period of post-CP observation.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1985

[Comparative study of the nociceptive reflex and late components of the evoked somatosensory potential during stimulation of the sural nerve in healthy subjects].

A study was carried out with 10 normal volunteers in order to find a correlation between nociceptive flexion reflexes from the biceps femoris muscle and the amplitude of the late component (N150-P220) of the vertex evoked potential elicited by sural nerve stimulations at various intensities randomly delivered. The range of stimulus varied from the perception threshold (usually 1 mA) to 2 times the reflex threshold. This latter parameter was usually found between 8 and 11 mA. While the nociceptive flexion reflex increased linearly as a function of stimulation intensity, the amplitude of N150-P220 was maximum at pain threshold and remained in plateau at this level or even slightly decreased as a function of stimulus intensity. No significant correlation was found between the recruitment curve of the nociceptive reflex and that of the late component of the evoked potential as a function of stimulus intensity. Functional implications of these data are discussed.

Adult↗
PubMed1985

[Somatosensory evoked potential and pain. I. Late cortical responses obtained at different levels of stimulation].

The characteristics of the late components of the somatosensory evoked potential (SEP) as a function of stimulation intensity have been studied in 10 normal volunteers following electrical stimulation of the distal cutaneous branches of the median nerve. The stimulus intensity (either single shock or train) was adapted in order to produce the following 4 types of sensation: liminal tactile (ST); frankly tactile but never painful (4 times ST); pain threshold (SD); and 1.5 time SD. A significant relationship was observed between the amplitude of the late component (N150-P220-N400), of the SEP and the stimulus intensity for a low rate of stimulation (below 0.25 Hz). In contrast this relationship is not verified for higher stimulation rates. These data are discussed with respect to their implication in pain research.

Adult↗
PubMed1985

[Evoked potentials and pain. II. Comparative study of subjective sensations, late components of the cortical potentials and afferent volleys].

The subjective sensations and late components of the cortical somatosensory evoked potential (SEP) have been correlatively studied when elicited by stimulation parameters which were selected in order to activate selectively, either the largest afferent fibers (train of shocks of 10 mA, with a 0.05-0.2 msec duration for each shock) or the several groups of fibers (A alpha beta; A delta and C) of the cutaneous branches of the median nerve (single shock, 1 msec duration; 20 mA). In both cases, a good correlation was found between the quality and intensity of sensations and the amplitude of the late component N150-P220-N400 of the SEP. However, it was also found that this relationship was not linear and suggested that it is possible to saturate the cortical integrative system responsible for the SEP. A selective blockage of the largest fibers (compression) or of the finest ones (lidocaine) have shown that there is no specific involvement of a particular type of peripheral fiber in the genesis of the N150-P220-N400 components. Moreover, these late components could also be recorded with similar latencies when cutaneous stimulations were applied in any part of the body.

Adult↗