Elevated visual dependency in young adults after chemotherapy in childhood

Chemotherapy in childhood can result in long-term neurophysiological side-effects, which could extend to visual processing, specifically the degree to which a person relies on vision to determine vertical and horizontal (visual dependency). We investigated whether adults treated with chemotherapy in childhood experience elevated visual dependency compared to controls and whether any difference is associated with the age at which subjects were treated. Visual dependency was measured in 23 subjects (mean age 25.3 years) treated in childhood with chemotherapy (CTS) for malignant, solid, non-CNS tumors. We also stratified CTS into two groups: those treated before 12 years of age and those treated from 12 years of age and older. Results were compared to 25 healthy, age-matched controls. The subjective visual horizontal (SVH) and vertical (SVV) orientations was recorded by having subjects position an illuminated rod to their perceived horizontal and vertical with and without a surrounding frame tilted clockwise and counter-clockwise 20° from vertical. There was no significant difference in rod accuracy between any CTS groups and controls without a frame. However, when assessing visual dependency using a frame, CTS in general (p = 0.006) and especially CTS treated before 12 years of age (p = 0.001) tilted the rod significantly further in the direction of the frame compared to controls. Our findings suggest that chemotherapy treatment before 12 years of age is associated with elevated visual dependency compared to controls, implying a visual bias during spatial activities. Clinicians should be aware of symptoms such as visual vertigo in adults treated with chemotherapy in childhood

Analysis of bone conducted sound over the cranial vault

International audienc

Treatment of a mastoid defect by free anterolateral thigh flap

International audienc

Thyrotoxic hypokalemic periodic paralysis. Report of three cases

Hypokaliemic thyrotoxic periodic paralysis (HTPP) is an uncommon complication of hypothyroidism. Mostly described among Asian patients, it is rare in the other ethnic groups, in particular in caucasians people. Among the possible mechanisms, modification of potassic flows in relation to anomalies of the sodium-potassium pump were evoked. PATIENTS AND METHOD: We present the cases of three caucasians patients operated on for HTPP. These patients had all previous history of several paretic episodes. The flask paralytic attacks occurred in a brutal way or were preceded by diffuse myalgias. They reached the proximal muscles, especially in inferior limbs. No patient had any respiratory complications. These three patients underwent total thyroidectomy to treat the symptoms of HTPP. RESULTS: In the three cases, a total thyroidectomy allowed the recovery of the symptoms. After a four years average period of post-operative follow-up, no patient presented any repetition of HTPP. The hyperthyroidism is the cause of decompensation of the molecular anomaly. CONCLUSION: In our opinion, surgical treatment (total thyroidectomy) is needed in order to reduce the potential gravity of this pathology