Parakinesia: A Delphi consensus report.

Abnormal movements are intrinsic to some forms of endogenous psychoses. Spontaneous dyskinesias are observed in drug-naïve first-episode patients and at-risk subjects. However, recent descriptions of spontaneous dyskinesias may actually represent the rediscovery of a more complex phenomenon, 'parakinesia' which was described and documented in extensive cinematographic recordings and long-term observations by German and French neuropsychiatrists decades before the introduction of antipsychotics. With the emergence of drug induced movement disorders, the description of parakinesia has been refined to emphasize the features enabling differential diagnosis with tardive dyskinesia. Unfortunately, parakinesia was largely neglected by mainstream psychiatry to the point of being almost absent from the English-language literature. With the renewed interest in motor phenomena intrinsic to SSD, it was timely not only to raise awareness of parakinesia, but also to propose a scientifically usable definition for this phenomenon. Therefore, we conducted a Delphi consensus exercise with clinicians familiar with the concept of parakinesia. The original concept was separated into hyperkinetic parakinesia (HPk) as dyskinetic-like expressive movements and parakinetic psychomotricity (PPM), i.e., patient's departing from the patient's normal motion style. HPk prevails on the upper part of the face and body, resembling expressive and reactive gestures that not only occur inappropriately but also appear distorted. Abnormal movements vary in intensity depending on the level of psychomotor arousal and are thus abated by antipsychotics. HPk frequently co-occurs with PPM, in which gestures and mimics lose their naturalness and become awkward, disharmonious, stiff, mannered, and bizarre. Patients are never spontaneously aware of HPk or PPM, and the movements are never experienced as self-dystonic or self-alien. HPk and PPM are highly specific to endogenous psychoses, in which they are acquired and progressive, giving them prognostic value. Their differential diagnoses and correspondences with current international concepts are discussed

Microbially mediated carbonates in the Holocene deposits from Sarliève, a small ancient lake of the French Massif Central, testify to the evolution of a restricted environment

International audienceBoth the mineralogy and facies of lacustrine bio-induced carbonates are controlled largely by hydrological factors that are highly dependent upon climatic influence. As such they are useful tools in characterizing ancient lake environments. In this way, the study of the sedimentary record from the small ancient Sarlie've Lake (Limagne, Massif Central, France) aims to reconstruct the hydrological evolution during the Holocene, using petrographical, mineralogical and geochemical analyses. The fine-grained marls, mainly calcitic, display numerous layers rich in pristine Ca-dolomite, with small amounts of aragonite, which are clearly utochthonous. As these minerals are rather unusual in the temperate climatic context of western Europe, the question arises about their forming conditions, and therefore that of the lacustrine environment. Ca-dolomite prevails at the base of the sequence as a massive dolomicrite layer and, in the middle part, it builds up most of the numerous laminae closely associated with organic matter. Scanning electron microscope observations reveal the abundance of tiny crystals (tens to hundreds of nanometres) mainly organized as microspheres looking like cocci or bacilli. Such a facies is interpreted as resulting from the fossilization of benthic microbial communities by dolomite precipitation following organic matter consumption and extracellular polymeric substance degradation. These microbial dolomites were precipitated in a saline environment, as a consequence of excess evaporation from the system, as is also suggested by their positive ¶18O values. The facies sequence expresses the following evolution: (i) saline pan, i.e. endorheic stage with a perennial lowstand in lake level (Boreal to early Atlantic periods); (ii) large fluctuations in lake level with sporadic freshening of the system (Atlantic); (iii) open lake stage (sub-boreal); and (iv) anthropogenic drainage (sub-Atlantic)