Contribution à l'étude de la rhéoencéphalographie chez l'homme normal et le malade atteint d'affections neurologiques

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

Corticobasal degeneration

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Alcohol toxicity in the cerebellum: clinical aspects

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La prégabaline (Lyrica) et les douleurs neuropathiques périphériques.

Pregabalin is a novel central nervous system (CNS) drug with no interaction at benzodiazepine or GABA receptor. Its mechanism of action is correlated with its high affinity for the alpha/delta submit of the voltage-dependant CNS calcium channel. Pregabalin is rapidly absorbed with at least 90% bioavailable irrespective of dose, does not bind to plasma proteins and is excreted virtually unchanged by the kidneys. Pharmacokinetics are linear and predictable across the therapeutic dose range (150-600 mg/ day). Pregabalin is indicated, like gabapentin, in the treatment of neuropathic pain syndromes like post-herpetic neuralgia (PHN) and diabetic polyneuropathy (DPN). Efficacy in other neuropathic pain syndromes need further investigations. This paper emphasizes advantages and disadvantages on a clinical point of view.English AbstractJournal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Shift from hypermetria to hypometria in an aberrant recovery following cerebellar infarction

Cerebellar hypermetria, a classical sign designating the overshoot when the patient attempts to reach rapidly an aimed target, is associated with an imbalance between timing and/or intensity of agonist and antagonist EMG activities. Recovery of hypermetria following a cerebellar ischemia or hemorrhage has been demonstrated to take place in a multistage process, but aberrant recovery following a cerebellar stroke has not been described previously. We report an 85-year-old woman presenting an abnormal recovery following a cerebellar infarction. We identified three successive stages. At stage 1, fast wrist flexion movements were severely hypermetric and associated with three EMG defects: a delayed onset latency of antagonist EMG activity, a reduction of intensity of the agonist EMG activity and a depression of intensity of antagonist EMG activity. At stage 2, movements were characterized by terminal oscillations around the target and the onset latency of the antagonist activity had returned to normal. At stage 3, movements were markedly hypometric, the intensity of the antagonist EMG activity had returned to normal, while the intensity of the agonist EMG activity remained abnormally low. This case illustrates an abnormal reprogramming of the EMG triphasic pattern, resulting in the shift from severe hypermetria to severe hypometria.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Cerebellar ataxia in Cogan syndrome

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Effectiveness of High-Dose Riboflavin in Migraine Prophylaxis. A Randomized Controlled Trial

A deficit of mitochondrial energy metabolism may play a role in migraine pathogenesis. We found in a previous open study that high-dose riboflavin was effective in migraine prophylaxis. We now compared riboflavin (400 mg) and placebo in 55 patients with migraine in a randomized trial of 3 months duration. Using an intention-to-treat analysis, riboflavin was superior to placebo in reducing attack frequency (p = 0.005) and headache days (p = 0.012). Regarding the latter, the proportion of patients who improved by at least 50%, i.e. "responders," was 15% for placebo and 59% for riboflavin (p = 0.002) and the number-needed-to-treat for effectiveness was 2.3. Three minor adverse events occurred, two in the riboflavin group (diarrhea and polyuria) and one in the placebo group (abdominal cramps). None was serious. Because of its high efficacy, excellent tolerability, and low cost, riboflavin is an interesting option for migraine prophylaxis and a candidate for a comparative trial with an established prophylactic drug

Comparative study of cerebral vasoactivity in vascular sclerosis of the brain in elderly men

Thirty five elderly patients underwent a systematic series of cerebrovascular examinations. The patients were divided into three groups on the basis of clinical criteria: normal patients (Group 1), patients with sequelae of a previous stroke or with minor mental disorders (Group 2), and patients with arteriosclerosis dementia (Group 3). The vasomotor reactions of the cerebral arteries were investigated by estimating regional cerebral blood flow (133Xe clearance technique). The authors emphasize the existence of cerebral vasoreactivity in subjects with clinical symptoms of senile dementia. Furthermore, in each of the three groups of elderly patients, there seemed to be a lack of correlation between the clinical symptoms and certain specific vascular examinations.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Cerebellar ataxia in upper limbs triggered by addition of carbamazepine to lithium treatment

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Shift from hypermetria to hypometria in multiple system atrophy: Analysis of distal and proximal movements

Dysmetria is a classical sign which designates the overshoot, also called hypermetria, and the undershoot, or hypometria, when the patient attempts to reach rapidly an aimed target. Dysmetria is typically observed in patients presenting a cerebellar dysfunction. Dysmetria of distal movements is associated with an imbalance between the timing and/or the intensity of agonist and antagonist EMG activities. So far, 1. there is only one description in human of a shift from hypermetria to hypometria for fast goal-directed single-joint movements during an aberrant recovery following a cerebellar infarction, and 2. such a shift has not been described for proximal movements. We report a patient presenting a multiple system atrophy (MSA). Initially, he exhibited a marked cerebellar syndrome. Fast wrist flexions and fast upper limb reaches in the sagittal plane were hypermetric. The distal hypermetria was associated with a delayed onset latency of the antagonist EMG activity and reduced intensities of both the agonist and the antagonist EMG activities. The proximal hypermetria was associated with a defect in the phasic spatial tuning of the EMG activities. He developed progressively severe extra-pyramidal signs. Distal hypermetria turned into hypometria, as a result of a decrease in the intensity of the agonist muscle. Proximal hypermetria turned into hypometria, as a result of the loss of directional preference of the EMG activities in proximal muscles. MSA is the second human model of a shift from hypermetria to hypometria.SCOPUS: ar.jinfo:eu-repo/semantics/publishe