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Biomedical subjects

D Parain

Publications and source records attributed to D Parain.

At least 19 recordsLinked to original sources

Vagal nerve stimulation in tuberous sclerosis complex patients.

This is an open-label, retrospective, multicenter study to determine the outcome of intermittent stimulation of the left vagal nerve in children with tuberous sclerosis complex and medically refractory epilepsy. The records of all children treated with vagal nerve stimulation were reviewed in five pediatric epilepsy centers to locate those with tuberous sclerosis complex who had been treated with vagal nerve stimulation for at least 6 months. These patients were compared with (1) a series of patients obtained from the literature, (2) 10 similar control patients with epilepsy obtained from a registry of patients receiving vagal nerve stimulation, and (3) four published series of tuberous sclerosis complex patients whose epilepsy was surgically managed. Ten tuberous sclerosis complex patients with medically refractory epilepsy treated with vagal nerve stimulation were found. Nine experienced at least a 50% reduction in seizure frequency, and half had a 90% or greater reduction in seizure frequency. No adverse events were encountered. Comparison with published and registry patients revealed improved seizure control in the tuberous sclerosis complex patients. Comparison with the group undergoing seizure surgery demonstrated improved outcomes after surgery. Vagal nerve stimulation appears to be an effective and well-tolerated adjunctive therapy in patients with tuberous sclerosis complex and seizures refractory to medical therapy. Resective surgery has a better prospect for improved seizure control.

Adolescent↗

[Photosensitive epilepsy and television epilepsy].

Photosensitivity is defined by the appearance of occipital or more diffuse electroencephalographic spikes and waves induced by intermittent light stimulation (ILS), particular patterns, TV-watching, and video games. Photosensitivity is a genetic characteristic. Only the diffuse spikes and waves induced by ILS are correlated with epilepsy. Pure photogenic epilepsy is characterized by seizures which are only visually induced, usually by watching TV. Video games sometimes add a trigger effect due to slowly moving patterns or intense brightness. Several epileptic syndromes are associated with a photosensitivity with or without visually-induced seizures, mainly generalized idiopathic epilepsy.

Adolescent↗

Epilepsies and video games: results of a multicentric study.

OBJECTIVES: The purpose of this study was to research whether or not video games may induce paroxysmal discharges (PD) in different groups of patients. METHODS: One hundred and fifteen subjects from 5 different French laboratories were studied: 33 had seizures exclusively under visual stimuli, 42 had both photogenic seizures and spontaneous seizures occuring independently, and 40 had non-photogenic seizures. The same protocol which included one TV sequence, 3 sequences of video games selected on particular criteria (pattern, luminosity and nature of the scene), were presented at different distances from the TV screen at 50 and 100 Hz. RESULTS: Among the factors provoking paroxysmal discharges (PD) some seem crucial: the frequency of the TV screen (the 100 Hz screen was significantly safer than 50 Hz), the distance from the screen (1 m safer than 50 cm), and, particularly for the 50 Hz screen, the specific pattern of the images and the act of playing. CONCLUSIONS: Video games are ineffective for subjects known as having a non-photosensitive epilepsy, but may induce PD on subjects known as photosensitive even when intermittent light stimulation (ILS) is not effective. These results based on a different approach than in other publications confirm data which were suggested by the literature, and suggest that 100 Hz TV screens should be recommended to patients with TV-induced attacks.

Adolescent↗

[Localized neonatal convulsions and cerebral arterial infarction].

BACKGROUND: Stroke is a rare cause of neonatal seizures. CASE REPORTS: During a 5-year period, eight full-term infants were admitted to hospital for seizures due to a stroke. Seizures began shortly after birth and were always one-sided. Early CT scans showed cerebral infarctions. Motor disabilities such as hemiparesis were found in three out of seven cases; language difficulties were observed in the same proportion; however all the children had not reached school age. CONCLUSION: Neonatal localized seizures may be symptomatic of a stroke and therefore justify a computerized tomography (CT) scan. Motor and cognitive sequelae require early management.

Cerebral Infarction↗

[Generalized or focal photosensitive epilepsies].

Photosensitivity is defined by a pattern of occipital or more diffuse spikes and waves. Several techniques are needed for exploration: intermittent light stimulation (ILS), patterns, TV-screen, video games. Photosensitivity is a genetic characteristic. Only diffuse spikes and waves induced by ILS are correlated with epilepsy. Pure photogenic epilepsy is characterized by seizures induced by visual stimuli alone, usually by TV-screen. Video games may also have a triggering effect due to the slow-moving patterns or intense brightness. Several epileptic syndromes are associated with photosensitivity with or without visually-induced seizures. These syndromes are most often generalized and idiopathic.

Adolescent↗

Prognostic value of neonatal electroencephalography in premature newborns less than 33 weeks of gestational age.

In a prospective study of 417 premature neonates born before 33 weeks' gestational age, neonatal tracings were reviewed to evaluate the use of EEG in prognosis of neurological injuries. The population was divided into two groups: Group 1, infants who died before the age of 1, and Group 2, survivors in which two categories of motor development were considered. Category A, were abnormal, and Category B, were always normal. Positive rolandic sharp waves (PRSW), which reflect white matter injury, occurred equally in both groups, indicating a similar incidence of white matter damage in Groups 1 and 2. In Group 2, there was a significant correlation of PRSW with developmental motor sequelae (Category A). A frequency of PRSW above 2/min (suggesting more severe periventricular white matter injury) and seizures were significantly more prevalent in Group 1 than in Group 2 and in Category A of Group 2 than in Category B. Background abnormalities occurred equally in both subgroups of extremely premature infants (< or = 28 weeks' gestation) they were significantly more numerous in the subgroup of very premature infants (between 28 and 33 weeks' gestation) who died, than in the subgroup of very premature infants who survived. This study shows the potential utility of using neonatal EEG in association with transfontanellar ultrasonography in anticipating the neurological development of very (> 28 weeks' gestation) and extremely (< or = 28 weeks' gestation) premature newborns.

Asphyxia↗

[EEG recordings during episodes of palinacousis and palinopsia].

Palinopsia (visual perseveration) and palinacousis (auditory perseveration) are reported in a 51-year-old woman with a left temporo parietal astrocytoma. EEG showed a left temporal delta-focus with sharp waves. EEG was not modified during neither palinacousis nor palinopsia. The relationship between the two hallucinatory phenomena and epilepsy is discussed.

Brain Neoplasms↗

[Long term evaluation of sensation sequelae of bipedicled digital advancement island flaps. Comparison of clinical and electrophysiological results. Apropos of 13 cases].

Thirteen homodigital bipedicle island flaps for digital pulp amputation were reviewed to allow a better evaluation of sensory sequelae. A clinical and electrophysiological study of the sensory score of the pulp were compared to the contralateral normal digit and expressed in relative values. Sensory sequelae, even minor, are constant. The summated scores of dynamic and static 2 point discrimination test, appeared correlated to the electrophysiological amplitude modulations. This result seems particularly interesting as it adds another test for the objective evaluation of sensitivity.

Adolescent↗

Positive rolandic sharp waves in the EEG of the premature newborn: a five year prospective study.

In a prospective study of 301 premature newborn infants, neonatal tracings were done to evaluate the use of the electroencephalogram (EEG) and positive rolandic sharp waves (PRSW) in the diagnosis and prognosis of periventricular leucomalacia. Each infant had ultrasonographic studies and standardised neurological examinations at 1 year of age or later. Two hundred and eighty infants were followed up at 1 year. This study demonstrated that the absence of PRSW was correlated with a favourable motor development (98.2%) and confirmed the great value of PRSW in the diagnosis and the prognosis of periventricular leucomalacia. PRSW were sensitive (98%) and specific (84%) markers of developmental motor disability and were a sensitive (96%) marker of severe spastic diplegia. A frequency above 2/minute was a specific (92%) sign of severe spastic diplegia. Social and language developmental abnormalities were not correlated with the neonatal EEG.

Cerebral Hemorrhage↗

Effects of stimulus intensity increase on short-latency somatosensory evoked potentials: application of polynomial curvature coefficients.

We assessed the influence of increasing stimulus intensity from motor threshold to pain threshold on short latency somatosensory evoked potentials recorded over the parietal and frontal scalp in 14 subjects during median nerve stimulation at the wrist. We used the curvature polynomial coefficient to evaluate alterations of the main components. The N20 and P27 curvature coefficients are not modified. The change of the N30 curvature coefficient is the result of shortened P45 latency. The increase of N60 curvature coefficient shows a great interindividual variability, probably due to a central amplification and synchronization or to involvement of nerve fibres with different excitability.

Adult↗

[Contribution of the EEG and evoked potentials in the prognosis of post-anoxic comas in children].

Six children with post-anoxic coma were studied and there was evidence of preserved brainstem function together with the presence of electrocerebral activity on EEG. There is no definite prognosis with slow EEG; patients can either die, survive, but with major neurological damage, or recover completely. In that case, evoked potentials have a good prognostic value. Normal BAEP indicate that patients will survive. However, absence of the cortical component of SEP indicates major cerebral damage. Evolution towards a vegetative state can therefore be predicted.

Adolescent↗

Postinfectious encephalitis with multifocal white matter lesions.

Two cases of multifocal white matter lesions occurring after viral illness are reported. Evoked potentials study and cranial magnetic resonance imaging (T2-weighted image) showed early abnormalities while CT scan was initially normal. Patients improved dramatically with steroid therapy. It would seem that because of a considerable responsiveness to steroids this affection should be differentiated from other types of encephalitis. Relations with multiple sclerosis are discussed.

Child↗

Risk of recurrence after a single, unprovoked, generalized tonic-clonic seizure.

A cohort of 119 two- to 16-year-old patients was followed to assess the risk of recurrence after a single, unprovoked, generalized tonic-clonic seizure. Only children with a normal neurological examination and intellectual development, and an EEG showing no focal abnormality, were studied. The risk of recurrence at six months was 22 per cent, at one year 28.5 per cent, at three years 32.6 per cent and at eight years 37.7 per cent. 58 per cent of recurrences occurred within the first six months and 87 per cent within the first two years. Initial EEGs showing generalized, unprovoked spikes and waves, generalized paroxysmal discharges precipitated by intermittent photic stimulation, or isolated slowing, were associated with risks of recurrence at two years of 40, 50 and 26 per cent, respectively. These results do not differ significantly from those obtained when the initial EEG was normal (29 per cent). Age, seizure duration and history of epilepsy in the family were not associated with a significantly higher risk of recurrence. The risk of recurrence was similar for treated and untreated patients.

Adolescent↗

[Positive rolandic sharp waves, periventricular ischemia and neurologic outcome. Prospective study in 66 premature infants].

A prospective study concerning 66 prematures born after 32 weeks of gestation showed a 33% incidence of positive rolandic sharp waves (PRSW) on EEGs. The results showed a good sensitivity (Se = 95%) and specificity (Sp = 93%) of PRSW for the diagnosis of periventricular ischemia with motor sequelae. A PRSW frequency higher than one per minute and its persistence on 2 successive EEGs constitutes an indication of severity of the lesions. This study emphasizes the necessity of several EEG recordings in prematures.

Brain Ischemia↗

[Multifocal epileptic crises following mumps].

A 15 years-old girl with no previous history of epilepsy or neurological disease presented three types of epileptic symptoms the same day: 1) clusters of rhythmic myoclonus of the left hemiface; 2) episodes of painful paresthesias of the left arm followed by secondary generalised seizures; 3) episodes of elementary visual hallucinations of the right hemifield. She had several seizures each hour and some were recorded. There were no EEG abnormalities during the facial myoclonus but rapid rhythms were seen during the sensory and visual partial seizures on the right parietal and left occipital lobes. There was no fever and no drowsiness. The CSF tap showed pleocytosis. Serological studies indicated recent mumps. The drugs were initially inefficient. The seizures disappeared after a month. The drugs were stopped after three months and the seizures had not relapsed after a one year's follow-up. Though there were no other sign of encephalitis, we believe that episode of multifocal seizures was due to mumps encephalitis.

Adolescent↗

[Topographic aspects of visual evoked potentials recorded after flash-pattern stimulation in normal subjects].

Visual evoked responses have been recorded on 14 leads placed on the scalp. They were localised on the central, parietal, temporal and occipital regions. The common reference was linked-ears. The stimulus consisted of a flash pattern. The size of the pattern and of each square was respectively of 20 degrees and 30 min. The stimulation of the total visual field had evoked two families of curves. One of these types of curves was posterior (occipital, temporal and parietal) and consisted in a positive, negative, positive wave (100, 136, 200 msec on average) and the second type was localised on the central leads and much more rhythmic than the posterior response. The initial complex (negative, positive, negative, positive: 70, 92, 120, 178 msec) was followed by a slow after-discharge. The half-field stimulation evoked a P100 component on the contralateral posterior leads, but this P100 was less prominent on the ipsilateral posterior leads. The modifications were particularly evident at the level of the temporal posterior electrodes. This P100 component was the only wave to be modified by half-field visual stimulation. The posterior N136 and P200 wave and all the rhythmic central response were exactly the same with half or total visual field stimulation. The results have obviously shown that the different waves of the visual evoked responses are not coming from the same sources. The interpretation of multichannel evoked recordings was therefore very difficult.

Adult↗

Positive rolandic sharp waves and periventricular leukomalacia in the newborn.

Four cases of periventricular ischemia without hemorrhage in premature infants are described in which positive rolandic sharp waves (PRSW) were predominant in the electroencephalogram (EEG). These findings suggest the relationship of PRSW to periventricular ischemia rather than to intraventricular hemorrhage, per se, as has been considered by most investigations in the past. These PRSW can provide an early indication of periventricular leukomalacia.

Electroencephalography↗