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Biomedical subjects

D Zegers de Beyl

Publications and source records attributed to D Zegers de Beyl.

At least 19 recordsLinked to original sources
PubMed2003

Effects of levodopa on upper limb mobility and gait in Parkinson's disease.

BACKGROUND: Most clinicians rely on clinical scales such as the unified Parkinson's disease rating scale (UDPRS) for evaluating parkinsonian patients and assessing their response to levodopa. Gait analysis is not commonly used, probably because of the equipment required and the time needed. Few data have been published on the relations between gait variables and measures of arm and hand mobility. OBJECTIVES: To evaluate the correlation between dopa induced gait improvement and upper limb motor improvement using a rapid and simple method; and to evaluate the correlation between gait improvement and UPDRS III improvement. METHODS: A finger tapping test and a simple walking test were used to measure the OFF-ON variations of upper limb motor function and gait in 23 patients with Parkinson's disease. The UPDRS motor score and the Hoehn and Yahr stage were measured in the OFF and the ON state. RESULTS: There was no correlation between OFF-ON variation of the number of hits with the finger tapping test and OFF-ON variation in the gait variables. OFF-ON variation in the UPDRS motor score was not correlated with OFF-ON variation in the gait variables. CONCLUSIONS: There was a dissociation between the effect of levodopa on upper limb and gait. The findings suggest that simple measures like the finger tapping test and a walking test should be included in the usual evaluation of patients with Parkinson's disease.

Aged↗
PubMed2002

Painful arm and moving fingers: clinical features of four new cases.

The syndrome of painful arm and moving fingers associates pain in one arm or hand with involuntary movement of one or several fingers. In the four cases described, an association between a central and a peripheral nervous system lesion is demonstrated or suspected. Treatment of the condition is disappointing.

Adult↗
PubMed2002

[The neurology department].

The department of neurology is devoted to the diagnosis and medical treatment of organic diseases of central nervous system (brain and spinal cord) and peripheral nervous system (peripheral nerves and muscles). Basic and clinical research in neuroscience constitute an essential activity of the department that defines its academic character. Over the years, the department of neurology has evolved from providing general neurology services to a multifaceted unit that has developed the several subspecialties of clinical neuroscience. Main research areas have included neurooncology, neurophysiology, neuropsychology, cerebrovascular diseases, childhood epilepsy and conditions affecting the psychomotor development of children. Neurogenetics is a recent addition to the areas of the interest of the department; research in neurogenetics includes basic investigations as well as clinical studies and focuses on inherited ataxias and genetic epilepsies.

Belgium↗
PubMed2001

Frontotemporal dementia: a clinical-pathological study.

We report a 44-year-old female patient without any familial history of dementia presenting with increasing disturbances in behaviour and language followed by a progressive cognitive deterioration. Neuropsychological evaluation revealed a significant impairment on frontal lobe tests. A brain PET scan disclosed a severe frontal hypometabolism. The tentative diagnosis of frontotemporal dementia was made. Her condition rapidly worsened and she died 2 years after the beginning of her disease. Gross examination of the brain showed a selective symmetrical atrophy of both frontal and anterior part of the temporal lobes. Microscopical examination revealed severe neuronal loss in the frontal and anterior temporal cortex associated with gliosis and microvascular spongiosis in the superficial cortical layers in the absence of any specific neuronal or glial inclusions. These neuropathological findings were consistent with the diagnosis of dementia lacking distinctive histology. We discuss the nosology of the frontotemporal dementias, the diagnostic value of PET scan, the recent genetical developments which strongly support the pathogenic role of tau and we emphasize the importance of immunohistochemical examination for a definite neuropathological diagnosis.

Adult↗
PubMed2000

[Dopaminergic agonists in the treatment of Parkinson's disease].

After levodopa, dopaminergic agonists are the most powerful agents in idiopathic Parkinson's disease treatment. Used in monotherapy or rather in early combination with levodopa, they allow a dramatic reduction of long-term motor side effects of the latter: onset and peak-dose dyskinesias, early morning dystonias. Their gastro-intestinal (nauseas) and moreover psychiatric (confusion and hallucinations) side effects limit their use, notably in geriatric populations. Superiority of so-called "second generation" agonists (ropinirole, pramipexole) on "first generation" agonists (bromocriptine, pergolide) remains to be proved.

Aged↗
PubMed1999

[Surgical treatment of Parkinson disease: indications and limitations].

Thalamotomy, a surgical lesion of the ventro-intermediate nucleus of the thalamus, is a well known surgical treatment of tremor in Parkinson's disease. Over the last years, new surgical therapies had been developed. These therapies, instead of making a lesion in the brain, consist in placing electrodes in specific areas of the brain and to inhibit neuronal function by electrical stimulation. Electrical stimulation of the subthalamic nucleus or of the pallidum are effective to treat motor symptoms of Parkinson's disease. The procedure can be done bilaterally, contrary to thalamotomy. A short overview of the indications and contra-indications of this kind of therapy is given.

Contraindications↗
PubMed1997

Effects of vigabatrin on motor potentials evoked with magnetic stimulation.

We studied the effect of an acute loading dose of vigabatrin on threshold of motor responses and duration of silent period elicited with cortical magnetic stimulation in normal subjects. In contrast to phenytoin, vigabatrin does not increase the motor threshold of first dorsal interosseus muscle. We also show that, although vigabatrin increases GABA concentrations in the central nervous system, duration of silent period studied at various stimulus intensities is not modified after vigabatrin administration.

Adult↗
PubMed1997

Central nervous system lesions associated with Crohn's disease.

Central nervous system vasculitis is an exceptional extraintestinal manifestation of Crohn's disease. Reported here are 2 cases, highlighting the difficulty of differential-diagnosis with multiple sclerosis and stressing the importance of early immuno-suppressive therapy.

Adult↗
PubMed1997

Audiogenic startle reflex in acute hemiplegia.

The generators of the audiogenic startle reflex (ASR) are located in the bulbopontine reticular formation. We studied the influence of acute vascular supratentorial lesions on ASR. Ten patients with hemiplegia due to hemispheric cerebral infarct were studied within 5 days of stroke onset. ASR and magnetic cortical stimulation were performed the same day. A muscle response to magnetic stimulation was not elicited over the plegic side in any patient. In four of seven patients, ASR was enhanced over the plegic side. We suggest that enhanced ASR is due to the loss of a predominantly inhibitory hemispheric drive on ASR generators.

Acoustic Stimulation↗
PubMed1995

Abnormal motor evoked responses to transcranial magnetic stimulation in focal dystonia.

We evaluated motor responses evoked after magnetic cortical stimulation in dystonia, emphasizing the relationship between resting and facilitation state. We studied 15 normal controls (mean age, 37.9 years; range, 23 to 63) and 13 dystonic patients (mean age, 43.4 years; range, 20 to 56). Surface electrodes were placed over the right first dorsal interosseous muscle to measure motor evoked potentials and inhibitory silent periods obtained with magnetic stimulation. The amplitude ratio of motor evoked potentials measured during facilitation and at rest with low-intensity magnetic stimulation was significantly higher in dystonic patients (15.09) when compared with normal subjects (5.43; p = 0.04). The ratio of duration of silent periods evoked with 120% motor threshold (MT) and MT + 25% magnetic stimulus intensity was significantly higher in dystonic patients (78.4%) when compared with normal subjects (69.7%; p = 0.04). We conclude that with low-intensity magnetic stimulation the relationship between amplitudes of motor potentials evoked at rest and during facilitation, as well as the responses of pathways that mediate silent periods, are disturbed in focal dystonia.

Adult↗
PubMed1995

Chronic intrathecal baclofen in severely disabling spasticity: selection, clinical assessment and long-term benefit.

Flexor and extensor spasms associated with severe spasticity frequently cause pain and suffering in neurologically impaired patients, and greatly interfere with comfort and activities. When high doses of oral medications are necessary to keep the symptoms under control and are poorly tolerated, the long-term spinal-selective intrathecal infusion of baclofen by means of implanted drug pump and catheter is a safe, efficient and reversible alternative to destructive surgical procedures. Between September 1991 and March 1995, intrathecal baclofen was infused in 18 selected patients out of a series of 42 severely disabled spastic cases. We report here our preliminary experience with the criteria of selection, the initial intrathecal bolus test and the long-term benefit of the selected patients. Our results confirm the dramatic immediate and long-term benefit reported in other series. After a period of treatment of 1 to 42 months, 13 patients had a complete disappearance of their spastic symptoms without any oral treatment, one patient kept unchanged clonus despite the use of low-dose oral treatment and another one a severe, not improved dysuria although in both of them hypertonia and spasms were abolished. Finally, 2 patients had important joint stiffness slightly impairing the benefit from the treatment. None of the 18 patients had central side-effects related to baclofen. With time, a slight increase in daily dose (inferior to 10%) was necessary in most patients.

Adult↗
PubMed1994

Spinal and brain-stem SEPs and H reflex during enflurane anesthesia.

Whereas cortical SEPs are altered by halogenated anesthetics, spinal and subcortical SEPs are thought to be hardly affected. In this study the spinal N13 potential (recorded with anterior neck reference) showed a significant delay with enflurane anesthesia. The P13 and P14 far-field potentials, however, remained unchanged. Our results indicate that oligosynaptic as well as polysynaptic pathways are influenced by halogenated anesthetics and that enflurane has different effects on spinal gray matter and cuneate synapses. Our data also demonstrate that earlobe reference recordings are not adequate to measure pharmacologic effects on subcortical SEPs.

Adult↗
PubMed1994

Effects of diphenylhydantoin on motor potentials evoked with magnetic stimulation.

We studied the effect of an acute loading dose of diphenylhydantoin (DPH) on motor responses elicited with cortical magnetic stimulation in normal subjects. DPH increased significantly the motor threshold activation of ADM, APB, FDI and biceps. The motor threshold increase was of greater magnitude for the proximal muscle. Spinal soleus alpha-motoneuron pool excitability assessed by H-reflex was increased significantly suggesting that the motor threshold increase is related to a supraspinal effect of the drug. Our study demonstrates that the motor threshold increase observed after DPH administration occurs not only in epileptic patients but also in normal subjects.

Adult↗
PubMed1994

Somatosensory central conduction time after sural and tibial nerve stimulation.

We recorded spinal and cortical somatosensory evoked potentials (SEPs) after sural and tibial nerve stimulation at the ankle in 34 normal subjects. Spinal SEPs were reproducible with sural nerve stimulation in only 65% of normal subjects. The spinal amplitudes were significantly smaller after sural nerve stimulation. Central conduction time (CCT) was significantly shorter when measured from onset instead of peak latencies. There was a significant difference between CCT with tibial nerve and sural nerve stimulation. Our results are consistent with the idea that CCT measures from onset and peak latencies do reflect the travel of the afferent volley in different spinal fiber populations.

Adult↗
PubMed1991

Frontal impairment and hypoperfusion in neuroacanthocytosis.

Cerebral blood flow tomography, by xenon 133 inhalation or HMPAO (99mTc-d, l-hexamethyl-propylene amine oxime) technetium Tc 99m injection, revealed a severe hypoperfusion in both frontal lobes of a 40-year-old woman with confirmed neuroacanthocytosis. This finding occurred in conjunction with neuropsychological deficits consistent with selective frontal lobe dysfunction. This observation is the first documentation of this type of dementia in neuroacanthocytosis.

Acanthocytes↗
PubMed1991

Acute effects of diphenylhydantoin on peripheral and central somatosensory conduction.

We studied the acute effects of an intravenous loading dose of DPH (16 mg/kg body weight) on peripheral and central somatosensory conduction in 10 normal volunteers. Somatosensory evoked potentials were recorded before and at regular intervals after DPH infusion. There was no effect on peripheral conduction. DPH significantly delayed N13 peak latency without changing conduction in the posterior spinal columns. Although the N13-N20 interpeak interval remained stable because of the parallel shift of the 2 peaks, the central conduction time measured from onset latencies of N11 and N20 significantly increased. We conclude that acute administration of DPH at serum levels below 30 micrograms/ml induces a reversible delay of synaptic transmission in spinal and central somatosensory structures.

Adult↗