[Eyelid ptosis revealing a cerebral schistosomiasis].
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Biomedical subjects
Publications and source records attributed to E Marsaudon.
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INTRODUCTION: Acute gout arthritis and tophaceous gout of the spine is rare. EXEGESIS: We report the case of a 54-year-old man with chronic low back pain. Physical examination and myelography showing neurological compression on L4 laminectomy evidenced tophaceous gout. CONCLUSION: Gout arthritis should always be suspected and investigated in patients with either chronic low back pain or non-specific spinal cord compression.
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Infective complications after epidural anesthesia for delivery are uncommon. We reviewed 21 cases of epidural abscesses, 7 cases of meningitis and one spondylitis reported in the literature. These infections usually occurred in debilitated patients either by direct contamination at puncture or indirectly from a neighboring infection or from the blood stream. Prognosis depends on early diagnosis. The first manifestations are spinal stiffness or local pain. Signs of neurological deficiency come later at a stage when complete recovery is compromised. This emphasizes the importance of the clinical examination before delivery in search for skin or deep infections.
Bromocriptine, used in the treatment of acromegaly, hyperprolactinemia and Parkinson's disease, may be responsible in this last case, for pleuro-pulmonary complications in higher doses. Since 1981 about thirty cases were described. It was mostly pleural effusions, pleural thickening and parenchymal lung fibrosis. The prevalence of pleuro-pulmonary diseases is between 2 to 5% after 5 years with bromocriptine that varied in dosage from 20 to 90 mg daily. The patients developed symptoms from nine months to four years. We report a case of a patient treated for one year for Parkinson's disease with daily dose of 105 mg of bromocriptine in whom bilateral pulmonary infiltrate was discovered with a deterioration in the general physical state and dyspnea. There was a favorable clinical and chest roentgenogram outcome following the cessation of treatment, in six months. The hypotheses to explain the pathogenesis of these disorders were always discussed: a vascular theory, an immunological theory or a toxic fibrogenesis induced by the molecule acting on dopaminergic receptors and serotonergic synapses. Now, in our knowledge, these complications justify a clinical and chest roentgenogram follow up for any patients treated with bromocriptine.
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