Biomedical subjects

F Chéliout-Héraut

Publications and source records attributed to F Chéliout-Héraut.

5 recordsLinked to original sources

PubMed2001

[Electrophysiologic study of 10 cases of Miller Fisher syndrome].

The association of ophthalmoplegia, ataxia and areflexia was described by Miller Fisher in 1956. It is postulated as a variant of the Guillain Barré syndrome. We report 10 Miller Fisher syndrome patients admitted in an intensive care unit between June 1990 and February 1999 who were selected according to clinical criteria of Ropper and Wijdicks. All patients had motor and sensory nerve conduction studies and electromyography, nine had visual and brainstem auditory evoked potentials and two had short latency somatosensory evoked potentials. Peripheral neuropathy was found in all patients. All had sensory nerve changes and some were severe. Motor nerve conduction abnormalities were observed in 7 only cases with moderate increase of F latency in 3 cases and compound muscle action potential reduction in 3 other cases. In the last case, motor conduction abnormalities was more severe, characterized by conduction velocity slowing in both distal and proximal sites and by temporal dispersion of action potentials. All brainstem auditory evoked studies were normal. In 4 patients, MRI studies were normal. These data support that brainstem is preserved in MFS. Only one patient had visual evoked potential abnormalities. Optic neuropathy is debated in Miller Fisher and in Guillain Barré syndrome. As a conclusion, in MFS peripheral neuropathy is always present with severe sensitive changes and moderate motor changes (This is different as compared to Guillain Barré syndrome according to electrophysiological data). We did not find involvement of brainstem in our patients with Miller Fisher syndrome.

Adolescent↗

PubMed1999

[EEG anomalies, sleep modification and developmental dysphasia ].

The relation between severe developmental dysphasia and paroxystical anomalies was analyzed in 52 children, mean age 9 years (group I) suffering from developmental dysphasia, compared to a control group of 20 children, mean age 8 years (group II). The children of both groups were selected excluding cases with a prior history of epilepsy or neurological disease, and all had a cerebral MRI in the normal range. In group I, using the Rapin and Allen classification, we distinguished: 14 children with a syntactic-lexical syndrome and 34 children with a syntactic-phonological syndrome. Two children had verbal agnosia and two others verbal dyspraxia. The analysis of repeated standard EEGs showed: normal recordings in all the group II children and paroxystical anomalies in six of the 52 group I children. Night ambulatory sleep recordings showed such anomalies in 18 of the 34 children with a syntactic-phonologic syndrome and in 6 of the 14 children with a syntactic-lexical syndrome, but in only two of the 20 children of the control group. Paroxysmal abnormalities predominated in light sleep (stages I + II) and slow wave sleep (stages III + IV), but were rare in REM sleep. The abnormalities were diffuse or localized over the left frontotemporal area. Children with developmental dysphasia also showed an inconstant nocturnal sleep pattern with a higher incidence of awakenings during sleep significantly different from our group control. The relations between dysphasias, Landau-Kleffner syndrome, paroxystical anomalies, and sleep disorders are discussed and the results of genetic research concerning such population suffering from language disorders analyzed.

Aphasia↗

PubMed1998

Evaluation of early motor and sensory evoked potentials in cervical spinal cord injury.

To determine the efficacy of motor evoked potentials (MEP) and sensory evoked potentials (SEP) in the assessment of severe cervical injury, 17 subjects with severe cervical injury were studied. During the 1st week post-injury and post-surgical treatment, all subjects were submitted to electromyogram (EMG) recordings, dermatomal somatosensory evoked potentials (D.SEP), posterior tibial nerve somatosensory evoked potentials (PTN.SEP), MEP and bilateral cervical electrical stimulations with recording of the diaphragm. For the D.SEP, the latencies of the N9 and N20 responses and the conduction time (N9-N20) were measured in the upper limbs; the latencies of the P40 and P60 responses were measured in the lower limbs. MEP were recorded from distal upper and lower limb muscles following transcranial electrical stimulation of the cortex. (Magnetic stimulation was not indicated because of implanted metallic material in the cervical skull of many patients.) A SEP and MEP grading system was used to improve the assessment of different root neurological levels. In patients with incomplete lesions PTN.SEP, D.SEP and MEP responses could be recorded in territories that were clinically deficient. Patients with complete lesions and absent SEP and MEP responses had a poor outcome. A good correlation was found between the severity of the spinal cord injury and SEP grading. For MEP, the presence or absence of intercostal responses (C4) to cervical and cortical stimulation was the best prognostic indicator. The combined electrophysiological exploration of MEP and SEP proved to be a useful tool for monitoring patients with severe spinal cord injury.

Adolescent↗

PubMed1997

[Visual, auditory and somatosensory potentials in the diagnosis of vitamin B12 deficiency].

We describe visual, brain stem auditory, and somatosensory evoked (VEP, BAEP, SEP) in a 49-year old male patient presenting with subacute degeneration of the spinal cord due to vitamin B12 deficiency. Neurological signs included tetraplegia with a C4-C5 spinal cord compression that was unchanged after surgical decompression. Before treatment, the duration of the bilateral VEP was slightly increased, though their amplitude and morphology were not modified. BAEP were normal. However, abnormalities of SEP with loss of cortical potentials were noticed. Two months after initiation of the treatment, both VEP and SEP recorded in response to median nerve stimulation had improved, but there was still no cortical response to tibial nerve stimulation. Eighteen months later, VEP were normal and recovery of SEP in response to tibial nerve stimulation was observed; however, alterations of peripheral sensory and motor action potentials were still present. These findings are in good agreement with previously reported pathological changes in patients presenting with subacute combined degeneration. Similar abnormalities have been described in patients with multiple sclerosis. Evoked potentials in this case proved to be useful for the diagnosis and the evaluation of the efficacy of the treatment. These findings also suggest that demyelination of the posterior part of the spinal cord and peripheral axonal degeneration might be the main pathological changes related to vitamin B12 deficiency. The former, but not like the latter, were clearly responsive to the treatment.

Evoked Potentials, Auditory↗

PubMed1991

[Contribution of somatosensory evoked potentials in the surveillance of the spinal cord during spinal surgery].

This study shows the results obtained in 51 patients, children and adolescents by monitoring somatosensory evoked potentials during spinal surgery: Cotrel-Dubousset instrumentation, surgical anterior correction by plating, spondylolisthesis and hemivertebra surgery. The recordings were made in preoperative, peroperative and postoperative periods; the electro-physiological and anaesthetic conditions allowed us to obtain reliable recordings. Analysis of the peroperative somatosensory evoked potentials showed significant differences in latencies, but also in amplitudes and morphology during distraction in scoliosis or spondylolisthesis. These impairments gradually improved and recovered their normal values at the end of the operation. The impairments were, with equal correction, 4 times more important in Cotrel-Dubousset instrumentation than in surgical anterior correction by plating. In 3 cases, the modifications observed during instrumentation led the surgeon to change his operative behavior avoiding certainly a postoperative neurological disorder. The correlation between the neurological troubles and the impairments of the potentials allowed us to define alarm criteria, and if they persist the wake-test becomes necessary.

Adolescent↗