PubMed Health⌕ Search

Biomedical subjects

F Lhermitte

Publications and source records attributed to F Lhermitte.

At least 73 records · Page 4Linked to original sources
PubMed1984

Pergolide in the treatment of Parkinson's disease.

Pergolide, a long-acting central dopamine agonist, was used as monotherapy in 16 parkinsonian patients. A mean daily dose of 6.3 mg resulted in 73% improvement of parkinsonian disability. Clinical improvement after acute administration of one dose of pergolide was similar to that observed after levodopa plus a peripheral decarboxylase inhibitor but at a dose 100 times lower (2.2 mg and 200 mg, respectively). The effect lasted twice as long (5 1/2 hours and 2 1/4 hours, respectively).

Adult↗
PubMed1984

[Prolonged treatment of multiple sclerosis with average doses of azathioprine. An evaluation of 15 years' experience].

Since 1967, 211 probable or definite multiple sclerosis (MS) patients have received azathioprine (100 mg daily) as primary immunosuppressive treatment. Treatment results are evaluated in 145 patients who have received prolonged (one year or more) continuous therapy and whose disability had been evaluated prospectively. The main characteristics of these patients are the following: male 45, female 100; mean age of onset of MS: 27 years; mean duration of treatment and follow-up: 67 and 115 months, respectively. 48 patients were in the progressive phase of MS at the onset of treatment; 17 of these had a stable disability score during therapy; however, the number of stabilized patients decreased significantly with duration of treatment. Among 97 patients in the remittent phase of the disease, 22 had no further bout during treatment, 41 had bouts but had no increase in disability, and 34 were aggravated; in 14 of these, secondary progression occurred during therapy. Haematologic, cutaneous, digestive and infectious side-effects occurred but were always reversible. In the subgroup of 131 patients who had received no other immunosuppressive treatment than azathioprine and in whom information was obtained at the end of 1982, 10 cancers (all of them epitheliomas) were diagnosed. The frequency of malignancy in the patients followed for 5 years or more was 10 p. 100. Five patients died from cancer (4 of 6 deaths in the remittent group). These results are compared with those of other series. It is suggested that the use of azathioprine in MS should be restricted.

Adult↗
PubMed1984

[Intention and action myoclonus disclosing occupational mercury poisoning].

A 58-year-old laboratory-glassware manufacturer was referred to hospital because of coarse "tremor" of the upper extremities of 16-months-duration. Examination showed severe intention and action myoclonus, confirmed by electromyographic recording, slight memory impairment but was otherwise normal. Mercury levels were high in blood and urine (not in CSF) and, as other causes of myoclonus were excluded, inorganic mercury poisoning, was diagnosed. Only slight unilateral intention tremor persisted after dimercaprol treatment. Inhalation of mercury vapor was the mode of contamination. Myoclonus is the hallmark of severe inorganic mercury intoxication, the main clinical and pathological aspects of which are briefly discussed.

Humans↗
PubMed1984

[Parkinson syndrome, frontal tumor and L-dopa].

A case of frontal astrocytoma revealed by an extrapyramidal syndrome and improved by L-DOPA treatment is reported. Thus, at least partly, parkinsonian signs were provoked by dysfunction of the central dopaminergic systems.

Adult↗
PubMed1983

Antiparkinsonian and antidepressant effects of high doses of bromocriptine. An independent comparison.

Ten depressed parkinsonian patients were treated with high doses of bromocriptine (rang 85-220 mg/day). Changes in the parkinsonian and depressive symptomatologies were independently evaluated by a neurologist and a psychiatrist. Rating took place before treatment after wash-out and again 8 days later. Results show a significant mean improvement of both depressive and parkinsonian symptomatologies. However, there was no correlation between the two therapeutic effects in the 10 patients. Clinical and biological implications of these heterogeneous patterns are discussed.

Adult↗
PubMed1983

'Utilization behaviour' and its relation to lesions of the frontal lobes.

A new type of behaviour, termed 'utilization behaviour', was observed among patients affected with left or right unilateral, or bilateral, frontal lesions. It is an extension of bilateral manual grasping behaviour (magnetic apraxia). The tactile, visuotactile and visual presentation of objects compels the patients to grasp and use them. This behaviour was obtained with miscellaneous utilitarian objects. For the patients, the presentation of objects implies the order to grasp and use them. It is proposed that the balance between the subject's dependence on and independence from the outside world is disturbed. With frontal lesions, the inhibitory function of the frontal lobes on the parietal lobes is suppressed. The result is a release of the activities of the parietal lobes so that the subject becomes dependent on visual and tactile stimulation from the outside world. Five cases are reported as examples: one anatomoclinical case with bilateral lesions of the frontal lobe. The role of lesions affecting different parts of the frontal lobes is discussed. The neuropathological observations lead to the suggestion that lesions of the orbital surface of the frontal lobe, and perhaps of the head of the caudate nucleus, are responsible for this behaviour.

Aged↗
PubMed1983

[Multiple sclerosis. Current status of research. I].

Multiple sclerosis (MS) affects nearly 40 000 patients in France. Many factors are mixed up in the development of MS. Epidemiologic studies demonstrate the importance of environmental factors and some possible epidemics of MS in Faroe Islands and Iceland. Recent investigations in Orkney Islands present the hypothesis of two periods of peculiar vulnerability. In Caucasians, genetic investigations show the overpresentation of antigens HLA A3, B7, DR2-DW2. It is possible that remittent MS is related to B7, DW2, DR2 and progressive MS to DR3, B8 DR3, A1 B8 DR3. This distinctions could be also applied to response to immunosuppressive treatment. However, studies of familial MS suggest that only one gene is not able to induce susceptibility to MS. Interpretation of virologic studies is difficult; recent advances in virologic research (isolation, hybridization) will perhaps demonstrate the importance of viral components in MS. Interpretation of presence of myelin basic protein, antimyelin antibodies, anti-oligodendrocytes antibodies, antigangliosides antibodies, antibrain antibodies is also difficult because identification methods are in constant progress and it is not possible to know whether these antibodies are cause or only consequence of pathologic process. Lymphocytic populations studies demonstrate that immunoregulation is probably defective in MS and that T lymphocytes subpopulations fluctuate, according to the state of the illness. Variations of NK activity are discussed. MS lymphocyte production of interferon is probably decreased. Recent advances in neuropathologic studies, central nervous system tissue cultures and in experimental demyelination are summarized. Cultures of precursors of oligodendrocytes and their maturation in vitro, selection and culture of mature oligodendrocytes, their applications to MS oligodendrocytes are emphasized. The recent models of chronic experimental allergic encephalomyelitis (EAE), the prevention of EAE by interferon, basic protein, copolymer I have already place and implication in the comprehension and treatment of MS. Virologic models are also in important progress. Interests of evoked potentials, C.T. Scan and of nuclear magnetic resonance are discussed. Main therapeutic trends are emphasized. The underlying ethic problem of the choice of a therapy is discussed.

Antibodies, Viral↗
PubMed1982

[Trichinosis of the central nervous system. One case (author's transl)].

A case of trichinosis involving the cental nervous system is presented. The neurological symptoms developed 20 days after ingestion of the larvae and 3 days after the onset of facial oedema. They consisted of behavioural disorders, tetraparesis, incontinence and oculomotor paralysis. All symptoms progressively regressed. Computed tomography showed transient low-density areas in the white matter. The main manifestations and the physiopathological mechanisms (transport of the parasite through the bloodstream, immuno-allergic reaction) of cerebral trichinosis are discussed.

Adult↗
PubMed1982

Effect of gamma-vinyl GABA in Friedreich's ataxia.

Gamma-Vinyl GABA, an irreversible inhibitor of GABA-transaminase, was administered orally in two daily doses of 250 mg to 10 patients with cerebellar ataxia (9 with Friedreich's ataxia, one with olivo-ponto-cerebellar atrophy) for at least one month in an open study. No significant difference occurred in the disability scores of cerebellar symptomatology for the group as a whole, but seven patients showed some improvement in scores with treatment and two patients claimed marked subjective amelioration. Tolerance to Gamma-Vinyl-GABA treatment was excellent. These preliminary results suggest that further studies with well-tolerated agents which enhance CNS GABA-ergic function are warranted in patients with cerebellar ataxia.

4-Aminobutyrate Transaminase↗
PubMed1982

Parinaud's syndrome: electro-oculographic and anatomical analyses of six vascular cases with deductions about vertical gaze organization in the premotor structures.

Six cases of Parinaud's syndrome, with downward (Cases 1, 2), upward (Cases 3, 4) and both downward and upward gaze paralysis (cases 5, 6) are reported. Four cases (Cases 1, 2, 3, 5) were studied anatomically using serial sections of the brain and 3 cases (Cases, 1, 4, 6) analysed electro-oculographically. In all the cases there were rather small vascular lesions in the mesodiencephalic region, sparing the oculomotor nuclei. Since the rostral interstitial nuclei of the medial longitudinal fasciculus (riMLF), located above the oculomotor nuclei, contain the final relays producing all vertical saccades, it is suggested that the different aspects of Parinaud's syndrome may result from damage to their cells or to their excitatory efferent tracts, or even to their afferent pathways. Downgaze paralysis results from bilateral lesions involving the regions located just caudal, medial and dorsal to the upper poles of the red nuclei. The critical area is probably related to the mediocaudal part of the riMLF, the lateral portion of which appears to be spared. These anatomical data, combined with the clinical observation that most downward eye movements (except slow reflex movements) are affected in the case with such paralysis, lead us to propose that it is the riMLF efferent tracts mediating downgaze and projecting on to the oculomotor nuclei that are principally damaged by the lesions. Upgaze paralysis results from unilateral lesions in or near the posterior commissure. The clinical data allow us to propose that it is also the riMLF efferent tracts, mediating upgaze, that are damaged in such cases. consequently these tracts, probably originating from the dorsolateral part of the riMLF, would decussate through the posterior commissure before they reach the oculomotor nuclei. Combined downgaze and upgaze paralysis results from bilateral lesions involving the region related to the whole riMLF on both sides. The principal conclusion is that the riMLF efferent tracts mediating upward and downward gaze have clearly separate courses in the immediate premotor structures.

Adult↗