Biomedical subjects
G M Rémillard
Publications and source records attributed to G M Rémillard.
Epilepsy and driving.
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[Chronic pain and syringomyelic slit of the posterior horns of the spinal cord].
Two male patients 46 and 44 y.o. respectively, were admitted for a syndrome of chronic pain characterized by: sudden onset, spontaneous or following spasmodic coughing, of an anterior hemithoracic pain slowly progressing to involve several unilateral cervicothoracic dermatomes, a continuous burning sensation made worse by light touch, limb movements and cold water, and partially relieved by warm water or deep palpation. On examination, patient 1 revealed no sensorimotor deficit after repeated observations during 8 years. At autopsy, a syrinx localized at the cord segments corresponding to the symptoms was found without documentation of specific causal factors. It involved the posterior horn of the cord selectively. In patient 2, pain was associated with slight hypesthesia to pinprick and heat from C2 to T5 on the left without motor deficit since 18 months. A high resolution C.A.T. scan showed an intramedullary cavity 0.3 cm from the midline in the projection of the posterior horn without anomalies at the cervicomedullary junction. These observations link chronic pain syndromes with predominantly posterior horn lesions, which so far have failed to respond to conventional therapeutic measures.
Sexual ictal manifestations predominate in women with temporal lobe epilepsy: a finding suggesting sexual dimorphism in the human brain.
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Water-drinking as ictal behavior in complex partial seizures.
The urge to demand, pour, and drink water at the time of an attack was encountered in 20 patients who had seizures with complex partial symptomatology. Two patients were studied with bitemporal stereotaxically implanted depth electrodes. Drinking was associated with electrographic and clinical seizures starting in the amygdala, hippocampus, and parahippocampal gyrus. Sometimes, this was the only clinical manifestation of an attack, and its significance would not have been recognized without depth recording. Ictal drinking was never encountered in patients without electroencephalographic evidence of temporal epileptic abnormality, and therefore seems to have localizing significance.
[Symptomatology of partial temporal lobe epilepsy].
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[The role of the physician in the rehabilitation of patients with cerebral lesions].
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Postictal psychosis after partial complex seizures: a multiple case study.
Bouts of unusually frequent partial complex seizures originating in the temporal lobe, that sometimes became secondarily generalized, induced psychotic episodes in 9 patients. In 7, the increase in seizures occurred at a time when antiepileptic drugs (AEDs) were being reduced during intensive EEG monitoring with a view to surgical treatment of intractable epilepsy. According to DSM-III-R criteria, the postictal psychosis resembled an organic delusional syndrome which was paranoid in 7 and schizophreniform in 1 and an organic mood syndrome in 1. A high incidence of ictal fear, of bilateral independent epileptogenic discharge, and of small foreign tissue lesion were unexpected findings and appeared to represent risk factors, especially in patients otherwise handicapped by an epileptic personality disorder. Recognition of postictal psychosis in this setting and in others is important both prognostically and therapeutically. Postictal psychosis does not constitute a contraindication to surgical treatment of epilepsy.