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Biomedical subjects

G Rancurel

Publications and source records attributed to G Rancurel.

At least 91 records · Page 5Linked to original sources
PubMed1985

Acute migraine attack therapy: comparison of naproxen sodium and an ergotamine tartrate compound.

The efficacy of safety of naproxen sodium and ergotamine tartrate were compared for the treatment of acute migraine attack in a randomized, parallel trial with 114 participating patients. At the start of symptoms, patients took either three tablets of naproxen sodium (275 mg each) or one of an ergotamine combination (containing 2 mg ergotamine tartrate, 91.5 mg caffeine, and 50 mg cyclizine chlorhydrate). Patients were followed for three months or until six attacks were monitored, whichever came first. Both medications substantially shortened the duration of migraine attacks and reduced the severity of symptoms. When the test medications were taken within 2 h of onset of attack, naproxen sodium was statistically significantly more effective than the ergotamine combination in reducing the severity of headache pain, nausea, and lightheadedness. The ergotamine combination was associated with significantly more vomiting, need for rescue medication, and side effects than was naproxen sodium. Four patients required discontinuation of the ergotamine combination and one of naproxen sodium. Both patients and investigators rated tolerance for naproxen sodium as superior to tolerance for the ergotamine combination. Naproxen sodium seems to be an effective and safe treatment for migraine attacks.

Acute Disease↗
PubMed1985

[Hemichorea and oral contraceptives].

A 26 year-old woman presented with a left hemichorea while taking oral contraceptives (a combination of ethinyl-estradiol and norethisterone). There was marked improvement of the choreic movements after discontinuation of the oral contraceptive and complete resolution by 6 weeks. Induction of chorea is a rare complication of oral contraceptives. The possible mechanisms are briefly reviewed.

Adult↗
PubMed1985

[Retinal, muscular and cutaneous cholesterol emboli. Progressive encephalopathy].

A 73 year-old man experienced left monocular blindness and transient right hand clumsiness. A left carotid arteriogram was performed 4 days after admission. Immediately following arteriography, there was a right hemiparesia and dysphasia. After 24 hours, the abnormalities resolved. The patient was treated with heparin. During the following weeks, he became gradually drowsy and confused. Pseudo-bulbar palsy and astasia appeared after a fluctuating but progressive neurological course. The combination of systemic symptoms, high sedimentation rate, renal failure, livedo reticularis and purple toes suggested necrotizing angiitis. With corticosteroid treatment, there was a slight improvement of systemic symptoms. Cholesterol emboli were seen in both fundi. Cholesterol embolization was proved by identifying the biconcave cholesterol crystal clefts in muscle and skin biopsies. The subsequent course was marqued by continuous neurological deterioration. The patient became stuporous and died 7 months after admission. Despite the lack of central nervous system pathological study, the clinical picture was highly suggestive of cerebral cholesterol embolism. A few cases have been reported, with only eight well-documented clinical descriptions. Clinical signs and symptoms were closely similar to those of the present case. Anticoagulant therapy of cholesterol emboli has been unsuccessful. In the present case, the onset of embolization was temporally related to anticoagulation.

Aged↗
PubMed1983

[Acquired cerebral toxoplasmosis in adults. Clinical and neuropathologic study].

Two cases of acquired cerebral toxoplasmosis in adults are reported. In the first case no subjacent disease was found, and the neurological signs were of a meningo-encephalitic type with disorders of consciousness and a C.S.F. cellular reaction. A second case was observed in the course of the treatment of Waldenström disease by chloraminophene. The neurological signs were bifocal, and the C.S.F. showed a moderate increase of protein. In both cases C.T. scan showed contrast enhanced and hypodense areas. In the first case the enhancement was heterogenous and the hypodense area occupied the whole right hemisphere. The second case showed two ring enhancements in the left frontal and the right occipital regions. A cerebral biopsy was performed in both cases but no parasite was found. The diagnosis was presumed to be malignant lymphoma or encephalitis in the first case, glioblastoma in the second. No specific treatment was administered and the patients died within a few weeks. The complete pathological study by light and electron microscopy showed free and cystic forms of Toxoplasma Gondii. The results of the neuropathological examination and the thorough study of the biopsy specimens were compared to the pathological findings in the literature. The particular character of the necrosis and the inflammatory encephalitic reaction in the absence of the parasite may suggest the diagnosis when the clinical, biological and radiological data are compared.

Aged↗
PubMed1982

Myelin basic protein in CSF and blood. Relationship between its presence and the occurrence of a destructive process in the brains of encephalitic patients.

Serum and CSF levels of myelin basic protein (MBP) were measured in 50 patients with encephalitis of various origins and severity. In nearly 50%, the CSF samples were found to display immunoreactivity of MBP. Positivity was found to be correlated with the severity of the clinical signs. More precisely, it corresponded to cases with suspected extensive brain destruction. No relationship could be observed with the cause of disease. Positive tests of sera were infrequent, even from patients whose CSF was rich in MBP. Longitudinal studies performed on 20 patients who were serially investigated during periods ranging from three weeks to 18 months demonstrated that after an attack, MBP liberation into the CSF persists for one to three weeks. The MBP assay should serve as an index for destruction of nervous tissue.

Encephalitis↗
PubMed1981

Epileptic phenomena in bismuth toxic encephalopathy.

Seventy patients admitted to hospital with bismuth encephalopathy had repeated clinical and EEG examinations. All the patients exhibited myoclonic jerks, but no paroxysmal features ever appeared on EEG. Computed tomography showed cortical hyperdensities. Seizures were observed in 22 patients, but epileptic EEG patterns appeared only when the bismuth blood level was below 1500 microgram/1. It is suggested that a high cortical intracellular bismuth concentration induces a "cortical inhibition" which causes suppression of physiological electrical brain activity, the absence of EEG paroxysmal phenomena during myoclonic jerks, and explains the rarity of epileptic seizures.

Adult↗
PubMed1980

[The treatment of peripheral neuropathies in a case of IgA myeloma and one of mixed cryoglobulinaemia. Repeated plasmapheresis (author's transl)].

Peripheral neuropathies were the presenting feature of an IgA lambda myeloma in a 61-year-old man and a mixed cryoglobulinaemia in a 46-year-old woman. A spectacular improvement in these symptoms followed treatment including large volume plasma exchanges with appropriate chemotherapy. This efficacy of repeated plasmapheresis leads to a discussion of the possible mechanisms of these neuropathies.

Cryoglobulins↗
PubMed1980

[Acute spongiform leucoencephalopathy with selective intramyelinic involvement of U fibers associated with an ovarian carcinoma. Syndrome of disconnection of U fibers (author's transl)].

Case report of clinical, pathological and ultrastructural features in an acute spongiform leucoencephalopathy with selective involvement of U fibers. A 52 years old woman exhibited an acute encephalopathy of 2 months duration, with dementia and multifocal impairment of cortical functions. The cerebral cortex was normal. This acute dementia resulted from a diffuse intercortical disconnection. Spongy degeneration was only found in U fibers. No other changes were noted especially in basal ganglia, optics tracts, and spinal cord. The white matter status spongious was related to an intramyelinic oedema. Such intramyelinic oedema is known only in Van Bogaert and Bertrand and Canavan disease, which is quite different, and in toxic encephalopathies, especially those induced by the hexachlorophene and triethyltin. In the present case no drugs or toxins were found. An ovarian carcinoma was found at post-mortem examination.

Acute Disease↗
PubMed1979

[Chronic inflammatory neuromyopathies in adults treated for gluten-sensitive enteropathy. A report on three cases with microvascular nerve and muscle lesions (author's transl)].

Neuromyopathies developed in three patients with gluten-sensitive enteropathy, a long time after they had been cured of their digestive disease by following a gluten-free diet. These cases differed radically from typical deficiency neuropathies by the presence of microvascular inflammatory lesions in nerves and muscles. The semiological findings were similar in all 3 cases, and were distinguished by the association of signs eveking lesions of the largest myelinated nerves fibers to the posterior rami with lesions in the muscles. Corticotherapy improved the condition but did not affect its chronic course. Nerve and muscle biopsies revealed the presence of segmentary microrascularitis, mainly lymphohistiocytic. The probable mechanism of these histological changes is alterations in the circulating immune-complexes, usually found in gluten-sensitive enteropathy, producing various types of associated disorders. Some of these immune-complexes would not be related straight to digestive intolerance to gluten, but would persist during the gluten-free diet period, and could be responsible for the micro-angiitis.

Adult↗