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H Vespignani

Publications and source records attributed to H Vespignani.

52 records · Page 3Linked to original sources

[Changes in somatosensory evoked potentials during EEG activation by bemegride in man].

The use of evoked potentials for the evaluation of neuronal mechanisms by which convulsant drugs activate epilepsy and produce seizure has been reported by many authors. Electrophysiological effects of bemegride with augmented responsivity of brain structure to sensory stimulation is well known, especially in experiments performed with implanted electrodes in animals. After recording evoked activity from parietal scalp following median nerve stimulation before and during 12 human EEG activations by bemegride, the authors find an increase in amplitude of cortical somatosensory evoked potentials. Changes in amplitude after diazepam administration are analysed, as well as morphological changes preceding and following grand mal seizures induced by bemegride administration. This variation in amplitude of evoked responses is compared with those recorded in animals with several convulsant drugs and in man affected with progressive myoclonic encephalopathies. A common action of these agents, beyond their effects on specific neurotransmitters (perhaps mediated by a blockade of neurotransmitter-induced chloride conductance increases), is discussed.

Adolescent↗

[Changes in the semeiology of epileptic seizures after status epilepticus: apropos of 65 cases].

In 65 patients with status epilepticus, we compared the clinical expression of isolated seizures and of status seizures. In 22 patients there was no relationship between status and isolated seizures. In addition the number of partial status is greater than that of partial seizures. In 9 patients, the type of seizures was modified after the status. From these results, status epilepticus seems to favor the eruption of secondary epileptogenic focuses, generally transitory.

Adolescent↗

[Nontumoral nervous complications of bronchial cancer].

The authors present 52 cases of neurological complications of bronchial cancer including 35 cases of non-tumoral manifestations. They stress the frequency and the severity of these complications which are dominated by cerebral vascular accidents and describe the pathogenic features of this particular complication. They define the complications accessible to treatment: iatrogenic pathology, deficiency disorders and certain paraneoplasic syndromes.

Adenocarcinoma↗

[Frequency and semeiological evolution of epileptic seizures occurring between 40 and 65 years of age (author's transl)].

458 patients who had their first epileptic fit between the ages of 40 and 65 are classified into 5 groups according to the seizure symptomatology: when the symptomatology remains unchanged, the frequency of fits is less than 1 per month in 84% of generalized fits and more than 1 per month in 52% of focal fits. When the symptomatology changes, the frequency of fits is less than 1 per month when the inaugural fit is generalized (23 out of 27) and more than 1 per month when the inaugural fit is focal (15 out of 21). Modifications of the symptomatology correlate positively with a prevalence of tumor aetiology. Primary generalized epilepsies are rare (4.4%). Non-specific secondary generalized epilepsies (including vascular, metabolic or toxic encephalopathies) account for 24.4% of the cases. Focal epilepsies are the most common form (40.7%), elementary fits being four times more frequent than complex fits.

Adult↗

[Bilateral mental neuropathy revealing prolymphocytic transformation of chronic lymphocytic leukemia].

Authors report an original case of mental neuropathy which reveal prolymphocytoid transformation of Chronic lymphocytic leukaemia. They discuss various pathogenic hypotheses which can join these two events; these are evolutive markers of bad prognosis concerning this hemopathy. Clinical, etiopathological and prognostic features of mental neuropathy associated with hemopathies are studied through this case.

Aged↗

[Contribution of electromyography to the study of ulnar nerve lesions in the hand. Compression syndrome of the motor branch of the ulnar nerve (author's transl)].

Standard electromyographic investigations: detection and stimulodetection; segmental motor nerve conduction rate, distal motor latencies (interphalangeal V and I short abductor muscles), and distal sensory (antidromic) conduction time, were used to explore seven cases of distal paralysis of the ulnar nerve. Results enabled differentiation of elective lesions of the deep motor branch from those of the ulnar nerve in Guyon's canal. These two types of lesion correspond to precise anatomical features: the channel between the pisiform and unciform bones on the one hand and Guyon's canal on the other. The electroclinical syndrome of the deep branch should be considered as a separate true canalicular syndrome. Treatment is by surgery in most cases.

Electromyography↗

[Ethical approach to informed consent for participation in clinical studies in acute cerebral infarct].

OBJECTIVE: We sought to evaluate the application of the French law for the protection of persons participating in research studies in biology and medicine. Specifically, we examined comprehension and consequences of informed consent procedures in the field of stroke, characterized by an emergency setting, cognitive impairment and poor prognosis. PATIENTS AND METHODS: Patients (or proxies) included in recent years in clinical studies conducted in our Neurology Department for evaluating treatment of acute phase cerebral ischemia were interviewed to determine their knowledge of the disease, its treatment, the study protocol and the legal regulations, and the affective and psychological consequences of the informed consent procedure. RESULTS: Among 72 patients included in 7 studies ([fibrinolytic agent: 3 (n = 43), anticoagulant agent: 1 (n = 4), neuroprotective drugs (n = 25)], [7 randomized studies, 6 double-blind versus placebo, 5 with a 6-hour inclusion time interval]), 15 died during the acute phase, 5 were lost to follow-up, 4 refused to participate and 7 gave very partial answers. Consent was signed by the patient in 15% of cases, the spouse in 50%, a descendant in 23%. These persons were aware of the spontaneous risk of death (85%) or definitive functional impairment (95%). Half of them thought a specific treatment existed, 11% had some idea of the mechanism of action of the proposed treatment while 67% learned about this mechanism from the information provided. Although they had received information, only 25% of the patients had knowledge of placebo and 7% of therapeutic risk. 37% expected complete recovery from the treatment, 44% partial recovery, and 13% were very disappointed by the outcome. 81% felt they were free to make their own decision. Although 86% did not know there was a law protecting them, 82% were in agreement with the requirement for their consent while 17% would have preferred to delay consent. Most wished to be given the opportunity to discuss the study again, after the acute phase, and to receive the results of the study. CONCLUSION: This study shows that most French stroke victims and their closest relatives are unaware of the law protecting persons in biomedical research and have poor knowledge of medical data after being given appropriate information. Even so, the quality of information increases the quality of the patient-physician relationship. Patients want to be free to make their own decision to consent to biomedical research, but their desire was more for good information than for the power to make their decision alone. Being asked to give informed consent in order to participate in a clinical study accentuates the affective and psychological consequences of stroke, a factor which should be taken into consideration during follow-up.

Acute Disease↗