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Biomedical subjects

J Courjon

Publications and source records attributed to J Courjon.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Use of intravenous phenytoin in treatment of partial status epilepticus (author's transl)].

Twenty-two patients with partial status epilepticus were treated with phenytoin (DPH) intravenously (mean daily dose: 18,6 +/- 7,3 mg/kg). Benzodiazepines had been administered unsuccessfully in 18 cases before DPH. Seizures were stopped in 14 cases (less than 2 hours after the end of the initial dose in 13 cases). Failures were usually encountered in patients with severe brain damages. Adverse effects were observed in two patients: choreo-athetosic movements in one case with DPH plasma levels lower than 15 mg/l, cerebellar signs in the second patient whose DPH plasma level was 28 mg/l. As previously suggested by Cranford and al., the authors recommend a single slow intravenous infusion of 20 mg/kg (at a rate not exceeding 1 mg/kg/mn). The determination of DPH plasma concentrations demonstrated that with this procedure effective plasma levels are obtained during the 24 hours following the IV injection. In case of failure or of adverse effects determination of DPH plasma levels may be useful for adjusting the daily DPH dose.

Adult↗
PubMed1981

The origins of short-latency somatosensory evoked potentials in humans.

Short-latency somatosensory evoked potentials (SEPs) to median nerve stimulation were studied in three patients with well-localized lesions of the lemniscal pathways. In two patients who had focal thalamic vascular lesions, the early scalp-recorded P15 far-field potential was unaltered while later SEP components were absent. In the third patient, operated on for astrocytoma of the dorsal medulla and right dorsal funiculus, the P15 potential was absent but the earlier negative potentials recorded from the neck persisted whichever side was stimulated. The data suggest a subthalamic origin for the scalp-recorded P15 far-field potential.

Adult↗
PubMed1981

[Short-latency somatosensory evoked potentials (SEPs) in dyssynergia cerebellaris myoclonica (author's transl)].

Short-latency SEPs following stimulation of the median nerve at the wrist have been studied in 6 patients suffering from dyssynergia cerebellaris myoclonica (DCM). Cervical N14 and scalp-recorded P15 potentials were found to be normal in patients with appropriate recording conditions. The N20 potential, usually recorded in normals in the parietal region contralateral to the stimulated side, was recorded only in 3 cases out of 6. When present, the N20 potential was found to be normal in latency, amplitude and topography. These data suggest that the electrophysiological events related with information processing at the subcortical levels of the lemniscal pathways (N14, P15) are unmodified in DCM, and lend substance to the hypothesis of a cortical long-loop reflex responsible for the triggering of intention myoclonus in these patients.

Adult↗
PubMed1981

[Epilepsy beginning between 18 and 39 years of age (author's transl)].

The frequency of primary generalized epilepsies is less than 20% of the epilepsies which begin between the ages of 18 and 39. Clinical seizures are rare, apart from myoclonus. A favourable outcome is observed in 70% of the patients. Seizures of frontal origin (absences and secondary generalized aversive seizures) are frequent in this group and difficult to control with anticonvulsant drugs, as are all other kinds of partial seizures with or without secondary generalization. Rarely, an epileptic state, most often of partial character, is the first ictal manifestation of epilepsy. Head trauma is the most frequent aetiology, followed by cerebral tumours and chronic alcoholic intoxication. The aetiology of epilepsy beginning in this class of ages remains unknown in nearly 50% of cases. The CT scan tends to reduce the frequency of cases of unknown origin.

Adolescent↗
PubMed1981

[Early somatosensory evoked potentials: a means of investigation of the lemniscal pathways (author's transl)].

The recording of the somatosensory evoked potentials (SEP's) elicited by stimulation of the median nerve is a non painful and non invasive mean to investigate the function of the different levels of the lemniscal pathways: peripheral nerves, dorsal root ganglia, dorsal funiculi, brainstem, thalamus, and somesthetic cortex. Recording technique, normative data in adults and abnormalities due to neurological diseases are reviewed. This investigation appears to be of peculiar interest in lesions of dorsal roots, cervical spinal cord and brainstem. SEP's recording may also be helpful for the functional testing of the somesthetic pathways in patients with disorders of consciousness.

Adolescent↗
PubMed1981

[Course of visual evoked potentials in multiple sclerosis. Electro-clinical correlations and pathophysiological considerations in 25 patients (author's transl)].

25 Multiple Sclerosis patients had Visual Evoked Potentials (VEPs) recorded at a one year interval. Abnormal VEPs were observed at least once in 21 patients. They were the only means to assess the lesional dissemination in 9 patients. Their contribution in the diagnostic classification is such that the proportion of "definite" cases rises from 44 to 80 per cent of the 25 cases. The degree of abnormality of the VEPs had no relation to the disability status and the whole severity of the disease. The main feature ws the variability of the VEP latencies at a one year interval: they seem to follow the remittent progressive course of the disease, whether visual pathways are clinically affected or not. These results are interpreted in the light of the pathophysiological data of the disease. In the cases with improvement or normalisation of the second VEPs, "en plaque" edema may be an important mechanism, sometimes free of demyelination so that true restitutio ad integrum may occur.

Adult↗
PubMed1981

[Diagnostic value of brainstem auditory evoked potentials (author's transl)].

The present work is an evaluation of brainstem auditory evoked potentials (BAEP) as a tool for neurological diagnosis. Filtered alternate clicks with monaural stimulation and ipsilateral recording between the vertex and the ipsilateral mastoid have been used. Normative data of the laboratory established in 50 normal subjects, mean age 35 years, and criteria for interpretation are given. 155 patients had or were suspected of having multiple sclerosis. In definite multiple sclerosis (33 patients), BAEP were abnormal in 67 p. 100 of the cases, among them the 4 patients with an internuclear ophtalmoplegia. In probable multiple sclerosis (54 patients) BAEP were abnormal in 41 p. 100 of the cases and in possible multiple sclerosis (68 patients) there were 19 p. 100 with abnormalities. Results show that BAEP are clearly a useful tool for diagnosis in progressive paraplegia, in optic neuritis, and in cases in which symptoms and signs lead to discuss posterior fossa tumours. In 66 patients with suspected or proved tumours (acoustic neurinomas excluded) and in 25 patients with vascular disease, the contribution of BAEP to neurological diagnosis is of unequal interest. In some cases BAEP only confirmed the data of the clinical examination. When tumours were diagnosed with the CT scan, BAEP could help in pointing out the accurate relation of the tumour with the brainstem and the auditory pathways. In 36 patients the contribution of BAEP was important in establishing the rostral extension of bulbocervical tumours or, mainly, in indicating the presence or absence of infiltrating brainstem tumours which were not clearly apparent on the CT scan.

Adult↗
PubMed1979

Transient hyperkinesia after a single intravenous perfusion of diphenylhydantoin. Report of a case associated with nontoxic plasma levels of diphenylhydantoin.

Transient hyperkinesia was observed in a 16-year-old epileptic and mentally retarded patient after a single intravenous perfusion of diphenylhydantoin (DPH). No clinical signs of DPH intoxication were associated with the movement disorder. Repeated plasma anticonvulsant level determinations never showed toxic concentrations of DPH. Since a few spontaneous episodes of hyperkinesia had been observed before, the DPH intravenous perfusion could have unmasked a preexisting latent movement disorder in our patient. However, neuroradiological investigations failed to demonstrate the existence of any anatomical damage of the basal ganglia, and HVA as well as 5-HIAA levels measured in the CSF with the probenecid technique were within the normal range 2 months after cessation of hyperkinesia. HVA and 5-HIAA levels have also been measured in the CSF during the period with hyperkinesia; the results are discussed with reference to previously published data concerning cerebral monoamine metabolism in drug-treated epileptic patients.

Adolescent↗
PubMed1977

[Cerebral arterial embolism during extracorporeal circulation].

From October 1st 1970 to October 1st 1975, electrical and clinical post-operative observation of 1.700 operations under E.C.C. allowed record of E.E.G. and thus study incidents depending of cerebral embolism during their formation. 18 cases have been seen during E.C.C. and 2 at the stop of E.C.C. In 9 cases, it was an air embolus, in 4 others an atheromatous embolus. In the 7 remaining cases, origin of the embolus is uncertain, but probably gaseous. Semiology of the accident is first only E.E.G. In 10 cases, signs were minor, and moderate in 10 others, preceding a late but hard clinical symptomatology, frequently characterized by a delayed advent of epilepsy crisis. Later on, an annoying evolution of the accident was seen in 4 cases (1 death, 3 lasting neurologic deficiency). For the treatment, many observations confirm the highly beneficient part of early hyperbaric oxygen.

Adolescent↗