Biomedical subjects
Publications and source records attributed to J P Lefevre.
A case of occlusion of the middle cerebral artery during a treatment with gonadotropin is reported. Such cases are unusual when one considers that these treatments are widely used. They occur after a markek ovarian hyperstimulation syndrome. Treatment is purely preventive with clinical, laboratory and ultrasonic examinations before injection of beta-HCG.
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The authors report on the case of a young woman, seven months gone, with an history of sudden onset of successive lobar intracerebral hematomas. They revealed a Rendu-Osler-Weber disease. The mechanism is discussed.
Eighty-seven patients (mean age 73 years) with histologically proven Horton's disease were followed up in 5 different specialized hospital units from 1970 to 1984. Except for one patient treated exclusively with antimalarials, all were under corticosteroids. The mean initial dose of prednisone or equivalent was 0.7 mg/kg/day and the mean maintenance dose, 10 mg/day. Steroids could be discontinued in 21 cases after 36 months on average; the other patients could not be weaned, even though 4 of them had been on steroids for more than 10 years. Side-effects were noted in 43 cases. Twenty-four patients died, mostly of cardiovascular diseases. Survival rates were 89 +/- 6.35% at 1 year, 60.2 +/- 8.7% at 5 years and 48 +/- 11.3% at 10 years. In the long run, mortality in our series proved to be exactly the same as in the general population. Nineteen patients had ocular manifestations of giant cell arteritis always from the onset, except for a fall in visual acuity; 26 relapses were observed in 18 patients, either during reduction of steroid dosage (21 cases) or after withdrawal (5 cases). In 2 cases histology showed typical lesions of giant cell arteritis after 41 and 50 months respectively under corticosteroid therapy.
Twenty-one diabetic subjects were studied; all manifested fasting hyperglycemia and elevated Hb A1C. Motor conduction velocity of the median, ulnar and peroneal nerves; F wave of the peroneal nerve; sensory conduction velocity and sensory potential amplitude of the median and ulnar nerves and H reflex were determinated immediately before and after two days of strict glucose control with an artificial endocrine pancreas. A significant and acute improvement of some electrophysiological parameters led us to presume that repair of structural lesions would be unlikely. Only a metabolic disturbance, due to hyperglycemia, can be rapidly corrected.
The case is reported of a patient who, after a left occipital infarction, presented a deficit in naming visually presented objects with neither aphasia, nor perturbation in the perceptive and associative processing of visual informations. This visuo-verbal disconnection was accompanied by disturbance of the semantic function when this was explored via the visual channel. In addition the patient showed an alexia which could be described as an abstraction defect. Finally, the patient showed a deficit in naming colors and faces, without evidence for agnosia. This observation argues in favor of maintaining a distinction between visual associative agnosia and optic aphasia. It also demonstrates that the naming deficit implies a deficit in extracting semantic values from visual informations such as objects or graphic symbols.
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The blink reflex obtained from 66 patients with multiple sclerosis (MS) shows 73% pathologic responses with MS considered as definite, 50% with MS considered as probable and only 18% with possible MS. These findings are of great diagnostical help, particularly in the absence of clinical evidence of involvement of the brain-stem. Among 8 electrological syndromes of alteration of the blink reflex, those due to large lesions of the brain-stem are often associated with definite MS, but small alterations of the blink reflex are more valuable for multifocal characterisation of the illness.
The study of 430 cerebrospinal fluids resulting from a neurological department showed 67 pathological medical cases according to following tests: intrathecal IgG synthesis and/or restricted heterogeneity with immuno-electrophoresis. We established a biological classification to approach the different etiologies. This classification was used for multiple sclerosis for which various strictly clinical classifications are not always able to diagnose the illness, as we show it for one of them.
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The authors report a series of 9 cases of meningoradiculitis after tick bites and compare them with 56 other cases in the literature. Clinically, the bite is followed by a free interval, then more or less extensive local erythema, pain then paralysis is undoubtedly the most typical presentation. Uni- or bilateral paralysis of the 7th cranial nerve was found in more than 50% of cases. Erythema may exceptionally be absent. There may be forms with pain alone. Finally, there may sometimes be pyramidal signs or signs of brain irritation. As concerns the course, one should note the absence of respiratory complications, and although there are usually no or minimal sequelae, one should note the slowness of the recovery in certain paralytic cases. In the laboratory, pleocytosis is constantly found in the C.S.F. As concerns physiopathology, there are 3 theories, virus, allergic and toxic.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A case of isolated trigeminal sensitive neuropathy revealed by a nasal ulceration is reported. Such case is quite unusual and requires a very thorough search for any local lesion or general pathology. The treatment is often disappointing.