[Abscess of the cauda equina].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J Pelissier.
Explore the source record for details and available documents.
The particular value of clinical, radiological and electromyographical features is compared in 42 patients with motor deficit related to cervicarthrosic myelopathy or amyotrophic lateral sclerosis. The initial onset of the disease was identical (motor deficit and long tracts pathways involvement). Three different groups were identifyed according to the evolution: -- Group I: (13 cases): true lateral amyotrophic sclerosis which were not operated on. -- Group II (10 cases): myelopathy called "cervicarthrosic" because of radiological findings which were operated on but had the same steady worsened course as a lateral amyotrophic sclerosis. -- Group III (19 cases): cervical myelopathy which had surgery. The operation brought about stabilization or fairly good recovery over the 18 months following at least. From a clinical aspect, the "Lhermitte sign" or objective sensitive deficit are strongly significant for cervical myelopathy. On the contrary, diffuse fasciculations specially in the tongue seem to be mostly found in lateral amyotrophic sclerosis, whereas they are restricted into the paralysed area in cervical myelopathy. Electromyographic examination is decisive: simple activity with high frequency motor units (increased amplitude and polyphasic waves) or "preponderant potentials" into a cranial nerve territory or three segments of the lower limbs are frequently found in lateral amyotrophic sclerosis. These electromyographic features are less significant in the upper limbs. The neuroradiological findings lonely cannot assert definitely the cervicarthrosic origin of the myelopathy but visualize the conflicting situation between the spinal cord and the cervical canal and allow to choose the surgical procedure.
The complications of modern surgical and radiotherapeutic methods of treating mammary neoplasms are studied on the basis of 36 cases. Although swollen arms are rare nowdays following the development of greater pectoral conservative mammectomy, lesions of the shoulder and post-radiotherapy plexal paralysis represent a heavy price to pay for these methods. Shoulder lesions are of two types with different prognosis : scapulo-humeral periarthritis, which is very frequent (22 cases) and related to post-radiotherapy axillary fibrosis, and glenohumeral radio lesions (2 cases), which result in blockage of the humeral head because of necrosis. The brachial plexus may be injured by high-energy irradiation. These pathological conditions of the plexus (11 cases), often associated with a painful syndrome that is intolerable, objective sensory disorders, and a motor deficiency that is poorly systematized, are difficult to differentiate clinically from cases of paralysis resulting from invasive neoplasms. Often it is possible to distinguish between them only by means of biopsy, which is difficult. Therapy of these plexopathies is difficult and is usually palliative, necessitating, in particular, the use of neurosurgery of the pain (radicotomies and cordotomies) rather than of neurolyses, the results of which are disappointing.
Explore the source record for details and available documents.
Explore the source record for details and available documents.