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K Masmoudi

Publications and source records attributed to K Masmoudi.

At least 19 recordsLinked to original sources

Parkinsonism and/or cognitive impairment with valproic acid therapy: a report of ten cases.

BACKGROUND: Valproic acid (VPA) is commonly prescribed and is generally considered to have a good safety profile. Severe neurological side effects, such as acute encephalopathy or tremor, are well-known. Parkinsonian syndromes and cognitive impairment have been very rarely reported with this drug. METHODS: Ten cases of reversible parkinsonism associated with VPA in 6 women and 4 men, associated with marked cognitive impairment in six cases, are described. These side effects sometimes occurred after several years of good tolerability. RESULTS: All patients had serum levels within the therapeutic range (50-100 microg/ml). Symptoms improved several weeks or months after discontinuation of VPA therapy in every case. CONCLUSIONS: Several cases of parkinsonian syndromes have been reported in the literature, but usually in children or young adults. These symptoms had an insidious and progressive onset. Clinical features can mimic Parkinson's disease and may be confusing, especially when they occur in older patients. The mechanism of these disorders is currently unknown, but several hypotheses have been proposed. Despite the good safety of VPA therapy for several years, a drug-induced mechanism of parkinsonism or cognitive impairment must be considered in all patients treated with VPA, as discontinuation of the drug can induce significant improvement of the patient's neurological and mental status.

Aged↗

[Extrapyramidal adverse effects of veralipride (Agreal), a drug used to treat hot flushes: a propos of 17 cases].

PURPOSE: Extrapyramidal disorders associated with veralipride therapy are rarely reported and often due to a drug misuse. METHODS: We evaluated cases of extrapyramidal disorders associated with veralipride. Cases were extracted from the regional pharmacovigilance centre of Amiens database. From January 1, 1995 to September 30, 2004, cases were selected on the basis of the occurrence of extrapyramidal disorders under veralipride therapy. RESULTS: Seventeen cases of veralipride-induced extrapyramidal disorders were found. They consist of 16 menopausal women and one old man with LH-RH antagonist-induced hot flushes. Mean age was 61 years (48-73). Adverse effects were acute dyskinesia (n=2) or parkinsonian syndrome, which occurred after several months or years of treatment (n=15). Parkinsonism was associated with other extrapyramidal symptoms in 8 cases: tardive dyskinesia (n=6), postural tremor (n=3), myoclonia (n=1), and trunk dystonia (n=1). In all cases, outcome was favorable after drug discontinuation. In most cases the tablet-free interval was not respected: this may lead to prolonged striatal D2 receptors blockade. It must be added that the diagnosis was often delayed and patients were considered as suffering from idiopathic Parkinson's disease. CONCLUSIONS: Prescribers should be aware that veralipride is a neuroleptic and could induce potentially severe extrapyramidal disorders. Increase veralipride prescription is expected due to the recent restriction of hormonal replacement therapy for menopause. The physicians should also use veralipride according to the Summary of the Product Characteristics.

Aged↗

Acute aphasia in multiple sclerosis: A multicenter study of 22 patients.

Aphasia is usually considered to be rare in multiple sclerosis (MS). To determine the clinical and radiologic characteristics of MS patients with acute aphasia, the authors investigated data from 2,700 patients from three MS centers and found 22 patients with acute aphasia (0.81%). Aphasia was the first clinical manifestation of MS in eight patients (36%). Brain MRI showed giant plaques in eight cases (40%). A full recovery was observed in 14 patients (64%). Furthermore, acute aphasia did not appear to be a criterion for poor prognosis.

Acute Disease↗

[Value of maximum expiratory volume per second and peak expiratory flow monitoring in asthma. 77 patients].

A retrospective study was conducted on a sample of 77 subjects to assess the interest of computerized flowmeter "one-flow" in the diagnosis and follow up of asthma. 77 patients and a control group matched for age and sex, measured four times by day, the forced expiratory volume in one second as well as the peak expiratory flow during 15 to 30 days. The monitoring of these two variables allowed to participate to the exclusion from the study of fifteen patients whose asthma diagnosis was informed. It also allowed the confirmation of four occupational asthma. Concerning the adherence of the treatment by patients, the conclusion of the study showed that 47% of patients modified their treatment at home without consulting their doctors, 38% resorted to their doctor and only 3% resorted to the emergencies.

Adolescent↗

Changes in Fos-like immunoreactivity evoked by maturation of the sneeze reflex triggered by nasal air puff stimulation in kittens.

The sneeze reflex is a valuable tool for exploring the maturation of the respiratory control in the newborn as it alters both inspiratory and expiratory activities. Air puff stimulation of the superior nasal meatus innervated by ethmoidal afferents consistently evokes sneeze in adult cats. Such stimulation evokes only a reinforcement of expiratory activities in newborn kittens. This study demonstrates that the pattern of Fos-like immunoreactivity evoked by nasal stimulation changes during functional maturation of sneeze. Nasal stimulation evoked immunoreactivity (i) in the trigeminal sensory complex, at the levels where nasal afferents project, (ii) in the reticular formation, (iii) in the solitary complex and (iv) in the parabrachial area of mature kittens. The evoked immunoreactivity was the same in newborn kittens as in mature kittens in the projection areas of the nasal primary afferents. Fos response was less than half that in mature kittens in the reticular formation and absent in the solitary complex or the parabrachial area. Sneeze can be elicited from the time when evoked immunoreactivity in the solitary complex and the parabrachial area is above control levels. These data provide evidence that the maturation of sneeze is dependent on the development of central relays allowing peripheral inputs to be integrated by neurons engaged in respiratory control.

Aging↗

C-Fos-like immunoreactivity in the cat brainstem evoked by sneeze-inducing air puff stimulation of the nasal mucosa.

Sneeze is one of the most important protective reflex of the respiratory tract. It is elicited from trigeminal peripheral fields and results in major changes in the discharge patterns of the medullary respiratory-related neurons. The pattern of c-Fos-like immunoreactivity evoked by sneezing was explored as a structural approach to the networks involved in this particular model of trigemino--respiratory interactions. Sneezes were elicited in anaesthetized adult cats by driving air puffs to the superior nasal meatus through a catheter. Additional cats were used as controls for anaesthesia and for catheter insertion into the nostril. In sneezing cats, immunoreactivity was evoked in projection areas of the ethmoidal afferents which innervate the superior nasal meatus, e.g. the subnuclei caudalis, interpolaris and in the interstitial islands of the trigeminal sensory complex. Immunoreactivity was also markedly enhanced in the areas devoted to respiratory control in the medulla (solitary complex, nucleus retroambiguus) and in the pontine parabrachial area. C-Fos expression was also evoked in the lateral aspect of the parvicellular reticular formation in sneezing cats. This area might be of major importance in the adaptation of the ventilatory system to expulsive functions.

Anesthesia↗

Saccade deficits after a unilateral lesion affecting the superior colliculus.

A 70 year old patient with a small haematoma largely restricted to the area of the right superior and inferior colliculi is reported. Eye movements were electro-oculographically recorded 17 and 80 days after the onset of the haematoma. At the first examination, latency of lateral reflexive visually-guided saccades was asymmetrical, both in the gap task (central fixation point switched off 200 ms before the onset of the lateral target) and in the overlap task (central fixation point remaining switched on). Furthermore, latency of leftward saccades in the overlap task was increased, and accuracy of these saccades was impaired, at both examinations. In the immobility task (fixation straight ahead while lateral targets suddenly occurred) and in the anti-saccade task (saccade made away from the lateral target), the percentages of errors (saccades made to the target) were high at the first examination, and noticeably lower at the second. These results suggest that the superior colliculus plays an important role both in the triggering and inhibition of reflexive visually-guided saccades.

Aged↗

[Two-dimensional echocardiography in 100 cases of unexplained cerebral ischemic complications].

One-hundred patients with unexplained cerebral ischaemic events were explored by two-dimensional echocardiography. Thirty-nine patients showed abnormalities considered causative of embolic stroke. The most frequent cardiopathy found was mitral valve prolapse (38.5 per cent). This study suggests that unexplained cerebral ischaemic events should be evaluated by two-dimensional echocardiography and that the most frequent source of emboli to be expected is mitral valve prolapse.

Adolescent↗

[Ocular bobbing. A new hypothesis].

Three of 4 patients with ocular bobbing were typical cases while in the last case the ocular disorder was asymmetric. A neuropathologic study was conducted in 2 cases. In both use, findings included variable degrees of pontine destruction without lesion of the medulla, with extension of the lesion into the mesencephalon in 1 case. The various physiopathogenic hypotheses put forward are reviewed but none appears satisfactory. A new hypothesis is proposed, based on available clinico-pathologic data (35 published and 2 personal cases) and recent experimental studies. Two centers, one mesencephalic, the other in the medulla, could exist that would generate saccadic movements downwards, and in the pons a center would provoke inhibition of saccadic movements. Destruction of the latter could activate spontaneous saccadic movements downwards (the only possible ones remaining) with the condition that the mesencephalic generating center and its pathways are intact.

Aged↗