Biomedical subjects
Publications and source records attributed to M Bouffard-Vercelli.
Clinical configuration of borderline period of awakening is described based on the triangular relation (Patient, Family, Care Team) beginning during coma. The possible suffering before awakening (regressive attitude, downfall of immune defences, and so on ...) evokes a sort of reply of trauma and the hypothesis that mechanisms of "negative hallucination" play a part in post-traumatic amnesia.
The question of head trauma reasons, and the shock of traditional family and therapeutic references, make the authors examine clinic coma evolution till awakening. From signs of libidinal values collected by care-team, another way during coma and till life recovery, is rebuilt.
A hundred patients with multiple sclerosis and urinary disorders were examined clinically and by gas or water cystometry. Particular attention was paid to abnormalities in the voiding need sensation. These abnormalities can best be studied by cystometry combined with urethral striated sphincter electromyography. When the sequence of the three degrees of need (usual need, pressing need and urgent need) is respected, there is a good correlation between the progression of the voiding need during the filling phase of the cystometry and during the detrusor action. When there is interference with the sequence of these three degrees of the voiding need, especially the absence of the sensation normally contemporaneous with the detrusor action or immediately preceding it, there is exaggeration of either the hyperactivity or the hypoactivity of the bladder, and this aggravates vesical sensitivity: premature contraction of the detrusor muscle eliminates the first two degrees (usual need and pressing need), while progressive distension of the detrusor muscle eliminates all three stages. As the multiple sclerosis evolves a stage is reached at which there are functional mictional disorders exclusively connected with the interference with the degrees of voiding need pollakiuria and urgency.
Sympathetic skin responses (SSRs) were recorded in six spinal cord injured patients. These SSRs were obtained at hands and feet, after electrical stimulation of the median or the posterior tibial nerves. Below the level of the lesion, SSRs had similar latencies than normal subjects, but were more inconstant, with a lesser amplitude and elicited after stronger stimulus intensity. The origin of these somatosympathetic reflexes are discussed. SSRs recordings seem to be a simple and suitable technique for investigation of the autonomic nervous system of the spinal cord injured patients.
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