PubMed HealthSearch

Biomedical subjects

M Devic

Publications and source records attributed to M Devic.

At least 37 records · Page 2Linked to original sources

[Course of obstructions of the carotid artery in the neck. 69 cases].

This study involved 69 patients with occlusion of the internal carotid artery in the neck confirmed by angiography. Ten patients were operated upon and 59 were treated medically. The clinical course was roughly the same in both group. Of the 62 patients who survived the initial stroke, 50 could be followed-up for a mean period of 57 months at the end of which 12% had died, 16% remained with a major degree of functional impairment and 72% had little or no residual symptoms. All but one deaths were of non-vascular origin. New cerebral vascular accidents occurred in 16% of the cases, always in the territory of the occluded artery. The long-term benefits of surgical cerebral revascularisation are discussed in the light of these findings.

Arterial Occlusive Diseases

[Utilization behavior during the course of progressive multifocal leukoencephalopathy].

A particular semiologic feature of a case of progressive multifocal leukoencephalopathy was the existence of utilization behavior as described by Lhermitte. The affection developed in a patient with myeloid leukemia treated by cytotoxic drugs. Multifocal low density areas were shown by CT Scan examination. The course of the disease was not altered by isoprinozine therapy.

Adult

[Familial paroxysmal ataxia responsive to acetazolamide].

From their early twenties, a 56 year-old french woman and her 33 year-old son suffered from paroxysmal attacks of gait ataxia, incoordination of both hands, dysarthria and nystagmus. These attacks lasted from one to three hours and occurred at the rate of one to seven per week. On examination between attacks, there was only a bilateral horizontal and upward-beating gaze nystagmus. This was documented by E.O.G. Biological investigations were normal with the exception of a mild elevation of glucose blood level. Treatment with acetazolamide 250 mg daily, completely abolished the attacks in both patients. These cases meet the criteria of familial paroxysmal ataxia, a disorder only described in the United States up to the present. Although rare, this disease should be recognized because of its dramatic response to acetazolamide.

Acetazolamide

[Study of 213 cases of multiple sclerosis treated with azathioprine from 1967- to 1982].

Effects of azathioprine, 150 mg per day on average, were studied in 213 patients with multiple sclerosis. Thirty-eight case reports were excluded from the final analysis due to lack of continuous treatment (22 cases) or of complete data (16 cases). The 175 patients followed up regularly for a mean of 10 years had received the drug for from 6 months to 15 years (mean approximately 4 years). The treatment was generally well tolerated and there were no irreversible side effects. Results for the different parameters studied, when compared with those in untreated controls, showed the following features: for patients with the remittent form of MS: a statistically significant increase in cases showing no further progression, a reduced frequency of attacks (increased during spontaneous evolution of the affection), a significantly lower incidence of cases that became progressive in nature, and a general improvement in disability score at the end of follow-up. The course of the disease appeared to be more severe before treatment than in untreated cases. In patients with the progressive form of MS (47 cases) the ratio of total disability scores to number of years of observation was reduced in treated when compared with control patients, whereas this ratio was similar in both groups before treatment. General improvement in scores was therefore definitely related to treatment. These findings are in agreement with those of our 1978 study (Aimard, Confavreux et al.) and of others using the same protocol (Oger et al., and Rosen).(ABSTRACT TRUNCATED AT 250 WORDS)

Azathioprine

[Encephalitis and acute amnesic encephalopathies. Retrospective study of 16 cases (author's transl)].

A retrospective study was conducted on sixteen cases of encephalitis or acute amnesic encephalopathies, only one of which was confirmed by pathological examination, seen over the last fifteen years. The amnesic syndrome was always associated with a very marked anterograde deficiency and the absence of severe disturbances of other higher functions. Its onset was always acute, was secondary to disturbances of consciousness or associated with epilepsy, and in half of the cases presented as a severe infections disorder with high fever. The mood and behavioural disorders, and the temporal epilepsy, were evidenced clinically as a pure or predominant hippocampic lesion. The diversity of the progressive nature of the disorders, and the etiological environmental factors, enable divison into three groups : a group of six cases of postencephalitic Korsakoff's syndrome, probably of herpetic origin, and associated with a stable amnesic syndrome which remained as a sequela ; a group of 5 patients with non-herpetic but probable viral "curable amnesic encephalitis" ; another group of 5 patients with "acute amnesic encephalopathy" with various etiologies and with obvious encephalitic lesions.

Acute Disease

[Surgically treated supratentorial gliomas in the adult. Favourable action of a podophyllin derivative (VM 26) administered alone (author's transl)].

The action of VM 26 on cerebral glioblastomas was suggested by studies of phase II or protocols in which the drug was used in association. The randomised protocol presented here, involving 10 treated subjects and 11 controls, showed that VM 26 was active in terms of the duration of survival of patients undergoing surgery for a glioblastoma. The mean survival was 16.4 months as against 9.6 months in the controls (statistically significant difference at p less than 0.05). This activity would tend to characterise the drug as one of the essential factors in the chemotherapy of all malignant gliomas, in particular since it is itself free of all haematological complications, even at high doses, and causes scarcely any allergic problems.

Brain Neoplasms

[Treatment of a case of grave orthostatic hypotension (Shy-Drager's syndrome) by an association of L-dopa and mono-amine-oxidase inhibitor (author's transl)].

The authors report a case of grave orthostatic hypotension (Shy-Drager's syndrome) with major postural disturbances. The biological test confirmed a catecholaminergic deficiency. After several drugs were tried unsucessfully, an association of L-Dopa and fractionated doses of mono-amine-oxydase inhibitor was proposed. The increase blood pressure was sufficient to block the diturbances of postural adaptation, without inducing hypertensive jerks. The functionnal result have been stable for three years, while the parkinsonian syndrome have shown little progression.

Aged

[Brachial diplegia--a post ECC neurological complication of a specific type].

Five cases of neurological disorders occurring after extra-corporeal circulation are presented owing to the singular nature of the clinical picture made up by the essential element of a progressive brachial diplegia, free from any sensory disorder. The topography of the lesion--single medullary lesion or bilateral encephalic--is discussed. An anatomic document enables the elimination of any médullary involvement in one of the cases, thus pointing to a bilateral central lesion. The physiopathological problems are looked at.

Adult

[Multiple sclerosis with reduced and with normal levels of complement in the blood. Clinical and genetic correlation].

The authors describe the results of immunological assay of complement factors C3, C4 (the usual path of activation of complement) and of B factor (the alternate path of activation) in 61 multiple sclerosis patients not receiving corticoids, 52 normal controls and 217 patients with other neurological disorders. Hypocomplementaemia (fall in factor C3 related to a fall in total haemolytic activity) was found in 29.5 p. 100 of the patients not on corticotherapy at the first assay, and in 36 p. 100 of the patients when repeated assays were carried out. Hypocomplementaemia is significantly more frequent in multiple sclerosis than in the normal population (0 p. 100) and in neurological patients (9.6 p. 100). In 13.1 p. 100 of the multiple sclerosis patients there was a decrease in B factor: 50.3 p. 100 of the multiple sclerosis patients exhibited no quantitative abnormality of the main factors of complement (normocomplementary multiple sclerosis). The group of multiple sclerosis patients with hypocomplementaemia was characterized by the incidence of other abnormalities in the complement system: cleavage of the C3 factor and a fall in B factor in 60 p. 100 of the cases. A more frequent increase in IgE and measles antibodies was found also while the normocomplementary multiple sclerosis patients more frequently had higher levels of IgA. Genetically, the group with hypocomplementaemia is related to a significant increase in the incidence of the HL-A W18 group while the normocomplementary multiple sclerosis patients appear closely related to the HL-A7 group. Familial investigations show that hypocomplementaemia is usually present in the ascendents and collaterals and that it seems to be transmitted with the HL-A haplotypes. Four families gave evidence of transmission with the W18 group. This transmission sometimes occurs together with transmission of an increase in IgE and/or of measles antibodies. In two pedigrees, one of the ascendents carried in his serum an activator of the alternate path of complement. There does not appear to be any prognostic difference between the two groups. In multiple sclerosis with hypocomplementaemia, the facts suggest a complex immunological abnormality, transmitted genetically to the subject and existing prior to the illness, comprising both elements of deficient and excessive immune response. The recognized presence of a gene of immunological reactivity and of genes of synthesis of complement on the 6th chromosome, in proximity with genes of histocompatability (HL-A and M.L.C.) provides a theoretical basis for this supposition.

Adult

[Amyotrophic lateral sclerosis occuring befor the age of 40 years. Remarks apropos of 25 cases].

Twenty-five cases of amyotrophic lateral sclerosis occurring before the age of 40, collected between 1963 and 1973 in the Neurological Hospital, Lyons, have prompted the authors to make the following observations. -The incidence of disease seems to have been on the increase during this period both in absolute terms and relatively speaking (relative to the total number of patients hospitalized and to the total number of patients hospitalized for amyotrophic lateral sclerosis after the age of forty). -The 25 cases involved mostly women--the opposite of what was found in cases of amyotrophic lateral sclerosis occurring after forty. -Only one was possibly familial. -The onset is mostly with purely pyramidal features or of the topographically circumscribed peripheral type. Development appears to take longer than the average for amyotrophic lateral sclerosis. It would be worth while confirming these findings by analysis of other similar groups.

Adult

[Pure (dynamic ?) agraphia of frontal origin. Apropos of one case].

A case of pure graphic disorder without any disorder of speech, reading or praxis is described. The conditions under which it occurred after surgery for frontal oligodendroglioma would seem to confirm that a single frontal lesion is involve affecting in particular the foot of F2. This case is compared with similar ones which have appeared in the literature and are classified within the wider category of kinesthetic disorders caused by frontal lobe lesion.

Agraphia