Biomedical subjects

M Gonce

Publications and source records attributed to M Gonce.

At least 19 recordsLinked to original sources

PubMed2005

[Gilles de la Tourette syndrome: a self-administered assessment questionnaire].

INTRODUCTION: An association of patients with Gilles de la Tourette syndrome enabled us to gather a large body of information regarding the disease manifestations, and patient-perceived consequences. METHOD: 350 questionnaires were sent to patients belonging to the AFSGT (French Association of Patients Suffering from Gilles de la Tourette Syndrome). 187 responses were received (53 percent). The patients were divided into four groups: those with motor tics, vocal tics, complex tics and complex tics with coprolalia. This last group corresponds to the DSM IV definition of "Tourette Disorder". The questions were grouped in five sections: simple manifestations, complex manifestations, family study, treatment and psycho-affective perception (social and in the context of schooling). RESULTS: The study of the simple manifestations of the disorder revealed the homogeneity of the four groups with an age of onset at on average 7 years and a male-to-female ratio of 3.5. The first signs of the disorder are motor tics of the face and neck, and the disorder shows a variable and fluctuating course characterized by periods of decreased or absent symptoms. Familial cases (58 percent) are found in all four groups. The complex signs included in part of behaviors corresponding to the definition of tics: sudden, brusque, repetitive, varied, escape despite efforts to repress them and reappearance more intensely after a period of conscious control. The complex signs also consisted of accompanying factors such as agitation, need to organize, classify or count. Treatments have been of limited success and a significant number of patients have abandoned treatment entirely. Our study demonstrates that this condition seriously affects the daily life of patients, including family and social relations, schooling and occupational life. No patients suffering from transient tics responded to our survey, but such tics were reported in family members. CONCLUSION: Overall, the condition is considered to be single family of disorders, despite the broad phenotypic spectrum, from transitory cases by children to very severe forms. Escape despite efforts to repress tics and the rebound after control tics is characteristic of the Georges Gilles de la Tourette syndrome.

Adolescent↗

PubMed1997

[Myoclonus].

Myoclonus (myos: muscles and klonos: agitation. jerk) reflect some dysfunction of the central nervous system. Their multiform clinical presentations correlate to various physiopathological mechanisms and neuropharmacological substrates, still imprecisely known. The etiologies are quite numerous but it is important to distinguish from the physiologic forms epileptic, symptomatic, essential or segmental myoclonus. The treatment, largely depending of the underlying cause, mainly includes clonazepam and valproate.

Humans↗

PubMed1993

Pars plana vitrectomy for complications of retinal arterial macroaneurysms--a case series.

Retinal arterial macroaneurysms are distinct vascular lesions with a typically benign course. Laser treatment to these vascular lesions is controversial, and has been limited to cases of persistent macular edema. Devastating vision loss can occur, however, through vitreous or subretinal hemorrhage. We describe eight cases of retinal arterial macroaneurysms associated with subretinal or vitreous hemorrhage requiring pars plana vitrectomy. Final visual acuities ranged from 20/20 to 20/400 at most recent follow up. Until reliable indicators of rupture are identified, we suggest consideration of laser photocoagulation to clinically active, identifiable retinal arterial macroaneurysms within the macula.

Adult↗

PubMed1993

Sustained-release levodopa in parkinsonian patients with nocturnal disabilities.

It is now well recognized that poor quality of sleep, with fragmentation as the main characteristic, is a common problem in patients with Parkinson's disease. The effect of a sustained-release levodopa compound (Prolopa HBS) was assessed in a long-term (12 months) study of 15 patients presenting with distressing night time symptoms prolopa HBS was administered only ante noctem, without changing the usual daytime treatment. It appeared that alleviation of nighttime akinesia, reflected by the ability to turn around in bed, was perceived as the most worthwhile improvement.

Aged↗

PubMed1986

Exteroceptive reflex myoclonus: clinical and electrophysiological study.

Clinical and electrophysiological data are reported on two patients presenting with unusual reflex myoclonus triggered specifically by exteroceptive stimulation.

Electroencephalography↗

PubMed1986

[From movements to tics: neurophysiologic aspects].

The definition and classification of tics is still based on clinical data. Furthermore, in Gilles de la Tourette syndrome, organogenetic and psychogenetic determinants are still opposed and the true automatic involuntary nature of tics is still debated. Neurophysiological assessments can provide objective data, useful in analysing the physiopathology of tics. Simple tics consist of short bursts of EMG activity (lasting usually less than 100 ms) whereas complex tics consist of prolonged EMG activity. In both cases, the reciprocal activation of antagonist muscles may be present or absent. EEG recording has revealed abnormalities in about 25 to 75 p. 100 of Gilles de la Tourette patients but these findings lack specificity. Furthermore there is no EEG-EMG correlates with conventional techniques. However Obeso et al. have shown that simple tics are not prefaced by a normal premovement EEG potential, suggesting that simple tics are physiologically distinct from normal self-paced willed movements. Overnight polygraphic sleep studies show perturbation of the normal sleep pattern and stress the fact that tics may persist during all stages of sleep. Thus electrophysiological assessments give clues to the classification of tics as true abnormal automatic movements but also demonstrate their diversity. A biochemical cortico-subcortical dysfunction can be postulated.

Brain↗

PubMed1985

[Clinical study of pergolide in Parkinson's disease].

Pergolide is thought to stimulate both D1 and D2 dopaminergic receptors. Its effects on Parkinson's disease were evaluated in an open trial, using clinical assessment scales and objective tests. Nine patients had previously been treated with L-dopa, but the drug had either gradually lost its effectiveness or produced invalidating side-effects. Pergolide in doses of 2 mg per day considerably and durably improved the parkinsonian symptoms and enabled the patients to reduce L-dopa dosage by about 50%. Dyskinesia and "on-off" phenomena partially regressed. Significant improvement was also observed in 3 of 4 patients with Parkinson's disease who had not previously received L-dopa. The side-effects of pergolide were fairly frequent in both groups, but they were relatively mild and reversible.

Aged↗

PubMed1984

Painful legs and moving toes: a syndrome with different physiopathologic mechanisms.

Six patients with the syndrome of "painful legs and moving toes" were studied. Although clinical differences were nonspecific, the EMG disclosed two subgroups: one with a simple, erratic pattern of spontaneous activities in foot and leg muscles, and the other with a complex alternating pattern in antagonistic muscles. In the first group, the physiopathologic mechanism is thought to act in the periphery: in the lumbar roots when local anesthesia of the posterior tibial nerve suppresses spontaneous discharges, or in the nerve trunk when it is ineffective. In the second group, the symptomatology may be generated centrally, implying a more general disturbance of sensorimotor control.

Aged↗

PubMed1984