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M J Estève-Fraysse

Publications and source records attributed to M J Estève-Fraysse.

7 recordsLinked to original sources
PubMed1997

[Rotatory impulse test does not replace caloric tests].

We sought to determine whether the rotatory impulsional test was capable of exploring the canalar function with sufficient precision to replace the caloric test, as it has been recently affirmed. We first compared the observed preponderance from this test with that measured during a sinusoidal (20 and 4 s) test. We observed that, in the case of a significant preponderance for a given test, there was complete redondance with the preponderance observed with any other test. The rotatory impulsional test does not present any specific advantage compared to other kinetic test as far as the observation of the preponderance phenomenon. We then compared the preponderance with the results of the caloric tests and came to the following conclusions i) the absence of preponderance does not allow us to predict the absence of vestibular deficit, due to the fact that 37% of the deficits were compensated for including acoustic neuroma; ii) the presence of a preponderance does not allow a priori to say whether it is of vestibular, cervical, or central origin and systematic caloric tests shows that almost one fourth of preponderance observed is not associated with unilateral weakness iii) supposing that a clinical argument allow us to conclude as to the probable vestibular origin of a vestibular preponderance, the direction of this preponderance does not allow us to determine which side is involved. In fact, if the undercompensated deficits are 3 times more frequent than overcompensated deficits, the proportion of preponderance not linked to a significant deficit indicates that the probability of encountering a preponderance related to a specific undercompensated deficit is approximately 50%. We thus did not find in the rotatory impulsional test any specific advantage allowing us to predict the laterality of a vestibular lesion.

Caloric Tests↗
PubMed1994

[Vertigo in non-vascular diseases of the central nervous system].

Excluding vascular involvement, vertigo due to a central vestibular syndrome reflects a median or paramedian lesion of the brain stem or the cerebellum. Recurrent attacks of vertigo usually occur with peripheral lesions. Persistent acute vertigo with peripheral destruction can reveal ischemia of the brain stem. Central positional vertigo is rare and has symptomatology that is different from that of benign positional vertigo. Persistent instability has a symptomatology that is more difficult to analyse and is usually associated with a central vestibular syndrome when it is organic. Diagnosis of a central vestibular syndrome is based on detection of well-defined clinical or electronystagmographic signs of which abnormal nystagmus is primordial. Some of them such as inferior vertical nystagmus or dissociated nystagmus can localise the site. MRI has become the diagnostic procedure which is best adapted for identifying the most frequent aetiologies such as tumors, congenital malformations and multiple sclerosis.

Central Nervous System Diseases↗
PubMed1993

[Value of auditory evoked potentials and electrocochleography in the diagnosis of small acoustic neuromas. Our experience on 131 cases].

The auditory brainstem responses, in a series of 131 patients with surgically confirmed acoustic neuroma, are reported. Six groups have been individualized according to the value of the I-V interpeak latency, the synchronisation of the waveform shape and the need to perform an electrocochleography. If we exclude the sixteen cases of profoundly deafness, or cophosis, where ABR and ECoG don't permit the recording of waves, the electrophysiological investigations allowed to provide the diagnosis of retrocochlear lesion in 115 patients, for a rate of 98.26%. This high degree of sensitivity favorably with data reported in literature, and supports the reliability of this method for detection of acoustic neuroma. According to these results, our diagnosis workup of a patient suspected of having an acoustic neuroma, presenting normal ABR findings, is presented.

Aged↗
PubMed1990

[Diagnosis of perceptive deafness in adults].

The finding of perception deafness in an adult patient should set off full clinical and paraclinical evaluation, as this symptom may hide two problems requiring urgent attention. The first problem concerns the diagnosis: any unilateral and progressive perceptive deafness suggests a possible acoustic neurinoma. The second problem is one of therapeutic decision, since in all patients with sudden onset deafness the prognosis depends on an early treatment. General practitioners can use simple tests that will give them some indications on the severity of the loss of hearing, but to establish the side and cause of the deficit, additional and highly specialized examinations are always needed. Medical and hearing aids are sufficient in most patients. Surgery should be reserved to very special cases and will be contemplated or not, depending on the cause of the deafness.

Adult↗