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Biomedical subjects

M Tournilhac

Publications and source records attributed to M Tournilhac.

At least 19 recordsLinked to original sources
PubMed1996

[Neurogenic muscle hypertrophy: 3 cases].

Three cases of neurogenic muscular hypertrophy are reported. First case presented a hypertrophy of one calf following S1 radiculopathy; the second had a hypertrophy of tibialis anterior muscle, five years after a compressive injury of the common peroneal nerve. The third case is a global hypertrophy of leg muscles after intensive care or legionella neuropathy. Previous cases of the literature are reviewed and the various pathophysiological hypothesis are considered. Among these hypothesis, the role of abnormal electrophysiological activities in most previous cases, as well as in ours (namely complex repetitive discharges and fasciculations), seems the most consistent.

Adult↗
PubMed1995

Narcolepsy associated with arteriovenous malformation of the diencephalon.

Narcolepsy associated with localized brain lesions is rare, and few reports of well-documented cases have been published. We describe the case of a 20-year-old male (HLA DQw1 negative) who fulfilled clinical and polygraphic criteria of symptomatic narcolepsy. Narcolepsy in this patient was associated with an arteriovenous malformation involving the structures around the third ventricle. Clinical symptoms improved after embolization and radiosurgery. These findings support the hypothesis that lesions in the vicinity of the third ventricle can cause symptomatic narcolepsy.

Adult↗
PubMed1995

[Cervical spinal cord compression caused by ossification of the posterior vertebral ligament. Apropos of a case].

Progressive cervical myelopathy due to an ossification of the posterior longitudinal ligament (OPLL) appeared in a sicilian women. Diagnosis was made by lateral conventional tomograms and CT Scan with mielography. Corporectomy of the 5th vertebra and ablation of the ligament dramatically improved the clinical symptoms. If OPLL seems a common cause of cervical myelopathy in Japan, it is very rate in Caucasian people. Instead of the origin of the patients, progressive tetraparesis of the 60 years old people is the usual presentation of this affection. The cause of OPLL remains unknown: genetic factors, vitamin A, association with diffuse idiopathic skeletal hyperostosis, calcium metabolism abnormalities are discussed. As far as surgical treatment is concerned, choice between anterior and posterior decompression is clarified on the basis of the type and the extension of OPLL.

Adult↗
PubMed1994

[Autoimmune familial myasthenia in 2 sisters with a follow-up of more than 30 years].

The clinical course of two sisters with myasthenia initially published in La Revue Neurologique in 1960 has been followed. Both had secondary severe respiratory impairment requiring a tracheotomy and mechanical ventilation. Thymectomy was performed in both and revealed residual thymic tissue. Complete remission was observed long after thymectomy even with the persistence of antiacetylcholine receptor antibodies which are still present in the older sister despite intercurrent autoimmune thyroiditis and in the younger sister despite the development of mediastinal lymphosarcoma leading to death 32 years after the onset of myasthenia.

Adolescent↗
PubMed1994

Apomorphine and diphasic dyskinesia.

We report on three observations of parkinsonian patients with levo-dopa-induced diphasic dyskinesias, who received subcutaneous apomorphine to reduce the duration of abnormal movements. Apomorphine was effective in reducing the duration of diphasic dyskinesias at doses higher than the threshold doses necessary to induce an "on" phase (mean increase: 43%). However, after a few months of treatment, apomorphine was ineffective in stopping abnormal movements, even when doses were increased. In two patients, apomorphine remained effective in the morning, but increased the intensity of the dyskinesias in the afternoon. Acute diurnal variations of the pharmacodynamic striatal response are suggested explanation for these clinical observations.

Aged↗
PubMed1993

Relation between clinical efficacy and pharmacokinetic parameters after sublingual apomorphine in Parkinson's disease.

Apomorphine was administered sublingually in two single doses (0.3 and 0.6 mg/kg) to seven patients with idiopathic Parkinson's disease (PD) to assess the relation between clinical efficacy, dosage, and pharmacokinetic parameters of apomorphine. On day 1 and day 3, patients were given 0.3 mg/kg and 0.6 mg/kg of apomorphine, respectively (3 mg tablets). Before apomorphine administration and during the following 4 h, motor score was assessed by measuring tremor, akinesia scores, rising from a chair, and walking speed. The delay to turn on was not different between the two doses but after the 0.3 mg/kg dose, only three patients turned on, whereas all the patients treated with 0.6 mg/kg turned on. Apomorphine (0.3 mg/kg) induced a shorter duration of the "on" period than 0.6 mg/kg (0.3 mg/kg: 24.2 +/- 14.6 min; 0.6 mg/kg: 86.7 +/- 14.9 min). The time to obtain the peak plasma concentration (tmax) obtained with the two doses were not different (0.3 mg/kg: 31.5 +/- 3.4 min; 0.6 mg/kg: 38.3 +/- 2.8 min). Peak plasma concentrations (Cmax) and areas under the curve (AUC) were significantly higher after 0.6 mg/kg than 0.3 mg/kg (Cmax: 0.3 mg/kg: 7.5 +/- 3.2 ng/ml; 0.6 mg/kg: 22.7 +/- 3.6 ng/ml; p < 0.01; AUC: 0.3 mg/kg: 929 +/- 109 ng/ml/min; 0.6 mg/kg; 2,277 +/- 209 ng/ml/min; p < 0.01). There was a significant linear correlation between the duration of therapeutic effect, AUC, and Cmax (r = 0.86, p < 0.01 for AUC; r = 0.63, p < 0.05 for Cmax). These results show that sublingual apomorphine could be of interest in the treatment of "off" phases in parkinsonian patients with motor fluctuations.

Administration, Sublingual↗
PubMed1993

Apomorphine in treatment of Parkinson's disease: comparison between subcutaneous and sublingual routes.

The efficacy of two routes of apomorphine, subcutaneous (SC) and sublingual (SL), successively administered in 7 Parkinsonian patients with motor fluctuations, was compared in reducing the daily duration of "off" phases. The mean duration of SC and SL treatment was 7.7 and 6.8 months respectively. The mean time spent in "off" phase was 55% after SC and 68% after SL treatment. The mean time before turning "on" after an "off" period was 14 minutes after SC and 28 minutes after SL treatment. Two patients developed stomatitis after SL route. SL apomorphine may be helpful in the treatment of motor fluctuations in PD.

Administration, Sublingual↗
PubMed1993

[Demyelinating involvement in Borrelian neuropathies].

Five patients (4 men, 1 woman, aged 51-67), were hospitalized for peripheral painful neuropathies. The serological survey and the dramatic responses to penicillin confirmed the responsibility of Borrelia burgdorferi in all 5 cases. Electromyographical studies showed evidence of demyelination: prolonged distal latency, slowing down of nerve conduction velocity. In 3 patients this pattern was related to axonal degeneration as shown by fibrillation potentials and reduced voluntary motor unit potentials recorded on needle examination. The other two showed no axonal degeneration. One also had motor conduction blocks. Such a demyelination could be due to vasculitis of the vasa nervorum described in tick-bone meningoradiculitis.

Aged↗
PubMed1992

[Sublingual administration of apomorphine in the treatment of motor fluctuations in Parkinson disease].

Apomorphine, a mixed dopaminergic agonist was given sublingually to 12 patients with Parkinson's disease disabled by severe on-off fluctuations. The patient's mean age was 57 years and the duration of Parkinson's disease was 12 years. All patients were also given domperidone (60 mg/day). Apomorphine was administered as soon as the off periods appeared. On periods were observed in 11 patients, with a mean apomorphine dose of 40 mg for each administration (extremes values: 20-60 mg). One patient had no motor benefit after an apomorphine dose of 120 mg. The mean duration of daily off periods was reduced by 64 per cent in 11 patients, for a mean duration of 8 months (extremes values: 2-12 months). Four patients developed stomatitis or gingival edema and stopped treatment. This pilot study shows that sublingual apomorphine, during a mean period of 8 months, significantly decreases off periods in parkinsonian patients. Others studies are necessary to confirm these results.

Administration, Sublingual↗
PubMed1991

Relation between plasma concentration and clinical efficacy after sublingual single dose apomorphine in Parkinson's disease.

Five patients with Parkinson's disease were given a single sublingual dose of apomorphine in 3 mg tablets (2 patients received 18 mg and 3 patients took 39 mg). The therapeutic effect appeared within 33.0 min and lasted 137 min. There was a significant correlation between peak concentration, area under the curve, dose (mg/kg) and the duration of the therapeutic effect.

Administration, Sublingual↗
PubMed1991

Detection of Epstein-Barr virus sequences in primary brain lymphoma without immunodeficiency.

We searched for Epstein-Barr virus (EBV) sequences by enzymatic DNA amplification in nine primary brain lymphomas from patients without immunodeficiency. We used seven nonlymphoma brain tumors as negative controls, and the Raji cell line as a positive control. We detected EBV DNA, using ethidium bromide-stained-agarose minigel electrophoresis and dot blot hybridization, in the positive control and in only one brain lymphoma tumor; we did not detect EBV DNA in the other tumors. The EBV-positive patient had a second B-cell monoclonal population in the peripheral blood without detectable EBV DNA, suggesting a direct role for EBV in the development of the brain lymphoma.

Brain Neoplasms↗
PubMed1990

[Polymyalgia induced by topical minoxidil].

Topical minoxidil, used in the treatment of baldness, has been commercially available since 1987. Its systemic side effects are rare. We observed an as yet unreported "polymyalgia syndrome" in four otherwise healthy males whose sole medication was topically applied minoxidil. They experienced fatigue, weight loss and severe pain in the shoulders and pelvic girdle, suggesting connective tissue disease. Three patients had a transient rise in liver enzymes, while other laboratory analyses remained normal. Tritanomaly was detected in two patients who underwent systematic color vision testing. All symptoms disappeared after withdrawal of minoxidil. Rechallenge was positive once in one patient and twice in another. The mechanism of this side effect remains to be determined.

Administration, Topical↗
PubMed1989

[Neurologic involvement in campylobacter infections. 5 cases].

Campylobacter are a newly recognized class of human infectious agents. Campylobacter fetus subspecies fetus is a cause of sepsis in immunocompromized hosts. Secondary neurological determinations, meningitis and meningoencephalitis appear to be rare. We report 2 cases, and 8 previously reported cases are reviewed. Campylobacter jejuni appears to be a common bacterial pathogen causing a syndrome of enteritis. Since 1982 it has been associated with Guillain-Barré syndrome (GBS). In one serological retrospective study, Campylobacter jejuni was the most common single pathogen identifiable in association with GBS, and these cases were significantly more severe. We report 3 cases with weakness and amyotrophy of distal limbs. Only 10 other cases have been found in the literature. Diarrhoea antedated the neurological illness by 4 to 21 days. In 4 syndromes of Miller-Fisher the prognosis was good. However electrophysiological axonal loss was reported in 6 GBS with poor functional prognosis. The pathogenic role of bacterial toxins and humoral immune response are discussed. Cross-reactivity between Campylobacter jejuni and human sciatic nerve proteins has not been demonstrated using sera from patients with GBS and serological evidence of Campylobacter enteritis.

Adult↗
PubMed1988

[The kidney in Refsum's disease. Clinical, histologic and ultrastructural study of a case].

A renal biopsy was performed in a 41 year old man with Refsum's disease, following the onset of renal failure. 30% of the glomeruli were sclerosed, the others appeared normal. Ultrastructural examination revealed several types of inclusions within the tubular epithelial cells: dense bodies, simple or complex lipidic vacuoles and particularly structures composed of quadrangular microtubules with sides measuring 400 angstrom, rarely encountered in renal pathology. These dense elements, devoid of membrane and often in close contact with lipidic vacuoles, are found within the epithelial cells of the distal convoluted tubules and Henle's loops. They were localized extramitochondrially and no specimen was suggestive of a degraded form of the mitochondria. Some analogy can be made with the renal inclusions observed in Gaucher's disease.

Adult↗
PubMed1987

[Therapeutic problems posed by hemiballism of metastatic origin].

A 40 year old woman undergoing treatment for cancer of the breast presented with metastatic hemiballism. Diagnosis was supported by the presence of bone and liver metastases and by CT-scan showing an enhanced rapidly growing lesion in the subthalamic region contralateral to hemiballism. Treatment by corticotherapy and neuroleptics was ineffective. Radiotherapy was unsuccessful. Metastatic hemiballism is a rare disease with no effective treatment.

Adult↗