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Biomedical subjects

P Lacert

Publications and source records attributed to P Lacert.

At least 19 recordsLinked to original sources

On subtypes of developmental dyslexia: evidence from processing time and accuracy scores.

Phonological dyslexics (Ph-DYS) are characterized by a phonological deficit, while surface dyslexics (S-DYS) are characterized by an orthographic deficit. Four issues were addressed in this study. First, we determined the proportion of Ph-DYS and S-DYS in a population of French dyslexics by applying Castles and Coltheart's (1993) regression method to two previously unused diagnostic measures: pseudo-word and irregular-word processing time. Thirty-one dyslexics were matched to 19 average readers of the same age (10 years, CA controls) and to 19 younger children of the same reading level (8 years, RL controls). Compared to CA controls, there were more Ph-DYS than S-DYS. Compared to RL controls, there were still a high number of Ph-DYS; however, the S-DYS profile almost disappeared. Next, we examined the reliability of these subtypes across different measures of phonological and orthographic skills. Compared to RL controls, both groups of dyslexics were found to be impaired only in phonological skills, either in processing time (Ph-DYS) or in accuracy (S-DYS). Then we assessed the moment at which the two dissociated profiles emerged in the course of cognitive development. In order to do so, we examined earlier longitudinal data, collected when the children were 7 and 8 years old, and found that only the S-DYS's orthographic deficit increased with development. Last, we looked at whether the Ph-DYS and S-DYS profiles were associated with other specific cognitive deficits. Specific deficits in phonemic awareness and in phonological short-term memory were found for both Ph-DYS and S-DYS. These data suggest that developmental dyslexia could be largely accounted for by an underlying phonological impairment.

Articulation Disorders↗

[EEG anomalies, sleep modification and developmental dysphasia ].

The relation between severe developmental dysphasia and paroxystical anomalies was analyzed in 52 children, mean age 9 years (group I) suffering from developmental dysphasia, compared to a control group of 20 children, mean age 8 years (group II). The children of both groups were selected excluding cases with a prior history of epilepsy or neurological disease, and all had a cerebral MRI in the normal range. In group I, using the Rapin and Allen classification, we distinguished: 14 children with a syntactic-lexical syndrome and 34 children with a syntactic-phonological syndrome. Two children had verbal agnosia and two others verbal dyspraxia. The analysis of repeated standard EEGs showed: normal recordings in all the group II children and paroxystical anomalies in six of the 52 group I children. Night ambulatory sleep recordings showed such anomalies in 18 of the 34 children with a syntactic-phonologic syndrome and in 6 of the 14 children with a syntactic-lexical syndrome, but in only two of the 20 children of the control group. Paroxysmal abnormalities predominated in light sleep (stages I + II) and slow wave sleep (stages III + IV), but were rare in REM sleep. The abnormalities were diffuse or localized over the left frontotemporal area. Children with developmental dysphasia also showed an inconstant nocturnal sleep pattern with a higher incidence of awakenings during sleep significantly different from our group control. The relations between dysphasias, Landau-Kleffner syndrome, paroxystical anomalies, and sleep disorders are discussed and the results of genetic research concerning such population suffering from language disorders analyzed.

Aphasia↗

Sleep EEG and developmental dysphasia.

To determine the relation between developmental dysphasia and EEG anomalies during sleep, we compared 52 subjects with dysphasia with a control group of 20 children by using the ambulatory EEG method. Whereas 50% of the children with dysphasia experienced paroxysmal activity (PA), only two of the control group did. It is likely that paroxysmal abnormalities and language impairment are related to architectural dysplasia and neuron-migration disturbances. PA is frequent in subjects with receptive developmental dysphasia and may be the cause of language deterioration. When the occurrence of paroxysmal abnormalities during sleep is higher than 8% of total sleep time, we suggest the use of antiepileptic drugs.

Agnosia↗

[Urination disorders in patients with sequelae of perinatal lesions without mental handicap].

Sixty-three patients with cerebral palsy and micturition disorders were investigated. The age ranged between 5.5 and 38 years (mean 13.5). Half had diplegia: one-third had quadriplegia and were therefore dependent incontinence was the most common symptom: dysuria was noted in half of the cases, mainly in quadriplegic patients. The urodynamic assessment confirmed the dysfunction and showed hyperreflectivity with or without asynergy. However, no therapeutic approach has been validated.

Adolescent↗

Contribution of computed tomography in the aetiology and prognosis of cerebral palsy in children.

Retrospective analysis of computed tomographic (CT) examinations in 76 children with cerebral palsy without any severe intellectual handicap has revealed abnormalities in 63% of these children; abnormalities were present in 88% of former pre-term infants. This study highlights the significant pathogenic role of periventricular leucomalacia in cerebral palsy, since in 45% of the cases of this series this diagnosis had been reached as a result of a characteristic CT appearance associated with a history of premature birth and very specific clinical deficits. The CT abnormalities, mostly posterior and generally bilateral and symmetrical, affect the contours of the lateral ventricles, which become straight and angular, and often involve ventriculomegaly (85%). Localized juxtaventricular hypodensities were only found in a few cases (6%). The cognitive and intellectual sequelae in these children were more severe than in those children whose CT examination was normal, and were also more pronounced when the longitudinal fissure of the cerebrum was enlarged.

Adolescent↗

[Spastic knee flexion deformity. Results of surgical treatment].

The records of 36 children who had been treated surgically for spastic knee flexion deformity were studied. The procedures were either a modified Eggers' operation, a lowering of the patella or a combination of both. Thirty-three children were reviewed at a distance and a comparison made between their initial and final function. The results were also assessed in relation to the state of the muscles and the length of follow-up. Many patients were improved but this improvement could not reasonably be expected except in those who could walk or in whom walking had been abandoned for a short time. The indications for the type of procedure should follow systematic examination by a medical and surgical team, taking account of the strength of the gluteus maximus and the quadriceps and the response to novocaine infiltration of the sciatic nerve.

Adolescent↗

[Ontogenesis of vesico-sphincter function].

On the basis of experimental data and clinical observations reported in the literature, the authors describe the development of vesico-sphincteric physiology from the stage of the foetus to adulthood. They then present the normal values for the principal urodynamic parameters (vesical capacity, urinary flow, vesical pressure and urethral pressure).

Adult↗

[Spondylo-enchondrodysplasia].

A case is reported of spondyloenchondrodysplasia associating platyspondylia and generalized enchondromatosis, affecting the spine also but absent in the extremities. A literature review enabled this entity to be grouped within the framework of other enchondroplasias with vertebral lesions. Radiologic signs and genetic data suggest heterogeneity of this group of affections.

Child↗

[Disorders of horizontal gaze motility in the cerebral palsy patient].

The authors studied voluntary and reflex horizontal eyes movements, median and lateral fixation, pursuit movements, binocular and monocular optokinetic nystagmus, and vestibulo-ocular reflex suppression by fixation in a group of 66 cases of cerebral palsy. Horizontal gaze is normal in only 26% of the cases. Pursuit movements and vestibulo-ocular reflex suppression by fixation are the most affected. These anomalies are more frequent in ex-premature babies. Only 2 of 32 ex-premature babies were normal. Whereas, 15 of 34 term babies had no anomaly of horizontal gaze. The frequency and intensity of the troubles seem to correlate with the extent and onset of the neurological lesions.

Adolescent↗

[Siblings of a child with a motor handicap].

The siblings of children with motor handicaps have been only very infrequently studied, perhaps because of the fear of inducing additional disorders. From his personal experience, the author suggests that the siblings are more influenced by efficient parental guidance than by the presence of the handicapped child, whether this child is with it's family or in an institution. The risk for one of the parents of being appropriated by the handicapped child, who is thus over-protected, must be countered in order to avoid adverse reactions from the siblings.

Adult↗

Trunk and leg growth in children with paraplegia caused by spinal cord injury.

After a survey of the bibliography on the subject of clinical and experimental data on retarded growth in children affected by lesions of the peripheral nervous system, the authors present a semi-longitudinal analysis of the anthropometric values obtained by spinal cord section in the case of young paraplegics. By this means, they demonstrate an average growth defect of the order of two standard deviations which only affects the body distal to the neurological lesion in cervical or dorsal injuries. The lower the level of the cord lesion and the earlier the paralysis the greater the growth defects.

Adolescent↗

[Long-term results of urinary rehabilitation in acquired infantile paraplegia (author's transl)].

The urinary rehabilitation of children suffering from acquired paraplegia is here the subject of a retrospective study of 29 patients observed over a long period. The study shows that the detrusor-sphincter balance cannot be exploited on a personal level before the age of 10 ; bacteriuria and persistent residue after the initial period may ultimately disappear under discontinuous bacteriostatic treatment and thanks to the acquisition of autonomy in relation to the residue ; out of the total of 29 patients, the authors only noted 3 morphological and functional deteriorations requiring cutaneous diversion by Bricker's method. Today, the number would have been even smaller thanks to better knowledge of the striated sphincter syndrome, which accounted for 2 of the 3 cases noted. At last in the case of 16 of the 20 initial results considered as favourable, in other words in a little over 3 out of 4 patients, the social and uro-nephrological situation is holding steady, and even improving.

Adolescent↗