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Biomedical subjects

R Marteau

Publications and source records attributed to R Marteau.

At least 19 recordsLinked to original sources
PubMed1995

Occupational environment as risk factor for unemployment in multiple sclerosis.

INTRODUCTION: Few studies have examined the factors of occupational environment related to unemployment in multiple sclerosis (MS). MATERIAL AND METHODS: A case control-study was carried out. Cases were patients unemployed for less than five years before the study (n = 77); controls were patients currently employed (n = 94). The odds ratios of the relationship under study adjusted for sex, age, disease form and educational level, were estimated. RESULTS: Employment in the public sector, sedentary jobs and possibility of obtaining specific improvements in the work environment were found to be protective factors, while jobs needing force, rigid work schedule, manual precision, frequent moves and a daily work duration over 8 h were found as risk factors. Multivariate analyses showed that the only remaining factors were public sector jobs as protective factor (OR = 0.4), and strenuous work as risk factor (OR = 4.5). Factors were slightly different in male and female patients. CONCLUSION: This study suggests that simple and early changes in the occupational environment could maintain MS patients at work.

Adult↗
PubMed1991

[Münchhausen syndrome. A study of 8 cases of neurologic manifestations].

Eight cases of Münchhausen syndrome were registered within two years in two hospital neurological departments. Summaries of their clinical history were obtained following an enquiry in 58 hospitals of Paris and suburbs. All patients met Asher's description for the emergency presentation, the truculence-evasiveness manner, the luxuriance of tales, the eclecticism of the alleged symptoms, the vehement request of dangerous or painful procedures and the apparent senselessness. The paucity of scars and modesty of peregrinations recorded are discussed, as well as the lack of self-inflicted injury. Ethical implications and traps set by these tricky patients against consistent medical strategies are developed.

Adult↗
PubMed1990

Vermal infarct with pursuit eye movement disorders.

Severe deficits of foveal smooth pursuit and optokinetic nystagmus in all directions were electro-oculographically recorded in an 80 year old woman. Magnetic resonance imaging (MRI) showed an infarct involving the postero-inferior part of the vermis (lobules VI to X) and a portion of the left cerebellar hemisphere, with apparent preservation of the flocculus and the brainstem. The role of the vermal lesion in these pursuit eye movement disorders is discussed.

Aged↗
PubMed1990

Infarction in the territory of the medial branch of the posterior inferior cerebellar artery.

We report 10 cases of cerebellar infarction in the territory of the medial branch of the posterior inferior cerebellar artery (mPICA). Axial sections on MRI through the middle of the medulla and the cerebellum showed the infarction as a triangular area with a dorsal base and a ventral apex directed towards the fourth ventricle. The infarct also involved the lateral and dorsal medulla when the mPICA supplied all or part of these regions. Three clinical patterns were observed: 1) pseudolabyrinthine signs with or without dysmetria and ataxia when the medulla was spared; marked axial lateropulsion was present in most cases; 2) complete or incomplete Wallenberg's syndrome, when the medulla was involved; 3) silent infarction. These syndromes are precisely those previously attributed to PICA occlusion without distinction of the branch involved. No alteration of consciousness was recorded and spontaneous recovery was the rule. Cerebellar infarction in the distribution of the mPICA can be regarded as a benign condition with a good prognosis.

Aged↗
PubMed1990

[Lateral inferior pontine infarction: 2 clinical aspects].

Cases of lateral inferior pontine infarction are rare in the literature. We report two cases with MRI correlations. One involved the whole territory, the other the tegmental area only. Both also involved the middle cerebellar peduncle and one of them the adjacent lobules of the cerebellum. The first case emphasizes the classical alternate syndrome. The second case shows that acute vertigo mimicking a labyrinthine lesion can occur when involving the territory of the anterior inferior cerebellar artery.

Aged↗
PubMed1989

Nonathymulin treatment of multiple sclerosis: double-blind pilot study.

We carried out a randomized, double-blind, placebo-controlled trial of Nonathymulin (NT, synthetic serum thymic factor) in patients with evolutive multiple sclerosis (MS) and moderate disability. Forty matched patients were treated with subcutaneous NT or placebo for 6 months and followed for another 6 months. There was no significant difference in treatment and control groups in the Kurtzke. Disability scores, Ambulation Index and Functional Scale. No significant side effects were recorded. NT is not effective in treating evolutive and moderately disabled MS.

Adult↗
PubMed1988

Oculo-facio-skeletal myorhythmia as a cerebral complication of systemic Whipple's disease.

A fifth case of oculomasticatory myorhythmia associated with cerebral Whipple's disease is reported. This peculiar abnormal movement has never been described in association with cerebral dysfunction other than Whipple's disease. The present case exhibited rhythmic convergence of the eyes and synchronous (1-2 Hz) contractions of the masticatory muscles and of the proximal and distal skeletal muscles. These abnormal movements occurred 13 years after the beginning of the disease. They were persistent and unchanged until the death of the patient 3 months later. No treatment was effective to suppress the involuntary movements (clonazepam, baclofen, antibiotics). Associated neurological signs included global supranuclear ophthalmoplegia, facial weakness, bilateral ptosis, absent gag reflex, and intellectual deterioration.

Brain↗
PubMed1988

[Vesical neuropathy in systemic vasculitis: 3 cases].

Bladder neuropathy was diagnosed in 3 patients with systemic vasculitis (temporal arteritis: 1 case; periarteritis nodosa: 2 cases). Clinical characteristics were: dysuria, diminished or abolished bladder sensation leading to indolent bladder retention. Urodynamic investigation showed hypotonic and underactive detrusor, increased detrusor compliance, hyposensitive bladder, and/or overactive urethral closure. Needle electrode examination showed signs of denervation of periurethral muscles; sacral evoked latencies were increased, favouring pudenal nerve alterations. Symptoms and urodynamic abnormalities resolved following corticosteroid therapy. Clinical and therapeutic implications of bladder neuropathy in necrotizing vasculitis are emphasized.

Adult↗
PubMed1988

[The Minimal Record of Disability and multiple sclerosis. Results of the evaluation of 200 patients].

The Minimal Record of Disability (MRD) for Multiple Sclerosis (MS) evaluates impairment in MS through 4 sets of data: Demographic Data, Kurtzke Disability Status Scale (DSS), Incapacity Status Scale (ISS) and Environmental Status Scale (ESS). We assessed with the 1985 version of MRD 200 consecutive patients attending our MS clinic during a 6 months period. 170 were out-patients and 30 inpatients. Diagnosis was definite in 197 and probable in 3. ESS and ISS were rated by a medical student according to a planned interview. The validity and internal consistency of DSS, ISS and ESS were evaluated by dependence analysis of each item to the sum of all items, and multivariate analysis was carried out on the first 15 items of ISS. Main clinical data were: age 43.0 +/- 11.8 years; age at onset of MS: 27.3 +/- 10.3; sex ratio (F/M): 1.75/1; mean DSS score: 4.6 +/- 0.1. Administration of MRD was easy and general acceptance was good. Some refinement in wording is needed for 5 items of ISS--mainly for "mood and thought disturbances" and "mentation" which do not score adequate mood and intellectual impairment in MS--and for 2 items of ESS. These 2 scales are otherwise of practical use and cover all the area of disability and handicap in MS. The levels of internal consistency of DSS, ISS and ESS are high, as well as correlations between the 3 scales (p less than 0.001). Correlations with age and duration of MS were established for total scores of DSS but not ISS and ESS. Our data confirms the validity of MRD as an evaluation tool of MS patients; they show that MRD can be applied with minor modifications to MS patients and support its use in therapeutic trials, rehabilitation and socio-economic inquiries.

Adult↗
PubMed1988

[Amnesic syndrome caused by infarction in the area of the left anterior choroidal artery].

A case of infarction in the left anterior choroidal artery territory presenting as a regressive amnestic syndrome, associated with the usual syndrome, is reported. This amnesia had the same characteristics as that found in the left posterior cerebral artery territory infarction. The anterior choroidal artery supplies the medial part of the temporal lobe, the amygdaloid nucleus, part of the hippocampus, uncal gyrus, and the mamillary body. Therefore, an amnestic syndrome can occur together with an infarction in the AChA territory. To our knowledge this is the first report of that occurrence.

Aged↗
PubMed1988

[Spinal dural arteriovenous fistulae: exacerbation after myelography with metrizamide].

Metrizamide dorsal myelography was performed in two patients with minor to moderate sensorimotor paraparesis. Direct and indirect myelographic signs of spinal arteriovenous aneurysm were seen and spinal cord angiography showed thoracic dural arteriovenous fistulae (AVF) in both cases. Within 24 hours following myelography, clear neurological worsening occurred, associated with cephalalgia, nausea and transient diplopia in one case, leading to paraplegia in a few days. Paraplegia was complete six months after surgery in one case, and had resolved after embolization of fistula in the other patient. The mechanism of neurological worsening may include: substraction of cerebrospinal fluid, sitting position during and after myelography and local increase of metrizamide concentration secondary to impaired resorption caused by the fistula. Water-soluble myelography is of invaluable aid in the diagnosis of dural AVF and must be followed by early angiography, thus allowing prompt therapeutic embolization.

Adult↗