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Biomedical subjects

S Aïdi

Publications and source records attributed to S Aïdi.

7 recordsLinked to original sources

[Acute Guillain-Barré-like polyradiculoneuritis revealing acute systemic lupus erythematosus: two case studies and review of the literature].

The involvement of the peripheral nervous system in systemic lupus erythematosus (SLE) is rare and is dominated by distal symmetric axonal polyneuropathy and multiple mononeuropathy. It usually occurs in late course of the disease. Acute polyradiculoneuropathy of Guillain-Barré syndrome type is very rare and can frequently constitute the first symptom of systemic lupus. We report two cases of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) complicated by respiratory failure due to systemic lupus. In the first case, the pure motor AIDP was the first manifestation of the SLE. The outcome under prednisone treatment was dramatically good with regression of clinical deficit and normalisation of nerve conduction within one month and 12 months of treatment respectively. In the second case the AIDP occurred only one week after diagnosis of SLE and corticotherapy. It was a demyelinating sensory-motor neuropathy. Clinical improvement was obtained after two cures of intravenous gammaglobulin (IVIg). The normalisation of nerve conduction was obtained within 8 months. AIDP is a very rare complication of SLE, but it should be searched as an aetiology of Guillain-Barré syndrome associated to systemic clinical symptoms or to blood inflammation. Corticotherapy could be sufficient, but in some cases the addition of IVIg or plasmapheresis might be necessary.

Acute Disease↗

Migraine and the risk of cervical artery dissection: a case-control study.

The association between migraine and cervical artery dissection (CAD) was explored in a hospital-based case-control study. Migraine was present in 49.1% (23/47) of patients with CAD and in 21% (11/52) of patients hospitalized for a cerebral ischemic event not related to a CAD (adjusted odds ratio = 3.6; 1.5 to 8.6, p = 0.005). This result supports the hypothesis that an underlying arterial wall disease could be a predisposing condition for migraine.

Adult↗

[Wilson's disease. Clinical presentation, treatment and evolution in 21 cases].

PURPOSE: Wilson's disease is characterized by neuropsychiatric symptoms with frequent extrapyramidal and intellectual presentations. They have an insidious evolution that leads to a late diagnosis and less therapeutic effectiveness in the advanced forms. METHODS: We report 21 cases of Wilson's disease with neurological complications, emphasizing clinical semiology, diagnostic means and problems of the therapeutics in our country. RESULTS: The average age at the beginning of the disease was 17.6 years, with a female prevalence (8/13). The signs at first were mostly all neurological (71.4%), then psychiatric (19%) or hepatic (19%). The most common neurological signs were dystonia of members (81%), dysarthria (76%), tremors (76%) or disorders of motoricity (71.4%). Sometimes there were sialorrhea or disorders of the handwriting. The Kayser-Fleischer ring was present in 19 patients. Eighteen patients had clinical and/or biological hepatic involvement. The diagnosis was confirmed by biochemical examinations, which found a low rate of copper in blood, a sinking rate of ceruloplasmin and a very high rate of urinary copper. The cerebral computer tomography shows a cortical and/or subcortical atrophy (37%), and/or a low density of the central grey cores (35%). The treatment was based on D-penicillamine and/or zinc sulfate, according to the availability of the drugs. The evolution was favourable among 18 patients (85%) and not good in 42.8% of the cases. Six of the first patients had poor evolution after many years of follow-up. Finally, only 12 patients (57%) had a very good outcome. The family investigation made among 17 patients revealed 13 family cases. The only predictive factor of a poor evolution was the therapeutic noncompliance (P = 0.006). CONCLUSIONS: The neurological presentations are traditional during the Wilson's disease, but are often ignored. We must suspect the disease in children when faced with disorders of handwriting or school failures and in the adult, when faced with neurological symptoms in a patient having a hepatic disease. We must not hesitate to consider it even given purely psychiatric signs, and we had better know to seek the neurological ones.

Adolescent↗

[Chronic inflammatory demyelinating polyradiculoneuropathy with hypertrophy of spinal roots, brachial plexus and cranial nerves].

We report two patients who presented an atypical chronic inflammatory demyelinating polyradiculoneuropathy with massive nerve root and brachial plexus hypertrophy, and pseudotumoral supraclavicular mass. They also presented an hypertrophy of oculomotor and trigeminal nerves causing an exophthalmos and ocular palsy. Spinal root enlargement and cranial nerve hypertrophy was demonstrated by CT scanner and MRI. Brachial plexus biopsy showed a similar aspect of sural nerve, with an extensive onion bulb formation and perivascular inflammatory cell infiltration. There was an excellent response to steroids in both patients.

Adult↗

[Neuropsychological disorders after bithalamic infarct caused by deep venous thrombosis].

We report a case of deep cerebral venous thrombosis with bithalamic infarction that led to neuropsychological disorders including left side visuospatial neglect, aphasia and amnesia, as well as frontal and intellectual disorders. After a six month course, the patient showed only slight intellectual deficit and mild anterograde amnesia. Deep cerebral venous thrombosis is uncommon and prognosis is poor. Reports in the literature illustrate the neuropsychological disturbances they provoke but provide little analyzable data. The positive progress in our case demonstrates that bithalamic lesions of venous origin can have a good prognosis.

Adult↗