Pituitary abscess revealed by sleep attacks.
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Biomedical subjects
Publications and source records attributed to Y Millet.
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To allow the experimental use in rats of a Gamma Knife Radiosurgical Unit, a stereotactic device adapted from the conventional Kopf's device was developed. To control the accuracy of the coordinate system based on the De Groot's rat stereotactic atlas, experimental radiosurgical lesions were made on the left striatum. The isodose curve distribution of the 4 mm collimator was calculated with the dose planning software used in Gamma Knife and superimposed on the left striatum target. Doses of 200 Gy were administered to the left striatum in six rats. The results were evaluated 21, 34 and 47 days later. At 34 and 47 days necrotic lesions were exactly as targeted. In a second group of 48 rats receiving a doses of 100 Gy, no lesions were observed after 7, 15, 24, 31, 45 days. However, in all rats sacrificed 59, 72 and 90 days after day radiation, a necrotic lesion was always present and confirmed that at each time the lesions were precisely targeted. This apparatus allows precise and reproducible gamma irradiation lesion in rat brain without expensive and time consuming imaging techniques. This device provides a useful system to observe the experimental effects of radiosurgery on the central nervous system in rats.
Ambulatory EEG (A-EEG) allows longterm polygraphic recording over 24 hours or more and proves to be particularly useful in the diagnosis of narcolepsy-cataplexy (N/C). We performed A-EEG using the Medilog 9000-8 channel system over a total of 36 24-hour periods in 20 consecutive N/C patients and recorded an average of 3.5 daytime sleep episodes, of which 2.2 were with SOREMP, AND 21 evening SOREMP (58%). A MSLT was performed using A-EEG in 16 cases. Continuous A-EEG proved to be more informative than the MSLT, and may represent a valid alternative to the classic continuous polygraphic recordings performed in the sleep lab, that are more cumbersome and costly. Although a full-night polysomnographic recording is still necessary whenever other sleep disorders are suspected in association with N/C, A-EEG is a first-line, practical method for the confirmation of N/C, which remains a clinical diagnosis.
Sleep abnormalities are frequently reported as possible etiopathogenic factor of fibromyalgia. We report 2 cases of fibromyalgia revealing a long-standing narcolepsycataplexy.
Fibrositis is often associated with sleep disturbances and with an alpha nREM abnormality on sleep electroencephalogram. We describe a case occurring during the course of a typical longstanding narcolepsy-cataplexy. Modafinil, that is an effective treatment of hypersomnia, did not alleviate the symptoms of fibrositis in the short term.
One study was performed in 12 patients with presenile Alzheimer's disease (group I), the other one in 16 patients with mild senile dementia of Alzheimer type (group II). In each study, patients were divided into two randomized parallel groups, one receiving placebo, the other piracetam (9 g daily in group I piracetam and 2.4 g daily in group II piracetam) during three months, piracetam induced a decrease in EEG power on the 2-6 Hz range (group I piracetam), 3-5 Hz and 7 Hz (group II piracetam) and an increase of EEG power in the 9-11 Hz range (group I piracetam) and in the 10 Hz and 13 Hz frequencies (group II piracetam). There was also a significant improvement in the Trail Making Test part A in group II piracetam. Correlations between decreased EEG low frequency components and improvement in some psychometric tests were found significant in the two groups. It seems that the main effect of piracetam was to induce increased alertness. The same results were found in both studies; the good reproducibility suggests that EEG spectral analysis is a reliable tool in the assessment of psychotropic drug effects.
An experimental system allowing both the incubation and rapid transfert of rat hypothalamic slices has been developed in order to approach the regulation of CRF secretion. The release of CRF has been quantified by a specific radioimmunoassay. Under basal conditions, immunoreactive CRF release reached an optimum of 96.2 +/- 10.4 pg/3 hypothalami/20 min. A depolarizing concentration of KCl (56 mM) or veratridine (50 microM) applied for 20 min. induced a 222 and 257% increase, respectively, in CRF release. The in vitro CRF values released under basal and stimulated conditions are comparable to those of other hypothalamic neuropeptides. Furthermore, in vitro CRF release from the hypothalamus is in the same order of magnitude as in vivo CRF secretion estimated by hypophysial portal blood collection or median eminence push-pull cannulation.
Cortical and cervical early somatosensory evoked potentials (SEPs) were recorded after stimulation of median, ulnar, tibial or common peroneus nerves in 23 patients with traumatic paraplegia or quadriplegia. The clinical progress of these patients was followed for more than 18 months. The gradual clinical recovery or its absence was compared with neurophysiological data. In complete spinal injury, the absence of SEPs in response to stimulation of a nerve entering the cord below the level of injury demonstrates the high degree of spinal cord damage. There was a good correlation between the presence of SEP, even of low amplitude or long latency, and a favorable prognosis. The return of the SEP could herald clinical recovery of posterior column function. From a practical point of view, these preliminary data suggest that the investigation of early SEPs must begin with a very short delay after injury and be continued for approximately 6 months so that the irreversibility of the lesion can be clearly established.
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Two peptides have a strong corticotropin releasing factor (CRF) activity: arginine vasopressine (AVP) and a 41-residue peptide (41-CRF). Both peptides are present in high concentration in the PVN of the Rat, a zone of the hypothalamus at which electrical stimulation elicits ACTH release. Since homozygous Brattleboro Rats (Di/Di) congenitally lack endogenous AVP, it was of interest to compare the ACTH and corticosterone release after electrical stimulation of the PVN in Long-Evans (L.E.) and Di/Di Rats. In both L.E. and Di/Di Rats, there is a significant increase in plasma ACTH and corticosterone after electrical stimulation of the PVN. However, corticosterone levels are significantly lower in Di/Di than in L.E. Rats whether the Rats have been stimulated or not. It is concluded that a physiological CRF activity is present in the PVN of Di/Di Rats independently of the CRF like activity of AVP.
A peptide with 41-residue having CRF activity both in vivo and in vitro has recently been isolated from ovine hypothalami (41-CRF). Passive immunization of Sprague-Dawley Rats with an antiserum against this peptide is followed by a significant decrease in plasma ACTH and cortisosterone levels under basal conditions as well as after ether-stress and adrenalectomy. These data demonstrate that 41-CRF plays a major role in the physiological regulation of ACTH secretion.
Brattleboro rats which lack endogenous vasopressin have been used to study the role of vasopressin as a corticotropin-releasing factor. Plasma ACTH, beta-endorphin, and corticosterone were measured by RIA in male and female Long-Evans and Brattleboro rats under the following conditions: unstressed, after ether stress, after nicotine injection, and after adrenalectomy. A significant reduction in the ACTH, beta-endorphin, and corticosterone responses to the different experimental procedures was observed in the Brattleboro rats. However, in this strain of rats, a significant increase in the release of all three hormones was obtained, suggesting that vasopressin has only a synergistic role in the regulation of their secretion.
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Commercial preparations of essences of sage, hyssop, thuja, and cedar have caused human intoxication in eight cases, from which tonico-clonic convulsions were the major symptom. The experimental study of the toxic properties of commercialized essential oils of sage and hyssop has revealed that their convulsant action was of central nervous system origin in unanesthetized rats, as proven by electrocortical records. The toxicity of the hyssop oil seems to be more powerful than that of sage, since the dose limit from which the cortical events are only subclinical is 0.08 g/kg for hyssop oil and 0.3 g/kg for sage oil. Above 0.13 g/kg for hyssop oil and 0.50 g/kg for sage oil, the convulsions appeared and became lethal above 1.25 g/kg with hyssop oil and 3.2 g/kg with sage oil. The daily repeated injection of subclinical doses revealed the cumulative toxic effect of hyssop oil, since the same low dose induced electrocortical clonic seizures. The toxicity of each oil appeared to be related to the presence of terpenic ketones, camphor in sage commercial oil, camphor and thujone in sage Dalmatian oil, thujone in thuja and cedar oils, and pinocamphone in hyssop oil. The convulsant properties of camphor are well known. The neurotoxicity of thujone and pinocamphone is demonstrated in rats for the first time.
Pyridoxylase at a concentration of 0.6 mmol/kg body weight injected intraperitoneally in rats, increased the resistance of animals to severe hypoxia (O2:3.2%; N2; 96.,%). The electrocorticogram (ECoG) was used to indicate the effectiveness of the drug in lowering the delay of electrographic silence, in 19 control rats and 12 pretreated rats. The ECoG was also recorded period under pure oxygen. In pretreated rats, the ECoG records became flat in a mean time of 551 s, compared with 269 s in the control group. The latent periods of successive steps during cerebral anoxia were significantly delayed in pyridoxylate-pretreated rats subjected to hypoxia. During the recovery period, pyridoxylate improved the recovery of the normal ECoG, particularly when values were expressed as a function of the duration of the hypoxic period. These findings are in good agreement with the significant protection afforded by pyridoxylate on the cerebral rate of energy-rich phosphate bond utilization during hypoxia studied in a separate work.
Pyridoxine (1-8 mmol/l) did not change significantly the cerebral oxygen nor the hypoxic or ischaemic degradation of phosphocreatine and ATP. Glyoxylic acid (1-8 mmol/l), an inhibitor of the citric acid cycle, depressed the electrically stimulated oxygen uptake of brain slices to a lesser extent than did pyridoxylate. Moreover, at concentrations of 0.66 mmol/l, pyridoxylate predominantly delayed the hypoxic or the ischaemic breakdown of creatine phosphate and of ATP compared with glyoxylic acid (0.66 mmol/l). These findings paralleled clearly the prominent hypoxic and post-hypoxic protection afforded by pyridoxylate upon rat brain electrogenesis, reported in the preceding paper.
Using the radioimmunoassay (R.I.A.) for neurophysins (I.R.N.) described in 1969, we demonstrated a concomitant, rapid release of both A.D.H. and I.R.N. within the first minutes (2') of the i.v. infusion of nicotine in 11 patients with normal neuropituitary function and 1 patient suffering from a Schwartz-Bartter syndrome. There is a close relationship (r : 0,82, p less than 0.001) similar to that described by other authors, between peak levels of A.D.H. and I.R.N. in all the patients. Hence, we proved that our R.I.A. system is influenced by nicotine stimulated neurophysins (N.S.N.). The negative results previously published by two of us in 5 normal men could have been due to the length of the period between the beginning of the test and the first blood sampling (30 mn).
The authors have developed a radioimmunoassay for human plasma vasopressin (AVP) which permits the estimation of antidiuretic hormon (ADH) levels as low as 0,8 pg/ml. The average plasma level of AVP after overnight water restriction was found to be 14,3 pg/ml (sd = 4,4 pg/ml) in normal subjects. They provoked a hypersecretion of ADH by the intravenous injection of 1-2 mg of nicotine. In 11 volunteer normal subjects this stimulation by nicotine provoked ADH hypersecretion which reached a maximum between 2nd and 15th minutes after injection. In 3 cases of diabetes insipidus, nicotine injection did not induce ADH hypersecretion; in 1 case of potomania this response was weak; in 2 cases of syndrome of inappropriate ADH secretion, AVP plasma levels were elevated and the response after nicotine stimulation was exaggerated.