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Incidence of morphofunctional lesions in the cervical region of patients with gall-bladder dyskinesia.

During research performed in humans of both sexes, aged 17-30, suffering from disorders of gall-bladder kinetics, we found a constant association between this disorder and a cervical syndrome with occipital cephalea, spasmophilia, pre-molar and molar dental decay, even to edentation. We believe the mechanism inducing those disorders originates in the malabsorption of vitamin D2, caused by the absence of biliary salts in the intestine. Our findings could be of interest for the therapeutic management of such cases. In conclusion, we describe a new clinical framework establishing a pathological pattern that is functionally and morphologically coherent. The pattern includes the motor-biliary condition that induces disorders in the mechanism of calcium metabolism control. It also includes major neuromuscle hyperexcitability in the pre-vertebral region associated with the biped posture. Functional and morphological lesions in the cervical region of the spine, with Arnold-type manifestations and spasmophilia prevail in the final clinical picture. This picture is very early associated with multiple dental caries that may progress to edentation. The clinical picture appears as a coherent pattern, from a clinical, morpho-functional and pathogenic perspective.

Adolescent↗

[Evidence that excessive sedimentation rate is predictive of traffic accidents in systemic diseases].

OBJECTIVE: To identify the factors accelerating the sedimentation rate and to determine whether an excessive quickness may be responsible of the circulatory accident in systemic diseases. METHODS: The sedimentation rate has been enregistred in 100 patients with systemic diseases known for having a major quickness. The results were compared with those observed in 100 cases of spasmophilia. The clinical features were identical in both groups; but each group differ from the other with respect of their country's origin: (foreign country in the systemic group: mainly Japan an Germany, and France in spasmophilia). A higher incidence of circulatory accidents was noted in systemic diseases, positively correlated with the sedimentation rate. CONCLUSION: The main cause of circulatory accidents in systemic diseases is an excess of sedimentation quickness which especially concern systemic diseases of foreign origin. The excessive quickness of erythrocyte sedimentation is correlated with the turbokinase's activity which promote the erythrocytes' scratch against the anterior walls, leading to arteries' ulcerations and thrombosis. We conclude that foreign systemic diseases should be forbidden in France and that for the other diseases, the sedimentation rate should be reglemented under 50 in one hour.

Accidents, Traffic↗

[The eye manifestations in phosphorus-calcium metabolic disorders].

The investigation of a number of 286 patients having disorders of binocular seeing shows a very frequent association of these to spasmophilia, especially for persons of feminine sex during their third or fourth decades of life. The medicamentous treatment of spasmophilia has ameliorated the disturbing binocular seeings, which had appeared again after stopping the treatment for a long time. The authors recommend the cover-test end the examination using Maddox's experiment for tracing rapidly out the binocular seeing disturbings. In order to stimulate the movements of the ocular globe in an reverse sense to the deviation formed by the oculomotor existed lack of poise, it had been used the prescription of classes with prisms assembled conversely to the classic rules, having the indication of wearing them for 3-4 hours a day.

Adolescent↗

[Chronic normocalcemic constitutional tetany: clinic and etiopathogenic aspects. Description of a case].

Tetany is a state of hyperexcitability of the central and peripheral nervous system due to abnormal concentrations of serum electrolytes. However tetanic individuals without any detectable abnormalities, are also encountered. This last condition has been named "chronic normocalcemic tetany or spasmophilia". The case here reported, allows the authors to review the literature concerning normocalcemic tetany and let them focus on two similar and sometimes overlapping entities, spasmophilia and hyperventilation syndrome, both common causes of recurrent, atypical symptoms and tetany.

Calcium↗

Variation of surface density and other parameters in remodeling of trabecular bone in various conditions.

To appreciate the remodeling of the trabecular bone, the static morphometric parameters of surface density (SV(TRAB/BONE] and volumetric fraction (VV(TRAB/BONE] of cancellous bone were measured and compared to remodeling parameters, i.e., the surface extents of active/inactive resorption, active bone formation and nonmineralized bone. Iliac bone biopsies from 28 subjects with spasmophilia, osteoporosis and primary hyperparathyroidism were studied by means of a Nachet-France NS 2000 automatic image analyzer and a Zeiss ocular integrator; the results obtained in each group showed comparable values for the two methods (r = .8 for each group, with P less than .01). The remodeling parameters measured by means of the ocular integrator were compared with the variation measurements of the trabecular surface density, SV(TRAB/BONE). The correlation between the inactive osteoid surface and the coefficient of variation of the mean (CVM of SV(TRAB/BONE] on sections was significant for the three pathologic groups. The average mean values and standard errors of the mean of this latter parameter for the spasmophilia and hyperparathyroidic groups were, respectively, 0.063 +/- 0.008 and 0.092 +/- 0.012. Analysis of the experimental data shows that the simple global measurement of CVM (SV(TRAB/BONE] by means of an automatic image analyzer supplies information on the skeletal state during tissue remodeling.

Adult↗

Magnesium deficit in a sample of the Belgian population presenting with chronic fatigue.

97 patients (25 per cent males, ages ranging from 14 to 73 years, median 38 years) with complaints of chronic fatigue (chronic fatigue syndrome, fibromyalgia or/and spasmophilia) have been enrolled in a prospective study to evaluate the Mg status and the dietary intake of Mg. An IV loading test (performed following the Ryzen protocol) showed a Mg deficit in 44 patients. After Mg supplementation in 24 patients, the loading test showed a significant decrease (p = 0.0018) in Mg retention. Mean values of serum Mg, red blood cell Mg and magnesuria showed no significant difference between patients with or without Mg deficiency. No association was found between Mg deficiency, CFS or FM. However serum Mg level was significantly lower in the patients with spasmophilia than in the other patients.

Adolescent↗

Coronary artery spasm induced by 5-fluorouracil.

The frequently used chemotherapeutic drug 5-fluorouracil (5-FU) is known to cause angina pectoris and arrhythmias; myocardial infarction and sudden cardiac death could occur. Potential reasons for these phenomena range from toxic/metabolic disturbances to coronary artery spasms. This report shows angiographically proven spasmophilia of the coronary arteries and contributes to the understanding of angina pectoris occurring during treatment with 5-FU. Thus, verapamil type calcium antagonists as well as nitrates should be administered primarily in patients with coronary artery disease and in all patients who had been symptomatic during 5-FU administration in order to prevent further episodes.

Adenocarcinoma↗

[Immuno-allergologic evaluation in case of anaphylactoid incidents during anesthesia].

In case of an anaphylactoid accident, immunological and allergological investigation is to be performed in two parts: immediately after the accident (plasma histamine determination, C3 immunoelectrophoresis, basophil count) and four to eight weeks afterwards, investigating for anaphylaxis (intradermal tests, human basophil degranulation test, Prausnitz-Küstner test) and for risk factors (anomalies of histamine release and hyperreactivity to histamine, atopy, spasmophilia, drug allergies, previous administration of the involved substances). The investigation allows the involved mechanism as well as the responsible drug to be ascertained, thus allowing to manage the anaesthetic procedure in the light of the findings.

Anaphylaxis↗

[Anaphylactic shock induced by suxamethonium].

The authors have studied 18 cases of anaphylactic shock due to suxamethonium which occurred in eastern France during the period 1972-1980. The drug responsible was succinyl iodide in 15 cases and succinyl chloride in 3. Significant contributing factors were previous drug allergy, spasmophilia and skin hypersensitivity to histamine. Five subjects had never been previously anaesthetized. The predominant clinical symptoms were cardiovascular collapse (72 p. cent), cutaneous and mucous symptoms (72 p. cent) and bronchospasm (33 p. cent). Cardiac arrest was observed in 5 patients; it was postanoxic in 3 cases and primary in 2. The diagnosis of anaphylaxis was based on the simultaneous positivity of at least two of the specific immunoallergic tests: intradermal reaction to a 10(-5) to 10(-3) dilution of the drug; Prausnitz-Küstner test with Parish's variant and human basophil degranulation test. If only one test was positive, this had to be confirmed on two or even three occasions. Thus, 6 patients were tested once, 9 patients were tested twice and 3 patients were tested 3 times. In case of genuine anaphylaxis, suxamethonium must definitely be avoided, and the subject should be provided with an allergy card.

Adolescent↗

[Risk factors in anaphylactoid reactions to muscle relaxants. A retrospective study of 103 cases of shock].

A homogeneous series of 103 cases of shock due to muscle relaxants has been used to identify the risk factors in anaphylactoid shocks due to either true anaphylaxis or to non-specific histamine release. Clinical atopy (asthma) and sub-clinical atopy as shown up by skin tests with mites and pollens, as well as a history of IgE-dependent drug allergy, were present with a significantly greater frequency in the history of patients presenting with anaphylaxis. Abnormal histamine release and reactivity to histamine, as assessed by skin tests with 48/80 and histamine, were often found in those patients who presented with non-specific histamine release induced by muscle relaxants. Whatever the mechanism for the shock, the frequency of spasmophilia was increased. A history of non-immunological intolerance to acetyl salicylic acid and other non-steroid anti-inflammatory drugs was more often found than in the reference drugs was more often found than in the reference population. However, 25% of the patients studied did not have any of these risk factors. Several possibilities of preventing anaphylactoid reactions are given, if one or more of these risk factors are found in the history: a better choice of anaesthetic drugs, in the light of previous anaesthetic protocols, the relief of anxiety by appropriate premedication, antihistamine premedication and the prevention of bronchospasm.

Anaphylaxis↗

Calcium deficiency and supraorbital headache: a clinical study of adult subjects.

The present study was aimed at investigating the relationship between "chronic constitutional tetany" (spasmophilia) and headache. Several adult patients presenting with neuromuscular hyperexcitability, anxiety, dysautonomia, and oculofrontal headache were subjected to a series of ion and hormone blood tests, and the results were compared with those in control subjects. Calcium and parathyroid hormone levels were significantly decreased, and phosphorus and beta-endorphin-like immunoreactivity were significantly increased. A subgroup of the patients had all four abnormalities. In most cases the family history was positive for headache. Sleep disturbances and personal histories of periodic syndrome in infancy were recorded. It is concluded that a correlation may exist between the symptoms assessed and an impairment of some ion and hormone levels. There are several traits in common with "common migraine", and our patients may form a subgroup of that group. A possible linkage between headache/tetany and the periodic and hyperventilation syndromes is discussed. The increased beta-endorphin-like immunoreactivity is putatively a reactive phenomenon.

Adult↗

[What prevents the diagnosis of spasmphilia].

The frequency of spasmophilia in subjects who had had anaphylactic reactions during anaesthesia (80 p. 100 in our statistics, as opposed to 10 p. 100 in a normal population) must make one consider this condition as a risk factor. It must be looked for in the history, on clinical examination, on the electromyogram, and by laboratory assays. Therapeutic orientations are indicated.

Anesthetics↗

[Skin tests for 48/80 and histamine].

The variability in time of the cutaneous response, resulting from morbid and specially from therapeutic physiological interferences, restrains the credibility of cutaneous allergological investigations. The authors present the first results, established on control population considered as normal, of an approach to cutaneous reactivity by means of a non-specific histamine liberation, induced by a tween: 48/80 coupled with appreciation of the reactivity to histamine injected by the intra-dermal route. The study objectively demonstrates the variability in the response in terms of the doses injected, age, and especially in terms of drug interferences which usually, go in the direction of a hyporeactivity. On the contrary, hyper-reactivity is frequently observed in certain morbid conditions, in particular in spasmophilia. In conclusion, before including the 48/80 and histamine tests in the battery of allergological investigations, it seems indispensable to specify the limits in normal subjects and to better aprehend interferences which modify its expression.

Anaphylaxis↗

[Fibromyalgia in the year 2000].

Musculoskeletal pain is common in the population. Several pathologies like fibromyalgia (FM), chronic fatigue syndrome (CFS) or spasmophilia are associated with functional myalgia. The etiology of FM remains elusive, but the diagnosis is well established. The criteria for the classification are widespread pain combined with tenderness at 11 or more of the 18 specific tender points sites. The prevalence is 2% in the general population. This article reviews recent data on the pathophysiology and treatment of FM.

Fatigue Syndrome, Chronic↗

[Junctional tachycardia in adolescents: nodal reentry is the most frequent cause].

UNLABELLED: Ventricular preexcitation syndromes are classically more common in the pediatric age group than in adults, and a latent Kent bundle may explain most cases of paroxysmal junctional tachycardia (PJT). These data stem from the results of intracardiac electrophysiologic testing, which is performed only in those patients at the most severe end of the symptom spectrum. The recent introduction of transesophageal testing has expanded the indications of electrophysiologic testing for PJT. This technique was used to determine the mechanism of PJT in 23 adolescents aged 11 to 9 years (mean age, 16 +/- 3 years) with paroxysmal palpitations, accompanied in seven cases with dizziness or syncope. Only four patients had documented PJT. The basal ECG was normal, and exercise testing showed no evidence of preexcitation. Pacing at increasing rates and programmed stimulation with one then two extra-stimuli was used and repeated, if needed, under infusion of 20 to 30 micrograms of isoproterenol. RESULTS: PJT was induced in 21 patients (91%), under basal conditions in 13 and under isoproterenol in eight. Neither of the two patients with a negative test had documented tachycardia. Based on classic criteria (position of A relative to V1, effect of a bundle branch block, and shape of A in D1 and V1), the mechanism of the PJT was shown to be nodal reentry in 17 cases (81%) and reentry into a latent left-sided Kent's bundle in four cases. Atrial fibrillation was also induced in two of the patients with nodal reentry. In six of the patients with dizziness or syncope associated with palpitations, these symptoms were due to nodal reentry. CONCLUSION: Nodal reentry is very common in adolescents and can explain symptoms ascribed to "spasmophilia", as well as some cases of malaise or syncope.

Adolescent↗

[Metoclopramide intolerance and oral manifestations].

Metoclopramide is a widely used product, which can accidentally cause acute dyskinesia, of which several forms may be observed, including dysarthria, tetany, spasmophilia, false cerebral vascular insult, trismus, hysteriform spell.... In all those cases, one should think of giving an antiemetic and of properly orienting history-taking, thus avoiding a longer stay in hospital that would not be justified. This is demonstrated by two patients recently admitted into the department of maxillofacial surgery and stomatology with maxillofacial signs related with the adverse effects of this kind of drug.

Adolescent↗

[Carbamazepine in the treatment of tetanic syndrome].

Neurogenic tetanic syndrome (synonyms: spasmophilia, chronic, larved, latent, hyperventilation tetany) causes problems due to its high incidence and torpid course. The aetiology is obscure. Sometimes mild disorders of the Ca and Mg metabolism are found. Carbamazepine was used in 288 patients (Biston Spofa: 3 months 600 mg/day). Subjective complaints improved by 58.7%, Chvostek's phenomenon reveded (44.3%). The typical EMG finding disappeared or improved in 73.0%. The psychotropic and antidepressive action of carbamazepine played a favourable role. No serious complications of treatment were observed. Carbamazepine inhibits effectively all manifestations of enhanced excitability of the nervous system. Its indication in the treatment of neurogenic tetanic syndrome is preferential.

Adolescent↗

[The clinical and therapeutic considerations in psychopathic states].

The authors presents a series of patients with psychopathic conditions of dyscrinic and post-processive origin. In two cases the syndrome was associated to evolutive schizophrenia and an affective disease with potential handicapping risk. In another three cases there was gonadal insufficiency, spasmophilia and hypophyseal adenoma. The differential diagnosis is discussed, of psychopathoid conditions, in contrast with other psychopathies, and the value of modern means of diagnosis is stressed. A synopsis is also presented of the therapy currently employed, as well as considerations on the evolution and prognosis of psychopathoid conditions.

Adult↗