[Cranial pachymeningitis or unknown origin].

Pachymeningitis of unknown origin is uncommon and is usually associated with headaches, cranial nerve lesions and cerebellar ataxia. Magnetic resonance imaging is particularly contributive to diagnosis. The default diagnosis must however be confirmed by brain biopsy.

[Peripheral neuropathies caused by disulfiram].

Disulfirame is a rare cause of peripheral neuropathy in subjects with chronic alcoholism. We report here a case in a 42-year-old man and present the main clinical features and electrophysiological and pathology results. Disulfamine-induced peripheral neuropathy is dose-dependent and never occurs below 250 mg/d (1/2 tables of Espéral*).

A multiparametric data analysis showing the potential of localized proton MR spectroscopy of the brain in the metabolic characterization of neurological diseases.

We conducted an extended clinical evaluation of localized proton magnetic resonance spectroscopy (MRS) of the brain, performed on various brain diseases using short stimulated echo times. Pathologies studied were mainly multiple sclerosis, stroke, leukoaraiosis, AIDS-related leukoencephalopathies and glial tumors. Other miscellaneous pathologies were also studied.

Nociceptive threshold in patients with epilepsy.

Clinical practitioners have often observed in the course of their daily work that the pain thresholds of epileptic patients seem to differ from those of healthy subjects. These patients can suffer from quite severe traumatic lesions without apparently experiencing any pain. Since they are usually under treatment for epilepsy, it is difficult to determine whether the absence of pain is due to these patients' epileptic condition or to its treatment, since most antiepileptic drugs also have analgesic effects.

Metabolic characterization of neurological diseases by proton localized NMR spectroscopy of the human brain.

Proton localized Magnetic Resonance Spectroscopy (MRS) of the brain allows the non invasive detection of intracellular cerebral metabolites. Localized MRS has been performed using short stimulated-echo times in various neurological diseases including stroke, multiple sclerosis, and AIDS-related leukoencephalopathies. Principal component analysis (PCA) was used to determine the critical parameters defining the metabolic profile of normal and diseased brain.

[HTLV1 and coinfections].

After reminding the epidemiology of the HTLV1 infection the authors sum up the actually recommended diagnosis procedure. --Case finding by ELISA, confirmation by WESTERN-BLOT and/or RIPA (anti-gag and anti-env specificities), or even PCR which makes specific diagnosis of HTLV1/2. --Or if possible directly by PCR which has helped some authors to find provirus in seronegative people.

Q fever meningoencephalitis in five patients.

Within the last four years, we have observed five patients with epidemiological, clinical, and serological features that were consistent with Q fever meningoencephalitis. Attempts to isolate Coxiella burnetii from the cerebrospinal fluid of two patients were unsuccessful. Neurological features ranged from coma, general seizures, confusion, to palsy and meningitis.

[High resolution NMR spectroscopy of CSF: methodological issues and perspective clinical applications].

High resolution proton nuclear magnetic resonance (NMR) spectroscopy is a new analytical technique which allows to readily identify and quantitate a variety of key metabolites in cerebrospinal fluid (CSF) in relation to normal and pathological brain activity. Proton NMR spectroscopy can be performed on native CSF, with or without addition of exchange reagent (NH4Cl). The analysis of native CSF provides qualitative information (identification) of metabolites or xenobiotics present in the fluid.

[Ataxic hemiparesis and simultaneous supra- and subtentorial hematomas].

In a chronically hypertensive woman with a rapidly developing right ataxic hemiparesis syndrome, computed tomography and magnetic resonance imaging (MRI) revealed two small unrelated hemorrhages: one in the posterior limb of the left internal capsule, the other in the right cerebellar hemisphere. In this patient, the ataxic hemiparesis syndrome might have resulted either from the association of the two lesions or from the capsular hemorrhage alone. The rarity of simultaneous hypertensive hematomas and the value of MRI in the diagnosis are underlined.

[Meningoencephalitis caused by Coxiella burnetii].

Meningoencephalitis caused by Coxiella burnetii is exceptional and its clinical presentation is varied. We report a case which presented as transient central neurological deficits and intracranial hypertension without fever. The condition was diagnosed by indirect immunofluorescence.

[Paralysis of the right arm caused by vertebral arteriovenous fistula].

Traumatic vertebral arteriovenous fistulas rarely result in neurological disorders. We report a case of upper limb paralysis caused by a C5-C6-C7 radiculopathy, 44 years after a trauma and successfully treated by surgery and embolization.

[Tendon vibrations as a tool for clinical investigation of the myotatic loop].

The degree of alteration of the myotatic loop was evaluated in 6 patients with polyradiculoneuropathy by studying deep reflexes and vibratory motor responses. The results showed that the reflex motor responses induced by vibration reappeared 2 to 4 weeks before the deep reflexes. Vibrations, therefore, could be a useful tool for the clinical follow-up of polyradiculoneuropathy.

Early clinical experience with subcutaneous GR43175 in acute migraine: an overview.

In six European clinics 111 migraine patients were treated in a series of open dose-ranging studies with subcutaneous injections of 1 to 4 mg GR43175, a novel 5-HT 1-like receptor agonist. Response rates after 20-30 min were dose related and rose from 33% with 1 mg to 96% with 4 mg GR43175. Side effects were minor and transient.

[Cerebral atrophy and chronic alcoholism].

Fifty chronic alcoholic male patients, were investigated to determine characteristics of alcohol intoxication, neurologic and hepatic complications and degree of cerebral atrophy by CT. CT imaging criteria for definition of alcoholic cerebral atrophy are proposed, discussed and compared with those previously reported. Findings showed that alcoholic cerebral atrophy is added to atrophy due to age and is in correlation with the duration of intoxication.

[Parkinson's disease and inappropriate antidiuretic hormone secretion syndrome].

A possible etiology considered in a case of inappropriate antidiuretic hormone secretion syndrome in a patient with Parkinson's disease treated with levodopa was an organic or functional dysregulation due to Parkinson's disease or its treatment. An unusual feature in this case was the long duration of the syndrome.