Cognitive impairments in alcohol-dependent subjects.

Chronic excessive alcohol consumption induces cognitive impairments mainly affecting executive functions, episodic memory, and visuospatial capacities related to multiple brain lesions. These cognitive impairments not only determine everyday management of these patients, but also impact on the efficacy of management and may compromise the abstinence prognosis. Maintenance of lasting abstinence is associated with cognitive recovery in these patients, but some impairments may persist and interfere with the good conduct and the efficacy of management.

[Cognitive impairment of alcohol-dependent subjects].

Chronic excessive alcohol consumption induces multiple brain damages. Secondary cognitive disorders include executive functions, episodic memory and visuospatial capacities. The severity of these alcohol induced disorders may vary between sub-clinical manifestations (that may, nevertheless, interfere with medical management) and more important ones like Korsakoff syndrome or dementia.

[Trusted person and living will: information and implementation defect].

Purpose: The French law allows the persons of age to appoint a trusted person and to draft advance directives in case they are one day in a condition that prevents them from expressing their will regarding their health care. Our study objective was to assess patients' and relatives' knowledge and collecting their opinion regarding these means of expression of their will.

Methods: An anonymous survey by self-administered questionnaire was conducted in the admission offices of the University Hospital of Nancy in April 2011.

[Cognitive impairment induced by digoxin intake in patients older than 65 years].

Cognitive impairment or clinical signs of dementia in an old patient who receives digoxin, should suggest a digitalis intoxication. Symptoms can be present although a normal digoxin serum concentration. It is recommended to stop the treatment to obtain a regression of dementia symptoms.

[Neurosyphilis: a rare cause of dementia].

Introduction: Neurosyphilis had to be evoked in the face of an atypical dementia.

Case Record: We describe the case of a 65-year-old man who presented with neurosyphilis suspected to precede behavioral and cognitive problems in the context of risky sexual behavior and was confirmed by serologic tests in the cerebrospinal fluid.

Discussion: This case proves the necessity to investigate the possibility of neurosyphilis in subjects with dementia syndrome which does not correspond to classic etiologies.

[Paroxysmal atrioventricular block due to anticholinesterase therapy].

The authors report a case of paroxysmal syncopal complete atrioventricular block due to anticholinesterase therapy occurring after the first administration. The block was reversible. It is therefore important to exclude this cause of atrioventricular block in the elderly in view of the increasing indications of this therapy.