[Which therapy for acute and chronic migrains?].

The onset of a migraine attack is associated with the activation of the trigemino-vascular system. Early intervention with triptans, which inhibit this activation is an effective treatment for migraine attacks. To avoid a cutaneous allodynia it is necessary to introduce as soon as possible the treatment with triptans.

[Cervical sprain and chronic disorders: the neurologist's point of view].

The Whiplash Associated Disorders (WAD) are mostly chronic cervical and cephalic pain syndromes. They are often associated with general disorders and with sensorial difficulties. The neurologist evaluates this trouble according to neurochemical and neurophysiological models, hypothesizing a "central hypersensitivity" after a localised peripheral lesion (such as cervical distortion).

[Cervicogenic headaches].

Cervicogenic headaches are a relatively new nosological entity. The diagnostic criteria are still under discussion. They are rare: the diagnostic is based on anamnestic and clinical considerations.

[Facial pains].

Facial pain can represent an expression of an initial symptom of a severe primary neurological disease. Some examples are presented. In the second part chronic pain like facial pain, stomatodynia, odontalgia and temporomandibular disorders are illustrated and grouped together under the name idiopathic facial or orofacial pain.

Heralding manifestations of basilar artery occlusion with lethal or severe stroke.

Background: Basilar artery occlusion usually causes severe disability or death. Until the recent developments in local intra-arterial or systemic intravenous fibrinolysis, interest in early diagnosis was low because there was no satisfactory treatment. Thus there is little information about the initial phase of the disease.

Effects of proximal and distal muscles' groups contraction and mental stress on the amplitude and frequency of physiological finger tremor. An accelerometric study.

Physiological finger tremor was assessed by two-dimensional solid accelerometry in 40 healthy normal subjects at rest (R) with the hand hanging over the armrest of a chair, in posture (P) with the arm rested on the armrest but the hand extended from the wrist, and finally adding proximal muscles contraction in extension (E) with the arm extended in front of the patient, each time with and without mental stress. The mean amplitude for physiological tremor, about 30 microns, was almost doubled by hand extension and increased by 4 to 5-fold by arm extension with further increase by mental stress in each position, which gives a good estimation of the contribution of proximal and distal muscles into the amplitude of physiological tremor. There was no significant effect of age between 20 and 60 years on tremor amplitude, but mean tremor frequency decreased significantly between 40 to 60 years.

[Recurrent subacute encephalopathy in the framework of idiopathic hypereosinophilic syndrome].

History: An 81-year-old man, previously good health, suddenly developed confusion and rapidly progressive severe tetraparesis.

Investigations: Peripheral blood and bone marrow revealed marked eosinophilia: allergic, parasitic, neoplastic or vasculitic causes were excluded. Magnetic resonance imaging demonstrated multiple lesions in the cortical and subcortical white matter.

The alpha2-adrenoceptor agonists xylazine and guanfacine exert different central nervous system, but comparable peripheral effects in calves.

Acute pharmacodynamic effects of the alpha2-adrenoceptor agonists, xylazine and guanfacine, were investigated in nine healthy calves in an open crossover trial. Xylazine (100 microg/kg body weight intravenously (i.v.

Autologous fat injection for soft tissue augmentation in the face: a safe procedure?

Autologous fat injection for soft tissue augmentation in the face is claimed to be a safe procedure. However, there are several case reports in the literature where patients have suffered from acute visual loss and cerebral infarction following fat injections into the face. Acute visual loss after injection of various substances into the face is a well-known complication of such interventions.

Persistent recurrence of hypomania and prosopoaffective agnosia in a patient with right thalamic infarct.

The authors report a 63-year-old man with a history of brief isolated manic episodes who became persistently hypomanic after a small right thalamic infarct. Detailed behavioral and neuropsychologic assessment were performed 18 months after the stroke and revealed a prosopoaffective agnosia as the foremost cognitive disorder, i.e.

Delayed segmental axial dystonia of the trunk on standing after lumbar disk operation.

We report four patients with various degrees of chronic, tonic, mildly painful, or non-painful, kyphoscolioses in orthostatism, which developed weeks, or months, after one or several laminectomies for lumbar disk hernia, in the absence of recurring radicular pain or acute lumbar pain. No family history or personal antecedent, of focal or generalized dystonia was found and the dystonia was not seen in any of the four patients pre-operatively, or during the immediate post-operative period. Only ill-defined lumbar 'discomfort', unlike their pre-operative lumbago, was reported by the patients, before and during the occurrence of the pathologic trunk posture on standing.

[Behavior disorders of neurological origin].

The modifications of behavior related to neurological diseases are various and important to be correctly diagnosed. The purpose of this article is to present the clinical features of main neuropsychiatric syndromes: depression, delusions, anxiety, obsessive-compulsive syndrome. The differential diagnosis is also developed.

[Olivo-ponto-cerebellous degeneration. A study of 21 patients defined by the Quinn criteria].

21 patients with diagnosis of idiopathic OPCA were examined clinically and evaluated by MRI or CT-scan. On the basis of Quinn's criteria for MSA, patients were subdivided into those with probable MSA (48 p. cent) and those with possible MSA (52 p.

[Sentinel headache: a premonitory symptom too often unrecognized in intracranial ruptured aneurysm].

Headache is a common complaint in emergency departments, but only a small percentage of patients have a serious disease. Nevertheless, some forms of headache, such as "warning headaches", need special attention. By far the most common symptom associated with aneurysmal minor bleed (warning leak) is a sudden headache that is considered to be a warning symptom of impending aneurysmal rupture.

Hyperkinetic movement disorders during and after acute stroke: the Lausanne Stroke Registry.

Background And Objective: To study consecutive patients with acute or delayed hyperkinetic movement disorders in the Lausanne Stroke Registry.

Methods: We have identified 29 patients with acute or delayed movement disorders among 2500 patients who had their first-ever acute stroke in the Lausanne Stroke Registry.

Setting: Department of Neurology, Lausanne University Hospital.

[Astral and out-of-body voyages. Heautoscopy, ecstasis and experimental hallucinations of epileptic origin].

We report a 38 year-old patient who had temporoparietal epilepsy and unusual ictal "out of body" experiences that remained undiagnosed for more than ten years, until her admission for a motor seizure of the left hemibody. Out of body episodes were experienced as intense and ecstatic astral journeys. EEG showed a bilateral extension of epileptiform abnormalities to the parietal regions, predominantly on the right side.