[Differential diagnosis of strokes, the traps to avoid].

Strokes are a significant issue in geriatric medicine as more than half occur in patients over the age of 75. However, not all the symptoms of a focal neurological deficit in the elderly are indicative of a stroke. There are a number of differential diagnoses and only a detailed examination of the patient can enable an accurate diagnosis to be established.

Contribution of geriatric model to the management of an epileptic seizure or epilepsy.

Epileptic seizures and epilepsy appear frequent in the elderly. The diagnosis is often more difficult and therapeutic decisions are often debated. In this context, the implementation of a rigorous analysis and reasoning to correctly determine the various components at the origin of the epileptic seizure is fundamental.

[Restraint in geriatric care, pharmacological and non-pharmacological approaches].

Restraint in geriatric care is not a trivial act. It must be regulated, performed in accordance with best practice guidelines and respect patients' fundamental rights. It requires initial evaluation as well as daily re-evaluation.

[Link between non hypoxemic chronic obstructive pulmonary disease and executive functioning in oldest old].

COPD (chronic obstructive pulmonary disease) may result in cognitive disorders (mainly executive) even without hypoxemia. The aim of this descriptive study was to highlight a deficit in task-switching in non-hypoxemic patient with COPD and mild cognitive impairment (MCI) or Alzheimer disease (AD). The main judgment criterion was patients' performances on the TMTA and B.

Klebsiella pneumoniae necrotizing fasciitis of the leg in an elderly French woman.

Klebsiella pneumoniae necrotizing fasciitis is a rare infection in regions outside of Asia. Here, we present a case of necrotizing fasciitis of the leg caused by K. pneumoniae in a 92-year-old French woman hospitalized in a geriatric rehabilitation unit.

[Epilepsy in the elderly].

Epilepsy is one of the most frequent neurological diseases in the elderly. Its incidence and associated-mortality rise in old age. Distinguishing epilepsy from paroxysmal non epileptic events can be a real challenge for physicians.

Spread deficits in initiation, speed and accuracy of horizontal and vertical automatic saccades in dementia with lewy bodies.

Background: Mosimann et al. (2005) reported prolongation of saccade latency of prosaccades in dementia with Lewy body (DLB). The goal of this study is to go further examining all parameters, such as rates of express latency, but also accuracy and velocity of saccades, and their variability.

[Preservation of automatic ocular saccades in healthy elderly: alteration in patients with dementia with Lewy body].

We studied, in healthy elderly subjects (aged from 63 to 83 years) and adults (aged from 20 to 32 years), ocular saccades in two conditions: one the one hand, the gap condition, where the central target disappears; then follows a period of 200 ms during which the fixation and attention were disengaged; finally, a visual target appears in the periphery. On the other hand, the overlap condition, in which the peripheral target appears when the central target is still present, the subject should voluntarily disengage his attention and fixation to orient them toward the peripheral target. These paradigms stimulate automatic versus controlled triggering of saccades.

A stable proportion of Lewy body bearing neurons in the substantia nigra suggests a model in which the Lewy body causes neuronal death.

Lewy bodies in Parkinson disease could be innocent bystanders or active agents responsible for neuronal death. Eighteen elderly patients with a Parkinson syndrome were studied prospectively and selected postmortem on the presence of Lewy bodies (14 cases with Parkinson disease, four with dementia with Lewy bodies). Information on disease duration was available in 17 cases.

Motor score of the Unified Parkinson Disease Rating Scale as a good predictor of Lewy body-associated neuronal loss in the substantia nigra.

Background: How well the motor symptoms assessed by the motor section of the Unified Parkinson Disease Rating Scale (UPDRS3) reflect the neuronal loss observed in the substantia nigra is not known.

Objective: To study the relationships among the motor symptoms assessed by the UPDRS3, Lewy body-associated neuronal loss in the substantia nigra, and duration of disease.

Design: Longitudinal, prospective, clinicopathological study.