Showing papers by "Marie Vidailhet published in 1993"

Assessing Tremor Severity

Abstract: A clinical rating scale which measured the severity of tremor in 20 patients (12 with essential tremor and 8 with "dystonic" tremor) was assessed at specific anatomical sites for both inter and intra-rater reliability using four raters. The scores obtained with the scale were compared with the results of upper limb accelerometry, an activity of daily living self-questionnaire and estimates of the tremor induced impairment in writing and drawing specimens. The results show that, for the purposes of routine assessment and therapeutic trials, a clinical rating scale can produce reliable results which are a more valid index of tremor induced disability than standard postural accelerometry.

Loss of brain 5-HT2receptors in Alzheimer's diseaseIn vivo assessment with positron emission tomography and (18)setoperone

Abstract: Using 18[18F]setoperone and positron emission tomography (PET), alterations in serotonergic 5-HT2 receptor binding were studied in cerebral cortex of nine unmedicated patients with probable Alzheimer's disease and 37 healthy controls. The kinetics of unchanged radioligand in plasma and 18F-radioactivity in blood and brain were obtained for 90 min following tracer injection. The specific binding of [18F]setoperone to 5-HT2 receptors in the cerebral cortex was quantitated by subtraction using cerebellum as reference. In controls, a significant reduction in specific binding was associated with age and similar linear regression slopes were obtained in all the cortical regions studied. No significant difference was observed between patients with Alzheimer's disease and age-matched controls in the injected mass of setoperone, percentage of unmetabolized18setoperone in plasma, 1818F-radioactivity in blood fractions and cerebellar 18F-radioactivity concentration, indicating similar non-specific brain kinetics and metabolism of the radioligand. In contrast, there was a significant reduction in specific [18setoperone binding in the cerebral cortex in patients with Alzheimer's disease relative to control values (temporal, 69% frontal, 69% parietal, 55% temporo-parietal, 54% occipital cortex, 35%). The results demonstrate that the loss in 5-HT2 receptor binding in the cerebral cortex of patients with Alzheimer's disease, long documented by post-mortem studies, can now be assessed in vivo using PET. Correspondence to: Je rð me Blin, Nouvelle Pharmacie U289, Hðipital de la Salpetriere, 75651 Paris Cedex 13, France.

MRI in 31 patients with Behçet's disease and neurological involvement: prospective study with clinical correlation.

Abstract: Thirty one patients with Behcet's disease and neurological manifestations were prospectively studied with MRI. Cerebral venous thrombosis was diagnosed in 10 patients. MRI performed during the acute illness in eight patients showed an abnormally high signal on the T2 weighted sequences in the occluded sinus. MRI showed minor flow abnormalities suggestive of partial recanalisation of the sinus in two cases at a later clinical stage. MRI can be an alternative, non-invasive, investigation to intravenous cerebral angiography. In 13 patients with central nervous system involvement, MRI performed during the acute illness showed multiple hyperintense lesions on T2 weighted sequences. They were usually less than 5 mm, scattered and confluent, mainly in the white matter, distributed in the hemispheric white matter in nine cases, brainstem in eight, basal ganglia and thalamus in five, and cortex in two. MRI abnormalities were usually associated with appropriate clinical deficits, but were larger and more disseminated than expected.

The Bereitschaftspotential preceding simple foot movement and initiation of gait in Parkinson's disease.

Abstract: We compared the Bereitschaftspotential preceding a simple foot movement while sitting and a stepping movement while standing in a group of normal subjects and seven patients with mild to moderate Parkinson9s disease (PD) while off medication None had major difficulties stepping to initiate gait Electromyographic signals from tibialis anterior triggered the averaging of electroencephalographic signals from the scalp Bereitschaftspotentials preceding a standing stepping movement were larger than those before a foot movement while sitting in normal subjects, but no difference was observed in patients with PD The absence of an increase in the Bereitschaftspotential when stepping in PD may reflect an impairment of the preparation and assembly of the complex sequences of movement necessary to initiate walking, even in the early stages of the illness

Trigeminal neuropathy and connective tissue diseases

Abstract: Connective tissue diseases are a rare and poorly understood etiology of trigeminal neuropathy In a retrospective multicentric study covering 12 years 12 cases were identified in the archives of the Departments of Neurology, Rheumatology and Internal Medicine: 4 were associated with progressive systemic sclerosis 4 with mixed connective tissue diseases and 4 with Sjogren's syndrome In 9 of the cases, the neuropathy led to the diagnosis of connective tissue disease Trigeminal neuropathy usually developed during the evolution of the connective-tissue disease but, in 3 cases, it preceded other clinical signs As a rule, the connective tissue disease was relatively inactive when the trigeminal nerve was involved The neuropathy was usually unilateral (9 times), localized to the inferior branch(es) of the trigeminal and manifested itself by an isolated sensation of cutaneous numbness associated with paresthesias Only one patient had mixed motor and sensory involvement The topography of the lesions (peripheral, truncal, radicular or central nuclear) remains unknown in most cases, however, electromyographic study of the blinking reflex in 2 patients confirmed peripheral neuropathy in both of them Corticotherapy had only a minor effect: neuralgia was rare and carbamazepine was ineffective The pathogenicity of trigeminal involvement is discussed and these observations are compared to the 151 cases reported in the literature