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Agard E, El Chehab H, Vanquaethem H, Malclès A, Drouet A, Dot C, Guilloton L. [Bilateral infiltrative optic neuropathy as presenting sign of Waldenström macroglobulinemia]. J Fr Ophtalmol 2017; 40:e95-e96. [PMID: 28318712 DOI: 10.1016/j.jfo.2016.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 12/18/2015] [Accepted: 01/04/2016] [Indexed: 11/16/2022]
Affiliation(s)
- E Agard
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
| | - H El Chehab
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - H Vanquaethem
- Service de médecine interne, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - A Malclès
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - A Drouet
- Service de neurologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - C Dot
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - L Guilloton
- Service de neurologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
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Guilloton L, Pegat A, Defrance J, Quesnel L, Barral G, Drouet A. Neonatal pancytopenia in a child, born after maternal exposure to natalizumab throughout pregnancy. J Gynecol Obstet Hum Reprod 2017; 46:301-302. [PMID: 28403930 DOI: 10.1016/j.jogoh.2017.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 01/23/2017] [Accepted: 02/01/2017] [Indexed: 10/20/2022]
Abstract
Natalizumab is a monoclonal antibody indicated for the treatment of patients with relapsing-remitting multiple sclerosis. Its use is prohibited during pregnancy. However, natalizumab exposures throughout the gestation period or during the third trimester, because of intense disease activity, are possible and begin to be reported. There are enough reassuring arguments against a teratogenicity, through pregnancy registries; but deleterious effects in the monitoring of newborn, are not well known. A disorder of hematopoiesis is possible with anemia, thrombocytopenia or pancytopenia, as discussed by the author through an observation. These hematological disorders seem to be asymptomatic; they resolve spontaneously and require a simple biological and clinical monitoring of the newborn.
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Affiliation(s)
- L Guilloton
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
| | - A Pegat
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - J Defrance
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - L Quesnel
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - G Barral
- Cabinet de gynécologie, 12, chemin de la Croix-Pivort, 69110 Sainte-Foy-les-Lyon, France
| | - A Drouet
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
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Guilloton L, Bruneau O, Trousselard M, Zagnoli F, Blanc PA, De Greslan T, Drouet A. [Impact of headache among studied military population in Afghanistan deployed in the Kabul military field hospital]. Rev Neurol (Paris) 2015; 171:792-5. [PMID: 26318902 DOI: 10.1016/j.neurol.2015.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 04/01/2015] [Accepted: 05/06/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Headaches are a common reason for consultation with a prevalence of 30%. Few data exist for military personnel, including in situations of war operations. The main objective of this work was to measure the evolution of the impact of headache in such a context. MATERIALS AND METHODS Two hundred and one personnel deployed in the Kaïa military field hospital in Afghanistan were recruited. A questionnaire designed to recognize headaches, supported by two quality of life scales (MIDAS and HIT-6) and a stress questionnaire were filled out before departure and upon return from missions. DISCUSSION Sixty-three patients with headache were initially identified, of whom 52 remained symptomatic during the mission. The average total score of MIDAS before departure was 4 days and fell to 1.4 days upon return, with a mean measured change of 3.3 days. For HIT-6, the mean total score was 51.2 points initially and 51.9 points at the end of the mission with a mean change of-0.3 points. Nine patients without headache initially became symptomatic: MIDAS and HIT-6 were not affected. CONCLUSION Thus, the impact of headache in the particular context of presence in a theater of operations was low: improved MIDAS score and the lack of influence on the HIT-6 score are underlined.
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Affiliation(s)
- L Guilloton
- Service de neurologie HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
| | - O Bruneau
- Service de neurologie HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - M Trousselard
- Service de neurophysiologie du stress, institut de recherche biomédicale des armées, BP 73, 91223 Bretigny-sur-Orge cedex, France
| | - F Zagnoli
- Service de neurologie, HIA Clermont-Tonnerre, rue du Colonel-Fonferrier, 29240 Brest cedex 9, France
| | - P A Blanc
- Service de neurologie HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - T De Greslan
- Service de neurologie, HIA Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris 5, France
| | - A Drouet
- Service de neurologie HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
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Drouet A, Le Moigne F, Salamé D, Quesnel L, Motolese C, des Portes V, Guilloton L, Pinson S. [Type 2 neurofibromatosis: intergenerational differences in genetic and clinical expression]. Arch Pediatr 2014; 21:1233-40. [PMID: 25439059 DOI: 10.1016/j.arcped.2014.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 05/17/2014] [Accepted: 08/28/2014] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Neurofibromatosis type 2 (NF2) is a rare dominantly inherited disease. Its clinical presentation can be completely different in children and adults and early diagnosis is often difficult. The NF2 gene molecular analysis can help for diagnosis, but its result can be negative in case of NF2 mosaicism. OBSERVATIONS We report the case of a 43-year-old man who had developed a severe phenotype with bilateral vestibular schwannomas at 19 years of age. His son presented a retinal hamartoma with loss of vision in his right eye at 2 months of age. At 9 years of age, asymptomatic schwannomas of the cranial nerves were discovered: cranial nerves X (left), XI (left), and VIII (bilateral). Partial constitutional NF2 deletion (from exons 2-7) was detected in his son. The deletion was not detectable in the DNA blood of his father and we strongly suspect a mosaic form of NF2. CONCLUSION Ophthalmological manifestations can be the initial sign of NF2 in childhood. These features must be actively sought during the first year of life in individuals at risk of NF2. NF2 mosaicism is often described as a mild form of NF2 with a very low risk of transmission to the carrier's children. We show that NF2 mosaicism can sometimes develop severe NF2 symptoms and we confirm that the transmission risk to the offspring depends on the proportion of zygotes carrying the mutation. NF2 remains a life-limiting and life-spoiling condition. Early diagnosis is necessary to prevent complications and the follow-up of NF2 patients must be organized throughout life in specialty centers.
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Affiliation(s)
- A Drouet
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 3, France; Centre de compétence neurofibromatose, Rhône-Alpes-Auvergne, centre Léon Bérard, 28, rue Laënnec, 69373 Lyon cedex 08, France.
| | - F Le Moigne
- Service de radiologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 3, France
| | - D Salamé
- 1, rue de la Poterne, 71600 Paray le Monial, France
| | - L Quesnel
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 3, France
| | - C Motolese
- Service de neurochirurgie, hôpital neurologique, 59, boulevard Pinel, 69677 Bron cedex, France
| | - V des Portes
- Service de neuropédiatrie, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| | - L Guilloton
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 3, France
| | - S Pinson
- Service de génétique moléculaire et clinique, groupement hospitalier Édouard-Herriot, 5, place d'Arsonval, 69437 Lyon cedex 03, France; Centre de compétence neurofibromatose, Rhône-Alpes-Auvergne, centre Léon Bérard, 28, rue Laënnec, 69373 Lyon cedex 08, France
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Guilloton L, Wey PF, Quesnel L, Dardarre E, Rassat R, Faulcon C, Drouet A. Hoquet irréductible survenant précocement dans l’évolution d’un patient souffrant d’une sclérose en plaques. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Guilloton L, Wey P, Faulcon C, Gargi T, Quesnel L, Ghesquières H, Biron P. Syndrome de Guillain-Barré associé à un syndrome de reconstitution d’immunité survenant dans les suites d’une greffe autologue de cellules souches hématopoïétiques. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Drouet A, Le Moigne F, Quesnel L, Motolese C, Des Portes V, Guilloton L, Pinson S. Hamartome rétinien inaugurant une neurofibromatose de type 2 chez un enfant dont le père présente une forme sévère en mosaïque. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Quesnel L, Guilloton L, Truy E, Pinson S, Drouet A. Cohorte neurofibromatose de type 2 centre de référence Rhône Alpes : épidémiologie – analyse comparée des données de la littérature. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bruneau O, Zagnoli F, de Greslan T, Quesnel L, Antoine Blanc P, Drouet A, Guilloton L. Évolution de l’impact des céphalées dans un contexte exceptionnel d’opérations extérieures. Étude d’une population militaire en Afghanistan, au sein du personnel de l’hôpital médico-chirurgical de Kaia en 2012. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Guilloton L, Camarasa C, Agard E, Tondeur G, Dot C, Drouet A. Ataxie avec ophtalmoplégie : syndrome de Miller-Fisher avec positivité des anticorps anti-GQ1b. J Fr Ophtalmol 2014; 37:89-92. [DOI: 10.1016/j.jfo.2013.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 05/07/2013] [Accepted: 05/17/2013] [Indexed: 10/25/2022]
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Bylicki O, Delcasso B, Loheas L, Guilloton L, Peloni J, Dot J. Un essoufflé qui tremble. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Guilloton L, Demarquay G, Quesnel L, De Charry F, Drouet A, Zagnoli F. [Dysautonomic syndrome of the face with Harlequin sign and syndrome: Three new cases and a review of the literature]. Rev Neurol (Paris) 2013; 169:884-91. [PMID: 23726525 DOI: 10.1016/j.neurol.2013.01.628] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 11/12/2012] [Accepted: 01/03/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Harlequin phenomenon is characterized by a strictly unilateral erythrosis of the face with flushing and hyperhydrosis, and controlaterally a pale anhydrotic aspect. This syndrome can occur alone or associated to other dysautonomic phenomena such as Horner syndrome, Adie syndrome or Ross syndrome. PATIENTS AND METHODS We report three cases: two patients presented a Harlequin sign, associated with Horner syndrome for one and Ross syndrome for the second. The etiologic investigation was normal, allowing recognizing the idiopathic nature of the disorder. For the third patient, Harlequin syndrome was observed in a neoplastic context due to breast cancer, metastatic dissemination, and bone metastases involving the right side of the T2 body. DISCUSSION We reviewed the literature: 108 cases have been described. This syndrome occurred alone in 48 patients and was associated with other dysautonomic syndromes such as Horner syndrome in 38 patients, Holmes Adie syndrome in six, and Ross syndrome in six; both Ross and Holmes Adie syndrome were associated five cases and associations were not reported in five patients. The pathophysiological mechanisms of this autonomic cranial neuropathy, the possible etiologies, and therapeutic management were discussed. CONCLUSION Harlequin phenomenon with flushing and unilateral hyperhydrosis is rare, occurring alone or in combination with other autonomic syndromes of the face. Idiopathic in two-thirds of cases, Harlequin phenomenon does not require specific treatment; sympathectomy may be discussed in the severe cases with a significant social impact.
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Affiliation(s)
- L Guilloton
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
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Guilloton L, Meyronnet D, Claude V, Quesnel L, Rassat R, Drouet A, Felten D. Présentation inhabituelle d’un germinome intracérébral avec dissémination ventriculaire. Rev Neurol (Paris) 2013. [DOI: 10.1016/j.neurol.2013.01.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Poyat C, Isnard P, Brunetti B, Melaine R, Quesnel L, Drouet A, Guilloton L. Intérêt de l’EEG couplé à une consultation de neurologie dans les suspicions de crises comitiales inaugurales discutées en urgence étude descriptive de janvier 2008 à août 2010. Rev Neurol (Paris) 2013. [DOI: 10.1016/j.neurol.2013.01.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bruneau O, Le Moigne F, Guyotat J, Nicolas-Virelizier E, Guilloton L, Drouet A. [Occipital neuralgia (Arnold) as the presenting symptom of diffuse large B-cell non-Hodgkin lymphoma]. Rev Neurol (Paris) 2012; 169:175-8. [PMID: 23079854 DOI: 10.1016/j.neurol.2012.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 05/20/2012] [Accepted: 05/25/2012] [Indexed: 10/27/2022]
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Donat A, Guilloton L, Bonnet C, Depreux G, Lamboley JL, Drouet A. [Partial visual seizures induced by non-ketosic hyperglycemia: magnetic resonance imaging and visual evoked potential descriptions. A study of two cases reports with radiologic and electrophysiologic abnormalities]. Rev Neurol (Paris) 2012; 169:154-61. [PMID: 23079857 DOI: 10.1016/j.neurol.2012.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 05/02/2012] [Accepted: 05/30/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Non-ketosic hyperglycemia (NKH) may increase the likelihood of focal epileptic seizures, including commonly motor expression; rarely, they can have a visual expression. METHODS The authors describe the observation of two men, who were hospitalized for visual manifestations; with episodes of homonymous hemianopia and hallucinations, revealing occipital seizure, secondary to NKH. Clinical data and characteristics of the investigations, including radiological imaging (MRI) and electrophysiological results of visual evoked potentials (VEP) are specified. RESULTS MRI showed transitory low signal on T2 and FLAIR in occipital areas. Spectro-MR identified a moderate diminution of the NAA and lipids spikes, compatible with laminar necrosis. VEP revealed a transient decrease of the P100 amplitude. DISCUSSION These two observations underline the existence of acute symptomatic seizures with a visual starting point which is often indicative of diabetes. Through these observations with a review of 28 patients from the literature, MR imaging characteristics and possible anomalies collected on VEP are discussed. Such seizures are resistant to anticonvulsant treatment and respond best to insulin and rehydration. CONCLUSION The visual manifestations indicative of seizures with an occipital starting point in the context of NKH are possible enabling rapid initiation of effective symptomatic treatment with insulin.
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Affiliation(s)
- A Donat
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
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Depreux G, Rabar D, Bruneau O, Drouet A, Guilloton L. Syndrome de Parsonage et Turner révélant une primo-infection à VIH. Med Mal Infect 2012; 42:372-3. [DOI: 10.1016/j.medmal.2012.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 05/06/2012] [Accepted: 06/10/2012] [Indexed: 10/28/2022]
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Hajek V, Dussart C, Klack F, Lamy A, Martinez JY, Lainé P, Mazurier L, Guilloton L, Drouet A. Neuropathic complications after 157 procedures of continuous popliteal nerve block for hallux valgus surgery. A retrospective study. Orthop Traumatol Surg Res 2012; 98:327-33. [PMID: 22459100 DOI: 10.1016/j.otsr.2011.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 09/28/2011] [Accepted: 11/07/2011] [Indexed: 02/02/2023]
Abstract
BACKGROUND Continuous peripheral nerve block (CPNB), in particular at the popliteal fossa, is widely used in orthopedic surgery, allowing good postoperative analgesia. Possible neuropathic complications, however, remain poorly known. OBJECTIVE To review the characteristics of peripheral neuropathy (PN) after sciatic CPNB at the popliteal fossa, estimating prevalence, severity, evolution and possible risk factors, especially those relating to the procedure. METHODS Retrospective study of PN associated with popliteal fossa CPNB for hallux valgus surgery, between November 1st, 2005 and November 1st, 2009. All procedures were analyzed (type of anesthesia, approach, nerve location technique, number of procedures by operator) with, for each case of PN, analysis of clinical and electromyographic data. RESULTS One hundred and fifty seven sciatic CPNBs were performed (92% women; mean age, 55 years). The approach was lateral (n=62), posterior (n=74) or unknown (n=21). Ultrasound guidance was combined to neurostimulation for 69 patients (44%). Three women (prevalence=1.91%), aged 19, 24 and 65 years respectively, developed associated common superficial peroneal and sural nerve injury (2), axonal on electromyography, with motor (n=1) and/or sensory (n=3) residual dysfunction. DISCUSSION The higher prevalence found in the present study than in the literature (0 to 0.5%) raises questions of methodological bias or technical problems. The common peroneal and sural nerves seem to be exposed, unlike the tibial. Several mechanisms can be suggested: anesthetic neurotoxicity, direct mechanical lesion, or tourniquet-related ischemia and conduction block. Further studies are necessary to determine the ideal anesthetic procedure. CONCLUSION Patients should be informed of the potential risk, however rare, even during mild surgery. The best possible technique should be implemented, with reinforced surveillance.
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Affiliation(s)
- V Hajek
- Neurology department, Desgenettes military teaching hospital, 69275 Lyon, France.
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Guilloton L, Drouet A, Pasquet F, Camarasa C, Didelot A, Bruneau O, Felten D. Pandysautonomie paranéoplasique avec anticorps anti Hu. Rev Neurol (Paris) 2012. [DOI: 10.1016/j.neurol.2012.01.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Didelot A, Guilloton L, Drouet A, Honnorat J. Diagnostic des encéphalites auto-immunes. Rev Neurol (Paris) 2012. [DOI: 10.1016/j.neurol.2012.01.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Guilloton L, De Carvalho A, Quesnel L, Pasquet F, Mounier C, Drouet A. Paralysie périodique thyréotoxique hypokaliémique révélatrice d’une maladie de Basedow chez un caucasien. Rev Neurol (Paris) 2012; 168:170-2. [DOI: 10.1016/j.neurol.2011.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 01/09/2011] [Accepted: 03/24/2011] [Indexed: 10/17/2022]
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Pasquet F, Karkowski L, Hajek V, Pavic M, Guilloton L. Une manifestation inaugurale inhabituelle de la granulomatose de Wegener : l’accident vasculaire cérébral ischémique. Rev Med Interne 2012; 33:e6-9. [DOI: 10.1016/j.revmed.2011.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Accepted: 02/03/2011] [Indexed: 11/28/2022]
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Lamboley JL, Le Moigne F, Have L, Tsouka G, Drouet A, Salamand P, Guilloton L. [Artery of Percheron occlusion: Value of MRI. A review of six cases]. ACTA ACUST UNITED AC 2011; 92:1113-21. [PMID: 22153043 DOI: 10.1016/j.jradio.2011.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Revised: 07/06/2011] [Accepted: 08/17/2011] [Indexed: 11/17/2022]
Abstract
Blood supply to the human thalami is complex and multiple variants exist. The artery of Percheron is one of those variants and is characterized by a solitary arterial trunk that branches from one of the proximal segments of either posterior cerebral artery and supplies blood to the paramedian thalami. Its occlusion results in bilateral paramedian thalamic infarction sometimes extending to the midbrain. We report six cases of bithalamic infarction secondary to occlusion of the artery of Percheron. We will illustrate the complex clinical symptomatology and underscore the role of imaging, especially MRI, for diagnosis.
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Affiliation(s)
- J L Lamboley
- Service d'imagerie médicale, hôpital d'instruction des Armées Desgenettes, 108, boulevard Pinel, 69375 Lyon cedex 03, France.
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Havé L, Drouet A, Lamboley JL, Cotton F, St-Pierre G, Quesnel L, Guilloton L, Felten D. [Toxic leucoencephalopathy after use of sniffed heroin, an unrecognized form of beneficial evolution]. Rev Neurol (Paris) 2011; 168:57-64. [PMID: 21726885 DOI: 10.1016/j.neurol.2011.01.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 12/10/2010] [Accepted: 01/17/2011] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Serious leukoencephalopathy can be related to heroin injection or inhalation. OBSERVATION We report the first case of leukoencephalopathy observed three weeks after a 46-year-old man sniffed heroin. The clinical presentation included cognitive and behaviour disorders, pyramidal irritation and slight gait instability. Blood and cerebrospinal fluid analyse were normal. Brain magnetic resonance imaging showed diffuse, symmetrical supratentorial white matter lesions producing high intense signals on FLAIR and b1000-weighted sequences. Proton spectroscopy revealed an increased rate of cholin, in favour of active demyelinated lesions. Brain biopsy showed intramyelinic oedema with reactive gliosis. After two and a half years, moderate attentional fluctuations and difficulties in initiating activities persisted. Repeated MRI showed a reduction of the leukoencephalopathy. CONCLUSION Heroin could be a cause more common than thought of leukoencephalopathy. The clinical and radiological expression and prognosis could be related to the mode of consummation (inhalation, intravenous injection, sniffing). This parameter may modulate severity and localization of brain lesions. More systematic use of MRI for patients with psychiatric symptoms after heroin intoxications could lead to a better evaluation of heroin-related neurotoxicity and potentially improve prevention.
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Affiliation(s)
- L Havé
- Services de neurologie, HIA Desgenettes, 108 boulevard Pinel, Lyon cedex 03, France.
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El Chehab H, Le Corre A, Ract-Madoux G, Le Moigne F, Drouet A, Guilloton L, Taillia H, Swalduz B, Mourgues G, Dot C. Syndrome de SUSAC. Modes d’entrée et évolutions variables : à propos de deux cas. J Fr Ophtalmol 2010; 33:575.e1-7. [DOI: 10.1016/j.jfo.2010.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Accepted: 07/01/2010] [Indexed: 10/19/2022]
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Pasquet F, Karkowski L, Guilloton L, Debourdeau P, Pavic M. Un accident vasculaire cérébral révélateur d’une maladie de Wegener. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Drouet A, Have L, Jacquin O, Guilloton L, Felten D. [Post-traumatic focal fixed dystonia of the shoulder: a distinctive syndrome with speculative mechanisms?]. Rev Neurol (Paris) 2009; 165:975-9. [PMID: 19157474 DOI: 10.1016/j.neurol.2008.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Revised: 10/12/2008] [Accepted: 10/17/2008] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Whether post-traumatic focal fixed dystonia has a physiological or psychologically-mediated mechanism is discussed. CASE REPORT We report the case of an active 22-year-old soldier with shoulder-fixed dystonia, eight months after a fall with minor right-acromioclavicular sprain. CONCLUSION Psychiatric examination and search of complex regional pain syndrome, radicular or accessory nerve damage, and genetic predisposition to dystonia are necessary for selecting a difficult treatment in these patients.
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Affiliation(s)
- A Drouet
- Service de neurologie, hôpital d'instruction des armées-Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
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Guilloton L, Cotton F, Cartalat-Carel S, Jouanneau E, Frappaz D, Honnorat J, Guyotat J. Intérêt de l’IRM, avec séquences de diffusion, de perfusion et de la spectrométrie dans le diagnostic et la surveillance de gliomes d’aspect initial de grade 2 : recherche de marqueurs radiologiques orientant vers une aggravation tumorale de grade. Neurochirurgie 2008; 54:517-28. [DOI: 10.1016/j.neuchi.2008.02.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Accepted: 02/05/2008] [Indexed: 11/29/2022]
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Guilloton L, Didelot A, Gouillou A, Felten D, Drouet A. Syndrome de céphalées et déficits neurologiques transitoires avec lymphocytose du liquide céphalorachidien. Rev Med Interne 2008; 29:397-400. [DOI: 10.1016/j.revmed.2007.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 11/06/2007] [Indexed: 10/22/2022]
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Affiliation(s)
- A Drouet
- Service de Neurologie, Hôpital d'Instruction des Armées Desgenettes, Lyon.
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Guilloton L, De Carvalho A, Chevalier B, Drouet A, Felten D, Vallee B. S - 1 Bilharziose intracérébrale à Schistosoma mansoni de présentation pseudo-tumorale. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90754-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Drouet A, Caudie C, Vallat JM, Ruel JH, Felten D, Guilloton L, Giraud P. [Polyneuropathy involving cranial nerves associated with monoclonal IgM antibodies with anti-MAG/SGPG/SGPLG/sulfatides activity]. Rev Neurol (Paris) 2006; 162:760-6. [PMID: 16840988 DOI: 10.1016/s0035-3787(06)75077-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION A typically distal and symmetrical, slowly progressive sensorimotor demyelinating neuropathy is caused by monoclonal IgM against myelin-associated glycoprotein (MAG) and SGPG, SGLPG glycolipids in the context of a benign IgM paraproteinemia. We studied a patient with a neuropathy that fulfilled the diagnostic criteria for CIDP in whom IgM kappa anti-MAG/SGPG/SGLPG were detected. OBSERVATION The patient was a 57-year-old man who had developed a slowly progressive distal sensorimotor neuropathy, involving the lower then upper limbs, with cranial nerves palsies (oro-pharyngo-laryngo territory). ENMG showed a demyelinating neuropathy with a disproportionate slowing of conduction in distal segments of motor and axonal features in the lower limbs. The first routine laboratory analysis revealed negative or normal findings. Several serum protein electrophoreses were normal. The third cerebrospinal fluid examination demonstrated a moderate and late rise in CSF protein level with no cells. Monoclonal IgM-kappa against MAG/SGPG/SGLPG, was detected; anti-MAG antibody titre in the serum was 20 059 BTU (N<1000). A small IgM-kappa paraprotein was identified by immunofixation. Electron microscopy failed to show nerve fibers with widening of outer lamellae of the myelin. There is no clinical improvement after different treatments, immunoglobulins IV, cortisteroids, plasma exchange, rituximab. CONCLUSION It is not known whether this neuropathy is an atypical form of PNMAG or an CIDP associated with anti-MAG. When ENMG show a disproportionate slowing of conduction in distal segments of motor nerves, one should screen the serum with immunofixation to identify small monoclonal components. If IgM-MGUS is present, search should be undertaken for anti-MAG/SGPG/SGLPG antibodies. Diagnosis enables optimal treatment using, in severe cases, expensive current strategies with immunoglobulins IV, plasma exchange, and corticosteroids, or, in the event of no response, rituximab before resorting to more toxic drugs like cyclophosphamide.
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Affiliation(s)
- A Drouet
- Service de Neurologie, Hôpital d'Instruction des Armées Desgenettes, Lyon.
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Guilloton L, Michaud A, Potier V, Le Berre J, Drouet A, Felten D. Ataxie et confusion après traitement par 5-fluorouracile. Rev Med Interne 2005; 26:986-7. [PMID: 16337869 DOI: 10.1016/j.revmed.2005.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2005] [Accepted: 02/21/2005] [Indexed: 11/21/2022]
Affiliation(s)
- L Guilloton
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel 69275 Lyon cedex 03, France.
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Guilloton L, Allary M, Jacquin O, Billaud Y, Drouet A, Felten D, Volckmann P. Diastématomyélie révélée chez l’adulte : étude de deux cas et revue de la littérature. Rev Neurol (Paris) 2004; 160:1180-6. [PMID: 15602364 DOI: 10.1016/s0035-3787(04)71163-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Split cord malformation (SCM) is an uncommon developmental anomaly characterized a cleft spinal cord. In type I, each of the hemicords is contained within an individual dural tube whereas in type II there is a common dural tube housing both hemicords. Commonly diagnosed in childhood, adult presentation is exceptional. METHODS We report the case of two women whose type II SCM was discovered at the age of 40 and 54 years. RESULTS The first patient complained of chronic lombar and radicular chronic pain with dysuria. Physical examination revealed a radicular syndrome with abolition of the left Achille reflex and a lombar hair tuft. MRI showed a disc herniation at the L5-S1 level, with a partial SCM at the level of the L2 vertebra, spina bifida and tethered cord. The second patient complained of lombar pain with perineal irradiation for 6 years. Physical examination showed a lombar cutaneous angioma. MRI revealed a thoraco-lombar SCM at the T12 to L1 level, with spina bifida. No spur could not be identified in either patient. No further surgical treatment was given. CONCLUSION Based on these two observations, we propose a review of literature reporting 90 cases of adult SCM.
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Affiliation(s)
- L Guilloton
- Service de Neurologie, HIA Desgenettes, Lyon.
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Guilloton L, Renoult PA, Billaud Y, Honnorat J, Drouet A, Felten D. Désorientation temporospatiale après un cancer du poumon. Rev Med Interne 2004; 25:468-9. [PMID: 15158319 DOI: 10.1016/j.revmed.2003.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2003] [Accepted: 09/29/2003] [Indexed: 11/20/2022]
Affiliation(s)
- L Guilloton
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon 03, France.
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Guilloton L, Rabar D, Honnorat J, Drouet A, Pavic M, Felten D. Pandysautonomie paranéoplasique avec anticorps anti-Hu : révélation d’un adénocarcinome bronchique par le PET scan. Rev Neurol (Paris) 2004; 160:465-7. [PMID: 15103275 DOI: 10.1016/s0035-3787(04)70932-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 74-year-old man developed pandysautonomia with severe orthostatic hypotension. Search for a paraneoplastic etiology was confirmed with the positivity of anti-Hu antibodies. [18] Fluorodeoxyglucose positron emission tomography (PET) enabled recognition of a lung adenocarcinoma. We emphasize the usefulness of PET scans for early diagnosis of cancer.
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Affiliation(s)
- L Guilloton
- Service de Neurologie, HIA Desgenettes, Lyon.
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Pavic M, Le Pape E, Cruel T, Ruivard M, Guilloton L, Tebib J, Cathébras P, Dupond J, Vital Durand D, Rousset H. Granulomatoses systémiques non tuberculeuses pseudosarcoïdosiques: 11 cas. Rev Med Interne 2003. [DOI: 10.1016/s0248-8663(03)80379-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Drouet A, Meyer X, Guilloton L, Mullet JP, Dusseau JY, Denoyel GA, Felten D. [Acute severe leukoencephalitis with posterior lesions due to Borrelia burgdorferi infection]. Presse Med 2003; 32:1607-9. [PMID: 14576583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
INTRODUCTION Central nervous system manifestations represent 0.54 to 8% of neurological complication in Lyme disease. OBSERVATION A 78-year-old woman presented a severe meningo-encephalitis with visual disorders (agnosia, alexia) progressing towards coma. Cranial magnetic resonance imaging revealed large areas of hypersignal T2 in the white matter of the lower, parieto-occipital lobes and left temporal lobe. The cerebrospinal fluid (CSF) contained 16 then 293 white corpuscles/mm3 of lympho-monocytes, increased protein level from 2.67 to 5.83 g/l and an increase in IgG index with oligoclonal distribution of IgG. Serological Elisa analysis for Lyme disease was slightly positive in blood (confirmed by western blot) but clearly in the CSF (IgG and IgM). Treatment with ceftriaxone followed by methylprednisolone provided clinical improvement 3 months later. DISCUSSION Acute meningo-encephalitis is often benign, protein-like and of good prognosis: the gnosic visual disorders with posterior leukoencephalopathy are unusual. A blood level of specific antibodies slightly positive on Elisa at the early stage of the infection warrants confirmation by Western blot in the blood and by Elisa in the CSF. Additional corticosteroid therapy may be required in the severe forms that evoke acute disseminated encephalomyelitis.
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Affiliation(s)
- A Drouet
- Service de neurologie, HIA Desgenettes Lyon (69)
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Guilloton L, Drouet A, Renoult PA, Bedubourg G, Vial T, Felten D. [Oxcarbazepine-induced encephalopathy]. Presse Med 2003; 32:1323. [PMID: 14506441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
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40
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Drouet A, Guilloton L, Jacquin O, Renoult PA, Felten D. [Hashimoto's thyroiditis associated with recurrent transverse myelopathy]. Rev Neurol (Paris) 2003; 159:673-7. [PMID: 12910077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
A 55-year-old woman presented first episode of paraplegia at D6 level with a marked improvement of neurological signs, but relapse occurred five months later. Hashimoto's thyroiditis with euthyroidism was found. Long-term 9 months treatment with oral corticosteroids was applied. Also she was able to walk with help. Two years after the second palsy she developed a new paraplegia at D6 level with a severe residual deficit five months later in spite of oral corticosteroids. Thyroid antibodies remained positive. Devic's disease without optica neuritis associated with thyroiditis or spinal cord localisation of Hashimoto's encephalopathy was discussed.
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Affiliation(s)
- A Drouet
- Service de Neurologie, Hôpital d'Instruction des Armées Desgenettes, Lyon
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Guilloton L, Drouet A, Ehre P, Saint-Pierre G, Cruel T, Felten D. [Calcified brain metastases of a pulmonary neuroendocine carcinoma]. Rev Neurol (Paris) 2003; 159:444-6. [PMID: 12773875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
We describe an unusual case of pulmonary neuroendocrine carcinoma of intermediate cell type, revealed by calcified metastatic nodules of the brain in a 49-year-old man. Histological examination of the brain lesions disclosed necrosis and calcification in the center with small and medium-sized carcinoma cells. Pathophysiological mechanisms of such calcifications in metastasis lesions are reviewed.
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Affiliation(s)
- L Guilloton
- Service de Neurologie, Hôpital d'Instruction des Armées Desgenettes, Lyon.
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Drouet A, Swalduz B, Guilloton L, Faivre A, Felten D. [Usher syndrome: a case report]. Rev Neurol (Paris) 2003; 159:323-5. [PMID: 12703051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
A 60-year-old Jewish woman with consangineous parents had a history of severe sensorineural hearing loss since the age of 2 years. Hearing loss had not progressed since childhood, but her visual impairment due to pigmentary retinopathy, known since childhood, had worsened 15 years ago. The diagnosis was Usher syndrome type I, a rare heterogeneous disorder of autosomal recessive inheritance. Abnormal vestibular function and ataxia with neuroimaging anomalies including cerebellar atrophy have been reported, suggesting the disease process also involves the brain.
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Affiliation(s)
- A Drouet
- Service de Neurologie, Hôpital d'instruction des Armées Desgenettes, Lyon
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Drouet A, Guilloton L, Ribot C. [Diagnostic value of classical neurophysiologic profile in various phenotypes of hereditary, pressure-sensitive neuropathies]. Rev Med Interne 2002; 23:364-71. [PMID: 11980312 DOI: 10.1016/s0248-8663(02)00571-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We looked for electrodiagnostic features that raise suspicion of hereditary neuropathy with liability to pressure palsies (HNPP). METHOD A retrospective review of eight cases with confirmed histologic (one case) or chromosome 17 deletion (seven cases) analysis was performed. RESULTS Autosomal dominant disease was present in 63% of the patients, 75% being men. Mean age at examination and at first symptom was 27 and 22 years respectively. Five patients have one or more acute nerve palsies, without residual deficit, but one presented sensory symptoms in internal saphena territory. Three patients had others phenotypes: a man presented with four episodes of facial palsy and one woman was asymptomatic; another patient with diabetes mellitus presented an associated chronic sensorimotor polyneuropathy. In agreement with other studies of HNPP we found in most patients a diffuse increase in distal motor latence, contrasting with normal or moderately decreased motor nerve conduction velocity, multiple electrophysiologic entrapment and diffuse reduction in sensory nerve action potential and/or velocity. However, this electrophysiological pattern was incomplete or masked in HNPP with cranial nerves palsies, in asymptomatic form of HNPP or in HNPP associated with polyneuropathy. CONCLUSION These data confirm the clinical phenotypic heterogeneity of the 17p11.2 deletion and highlight the limits of the classic electrophysiological pattern in asymptomatic HNPP or associated with uncommon clinical features.
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Affiliation(s)
- A Drouet
- Service de neurologie, HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon, France
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Drouet A, Leturcq F, Guilloton L, Delage H, Ribot C. [Muscular exercise intolerance syndrome in Becker muscular dystrophy]. Presse Med 2002; 31:197-201. [PMID: 11878135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To determine whether exertional muscle pain syndrome (EMP) is a benign phenotype or an early stage of Becker-type muscular dystrophy (BMD). METHODS Muscle dystrophin analysis led to the diagnosis of BMD in 6 patients complaining of EMP. RESULTS Three patients had a history of X-linked inheritance and age at clinical onset was 4 to 11 years in five, and one patient had a later onset aged 23. Pseudohypertrophy of the calf muscles was absent in one patient, but all had experienced mild (5/6) pelvic weakness and (or) atrophy one to 17 years after the onset. High serum CK level was present (X 14). Normal anti-dystrophin immunostaining in two cases did not rule out the diagnosis that was only made made by Western blot analysis or genetic studies. All exhibited in-frame deletions (exons 45-48) within the dystrophin gene. CONCLUSION The 36 patients with BMD-EMP analysed in the literature, exhibited different deletions and no worsening in 66.7% of cases. Western blot was more precise than immunolabelling with 96.8% positivity versus 70.5%. Dystrophin analysis by Western blot and (or) DNA analysis should be included in the evaluation of patients with EMP syndrome without deficient muscle energy metabolism, particularly those with pseudohypertrophy of the calf muscles or high serum CK levels.
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Affiliation(s)
- A Drouet
- Service de Neurologie, HIA Desgenettes, 108, boulevard Pinel, F 69275 Lyon
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Guilloton L, Drouet A, Combemale P, Cruel T, Dupin M, Ribot C. [Neuritic leprosy disclosed by reversal reaction]. Rev Neurol (Paris) 2002; 158:84-6. [PMID: 11938329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
We report a case of neuritic borderline tuberculoid leprosy with lingering insidious growth disclosed by a brutal reversal reaction. Inflammatory polyarthralgia and sensory and motor loss in the median and ulnar territories, without skin lesions, suggested vasculitis. A few weeks later, inflammatory skin lesions developed leading to the diagnosis of biopsy proven leprosy. Leprosy should be considered as a possible diagnosis in patients with multineuritis, especially when associated with rheumatic or cutaneous manifestations. Early skin biopsy in neuritic leprosy is discussed.
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Affiliation(s)
- L Guilloton
- Service de Neurologie, 108 Boulevard Pinel, Lyon Armées, France
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Rabar D, Debourdeau P, Pavic M, Guilloton L, Crevon L, Colle B. Intérêt du PET-scan dans la prise en chargedes syndromes neurologiques paraneoplasiques. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)80189-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Guilloton L, Drouet A, Estival JL, Saint Pierre G, Dupin M, Ribot C. [Transformation of mycosis fungoides to pleomorphic T-cell lymphoma and central nervous system involvement]. Rev Med Interne 2001; 22:1244-7. [PMID: 11794895 DOI: 10.1016/s0248-8663(01)00496-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Although mycosis fungoides is a malignant T-cell lymphoma involving mainly the skin, neurological complications are possible, with a poor prognosis. EXEGESIS A 59-year-old man, treated for mycosis fungoides with transformation to a pleomorphic T-cell lymphoma for 1 year, was seen for mental status changes with confusion. A brain parenchyma localisation was found. CONCLUSION This observation emphasizes the exceptional neurological tropism in the patients with mycosis fungoides. A transformation to a more aggressive cutaneous T-cell lymphoma seems necessary to induce a central nervous system involvement.
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Affiliation(s)
- L Guilloton
- Service de neurologie, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69275 Lyon, France. laurent
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Guilloton L, Burckard E, Fresse S, Drouet A, Felten D. [Epileptic crisis after antimalaria chemoprophylaxis with chloroquine]. Presse Med 2001; 30:1745. [PMID: 11769070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
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Drouet A, Guilloton L, Pelissou-Guyotat I, Saint-Pierre G, Ribot C, Sindou M, Deruty R. [Multiple intracranial and intraspinal meningiomas successively discovered in the absence of neurofibromatosis: 2 cases]. Rev Neurol (Paris) 2001; 157:1264-9. [PMID: 11885519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Multiple meningiomas in different neuroaxial compartments are quite rare. We describe the case of a 44-year-old woman who developed three intracranial meningiomas and 8 years later a T3 dorsal meningioma. Histologically, the frontal and dorsal tumors appeared as benign psammomatouss meningiomas. Both tumors were removed successfully. The second patient was a 31-year-old woman who developed right benign fronto-parietal transitional meningioma. She presented local and spheno-orbital recurrences, then a lombo-sacral lesion. The histological picture worsened from benign to malignant with multiple recurrences. Several mechanisms could account for multiple meningiomas. Such meningiomas could arise from a single primary tumor via subarachnoidal spread of a benign or malignant nature. Alternatively, they could be atypical forms of neurofibromatosis type 2 or tumors with a multifocal origin.
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Affiliation(s)
- A Drouet
- Service de Neurologie, HIA Desgenettes, 108, bd Pinel 69275 Lyon
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