[Pathophysiology of complex regional pain syndrome [CRPS] type 1]

If the pathophysiology of complex regional pain syndrome [CRPS] type 1 remains controversial, most authors agree on a combination in varying proportions, a sensitization of peripheral nerves. To describe the state of advances in the physiopathology of complex regional pain syndrome type 1. Bibliographic research and literature review performed by referring to databases [Medline, Science Direct]. The physiopathology of complex regional pain syndrometype 1 remains still poorly understood and controversial. Several arguments demonstrated both peripheral [inflammation, abnormal sympathetic ...] and central [neurological and cognitive] mechanisms. A better knowledge of the physiopathology of complex pain syndrome type 1 is necessary in order to adapt efficient curative therapy or to a better prevention of this syndrome

Childhood occipital epilepsy of gastaut: a case report

Idiopathic childhood occipital epilepsy of Gastaut is a rare but well defined syndrome within the group of idiopathic focal epilepsies in childhood. Clinical manifestations are characterized b simple partial seizures with mainly visual symptoms followed by secondary generalization. Report of a case of Childhood Occipital Epilepsy. We report a case of 10-year-old-girl, with no history. At the age of 9 years, the patient started experiencing repetitive events without fever. The first event consisted of several episodes of loss of consciousness with hypotonia and post ictal amnesia. The second type was three episodes of stereotyped, elaborated complex visual hallucinations, during 10 minutes. One month later, a third type n‚ tonico-clonic generalized seizures appeared. Neurological examination and routine laboratory investigation were normal. Bram neuroimaging was normal. Interictal EEG showed bilateral discharges of slow generalized waves activated by hyperventilation. She has been treated by Sodium Valproate. All seizures stopped and she remained free of seizures. This epileptic syndrome must be identified, and treated without delay. In fact, without appropriate treatment, the evolution may lead to a continuous spike-wave during the sleep with cognitive deterioration

[Epilepsy surgery program in Tunisia, the Charles Nicolle hospital experience]

Epilepsy surgery is the best treatment in case of intractable epilepsy. However, it is underused in developing countries, creating an enormous treatment gap. On 2006, an epilepsy surgery program was set up in the Neurological Department of Charles Nicolle Hospital, Tunis, Tunisia. To describe its establishment and to emphasize on its originality that is an exchange and surgery decision taken by two Neurological teams via the internet. Patients underwent a phase 1 presurgical evaluation at the Neurological Department of Charles Nicolle Hospital of Tunis. It included a detailed clinical history, a neurological evaluation, brain MRI, a continuous video EEG scalp monitoring and a neuropsychological evaluation. According to the different electro clinical and radiological findings, the surgery indication was taken between the Neurological department of Charles Nicolle Hospital of Tunis and the Neurophysiological Department of Charles Nicolle Hospital in Rouen through the EUMEDCONNECT network project. ATL was performed and the four patients are actually seizure free. Epilepsy surgery is actually a possible treatment option in Tunisia and should be indicated in patients with intractable partial seizures