[Congenital syphilitic meningomyelitis manifested in the adult]. / Méningo-myélite syphilitique congénitale révélée à l'âge adulte.

We report a case of neurosyphilis of the spinal cord in a 38-year-old-man presenting with urinary incontinence and Argyll-Robertson sign. Anamnesis revealed the congenital origin of the disease. Urodynamics findings were consistent with a conus medullaris involvement and CSF study revealed a specific lymphocytic meningitis. A specific spinal arteritis was found by angiography. A quarterly 15 to 20 days course of intravenous penicillin was then instituted during 2 years. A specific treatment of urinary symptoms resulted in complete disappearance of sphincter dyssynergia. Antibiotic therapy was followed by clinical improvement and regression of most of the CSF abnormalities.

[Alcock's canal syndrome and perineal neuralgia]. / Syndrome du canal d'Alcock et névralgie périnéale.

Fifteen cases of perineal neuralgia are reviewed, the lesion arising from a canal syndrome due to compression of the pudendal nerve in the ischiorectal fossa (Alcock's canal syndrome). The clinical characteristic of the pain syndrome was its postural nature with the existence of a true Tinel sign (increased pain on sitting). Diagnosis was confirmed in all cases by a perineal electrophysiological which showed peripheral neurogenic signs on examination of perineal muscles and an increase in sacral evoked potentials latencies (latency of bulbocavernous or clitorido-anal reflexes, cortical somesthetic evoked potential from pudendal nerve). Treatment was infiltration of cortisone derivatives into the pudendal nerve canal, under CT guidance because of the difficulty of infiltrating the pudendal nerve by an external perineal approach. Results were satisfactory in 9 of the 15 patients.

[Polyneuropathy and solitary bone plasmacytoma. A new case]. / Polyneuropathie et plasmocytome solitaire osseux. Une nouvelle observation.

The authors report a case of acute polyneuropathy revealing a solitary osseous plasmacytoma with osteo-dense and osteolytic bone lesions. Initially, the rapid progression of the sensory and motor loss led to treatment by plasma exchanges and irradiation of the plasmacytoma. Four months later, despite a significant improvement of the neurological condition, serum protein electrophoresis continued to show a peak of monoclonal immunoglobulin. Chemotherapy with cyclophosphamide and prednisone was administered for one year whilst the neuropathy continued to regress. This case, which presents many classical features of plasma cell dyscrasia (polyneuropathy with albumino-cytological dissociation, radiological osseous condensation, low concentrations of lambda light chain protein), illustrates some unusual features of solitary plasmacytomas associated with peripheral neuropathy: the young age of our patient, an acute progression of the neuropathy in the early stages, tumoral localisation in the diaphysis of a long bone.

[Value of evoked sacral potentials in studying bladder sphincter disorders in peripheral neuropathies and central nervous system diseases. A study of 110 cases]. / Intérêt des potentiels évoqués sacrés dans l'étude des troubles vésico-sphinctériens des neuropathies périphériques et des affections du système nerveux central. Etude de 110 cas.

The sacral spinal cord is one of the main sites of integration of bladder and anal sphincter and sexual function. Clinical tests (bulbocavernous reflex, perineal reflexes) are often inadequate and urodynamic investigations (cystomanometry, urecholine test, Susset's test) are sometimes unhelpful. The integrity of this structure is essential for normal sphincter function and disease at this level (or of its afferent or efferent limbs) produces a peripheral type of disorder. Sacral evoked potentials are an electrophysiological means of testing the bulbocavernous reflex by external stimulation of the dorsal nerve of the penis or clitoris and recording by a needle bipolar electrode in the striated muscle of the sphincter or the bulbocavernous muscle. An objective study of the sacral reflex are (S2, S3, S4) can thus be performed. One hundred and ten patients have undergone this investigation. Normal latency established in a series of 26 healthy volunteers was less than 42.1 ms. Prolongation of this interval is a sign of disease of the reflex are and correlated with urinary or sexual problems in 46 cases of clinical or electrical peripheral neuropathy. The reflex time was normal in all patients with CNS disease (32 cases) and an impotence of psychological origin (6 cases).

[2 cases of Plasmodium falciparum malaria. Probable responsibility of Anopheles transported by air]. / A propos de deux cas de paludisme à Plasmodium falciparum. Responsabilité probable d'anophèles importés par voie aérienne.

Report of two cases of Plasmodium falciparum malaria which seem to be originary from the Pariser area: the first one in a luggage carrier working in an airport; the second one in a subject living in the neighbourhood of this airport. These cases perhaps question the hygiene measures taken on the arrival of planes coming from impalutaded regions.