[An immunologic etiology for hyperprolactinemia: macroprolactinemia]. / Une étiologie immunologique à l'hyperprolactinémie: la macroprolactinémie.

Besides classical etiologies of hyperprolactinaemia (pregnancy, pharmacological treatments, pituitary or hypothalamic perturbations), another less known cause may explain a spectacular idiopathic elevation of plasma concentrations of prolactin hormone. Macroprolactinaemia is characterized by the presence of a circulating high molecular weight complex of prolactin with an immunoglobulin G. In this article, we report the cases of 3 female patients for whom size exclusion chromatography technique permitted to give a precise biological diagnosis and to avoid heavy, expensive, time consuming and unnecessary clinical investigations or therapeutic actions. Patients with macroprolactinaemia do not exhibit clinical features of classical hyperprolactinaemia, notably as regard to menstrual and fertility disturbances.

[How I study thyroid pathology using ultrasonography-guided needle biopsy]. / Comment j'explore ... les pathologies thyroïdiennes par cytoponction échoguidée.

From a retrospective study of 259 files, the authors stress the value of US-guided thyroid cytoponction and its essential role in case of thyroid cancer suspicion. This very specific and inexpensive method fits perfectly into the other exploration techniques. It is the deciding factor in the thyroid nodule differential diagnostic and therapeutic planning.

Looking with one's mind's eye.

On the basis of clinical cases reported in the literature, an attempt is made to show that conscious mental representations of written words have a left-right dimension similar to their counterparts in the physical world. They may, therefore, be affected by unilateral neglect in much the same way as words on a written or printed page. Usually, real words and their representations run in the same direction. However, in some cases, they appear to run in opposite directions and this may result in the production of mirror writing.

Ictal verbal behaviour: a review.

An overview is given of the various disturbances which epileptic seizures without loss of consciousness may cause in the patient's voluntary verbal behaviour, as well as of the unintentional verbal activities which seizures may induce. It is shown that during seizures, patients may preserve their verbal skills, or lose them in part or completely. They may also show undeliberate verbal behaviours, of which they may or may not be conscious.

A case of acquired stuttering.

This case study of acquired stuttering confirms the reality of acquired or neurogenic stuttering. It further shows that the syndrome can exist in its own right. It is not simply a secondary psychological consequence of brain damage but a direct result of the cerebral lesion.

The effects of electrostimulation and of resective and stereotactic surgery on language and speech.

A fairly comprehensive survey is offered of the effects which cortical and sub-cortical electrical stimulation have on language and speech. A survey is also given of the verbal consequences of resections or coagulations which generally follow electrical stimulation.

Portraits in aphasia: Armand Trousseau (1801-1867).

Armand Trousseau's (1801-1867) contribution to the birth of aphasiology is sketched. It is shown that the French physician anticipated several of the important issues which aphasiologists were to debate at the end of the nineteenth century and in the first part of the twentieth century.

The language of epilepsy.

The various names of epilepsy in European languages are reviewed. It is shown that they reflect the beliefs and misconceptions that were entertained in the past about the disease.

Epilepsy and verbal behaviour.

A review is given on the various ways of influence between paroxysmal brain activity and verbal behaviour. In some cases the performance of specific linguistic tasks may precipitate an epileptic fit. Often epileptic discharges interfere with speaking, writing and/or understanding of speech or may result in palilalias, verbal automatisms or other forms of disturbance of verbal performance. A different but not uncommon aspect of epilepsy is hypergraphia. In some few cases even a speech deblocking effect of epileptic discharges has been observed.

Anosognosia in aphasics.

The notion that aphasia may be accompanied by some degree of unawareness of the disorder was introduced by Wernicke in 1874. Ever since the idea has prevailed that sensory aphasics, especially jargonaphasics, are not, or but little, conscious of their deviant verbal output. This view was disputed in recent years. It was claimed that anosognosia was not a typical feature of Wernicke's aphasia or of jargonaphasia. However, analysis of the behavior of sensory aphasics shows that some of these patients are not well aware of the deviances in their verbal output. This unawareness may be due to verbal deafness or to disturbed feedback. On the other hand, some aphasics appear to realize that their verbal expression is anomalous but choose to ignore the fact in order to preserve their self-image or to keep up the social intercourse with the environment. Anosognosia can be found in association not only with sensory aphasia but also with monophasia and with modality-specific aphasia, as well as with unilateral neglect and with apraxia. If a patient has anosognosia, the speech therapist must know about it and take it into account, lest it renders therapeutical efforts fruitless.

Neurogenic stuttering.

According to reports in the literature and our own observations, which are reported in this paper, acquired stuttering may occur in conjunction with focal or diffuse damage to the central nervous system. When the lesion is focal, it may be in the right or in the left hemisphere. When the left hemisphere is injured, acquired stuttering may be concomitant with aphasia. Indeed, in some cases the stutter-like repetitions appear to be an integral part of the aphasic syndrome. In other cases, on the contrary, the two disorders seem to be relatively independent of one another. Occasionally, stuttering is the only observable disorder in the linguistic-cognitive sphere.

[Videostroboscopy of the larynx]. / Videostroboscopie van de larynx.

The technique of telescopic videostroboscopy permits simultaneous audio and video recording of a laryngoscopy and a subsequent stroboscopy of the larynx during the same examination. The combination of laryngoscopy and stroboscopy is very favorable not only because stroboscopy is not possible in all pathological cases, but also because each of both methods can reveal facts the other does not. In addition, the possibility of playing back the video tapes as often as desirable is an important diagnostic and pedagogic advantage.