ABSTRACT
We report a case of cervical artery dissection following a Heimlich maneuver. Cervical artery dissections are at the present time well known and are sometimes associated with trivial traumas. However, to our knowledge, this complication of such maneuver was never reported in the literature. Pathophysiological mechanisms are discussed.
Subject(s)
Airway Obstruction/complications , Airway Obstruction/therapy , Carotid Artery, Internal, Dissection/etiology , Carotid Artery, Internal, Dissection/diagnostic imaging , Carotid Artery, Internal, Dissection/physiopathology , Cerebral Angiography , Female , Humans , Middle Aged , UltrasonographyABSTRACT
Parkinson's disease cannot be reduced to its motor symptoms. Psychological and behavioral disorders often accompany its development. Our study was conducted in June 1999 among 36 neurologists practicing in hospital or private clinic settings in the Poitou-Charentes area. Neurologists were requested to record hallucinations, delusions and nocturnal events observed in Parkinson's patients. A total of 152 reports were collected from 17 physicians. Fifty-three percent of the patients attended hospital clinics and 47p.100; were seen at the physician's office. Hallucinations were recorded in 23.1p.100; of the patients. The risk of hallucination symptoms was higher among patients seen at hospital clinics and who had more advanced disease. Only 7.2p.100; of the patients reported delusions, most often of a persecution type. Nocturnal events affected 49.3p.100; of the patients. The appearance of such symptoms was highly related to Hoehn and Yahr stage and was more frequent in hospital patients. Hallucinations, delusions, and nocturnal events affect patients with advanced Parkinson's disease, associated with long-term L-dopa treatment. Eighty-three percent of the patients had such symptoms and most of them used L-dopa. This long-term treatment is linked to these three symptoms. Hallucinations were increasingly reported for patients with increasing long-term medication with dopaminergic agonists. Nocturnal events, for patients on L-dopa, were associated with advanced disease, long-term treatment with L-dopa, and hospitalization. Psychic and behavioral disorders appear frequently in Parkinson's disease patients and are inter-related. Physicians should be aware of the relationship with treatment to avoid aggravation.
Subject(s)
Delusions/etiology , Hallucinations/etiology , Parkinson Disease/psychology , Sleep Wake Disorders/etiology , Aged , Aged, 80 and over , Antiparkinson Agents/therapeutic use , Delusions/epidemiology , Female , France/epidemiology , Hallucinations/epidemiology , Health Surveys , Humans , Inpatients/psychology , Levodopa/therapeutic use , Male , Middle Aged , Outpatients/psychology , Paranoid Disorders/epidemiology , Paranoid Disorders/etiology , Parkinson Disease/complications , Parkinson Disease/drug therapy , Parkinson Disease/epidemiology , Severity of Illness Index , Sleep Wake Disorders/epidemiologyABSTRACT
A 68-year old patient, suffering from a left temporal and right frontal multifocal glioblastoma, initially presented Wernicke's aphasia with abnormal behavior. After a stereotaxic biopsy of his right frontal lesion, the patient developed an activity of ceaseless writing associated with mutism. This hypergraphic behavior was accompanied with a production of numerous aphasic paragraphics contrasting with the mutism. Such association could evoke the rise of a suppressive activity of the right hemisphere on graphic functions linguistically organized by the left hemisphere.
