[Narcolepsy-cataplexy today]. / La narcolepsie-cataplexie aujourd'hui.

Diagnostic criteria and pathophysiology of narcolepsy-cataplexy have evolved considerably over the last 10 years. The main cause, already mentioned in a previous paper, in the Revue Médicale de Liège (65), in 2002, is based, in human beings, on a destruction of specific cells located in the lateral and posterior part of the hypothalamus (the perifornical nuclei, containing some 70,000 neurons), producing peptides which stimulate the central nervous system; they are called hypocretins or orexins. The role of autoimmunity in their disappearance becomes more evident. The treatment is simplified, but remains symptomatic. It is mainly based on Sodium Oxybate or Gamma-Hydroxybutyrate, syrup, prescribed for the night. The authors report on their own experience in this regard and on future therapeutics more targeted towards the cause of the disease.

Time-blind videotaped evaluation of injectable diazepam, lorazepam and placebo.

Eighteen inpatients suffering from a severe anxiety received in double-blind and crossover conditions iv and im injections of 10 mg diazepam, 5 mg lorazepam or saline t.i.d. during 5 days. The morning injections was made iv in a CCTV studio. Before injection and 20 mn after it, the patient filled out a 100 mm Visual Analogue Scale; his doctor-in-charge proceeded to a standard interview and to physiological measurements (tremor of hand, patellar reflexes, blood pressure, pulse rate). The videotaped interviews were randomly, i.e. time-blind, rated by two independent observers on 3 scales: the VAS, the Hamilton Anxiety Scale and an ad hoc Verbal and Non-Verbal Anxiety Scale (VNVA). The statistical analysis was completed by a logical analysis according to Lewis Carroll. The results demonstrate the superiority of lorazepam over diazepam on psychic anxiety, somatic anxiety, sleep and blood pressure, the only significant side-effect being drowsiness.

[Schultz autogenic training and galvanic skin response in the systematic desensitization of a compulsive phobia]. / Training autogène de Schultz et électrodermographie dans la désensibilisation systématique d'une phobie d'impulsion.

A patient suffering suicidal phobia and resistant to antidepressants as well as electroconvulsive therapy was submitted to Wolpe's systematic desensitization associated with Schult's autogenic training. Ten sessions were sufficient to cure the patient. A follow-up period now extends to one year, without relapse. The concomitent measure of skin galvanic response by an electrodermograph appears a privileged psychophysiological control of such a therapy, i.a. allowing for detection of the avoidance of the anxiogenic evocation by the patient.