A comparison of the electroencephalographic spectral modifications induced by diazepam and by hydroxyzine.

A double-blind, randomized controlled trial using an electroencephalograph computerized analysis and cartography was carried out to investigate the spectral modifications induced by diazepam and hydroxyzine. Without monitoring response to stimulation, the spectra found for diazepam and for hydroxyzine were qualitatively very similar, showing increase of the slow waves, reduction of the alpha rhythm and accentuation of the beta 1 rhythms. These traces suggested strongly that both drugs had produced a sedative, anti-anxiety effect. The intensity of the effect produced by 50 mg of hydroxyzine appeared to be less than that produced by 10 mg diazepam. After monitoring response to stimulation, the spectra were modified and the reactivity of the two drugs differed with regard to the slow delta, theta and alpha 1 frequency bands. It was possible to distinguish between the sedative and anti-anxiety effects of both diazepam and hydroxyzine. Even if the two drugs had some similar effects, the mode of action in the central nervous system was certainly different, as can be seen from the characteristics of distribution of the slow waves, their reactivity and, with regard to frequency, the fluctuation of the dominant frequency of rapid rhythms.

[Acetazolamide: an alternative to shunting in normal pressure hydrocephalus? Preliminary results]. / Acétazolamide: une alternative à la dérivation dans l'hydrocéphalie à pression normale? Résultats préliminaires.

From a series of 15 consecutive patients with a normal-pressure hydrocephalus examined over 2 years. 10 showed frank improvement with oral acetazolamide. The drug was a first-choice treatment in 5 cases and was given up after a spinal tap in 5 cases. Clinical response occurred even in the most severe cases, although it was slightly less impressive for intellectual impairment than for gait or bladder disturbances. Tolerance was excellent with a daily dose of 250 to 500 mg. The benefit remained stable on a more than 1 year follow-up in 8 cases. We suggest that acetazolamide should be tried in patients with normal pressure hydrocephalus prior to considering shunting.

Utility of short-latency evoked potentials in the classification of progressive, early onset cerebellar ataxias.

In recent years, several authors have proposed new classifications of inherited ataxias, some of them being based on systematic clinical studies of large groups of patients. This methodic approach has led to the identification of new types of ataxias and helped the development of molecular biology research in these diseases. Up to now, nerve conduction velocity and evoked potential studies have not been considered in the classification of hereditary ataxias. We have studied the results of short latency evoked potentials in 102 patients affected by a early onset, progressive cerebellar ataxia. Based on the results of this study and a review of the literature on this subject, we will evaluate the utility of nerve conduction velocity and evoked potential recordings in the classification of this group of diseases.

[Amyloid pseudotumor of the sciatic nerve]. / Pseudo-tumeur amyloïde du nerf sciatique.

A 60 year-old man complained of numbness and pain in the right lower limb, suggesting lesions of the fifth lumbar and first sacral roots. Sixteen months later, CT showed a tumor of 3.5 cm at the emergence of the first right sacral root. Microscopic examination disclosed an infiltration of the fibers of the nerve by numerous masses of hyaline eosinophilic material which stained with Congo red and produced green birefringence under polarized light. The persistence of congophilic properties of the amyloid deposits after permanganate pretreatment suggested an immunoglobulin origin (AL). A research of amyloid deposit in others viscera: heart, kidneys, digestive tract, was negative. We believe that this is the first reported case of amyloid pseudo-tumor involving a peripheral nerve.