[An oneiroid experience during severe acute polyradiculoneuritis]. / Expérience d'un vécu oniroïde au cours des polyradiculonévrites aiguës graves.

This study is to present a psychopathological analysis of complex hallucinatory symptoms--without consciousness breaking up in confusional state--occurring in patients with acute Guillain-Barré's syndrome diagnosis requiring neurological intensive care. Finally the patients experience an unitary and closed situation "close to dream without being dream". This experience is corresponding to the semeiology of the "oneiroid experience" (Mayer-Gross, 1924). The "oneiroid experience" appears to be of syndromic nature independent of any etiological and/or nosological classification. But its conceptualization does probably need widening: the oneiroid world appears to be a creation of a primitive function which inserts us in the world before any science or verification.

[Efficacy of uvulopalatopharyngoplasty (UPPP) and modifications in sleep structure in the sleep apnea syndrome (SAS)]. / Efficacité de l'uvulopalatopharyngoplastie (UPPP) et modifications de la structure du sommeil dans le syndrome d'apnée du sommeil (SAS).

Thirty-four patients (32 male, 2 female; mean age 53 +/- 7 years) with confirmed sleep apnea syndrome (SAS) were studied before and after uvulopalatopharyngoplasty (UPPP). Clinical symptoms were tiredness, excessive daytime sleepiness and snoring. All patients were overweight. Patients underwent a thorough physical and oropharyngeal examination and polysomnography before and 3 months after surgery. On the basis of post-operative results, patients are divided into 3 groups: --group 1: 16 cured patients: apnea index (A.I./h) 38 +/- 17 before and 4.4 +/- 4 apneas/h sleep after surgery. Improved nocturnal hypoxemia: mean minimum oxyhemoglobin saturation (SAO2) before and after UPPP in NREM sleep 83 +/- 4% v. 90 +/- 4% in REM sleep 76 +/- 11% v. 85 +/- 7%. Uninterrupted sleep is restored; --group 2: 8 improved patients: A.I./h of 64 +/- 11 before and 20 +/- 6 after UPPP: improved nocturnal hypoxemia: mean minimum SAO2 in NREM sleep 74 +/- 10% before and 86 +/- 6% after UPPP: in REM sleep 59 +/- 9% before and 79 +/- 6% after UPPP, lower amount and percentage of fragmented sleep; --group 3: 10 non-improved patients: A.I./h unchanged 55 +/- 22% before and 50 +/- 20% after UPPP. Persistent nocturnal hypoxemia: mean minimum SAO2 in NREM sleep 76 +/- 13 before and 81 +/- 12% after UPPP: in REM sleep 63 +/- 16% before and 65 +/- 24% after UPPP. Sleep remains fragmented. In this last group patients are more overweight and all suffer from severe SAS with greater nocturnal oxyhemoglobin desaturation. Surgical treatment by UPPP is shown to be effective for 70% of our patients. Better results are obtained when SAS is less severe and overweight less important.

Prevalence of asymptomatic internal carotid artery stenosis.

The prevalence of internal carotid artery stenosis was studied with continuous wave Doppler and Duplex scanning in 526 subjects aged 45-84 years of age. They were devoid of any cerebrovascular symptoms or signs and were not referred to us because of risk factors or manifestations of atherosclerosis. The prevalence of stenosis, whatever the grade, was low in both sexes aged under 65 years: 2.4% in males aged 55-64 years. It increased sharply with age, reaching 30.3% for stenosis of less than 50% and 6.1% for stenosis of greater than 50% in males aged 75-84 years. The prevalence of minimal lesion (plaque with less than 15% diameter reduction) was high: 32.1% in males aged 45-54 years and 48.5% in the 75- to 84-year age range.