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1.
Acta Neurol Belg ; 99(3): 185-8, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10544727

RESUMO

A case of early-onset adult dementia with family history of dementia is reported, characterised by neuropsychological deficits, suggesting frontal involvement, with mild non specific white matter abnormalities on CT scan. Familial Alzheimer's disease was suspected but the neuropathological diagnosis on brain biopsy was metachromatic leukodystrophy. 18FDG-PET revealed a very peculiar pattern of metabolic impairment in thalamic areas, in medial and frontopolar regions, and in occipital lobes. Neuropsychological follow-up showed relatively stable difficulties of long-term memory and signs of frontal lobe dysfunction, similar to those observed in subcortical dementias. MRI subsequently showed periventricular leukoencephalopathy. The brain metabolic pattern observed in that case of metachromatic leukodystrophy was quite different from that reported in other types of dementia.


Assuntos
Córtex Cerebral/metabolismo , Demência/etiologia , Leucodistrofia Metacromática/complicações , Tálamo/metabolismo , Adulto , Idade de Início , Doença de Alzheimer/diagnóstico , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Demência/diagnóstico , Demência/diagnóstico por imagem , Demência/metabolismo , Demência/patologia , Diagnóstico Diferencial , Metabolismo Energético , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/metabolismo , Lobo Frontal/patologia , Glucose/metabolismo , Humanos , Leucodistrofia Metacromática/diagnóstico por imagem , Leucodistrofia Metacromática/epidemiologia , Leucodistrofia Metacromática/metabolismo , Leucodistrofia Metacromática/patologia , Imageamento por Ressonância Magnética , Tálamo/diagnóstico por imagem , Tálamo/patologia , Tomografia Computadorizada de Emissão
2.
Encephale ; 24(2): 138-50, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9622793

RESUMO

The purpose of this article is to discuss the contribution that clinical neuropsychology and neuropsychological assessment can conter to neuropsychiatry, particularly in the evaluation of cognitive disturbances and pharmacological treatment of depression. Six patients (4 females, 2 males; age: 16-54 years old) suffering from depressive disorders underwent a clinical neuropsychological examination. Depending on the memory scores obtained on the Rey-Osterrieth complex figure test, the patients were classified as having mild or no memory impairment (< 20% decrease), moderate memory impairment (20-40% decrease) or severe memory alteration (> 60% deterioration). Evaluation of memory scores of two other memory tests (Wechsler memory scale and Rey visual design learning test) were also considered. Patients who were classified as having severe memory impairment were consistently reported as seriously impaired on all memory tests. The severity of cognitive dysfunction is in accordance with the serious ness of the neuropsychiatric disturbances of the patients as revealed by personality testing (MMPI, IDS and Eysenck questionnaires) or by personal details as assessed during the interview. This paper discusses the importance of the utility of a comprehensive neuropsychological evaluation of depressed patients and seriously considers the possibility of the use of this approach for pharmacological treatment evaluation.


Assuntos
Transtornos Cognitivos/diagnóstico , Transtorno Depressivo/diagnóstico , Rememoração Mental , Testes Neuropsicológicos , Comportamento Social , Adolescente , Adulto , Transtornos Cognitivos/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Retenção Psicológica
4.
Acta Neurol Belg ; 96(2): 89-101, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8711991

RESUMO

It is well established that head injury often causes brain damage leading to long term physical, cognitive and behavioural changes in the injured patients. Whereas the physical effects ranging from sensori-motor disturbances to posttraumatic epilepsy are often reported as well as cognitive sequelae, deteriorations of emotional and behavioural aspects are often neglected. Recent advances in imaging technology and clinical neuropsychology research have greatly contributed to increase our understanding of the effect of traumatic brain injury on diverse behavioural functions. After a brief review of the current status of problems facing the brain injured patients, this paper discusses the neuropsychological aspects of 3 long term brain injured patients. All 3 patients showed important behavioural and emotional distress several years after the accident. Whereas case report of patient A and C discuss the emotional and personality disturbance characterised by anxiety, depression and irritability, case report of patient C which is a case of classic frontal syndrome showed important memory impairment with emotional disturbance characterised by apathy, lack of motivation and complete indifference to his surrounding environment. Whatever the mechanisms involved, psychoaffective disturbances in the brain injured patients appear as important problems in the long term. These emotional difficulties must be considered in the treatment and rehabilitation procedures of these victims in order to help them to improve their social adjustment and quality of life aspects. Neuropsychological test data can be used to develop treatment strategies tailored for an individual's specific cognitive strengths and deficits.


Assuntos
Sintomas Afetivos/psicologia , Lesões Encefálicas/psicologia , Transtornos Cognitivos/psicologia , Adulto , Afasia/psicologia , Dano Encefálico Crônico/psicologia , Lesões Encefálicas/reabilitação , Humanos , Transtornos da Linguagem/psicologia , Masculino , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Transtornos da Personalidade/psicologia , Transtornos do Comportamento Social/psicologia
5.
Acta Neurochir (Wien) ; 124(1): 26-30, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8279287

RESUMO

A series of 35 selected non senile patients was investigated with stereotactic brain biopsies in frontal and temporal lobes including the rhinencephalon. Results of neuropathological studies are confronted with clinical proposals. Alzheimer's disease is diagnosed in about 10% of the cases under 50 years of age, but more than 50% after 50. In the whole series only 10 clinical diagnoses (29%) were confirmed by neuropathological findings, 14 cases (40%) were fully corrected, 5 out of 7 undefined demented patients were specified but 6 cases (17%) remained unspecified because only nonspecific gliosis was found. Thus stereotactic biopsies were without real interest in 10 confirmed diagnosis (29%), of relatively poor interest in 6 nonspecific gliosis (17%), but of great interest in 19 cases (40% corrected + 14% specified = 54%). It can be considered from a general point of view that in our series more than 50% of diagnoses benefit definitively by stereotactic brain biopsies bearing in mind that the clinical diagnosis fails in one case out of two. It is clearly demonstrated that this stereotactic methodology has a significantly higher score than conventional biopsies.


Assuntos
Demência/patologia , Lobo Frontal/patologia , Transtornos do Comportamento Social/patologia , Técnicas Estereotáxicas , Lobo Temporal/patologia , Adulto , Idoso , Doença de Alzheimer/patologia , Doença de Alzheimer/cirurgia , Demência/cirurgia , Diagnóstico Diferencial , Feminino , Lobo Frontal/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Psicocirurgia , Transtornos do Comportamento Social/cirurgia , Lobo Temporal/cirurgia
6.
Stereotact Funct Neurosurg ; 54-55: 409-12, 1990.
Artigo em Inglês | MEDLINE | ID: mdl-2080358

RESUMO

Precise diagnosis of presenile dementia is a great challenge. The only valuable classification of dementia is the neuropathological one. We present the first series of stereotactic biopsies in 28 presenile patients (18 males, age 39 less than or equal to 58 less than or equal to 69 years, and 10 females, age 23 less than or equal to 52 less than or equal to 66 years). The results demonstrate that the clinical and paraclinical diagnosis (including positron emission tomography scan, neuropsychological examinations, computed tomography scan, electroencephalogram) in only one third of all cases and only in 50% of the Alzheimer and Creutzfeld-Jakob cases. This is very important to be kept in mind when epidemiology or efficacy of drugs are investigated without any neuropathological confirmation.


Assuntos
Doença de Alzheimer/patologia , Biópsia/instrumentação , Encéfalo/patologia , Demência/patologia , Técnicas Estereotáxicas/instrumentação , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Lobo Frontal/patologia , Humanos , Sistema Límbico/patologia , Masculino , Pessoa de Meia-Idade , Lobo Temporal/patologia
7.
Acta Neurol Belg ; 90(4): 200-6, 1990.
Artigo em Inglês | MEDLINE | ID: mdl-2124030

RESUMO

A study of neurotransmitter release has been performed on human brain biopsies obtained during the course of a therapeutic neurosurgical procedure. The electrically evoked-release of 3H-dopamine and 3H-acetylcholine was studied on slices from the thalamus of two parkinsonian and two non-parkinsonian subjects. Electrical stimulation of the non-parkinsonian thalamus increased the dopamine release but had no effect on acetylcholine release. This characteristic response had been previously observed in the normal rat thalamus. In contrast, the parkinsonian thalamus responded with a sharp increase in acetylcholine release without concomitant increase in dopamine release indicating the possible existence of an inhibitory control effect action of dopamine on acetylcholine release as seen in rat striatum.


Assuntos
Acetilcolina/farmacocinética , Dopamina/farmacocinética , Doença de Parkinson/metabolismo , Núcleos Talâmicos/metabolismo , Idoso , Animais , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/cirurgia , Ratos , Ratos Endogâmicos , Técnicas Estereotáxicas
8.
Acta Neurol Belg ; 89(3-4): 161-7, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2516963

RESUMO

Early detection and precise diagnosis of dementias are important since they determine subsequent medical care. Presently the only way to classify these syndromes is by neuropathological examination. Between 1972 and 1988, 246 stereotactic serial brain biopsies were performed in 28 selected demented patients. Comparison between preoperative clinical diagnosis and histological finding gives the following results: the diagnosis has been confirmed in 32%, corrected or specified in 67% and stereotactic brain biopsies only showed unspecific pathological gliosis in 8%. This emphasizes the difficulties to assess precisely the diagnosis. This must be kept in mind when evaluating drug trials.


Assuntos
Encéfalo/patologia , Demência/patologia , Adulto , Idoso , Biópsia/métodos , Demência/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas Estereotáxicas
9.
Acta Neurochir Suppl (Wien) ; 44: 129-37, 1988.
Artigo em Inglês | MEDLINE | ID: mdl-3066129

RESUMO

A survey is given, on reports in the literature and personal experiences, on the neurophysiological basis of psychosurgery. Animal experiments as well as clinical-experimental observations in human beings are reviewed, following the usual present day targets: frontal lobe, cingulum, amygdala, thalamic and hypothalamic areas and anterior internal capsule. As a result, it has to be stated that there are no definite data resulting from animal experiments which could sustain the neurophysiological basis of psychosurgery. For psychiatric diseases animals are definitely not an adequate model. Therefore it is considered to be our neurosurgical duty to collect experimental data in human beings in a methodically proper manner and with respect to our ethical precepts.


Assuntos
Mapeamento Encefálico/métodos , Encéfalo/fisiopatologia , Psicocirurgia/métodos , Tonsila do Cerebelo/cirurgia , Animais , Comportamento Animal/fisiologia , Lobo Frontal/cirurgia , Giro do Cíngulo/cirurgia , Humanos , Transtornos Mentais/cirurgia
11.
Acta Neurol Belg ; 87(3): 132-9, 1987.
Artigo em Francês | MEDLINE | ID: mdl-3314308

RESUMO

Central nervous system (CNS) complications are currently described in patients with Acquired Immuno-Deficiency Syndrome (AIDS). CT-scan imaging is helpful in the description of the lesions. However, by CT-criteria alone, it is not possible to reliably distinguish toxoplasmosis from other CNS infections and from a primary CNS sarcoma. The authors consider that biopsy of the lesion is recommended to exclude other treatable diseases such as bacterial infections, tuberculosis, fungus and toxoplasmosis. Stereotactic technic gives the optimal precision and security.


Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Neoplasias Encefálicas/patologia , Encéfalo/patologia , Transtornos Neurocognitivos/patologia , Sarcoma/patologia , Síndrome da Imunodeficiência Adquirida/patologia , Adulto , Biópsia/métodos , Diagnóstico Diferencial , Humanos , Masculino , Transtornos Neurocognitivos/etiologia , Técnicas Estereotáxicas
12.
Appl Neurophysiol ; 50(1-6): 218-22, 1987.
Artigo em Inglês | MEDLINE | ID: mdl-3329849

RESUMO

Early detection and precise diagnosis of presenile dementias are important since they determine subsequent medical care. Presently the only way to classify these syndromes is by neuropathological examination. Between 1972 and 1987, 222 stereotactic serial brain biopsies were performed in 25 selected demented patients. Comparison between preoperative clinical diagnosis and histological finding gives the following results: in 32% the clinical diagnosis has been confirmed, in 60% the diagnosis has been corrected or specified and in 8% the stereotactic brain biopsies only showed unspecific pathological gliosis.


Assuntos
Encéfalo/patologia , Demência/patologia , Técnicas Estereotáxicas , Biópsia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Artigo em Francês | MEDLINE | ID: mdl-3544102

RESUMO

Confrontation of data obtained from several modern imaging techniques (CAT Scan, NMR Scan, PET Scan) is a fundamental problem in actual neurological practice and must be correlated with histology. For that purpose, we use the referential plane of the stereotactic Talairach frame. Using teflon intraosseous buttons, the referential plane and a common zero reference point can be objectivated by CAT, NMR and/or PET Scans. A computer program gives the exact coordinates of the chosen target. These coordinates are immediately usable in the operating room for stereotactic serial biopsies.


Assuntos
Encefalopatias/diagnóstico , Espectroscopia de Ressonância Magnética , Técnicas Estereotáxicas , Tomografia Computadorizada de Emissão/normas , Tomografia Computadorizada por Raios X/normas , Encéfalo/anatomia & histologia , Encéfalo/patologia , Encefalopatias/patologia , Humanos
15.
Appl Neurophysiol ; 45(4-5): 516-7, 1982.
Artigo em Inglês | MEDLINE | ID: mdl-7036890

RESUMO

A special stereotactic frame (Radionics) is dedicated to percutaneous electrocoagulation of the trigeminal ganglion. It permits a selection of the first, second or third rootlet according to the territory involved with pain. The penetration of the foramen ovale may be achieved by a jugal or a submaxillary approach, with a common fluoroscopic survey.


Assuntos
Eletrocoagulação/instrumentação , Técnicas Estereotáxicas/instrumentação , Nervo Trigêmeo/cirurgia , Humanos
16.
Acta Neurochir (Wien) ; (Suppl 24): 163-73, 1977.
Artigo em Inglês | MEDLINE | ID: mdl-920295

RESUMO

By means of implanted multileads electrodes, responses to clicks and prolonged sound stimulations were recorded from the Heschl gyrus of 2 human brains. These responses were strictly localized to this structure. Cortical averaged auditory evoked potentials (c.AEP) to clicks are consistent with scalp averaged auditory evoked potentials (s.AEP). So, Na Pa, Nb, P1, N1, waves have similar latencies and none of them in the s.AEP may be correlated with myogenic potentials (in opposition with the suggestions of Bickford et al. 1964 and Celesia et al. 1968). Increasing the duration of sound stimulation resulted in changes of the response. For a duration longer than 20ms, an "on-response" and an "off-response" were noted. No satisfying physiological explanation of these events is retained despite data obtained with monaural homo and heterolateral stimulations and with variation of tone of sound stimulation.


Assuntos
Córtex Auditivo/fisiologia , Percepção Auditiva/fisiologia , Vias Auditivas/fisiologia , Potenciais Evocados , Humanos , Tempo de Reação
17.
Acta Neurol Belg ; 76(3): 173-9, 1976.
Artigo em Inglês | MEDLINE | ID: mdl-9769

RESUMO

The anticonvulsive effect of Lorazepam -- one of the newer diazepines -- has been tested in 10 patients with induced epileptic conditions under continuous polygraphic control. The quantitative analysis of the paroxysmal discharges -- i.e. the evolution of the "paroxysmal index" -- shows that 5 mg IV Lorazepam normalize the tracings in 2.3 minutes. Parenteral Lorazepam inhibits pharmacologically-induced electroencephalographic abnormalities in man. Its action is slightly delayed. No effect on cardiac or respiratory function, or muscle tone was noted.


Assuntos
Ansiolíticos/uso terapêutico , Epilepsia/tratamento farmacológico , Lorazepam/uso terapêutico , Adolescente , Adulto , Avaliação de Medicamentos , Epilepsia/induzido quimicamente , Feminino , Humanos , Infusões Parenterais , Lorazepam/administração & dosagem , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
19.
Acta Neurol Belg ; 75(5): 219-29, 1975.
Artigo em Inglês | MEDLINE | ID: mdl-3939

RESUMO

The authors report their experience with parenteral lorazepam in the acute treatment of 11 patients with EEG-confirmed status epilepticus. Ten adults and one 6-year-old child were injected respectively with 5 mg and 2.5 mg lorazepam. All of these patients exhibited prompt cessation of seizures both electrical and clinical. Some data indicate a longer lasting relief than that provided by an equal dose of diazepam.


Assuntos
Ansiolíticos/uso terapêutico , Epilepsia/tratamento farmacológico , Lorazepam/uso terapêutico , Adolescente , Adulto , Criança , Avaliação de Medicamentos , Epilepsias Parciais/tratamento farmacológico , Epilepsia Tipo Ausência/tratamento farmacológico , Feminino , Humanos , Injeções Intravenosas , Lorazepam/administração & dosagem , Masculino , Pessoa de Meia-Idade
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