Search

The authors report 6 cases of acute frontal syndrome following severe seizures of frontal origin. The study of the 6 cases shows the place of disorders in affectivity, behavior, judgement and motor activity; such features changing over time. The relationship between the frontal syndrome and epilepsy is suggested by the fact that the frontal syndrome appears after an increased frequency of frontal seizures, with prolonged discharges of generalized or frontal spikes. The frontal syndrome disappears slowly with the epileptic discharges, and no frontal lesion is found on CT-Scan. Such cases suggest that the frontal syndrome is functional, linked to the localization of the epileptic discharges; it may be regarded as a post-critic deficit, and must be differentiated from a post-critic delirium or a psychotic state.

In an investigation of 15 patients with Duchenne muscular dystrophy, the authors found mental retardation in all cases. In addition, CT scan showed a cortical atrophy after the age of 10 years. This finding suggests that a cerebral degenerative process is present in cases of Duchenne muscular dystrophy.

The authors have evaluated the indications, method and results of utilising sphenoidal electrodes in epilepsy. This method makes it possible to study the hippocampal area which cannot be studied by extra-cranial electrodes. It also localizes in the temporal lobe complex seizures without investigation by an electroencephalogram, or with a non-specific electroencephalographic picture. Thus, sphenoidal electrodes enable temporal seizures to be identified and localized, leading to more specific neuroradiological exploration, and therefore to the selection of patients for specific surgery.

A gastric teratoma diagnosed after a gastro-intestinal tract bleeding in a neonate is reported. The endogastric tumor was shown by gastric endoscopy. The tumor was pediculated and a simple tumorectomy was performed, without trouble later. Fifty-three other cases have been found in the literature. Most of them presented with abdominal distension and a palpable mass; diagnosis was always made after surgery and the diagnosis of mature gastric teratoma was confirmed by histological examination. These rare tumors are always of benign nature, but are often revealed by complications. Their frequency is less than 1% of infants teratoma and 85% are found in the first year of life; they are more frequent in males.

The authors report the case of dizygotic twins suffering from transitory neonatal hypoparathyroidy and leading to the diagnosis of maternal hyperparathyroidy. The differences of clinical and biological symptomatology between these twins suggest individual variations in response to phosphocalcic disorders of the mother. A review of literature find 31 other cases. This study emphasize the aggravation by the mild hypomagnesemia frequently associated, the usual severity of initial clinical symptomatology in contrast with a good neurologic outcome, the diagnosis of maternal hyperparathyroidy.

The incidence of migraine was studied in 4 groups of patients: patients with centro-temporal epilepsy, patients with absence of epilepsy, patients with partial epilepsy, and non-epileptic patients with a history of cranial trauma. Migraines were present in 62% of the patients with centro-temporal epilepsy, 34% of the patients with absence of epilepsy, 8% of the patients with partial epilepsy and 6% of the patients with cranial trauma. These results suggest that the association of centro-temporal epilepsy and migraine is non-fortuitous as well as, to a lesser degree, absence of epilepsy and migraine. The authors discuss the role of serotonin in the association epilepsy-migraine and suggest that centro-temporal epilepsy might be a feature for the diagnosis of migraine.

A heparin-induced case of thrombocytopenia occurring in an adolescent is reported. Its physiopathology and treatment are discussed. Complications are not only bleeding, but also arterial or venous thrombosis. Usually, stopping of heparin therapy is necessary, but sometimes the treatment should be followed with low molecular weight heparin.

The authors report two cases of children, who had a severe head injury with large skull fracture. If neurological evolution was good, on the other hand, skull fracture went on to develop, to give a bone defect with a leptomeningeal cyst of arachnoidal origin, as it is pointed out by the classical authors. The authors insist upon the specificity of this entity in childhood, and upon the necessity to observe by repeated clinical and radiological examinations any young child who have a large skull fracture.

Cerebral echotomography interest in showing neonatal cerebral hemorrhage and their follow up toward porencephaly is pointed out in 4 neonates. The authors recall the electroencephalographic features which can lead to the diagnosis. Then, they insist upon a new concept which is the long delay between onset of the cyst and onset of hemiplegia. The rationnal for this concept is the gradual maturation of the pyramidal tracts in infancy.