Intraoperative Localisation of the Primary Motor Cortex Using Single Electrical Stimuli

in Journal of Neurology, Neurosurgery & Psychiatry (1996), 60(4), 442-4

A new method of intraoperative localisation of the primary motor cortex is described, based on the application of single anodal electric pulses to the brain surface. Patients were anaesthetised with ... [more ▼]

A new method of intraoperative localisation of the primary motor cortex is described, based on the application of single anodal electric pulses to the brain surface. Patients were anaesthetised with propofol infusion, and neuromuscular blockade was temporarily alleviated to allow recording of surface EMG responses (CMAPs) to the stimuli. Primary motor areas could be localised in 18/19 patients studied. In the other patient, no responses were elicited, as the operative field was posterior to the motor cortex. When compared with MEPs elicited in awake patients by magnetic stimuli, responses to intraoperative anodal stimulation were of small amplitude (usually less than 10% of MEPs) and their latency was some 1 to 2 ms longer. One month after the operation, only 1/19 patients was left with a slight muscle weakness, although seven showed preoperative motor deficit. The procedure proved easy and fast, needing no preliminary surgery or time consuming preparation. It did not induce any detectable side effects. [less ▲]

Potentiation instead of habituation characterizes visual evoked potentials in migraine patients between attacks

in European Journal of Neurology (1995), 2

Effets de la sénescence sur les neurones GABAergiques

in Encéphale (L') (1987), 13

Mazindol in the treatment of Parkinson's disease.

in Archives of Neurology (1983), 40(13), 788-90

Mazindol, a drug that blocks the reuptake of dopamine, was studied in the treatment of Parkinson's disease in both a pilot study (12 patients) and a controlled trial (11 patients). The patients had stage ... [more ▼]

Mazindol, a drug that blocks the reuptake of dopamine, was studied in the treatment of Parkinson's disease in both a pilot study (12 patients) and a controlled trial (11 patients). The patients had stage II or III disease, according to the classification of Hoehn and Yahr. Both studies showed that mazindol possessed anti-parkinsonian properties and that the improvement was statistically significant. The therapeutic effect was moderate, but could be of value for patients in the early stages of the disease. The drug was well tolerated; only two patients had side effects. [less ▲]

Motoneuropathie hereditaire: la forme proximale de l'adulte liee au sexe (ou maladie de Kennedy). Observations cliniques et neuroendocrinologiques.

in Journal of the Neurological Sciences (1979), 41(3), 343-57

Clinical, electrophysiological, histological and neuroendocrinological findings in a peculiar form of progressive spinal and bulbar muscular atrophy affecting 4 members in two different families are ... [more ▼]

Clinical, electrophysiological, histological and neuroendocrinological findings in a peculiar form of progressive spinal and bulbar muscular atrophy affecting 4 members in two different families are reported. The clinical hallmarks, which characterize this entity among the group of degenerative motor neuron diseases are: sex-linked recessive inheritance; onset in the third decade; slow progression; involvement of facial and bulbar muscles in addition to wasting of the proximal and, in some cases, the distal musculature; asymmetry of clinical signs; consistent and abundant fasciculations predominantly in the peri-oral muscles; intention tremor and a well-developed gynaecomastia, which is the first clinical sign. Electrophysiological and histological findings confirm the neurogenic origin of the muscular atrophy; in addition, muscle biopsy shows "myopathic-like" changes in one case and serum muscle enzyme levels are elevated in all neurologically affected patients. It is believed that the clinical entity corresponds to the rare type III proximal hereditary motor neuropathy (or "Kennedy's disease"), of which 25 published cases are reviewed. Neuroendocrinological data in two patients demonstrate an androgenic insufficiency of hypothalamo-hypophyseal origin and high levels of circulating oestrogens, which probably have induced gynaecomastia. Dynamic neuroendocrinological tests suggest that lesions of certain hypothalamic nuclei may exist, which should be looked for in the forthcoming anatomical studies. [less ▲]