The use of hypnosis in severe brain injury rehabilitation: a case report
VANHAUDENHUYSE, Audrey ; Laureys, Steven ; FAYMONVILLE, Marie-Elisabeth
in Acta Neurologica Belgica (2015)Detailed reference viewed: 5 (0 ULg)
Analysis and clinical correlates of 20 Hz photic driving on routine EEG in migraine.
; Gérard, Paul ; et al
in Acta neurologica Belgica (2014)
Enhanced photic driving (PD) during high-frequency flicker stimulation, the so-called H response, is a classical feature of migraine patients between attacks, but is thought to be of poor clinical utility ... [more ▼]
Enhanced photic driving (PD) during high-frequency flicker stimulation, the so-called H response, is a classical feature of migraine patients between attacks, but is thought to be of poor clinical utility. Visual inspection of the EEG for its detection may not be reliable, however, data on its possible correlations with clinical features and migraine pathophysiology are scarce. We have compared visual inspection and EEG spectral analysis to detect abnormal PD in 280 consecutive migraine patients of our headache clinic (episodic migraine without aura, n = 171; chronic migraine, n = 48; migraine with aura, n = 61) and in a group of 24 non-migrainous neurological controls. Spectral frequency analyses were performed blindly by one of us (YF). On visual inspection, 50.4 % of migraineurs were thought to have increased 20 Hz PD. After spectral analysis, only 62.4 % of them had PD power superior to the mean + 95 % CI of the control group. Sensitivity of visually identified PD was 82.24 %, specificity 69.36 %. Increased PD on spectral analysis was more prevalent in episodic migraine than in chronic migraine, in patients with low attack frequency, in those with ictal autonomic symptoms in addition to nausea and in those with a strong family history of migraine. We confirm therefore that 20 Hz photic driving is of little diagnostic utility and its prevalence in migraine overestimated on visual inspection. Its presence on spectral analysis of the EEG, however, might be of pathophysiological interest, as it identifies subgroups of migraineurs of whom the common denominator could be lack of habituation of cortical responses during repetitive stimulation. [less ▲]Detailed reference viewed: 2 (0 ULg)
Diagnosis, pathophysiology and management of chronic migraine: a proposal of the Belgian Headache Society.
; ; MAGIS, Delphine et al
in Acta neurologica Belgica (2014)
Chronic migraine (CM) is a disabling neurological condition affecting 0.5-2 % of the population. In the current third edition of the International Classification of Headache Disorders, medication overuse ... [more ▼]
Chronic migraine (CM) is a disabling neurological condition affecting 0.5-2 % of the population. In the current third edition of the International Classification of Headache Disorders, medication overuse is no longer an exclusion criterion and CM is diagnosed in patients suffering from at least 15 headache days per month of which at least eight are related to migraine. CM is difficult to treat, and preventive treatment options are limited. We provide a pathogenetic model for CM, integrating the latest findings from neurophysiological and neuroimaging studies. On behalf of the Belgian Headache Society, we present a management algorithm for CM based on the international literature and adapted to the Belgian situation. Pharmacological treatment options are discussed, and recent data on transcranial and invasive neuromodulation studies in CM are reviewed. An integrated multimodal treatment programme may be beneficial to refractory patients, but at present, this approach is only supported by a limited number of observational studies and quite variable between centres. [less ▲]Detailed reference viewed: 22 (1 ULg)
Upper airway imaging in sleep-disordered breathing.
POIRRIER, Anne-Lise ; ; Bruwier, Annick et al
in Acta neurologica Belgica (2014)
Our understanding of sleep-disordered breathing has evolved considerably over the past three decades, and clinical techniques of evaluation have progressed tremendously. Myriad imaging techniques are now ... [more ▼]
Our understanding of sleep-disordered breathing has evolved considerably over the past three decades, and clinical techniques of evaluation have progressed tremendously. Myriad imaging techniques are now available for the physician to approach the dynamic features resulting in turbulent airflow, upper airway narrowing or collapse at different levels. Controversy exists in the choice of investigations, probably because the best evaluation should be a combination of different techniques. Physical, radiographic, endoscopic and acoustic evaluations could be integrated to understand the degree and the levels of airway reduction and/or obstruction in a given patient. This review focuses on cost-effective and easily implemented techniques in daily practice, allowing quality assessment of the dynamic anatomy of sleep-disordered breathing: cephalometry, (sleep-)endoscopy and acoustic reflectometry of the upper airway. [less ▲]Detailed reference viewed: 34 (10 ULg)
Occipital nerve stimulation for intractable chronic cluster headache: a new hope for a dreadful disease?
MAGIS, Delphine ; Schoenen, Jean
in Acta Neurologica Belgica (2011), 111Detailed reference viewed: 71 (8 ULg)
Placental growth factor: a tissue modelling factor with therapeutic potentials in neurology?
Chaballe, Linda ; Schoenen, Jean ; Franzen, Rachelle
in Acta Neurologica Belgica (2011), 111(1), 10-7
Placental growth factor (PlGF) is an angiogenic factor that belongs to the vascular endothelial growth factor (VEGF) family. Besides its well known capacity to potentiate the angiogenic action of VEGF ... [more ▼]
Placental growth factor (PlGF) is an angiogenic factor that belongs to the vascular endothelial growth factor (VEGF) family. Besides its well known capacity to potentiate the angiogenic action of VEGF, PlGF also participates in inflammatory processes by attracting and activating monocytes; it plays therefore more specifically a role in pathological conditions. PIGF and its two receptors, VEGFR-1 and neuropilins (NRPs), are expressed in the brain and increase after experimental stroke, but their precise functions in the nervous system remain underexplored. In this review article, we summarize present knowledge on the role of PlGF in various nervous system disease processes. Given the available data, P1GF has neuroprotective and neurotrophic properties that make it an actor of considerable interest in the pathophysiology and potentially in the therapy of degenerative and traumatic brain or spinal cord diseases. [less ▲]Detailed reference viewed: 15 (0 ULg)
Central neuromodulation in cluster headache patients treated with occipital nerve stimulators: A PET study
Magis, Delphine ; Bruno, Marie-Aurélie ; Fumal, Arnaud et al
in Acta Neurologica Belgica (2010), 110(Suppl 1), 17
OBJECTIVES: Use functional brain imaging to explore activity changes in centres involved in trigeminal pain processing and control before and after occipital neurostimulation in drug-resistant chronic ... [more ▼]
OBJECTIVES: Use functional brain imaging to explore activity changes in centres involved in trigeminal pain processing and control before and after occipital neurostimulation in drug-resistant chronic cluster headache patients. BACKGROUND: Occipital nerve stimulation (ONS) provides relief to about 60% of patients suffering from drug-resistant chronic cluster headache (drCCH). Its mode of action, however, remains elusive, but the long latency to meaningful effect suggests that ONS induces slow neuromodulation. METHODS: Ten drCCH patients underwent an 18FDG-PET scan after ONS durations varying between 0 and 30 months. All were scanned with ongoing ONS (ON) and with the stimulator switched OFF. RESULTS: After 6-30 months of ONS, 3 patients were pain free and 4 had a ≥ 90% reduction of attack frequency (responders). In patients overall compared to controls, several areas of the pain matrix were hypermetabolic: ipsilateral hypothalamus, midbrain and ipsilateral lower pons. All normalized after ONS, except the hypothalamus. Switching ON or OFF the stimulator had little influence on brain glucose metabolism. The perigenual anterior cingulate cortex (PACC) was hyperactive in ONS responders compared to non-responders. INTERPRETATION AND CONCLUSIONS: Metabolic normalization in the pain neuromatrix and lack of short-term changes induced by the stimulation support the hypothesis that ONS acts in drCCH through slow neuromodulatory processes. Selective activation in responders of PACC, a pivotal structure in the endogenous opioid system, suggests that ONS may restore balance within dysfunctioning pain control centres. That ONS is nothing but a symptomatic treatment might be illustrated by the persistent hypothalamic hypermetabolism which could explain why autonomic attacks may persist despite pain relief and why cluster attacks recur shortly after stimulator arrest. [less ▲]Detailed reference viewed: 47 (4 ULg)
Botulinum toxin for the treatment of headache:a promising path on a “dead end road”?
DELSTANCHE, Stéphanie ; Schoenen, Jean
in Acta Neurologica Belgica (2010), 110Detailed reference viewed: 40 (2 ULg)
Primary diffuse leptomeningeal gliomatosis: an autopsy case and review of the literature
Somja, Joan ; Boly, Mélanie ; Sadzot, Bernard et al
in Acta Neurologica Belgica (2010), 110(4), 325-33
We report a case of primary diffuse leptomeningeal gliomatosis (PDLG) in a 76-year-old male presenting with confusion, dysarthria, diplopia, lumbal pain and headaches of recent onset. Neurological ... [more ▼]
We report a case of primary diffuse leptomeningeal gliomatosis (PDLG) in a 76-year-old male presenting with confusion, dysarthria, diplopia, lumbal pain and headaches of recent onset. Neurological examination revealed nuchal rigidity and bilateral sixth cranial nerve palsy. The cerebrospinal fluid showed a marked hyperproteinorachia (4711 mg/L) and mild cytorachia (5-10 leucocytes/mm3) with a few atypical lymphoid cells. On admission, brain CT scan and MRI demonstrated diffuse and nodular leptomeningeal contrast enhancement predominant at the skull base and several osteolytic lesions in the right parietal bone. Extensive serological studies for infectious, autoimmune or neoplastic diseases were negative. The work-up diagnosis was neurosarcoidosis or multiple meningeal and osseous metastases of an unknown primary cancer. Surgical biopsy of the right parietal bone lesion showed only fibrous tissue with no evidence of tumour or inflammation. The patient was treated with high dose corticosteroids but its neurological status progressively worsened and he died of aspiration pneumonia 35 days after admission. Post-mortem examination revealed a PDLG, a rare fatal tumour with about 60 cases reported. PDGL is characterized by the diffusion of neoplastic glial cells throughout the leptomeninges without evidence of a primary intra-parenchymal lesion. Recognition of this rare brain tumour is important as recent reports suggest that radiotherapy and chemotherapy can improve patient survival. [less ▲]Detailed reference viewed: 48 (18 ULg)
Honeycomb-like appearance of dilated Virchow-Robin spaces.
; ; et al
in Acta Neurologica Belgica (2010), 110(1), 116-7Detailed reference viewed: 23 (1 ULg)
Epidemiology of major depression in Belgian parkinsonian patients
; GONCE, Michel ; et al
in Acta Neurologica Belgica (2010), 110Detailed reference viewed: 29 (4 ULg)
Treatments for progressing Parkinson's disease: a clinical case scenario study.
MAERTENS DE NOORDHOUT, Alain ; ; et al
in Acta Neurologica Belgica (2009), 109(3), 189-99
OBJECTIVE: A 'case scenario' study on clinical decisions in progressing Parkinson's disease (PD) was developed to complement scientific evidence with the collective judgment of a panel of experts. METHODS ... [more ▼]
OBJECTIVE: A 'case scenario' study on clinical decisions in progressing Parkinson's disease (PD) was developed to complement scientific evidence with the collective judgment of a panel of experts. METHODS: The opinions of 9 experts in movement disorders on the appropriateness of 9 common pharmacological treatments for 33 hypothetical patient profiles were compared to those of 14 general neurologists. Before rating the case scenarios, all participants received a document integrating European and US guidelines for the treatment of patients with advanced PD. Case scenarios showing disagreement or with inconsistencies in appropriateness ratings were discussed at a feedback meeting. A tool for interactive discussion on the clinical case scenarios included was developed based on the outcome of the study. RESULTS: Current guidelines are often insufficient to adequately guide the management of patients with progressing PD. The case scenario study did not reveal major differences in opinions between experts in movement disorders and general neurologists about the appropriateness of certain drug choices for specific case scenarios. However in about 1 out of 5 treatment decisions where experts stated appropriateness or inappropriateness, the general neurologists panel had no or dispersed opinions. CONCLUSIONS: This study reveals more uncertainty about treatment of advanced PD in general neurologists compared with experts in movement disorders and underlines the need for additional support for guiding treatment decisions in clinical practice. [less ▲]Detailed reference viewed: 21 (0 ULg)
Species and tissue-independent rapid regulation of aromatase activity by phosphorylations.
Charlier, Thierry ; ; et al
in Acta Neurologica Belgica (2009)
Aromatase activity (AA) is rapidly inhibited in male quail brains, following expression of sexual behavior, activation of glutamatergic receptors or exposure to phosphorylating conditions. Questions ... [more ▼]
Aromatase activity (AA) is rapidly inhibited in male quail brains, following expression of sexual behavior, activation of glutamatergic receptors or exposure to phosphorylating conditions. Questions remain as to whether direct aromatase phosphorylation is the common key regulatory mechanism and whether these inhibitions are specific to quail hypothalamus. We now showed that AA is rapidly downregulated in quail ovary homogenates incubated in phosphorylating conditions, similarly to what is observed in hypothalamic homogenates. To understand the processes underlying this control, we expressed human aromatase in the human cell line HEK293 and 1) researched whether human aromatase can also be rapidly modulated by phosphorylations and 2) investigated more precisely the processes involved in this rapid control of activity. AA in HEK293 was rapidly inhibited following depolarization of intact cells with 100 mM KCl or in cell lysates exposed to phosphorylating conditions. Thus inhibition of AA in phosphorylating conditions is not unique to the quail hypothalamus neural environment but seems to be a general process. We are now defining the contribution of single residues of the aromatase protein to this enzymatic control. [less ▲]Detailed reference viewed: 16 (4 ULg)
Management of diffuse glioma in children: a retrospective study of 27 cases and review of literature.
Piette, Caroline ; Deprez, Manuel ; et al
in Acta Neurologica Belgica (2008), 108(2), 35-43
Gliomas are the most common CNS tumours in children and present either as circumscribed tumours or diffusely infiltrative neoplasms. Diffuse gliomas develop both in the cerebral hemispheres and the ... [more ▼]
Gliomas are the most common CNS tumours in children and present either as circumscribed tumours or diffusely infiltrative neoplasms. Diffuse gliomas develop both in the cerebral hemispheres and the brainstem and have a poor prognosis. Guidelines for the therapy of these tumours are still debated. In this study, we reviewed the clinical features of 27 consecutive patients with diffuse gliomas admitted to the Department of Paediatrics of CHR Citadelle, University of Liege, between 1985 and 2005. We review their clinical presentation, diagnosis, treatment and outcome with reference to the published literature. [less ▲]Detailed reference viewed: 69 (9 ULg)
Cost estimates of brain disorders in Belgium
Schoenen, Jean ; ; et al
in Acta Neurologica Belgica (2006), 106(4), 208-214
This article presents the data on cost of the major brain disorders in Belgium which were retrieved from "Cost of Disorders of the Brain in Europe" study sponsored by the European Brain Council and ... [more ▼]
This article presents the data on cost of the major brain disorders in Belgium which were retrieved from "Cost of Disorders of the Brain in Europe" study sponsored by the European Brain Council and performed by Stockholm Health Economics. The disorders selected were : addiction, depression, anxiety disorders, brain tumours, dementia, epilepsy, migraine and other headaches, multiple sclerosis, Parkinson's disease, psychotic disorders, stroke and trauma. Figures for prevalence of disorders and direct medical, direct non-medical and indirect costs are based on data coming from available electronic data bases, or when missing for Belgium, best possible estimates or extrapolated data were used. All economic data were transformed to E's for 2004 and adjusted for purchasing power parity (PPP). The results show that the total number of people with any brain disorder in Belgium amounts to 2,9 million in 2004, the most prevalent being anxiety disorders 1.1 million, migraine 860 000, addiction (any) 800.000 and depression 500.000 cases. The total cost of all included brain disorders in Belgium was estimated at 10.6 billion Euros. Most costly per case are brain tumours, multiple sclerosis, stroke and dementia. Because of their higher prevalence, however, depression, dementia, addiction, anxiety disorders and migraine have the highest total costs. Taken together, brain disorders consume 4% of the gross national product and cost each citizen of Belgium E 1029 per year The drug costs for brain disorders constitute only 10% of the total drug market in Belgium, and only 4% of the total cost of brain disorders in Belgium. This should be compared to the cost estimates and to a previous study which showed that brain disorders are responsible for 35% of the total burden of all disorders in Europe. This study suggests therefore that the direct healthcare resources, including expenses for drug therapies, allocated to brain disorders in Belgium are not leveled to the indirect costs and burden of these disorders. A comparison with data available from a direct prospective study in demented Belgian patients suggests that the mathematical estimates presented here reflect quite accurately the real average cost for dementia, although there are large variations depending on disease severity. As, in addition, subjects with brain disorders face collateral costs which have not been taken into account and may vary between countries, it seems worthwhile to conduct, in cooperation with patients associations, a complementary survey in the Belgian ecosystem to establish the cost profile of representative patients for the major brain disorders. Such a survey is being organized by a task force of the Belgian Brain Council. [less ▲]Detailed reference viewed: 23 (2 ULg)
Migraine specificities during childhood to adulthood: diagnosis and treatment
; Misson, Jean-Paul
in Acta Neurologica Belgica (2006)Detailed reference viewed: 21 (0 ULg)
Animal models of drug addiction: advantages and limitations
in Acta Neurologica Belgica (2006), 106
Various animal models have been developed to investigate the neurobiological and behavioral mechanisms of drug addiction. The most popular of these animal models include the locomotor sensitization ... [more ▼]
Various animal models have been developed to investigate the neurobiological and behavioral mechanisms of drug addiction. The most popular of these animal models include the locomotor sensitization paradigm, the place conditioning procedure and the self-administration technique. With these techniques, it is possible to mimic in rodents the major aspects of human drug addiction. The self-administration procedure is the most widely used and show an excellent natural and predictive validity. In the self-administration protocol, experimental animals, usually rats or mice, are allowed to press a lever in order to gain access to a small dose of an addictive drug. The drug may be given to the animal through the oral, the intravenous or the intracranial route of administration, according to the purpose of the study. In recent years, the classical self-administration procedure has been adapted to study the specific neurobiological basis of drug relapse. In this now called drug reinstatement paradigm, when drug self-administration behaviors are well established, an extinction procedure starts, during which lever pressing is no longer reinforced by drug access. After a number of such extinction sessions, lever pressing gradually declines and eventually stops. Drug-seeking behaviors are therefore said to be extinguished. It is then possible to test various stimuli in order to investigate whether they reinstate drug-seeking behaviors and use such a reinstatement as an animal model of drug relapse. Three types of stimuli have been shown to reinstate drug-seeking behaviors: a small priming dose of drug, drug-associated cues and a stressful stimuli. The effects of these three relapse-triggering stimuli are mediated by different neurobiological mechanisms, leading to the expectation that they may be targeted by different pharmacotherapeutic and behavioral interventions. Despite the high value of the current animal models of drug addiction, there show several limitations. In particular, it is difficult to differentiate between self-controlled and compulsive drug use in animals. As only uncontrolled compulsive drug consumption characterizes drug addiction in humans, such a limitation might explain the high frequency of false positive results in animal experiments. Indeed, it is common that therapeutic interventions successfully developed in animals later proved to be disappointing in humans. [less ▲]Detailed reference viewed: 120 (6 ULg)
The epileptic syndromes with continuous spikes and waves during slow sleep: definition and management guidelines.
; ; et al
in Acta Neurologica Belgica (2006), 106(2), 52-60
The authors propose to define the epileptic syndromes with continuous spikes and waves during slow sleep (CSWS) as a cognitive or behavioral impairment acquired during childhood, associated with a strong ... [more ▼]
The authors propose to define the epileptic syndromes with continuous spikes and waves during slow sleep (CSWS) as a cognitive or behavioral impairment acquired during childhood, associated with a strong activation of the interictal epileptiform discharges during NREM sleep--whatever focal or generalized--and not related to another factor than the presence of CSWS. The type of syndrome will be defined according to the neurological and neuropsychological deficit. These syndromes have to be classified among the localization-related epileptic syndromes. Some cases are idiopathic and others are symptomatic. Guidelines for work-up and treatment are proposed. [less ▲]Detailed reference viewed: 135 (4 ULg)
Detection of motor and non-motor symptoms of end-of dose wearing-off in Parkinson's disease using a dedicated questionnaire: a Belgian multicenter survey
; MAERTENS DE NOORDHOUT, Alain
in Acta Neurologica Belgica (2006), 106Detailed reference viewed: 15 (0 ULg)