Неврологические расстройства

Introduction: Frontal lobe seizures are one of the most frequent seizure types in children. Diagnosis and treatment could be difficult sometimes. In a context where there is no stereo-electroencephalography (SEEG), and epilepsy surgery is impossible. Methodology: We conducted a descriptive study from January to July 2016 at the neurophysiology department of Fann University Hospital in Dakar. Children with frontal lobe epileptic abnormalities were involved in the study. They had a standard EEG and neurological and neuropsychological assessment. Results: A total of 9 cases were collected and only 7 patients were included in the study. At the end of the study we found a good correlation between clinical signs and electrophysiologic findings. 4 out of 7 had had their first episode in preschool age, 6 out of 7 had nocturnal seizure, 5 out of 7 had 3 to 5 seizures each time. 4 out of 7 had seizures during EEG recording. EEG findings were fast rhythms, spike and spike and wave in frontal derivations. 5 out of 7 had neuropsychologic assessment and 4 patients had procedural memory; visio-spatial; planification; mental flexibility and inhibition impairment. We did not find the etiology in our patients. Evolution was good with antiepileptic treatment. All the patients were really improved. Conclusion: Frontal lobe seizure are one of the most frequent seizure type in children. Diagnosis and treatment could be difficult sometimes. In a context where there is no stereo EEG, no epilepsy surgery, we need to have the most precise diagnosis, to offer more chance to our patient to benefit from treatment to improve prognosis and outcome in children with frontal lobe seizures.

Background: To explore changes in blood-brain barrier (BBB) function and volumetry associated with Parkinson’s disease (PD) levodopa-induced-dyskinesia (LID). Methods: 26 PD patients [13 with LID (LID+) and 13 without (LID-)], matched into pairs, performed high resolution 3D FSPGR MRI, applying a methodology based on delayed contrast extravasation developed for calculating delayedenhancement subtraction-maps, exploring contrast clearance or accumulation, representing BBB function. Segmentation software calculated volumes of pre-determined brain structures and the mean signal intensity was calculated, reflecting each structure’s BBB function. Comparisons between the LID+ and LID- paired patients and within patient, between the more and less affected hemisphere (MAH, LAH) and correlation tests with lateralized UPDRS motor scores were performed. Results: There were no significant differences in volumetric or BBB map characteristics between the matched LID+ and LID- patients regarding most brain areas except for the inferior parietal cortex (IPC) of the MAH that displayed a less negative signal suggesting slightly higher BBB disruption in LID+ vs. LID- patients. A positive correlation was found with the motor score of the side contralateral to the MAH (r = 0.58, p<0.038) among the LID+ patients. Within-patient comparison of the MAH and LAH failed to reveal asymmetry in BBB function or volume in any of the brain areas studied. Conclusion: We demonstrated an association between slight BBB disruption in the IPC and LID in patients with PD using a new MRI methodology. Further studies to explore BBB functioning in the various stages of PD and its motor complications are needed.

Autism is characterized by perpetual and unrelenting hyperfocus, the state of intense single-minded concentration fixated on one thing at a time to the exclusion of everything else, including one’s own feelings. Most cases of autism appear to be congenital in origin. This report opens the door to the possibility that some cases of autism may be caused by extreme trauma. Three subjects were examined whose documented autism was precipitated by a single event that was experienced as so horrific as to make life too painful to continue living. In each case, the brain instantly responded by permanently altering its neurophysiology so that the person never again experienced emotional pain. Instead of ending their painful lives, these people put an end to emotional pain in their lives – with the unfortunate consequence that they also ended their ability to receive pleasure.