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Copyright of EMC-Kinésithérapie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Neurologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Involuntary movements, or dyskinesias, represent a debilitating complication of levodopa therapy for Parkinson's disease. Dyskinesia is, ultimately, experienced by the vast majority of the patients. Despite the importance of this problem, little was known about the cause of dyskinesia, a situation that has dramatically evolved in the last few years. The present review presents: 1) the current understanding of dyskinesia pathophysiology and 2) the therapeutic modalities, mainly non-dopaminergic, available or in development. We here show that the questions raised by the dyskinesia may have a clinically-driven pharmacological answer: the symptomatic treatment of dyskinesia, the prevention of the priming and the de-priming of the neural networks.

Many causes of saphenous nerve lesions at the knee or leg level have been reported. Proximal nerve lesions, especially after varicose vein stripping, are uncommon. We report a case of saphenous nerve lesion following catheterization of the femoral artery complicated with arterial spasm. The patient experienced pain for 10 years and only transdermal electroneural stimulation provided sedation. To our knowledge, this is the first published case of such an unusual complication after coronarography, despite the frequency of this procedure. We suggest nerve ischemia could explain the definitive neuralgia.

Constipation is a symptom not to be neglected, especially if the complaint is recent. We report a case where this symptom was the only clinical manifestation of a voluminous retroperitoneal tumor. The tumor was found to be a neurilemmoma of the fourth right lumbar roots, confirmed at pathological examination. Manifestations of extradural neurinomas generally result from compression of neighboring structures. The best preoperative diagnosis approach is magnetic resonance imaging but histology is required for confirmation. The close relations the tumor mass maintains with the unaffected nerve fibers makes resection difficult without postoperative functional consequences. Surgeons discuss the relevance of partial excision in order to preserve the nerve root in case of a benign slow-growing tumor. There does however appear to be a significant recovery of muscle strength even in case of total resection.

In Parkinson's disease, experimental studies favour a neuronal hyperactivity of the subthalamic nucleus. We carried out a subthalamic nucleus electrical stimulation in a patient aged 51, suffering for 8 years from a severe akineto-rigid form of Parkinson's disease, complicated with an on-off effect. Stereotaxic surgery was done under local anaesthesia on one side. Within the theoretical target, a 130 Hz stimulation induced akinesia alleviation mainly on the contralateral limbs. No abnormal movement was noticed. Then a long-term quadripolar DBS Medtronic electrode was inserted in that area. The study of the effects of chronic stimulation is in progress to determine the best temporal and electrical stimulation variables.

The potential neurotoxicity of iohexol and iopamidol in lumbar myelography was investigated in 20 patients using three criteria: clinical symptoms, EEG recordings with spectral analysis and CT scans of the brain. There was no significant difference in clinical side-effects between the two groups (Iopaminol, Iohexol). In 10 patients (iopaminol 4, iohexol 6) CT scans revealed an important penetration of the contrast media into the subarachnoid spaces at 3 hours and into the cerebral cortex at 24 hours. This cerebral contamination was unrelated to the headaches experienced by the patients or to the electrophysiological disturbances observed. Spectral analysis in brain-contaminated subjects showed a reduction of delta, beta 1 and beta 2 bands with iohexol. This reduction suggests that EEG activation is less pronounced with this agent than with iopaminol.

Huntington's chorea is a degenerative disorder of the human brain characterized by a marked loss of intrinsic neostriatal neurons. This situation can be reproduced by kainic acid injection in the caudate nucleus. Activity of pars reticulata neurons ipsilateral to the injected neostriatum was studied in normal, control (saline-injected) and lesioned rats. They were identified by electrophysiological and histological criteria (Fig. 1). Results obtained in normal and control rats were very similar (Table I). As previously described, the mean frequency of these neurons was high. An important percentage (respectively 72.5 and 73%) and these neurons presented the characteristics of a regular firing pattern (so called "organized neurons"). Results obtained in kainic acid lesioned rats were significantly different (Table I). The mean frequency was lower and only 11% of reticulata cells remained organized after neostriatal lesion. This important dysfunction may be explained in various ways: The neostriato-nigral pathway's destruction involves both the inhibitory GABAergic tract and the excitatory substance P tract (GALE et al., 1978). Other inputs arising from many structures in the brain continue to exert their own action on SN neurons, resulting in an unbalance in the SN inputs. It is well known that the nigral dopamine influences the neuronal activity of pars reticulata neurons (Ruffieux et Schultz, 1980; Waszczak et Walters, 1983). Doudet et al. (1984 b) previously reported a dysfunction of neuronal activity of dopaminergic cells after striatal lesion. A disturbance in the electrical activity may induce a similar disturbance in the intranigral dendritic release of DA.(ABSTRACT TRUNCATED AT 250 WORDS)

"Diazanalgesia" employs the combination diazepam + fentanyl. Its effects were studied on regional cerebral blood flow and oxygen metabolism in 8 normal subjects, who were examined angiographically. During diazanalgesia, cortical blood flow falls by 56 p. 100. The mean hemispheric flow calculated over 10 min falls by 34 p. 100. Cerebral O2 consumption (VcO2) falls by 34 p. 100. However, large individual variations are found which suggests that the fall in blood flow is not due solely to the decrease in O2 metabolism. The decreases in flow are not proportional to the amount fentanyl, and there is no direct relation between falls in VcO2 and amount of fentanyl. Cerebral vaso-reactivity to CO2 persists but is reduced under diazanalgesia compared with the waking state.

In this study, neuronal activity of dopamine (DA) containing neurons located in pars compacta of the substantia nigra is analysed by the use of the time interval histograms and autocorrelograms. These cells display a regular and rhythmic firing pattern which may possibly subserve the striatal regular spontaneous release of DA, and, then exert an homeostatic function within this part of the extrapyramidal system.

Recordings were electroencephalographical (EEG with spectral analysis), polygraphical (EMG, EKG, breathing). Visual and Auditory Cerebral Evoked Responses were also recorded. The depth of narcosis was quantified upon EEG data. The reactivity during the narcosis and the mechanisms of action of Etomidate on the "non specific structures" are discussed. Cautions should be taken with the use of tomidate in anesthesiology with epileptic and arteriopathic patients.

Neostriatal lesions by kainic acid provide a good model for studying Huntington's chorea. The pattern of discharge of nigral dopaminergic neurons of rats subjected to a kainate lesions of the caudate nucleus was compared to the nigral activity in control (saline-injected) and normal rats. The observed changes suggest that neostriatal degeneration does not simply induce a nigral dopaminergic hyperactivity but rather a disorganization of their slow and rhythmic pattern of discharge, thus eliciting in the nigral neurons abnormal messages which may reach the motoneurons and participate in the genesis of choreic movements.

A primate model of Parkinson's disease was obtained by i. v. administration of 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP). A behavioural, a mechanographic and an electromyographic (EMG) study were carried out during the execution of a rapid elbow movement, in two normal monkeys and, after the MPTP administration, before and after a L-DOPA therapy. Disturbances in behavior, movement parameters and EMG activity observed in MPTP-treated monkeys mimic those reported in Parkinsonian patients. Treatment with L-DOPA was effective in greatly correcting these disturbances. These results lend weight to the assumption that use of MPTP in primate provides a good model to study Parkinson's disease.

In order to study the role of the Biogenic Amines of the Median Eminence (M. E.) in the ovulatory neuroendocrinological reflex in the female rabbit, we analysed by semi-quantitative histofluorometry (Zeiss) the post-coïtum variations in formaldehyde induced fluorescence (Falck and Hillarp's technique) in the dopaminergic layer of the M. E. 116 female rabbits (62 control, 54 post-coïtum) were examined. In all the animals the dopaminergic layer of the M.E. displayed variations in fluorescence, both in thickness and intensity, along the antero-posterior axis and lateraly. In this respect, these results partly recovered those reported in the Rat (Lofstrom, 1976). Moreover, in half of the post-coïtum animals, from the 5 th min. up to the 30 th min, the intensity of the fluorescence was increased in the whole external layer. These results provide some evidence for a correlation between the variations in the Dopamine content of the M.E. and the involvement of the nervous mechanisms implied in the ovulatory neuroendocrinological reflex.