Rev Neurol France
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Review
[Apathy an neurodegenerative diseases: pathophysiology, diagnostic evaluation, and treatment].
Apathy is usually defined as a lack of motivation leading to reduced interest and participation in various activities. From a pathophysiological viewpoint, the most common cause of apathy is dysfunction of the frontal lobes, following either direct lesion of the frontal cortex or damage to regions tightly connected to the latter (such as the basal ganglia). ⋯ The methods for detecting apathy and assessing its severity are various, the main difficulty being to disentangle apathy and depression. The treatment of apathy per se remains anecdotal and, to date, little research into the efficacy of medication therapy has been performed.
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Case Reports
[Ischemic stroke revealed by a thunderclap headache: contribution of diffusion-weighted mri sequences].
Sub-arachnoid hemorrhage, cerebral venous thrombosis and cerebral reversible angiopathies are the main causes of secondary thunderclap headache. Ischemic stroke is rarely revealed by thunderclap headache. ⋯ Ischemic stroke is a rare cause of thunderclap headache but practitioners should bear in mind this etiology when the diagnostic work-up is negative. Diffusion-weighted sequences of the brain MRI can provide the diagnosis.
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[Use of generic anti-epilepsy drugs in France: survey of neurologists and review of the literature].
The use of generic substitution for antiepileptic drugs is more and more frequent but remains controversial. ⋯ A prospective controlled evaluation of the safety and efficacy of generic substitution in epilepsy needs to be performed.
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Pain is an unpleasant and intrusive sensation, warning of actual or potential tissue damage. Over the last fifteen years, functional cerebral imaging research has demonstrated the involvement of many cerebral structures in the experience of pain. ⋯ This close anatomical relationship between pain and emotions circuits could explain the powerful emotional impact of pain as well as the reciprocal modulatory effect of emotions on pain observed in clinical and experimental studies. More specifically, this modulatory effect might reflect interactions between emotional and nociceptive systems in the prefrontal and cingulate cortices, ventral striatum, amygdala and hippocampal regions. Taken together, these observations further attest to the emotional nature of pain experience.
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Brain death diagnosis is based upon several clinical and paraclinical criteria that have been legally defined. There is a medico-legal protocol when brain death diagnosis is made in order to allow organ removal for a possible transplantation. ⋯ However all the criteria have been made using conventional paper EEG, while numerized is now used. The comparison of EEG recording using both analogical and numerised acquisition allow us to report several recommendations to use EEG for brain death diagnosis.