Rev Neurol France
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Periodic hypokaliemic paralysis is an usual cause of severe hypokaliemia. Thyrotoxicosis periodic paralysis (TPP) is less common. Incidence is high in Asian people and rarely reported in caucasian people. ⋯ The clinical course is good with beta-blockers and antithyroid treatment. These treatments induce a total clinical and biological cure. In all the cases of hypokaliemic paralysis, even without symptom, an hyperthyroïdia must be searched for.
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The effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) or the internal pallidum (GPi) on the parkinsonian triad and on levodopa-induced dyskinesias are very similar. The antiakinetic effect of STN DBS seems to be slightly better. On the contrary to pallidal DBS, stimulation of the STN allows to reduce dopaminergic treatment by more than 50 p. 100 on average. ⋯ It is the responsibility of the operating centre to determine the levodopa response, to confirm the diagnosis, to rule out contraindications and to make sure that the medical treatment cannot be further optimised. Severe surgical complications with permanent sequels are relatively rare, about 1 p. 100 per implanted side. The patient selection, the precision of the surgery and the quality of the postoperative follow-up are the three main determinants of success.
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Case Reports
[Multifocal progressive leukoencephalitis in a patient given fludarabine for chronic lymphoid leukemia].
A 74-year- man was hospitalized for subacute aphasia and right hemiparesis. He had had chronic lymphoid leukemia for 11 years and had been treated 5 months earlier with 3 courses of fludarabine. ⋯ The diagnosis of PML was confirmed. The causality of fludarabine treatment is discussed.
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Case Reports
[Ptosis and mastication disorders revealing concurrent myasthenia gravis and chronic polyradiculoneuritis].
Although myasthenia gravis (MG) has frequently been associated with other autoimmune disorders, it has only rarely been reported in conjunction with diseases of the nervous system. A 74-year-old patient with hypertension suddenly presented left unilateral ptosis and mastication disorders. Clinical examination showed a concomitant loss of strength distally and reduced deep tendon reflex. ⋯ One month later, the cranial nerve deficit disappeared and strength was normal. It is likely that a basic abnormality of immune regulation was responsible for the emergence of diseases with different clinical presentations, but similar immunopathogenesis. Corticosteroid seemed to be the most effective treatment.