Rev Neurol France
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Non ketotic hyperglycemia is a metabolic disorder which can induce various hyperkinetic disorders. We report the case of a 74-year old woman admitted to hospital because of choreo-ballic movements of her left hemibody. Laboratory tests revealed non-ketotic hyperglycemia. ⋯ On T2-weighted images, there was a slight hyperintensity in the right putamen and head of caudate. Correction of the underlying hyperglycemia led to complete resolution of abnormal movements. Pathophysiology of this clinicoradiologic syndrome is briefly discussed.
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Amyotropic lateral sclerosis is a severe degenerative disease of the nervous system. Progressive death of central and peripheral motor neurons leads to rapidly extensive paralysis of the four limbs, the bulbar region and the respiratory system. Sleep respiratory disorders is a useful sign to follow in these patients. ⋯ These nocturnal respiratory disorders observed in amyotropic lateral sclerosis are similar to those observed in muscle diseases. Management must however be undertaken very early in these patients because outcome can be rapidly fatal after the development of significant desaturation. Nasal ventilation can improve not only quality of life but also life expectancy for these patients.
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Comparative Study
[Treatment of remitting forms of multiple sclerosis].
Disease-modifying treatments in multiple sclerosis emerged during the last few years, concerning mainly relapsing-remitting forms of the disease. They are essentially represented by beta-interferons. beta-interferons reduce relapse rate, achieving about 30 p. cent, and have an effect on brain lesions detected on MRI. ⋯ Copolymer, which has a different mechanism of action, also decreases frequency of relapses, and the magnitude of the clinical effect is similar to beta-interferon. Copolymer is indicated for use in patients with relapsing-remitting multiple sclerosis, having either an intolerance or a contra-indication to beta-interferon.
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Spasticity is reported in 90 p. 100 of multiple sclerosis patients causing pain, spasms, loss of function and difficulties in nursing care. A variety of oral and parenteral medications are available. Review of comparative efficacy and tolerability of anti-spastic agents is performed in order to guide rational prescribing.
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Border forms of multiple sclerosis (MS) can be separated in two groups: either they are variants of MS or they are distinct from MS but they share several characteristics with MS thus representing for some of them a continuum with MS. All these entities are central nervous system demyelinating diseases. Here we describe, for the first group, MS in childhood, MS in elderly subjects, Balò's concentric sclerosis, Schilder's myelinoclastic diffuse sclerosis and MS simulating a mass lesion, and for the second group, acute disseminated encephalomyelitis and Devic's neuromyelitis optica.