Rev Neurol France
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Twenty patients with multiple sclerosis (MS), 19 women and 1 man, with acute proprioceptive sensory disturbances related to the presence of plaques on the posterior columns (posterior column syndrome) at the cervical or thoracic levels of the spinal cord, were selected among 138 new patients with MS assisted in our neurological unit over the past five years. In 17 of these patients, the acute posterior cordonal syndrome was responsible for the first clinical manifestations of the disease. The other 3 patients had a history suggestive of MS. ⋯ This study confirms the contribution of serial spinal cord MR studies to understanding the natural history and pathophysiology of medullary forms of MS presenting as a cordonal posterior syndrome. It also shows a good relationship between the clinical manifestations and course of this form of MS and the localization and variable morphology of plaques. Finally, our results suggest the predictive benign course for this medullary form of MS that seems to be almost exclusively restricted to the female gender.
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Review Case Reports
[Postoperative combined medullary sclerosis revealing Biermer's disease: toxic effect of nitrous oxide].
Combined medullary sclerosis developed suddenly postoperatively in a patient with unknown Biermer's disease. The neurological lesions were undoubtedly induced by nitrogen protoxide via an inactivation of vitamin B12.
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Multicenter Study Clinical Trial
[Sumatriptan nasal spray 20mg: efficacy, tolerance and quality of life in migraine patients].
The primary objective of this prospective, open, non controlled, multicenter study was to collect data on migraine patients' health related quality of life before and after treatment of their migraine attacks by sumatriptan nasal spray 20 mg over a 12 week period. The impact on health related quality of life was evaluated by the mean change from pre-treatment scores french migraine health related quality of life specific questionnaire (QVM). A total of 219 patients have been included in the study, whose migraine attacks were not usually relieved by first line therapy. A statistically significant improvement in health related quality of life (as measured by the global score and the four scores related to the four dimensions of the QVM questionnaire (functional, psychological, social and therapeutic) were observed compared to the pre-treatment score values. At the end of the treatment period, 60% of patients preferred sumatriptan nasal spray 20 mg to their usual treatment. Headache relief was reported 2 hours after administration in 66% of attacks treated by sumatriptan nasal spray 20 mg during the study period and pain free in 46% of treated attacks. The nature and incidence of adverse events were similar to these observed in previous studies performed with sumatriptan nasal spray 20 mg and no unexpected events were reported. ⋯ Those data suggest for the first time that the use of sumatriptan nasal spray 20 mg for the treatment of migraine attacks during a 12 week period may be associated with a significant improvement in migraine patients' quality of life. The clinical efficacy and tolerability results observed in this study are similar to those from controlled studies previously published with sumatriptan nasal spray 20 mg.