Rev Neurol France
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Prophylactic treatment is mainly intended to reduce the frequency of migraine attacks. It is usually proposed to patients who suffer from two or more attacks per month. It should also be considered in patients who suffer from less frequent, but prolonged, disabling attacks with a poor response to abortive treatment, and who consider that their quality of life is reduced between attacks. ⋯ If the drug is judged ineffective, an overuse of symptomatic medications should be checked, as well as a poor compliance, either of which may be responsible. In case of a successful treatment, it should be continued for 6 or 12 months, and then, one should try to taper off the dose in order to stop the treatment or at least to find the minimum active dose. Relaxation, biofeedback, stress coping therapies, acupuncture are also susceptible to be effective in migraine prophylaxis.
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Cluster Headache associates a severe pain generally unilateral and autonomic symptoms with a remarkable periodicity. In the first part we tried to explain the conception of physiopathology of these short lasting headache syndromes and in the second part we described the clinical features. The short lasting primary headaches are divided into two groups: those with marked autonomic activation which comprise chronic and episodic paroxysmal hemicrania, short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT syndrome) and cluster headache. ⋯ The paroxysmal hemicranias are characterized by attack frequency ranges from 15 to 20 per day of short lasting attacks of unilateral pain that typically last 2 to 10 minutes, the severe pain is associated with autonomic symptoms and responds to treatment with indomethacin. The SUNCT syndrome has a less severe pain but marked autonomic activation during attacks, this syndrome is actually resistant to proposed therapy. The Hypnic Headache and the Hemicrania Continua have yet less severe pain with very mild or without autonomic features.
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The thoracic outlet syndrome (TOS) encompasses various clinical entities affecting the neurovascular bundle crossing the thoracic outlet. Unfortunately, this term often proves to be confusing because many of these entities have little in common beyond their known or presumed lesion site. Neurogenic TOS (true TOS) is caused by compression of the lower trunk in the brachial plexus, the cervical ribs or fibrous band. ⋯ Pain was relieved after 1 to 4 weeks. A minimal motor improvement was observed after one year. Electrophysiological results were unchanged.
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Quarrels over aphasia are no recent phenomena and have not always been explicit. Lordat and Gall can be cited in this respect as well as Dax and Bouillaud. Reference is also made to Broca-Dax and Trousseau-Lordat. ⋯ However, his patience eventually ran out and he replied sharply to the comments of Dejerine on "images of language" and those of Dupré on "mental representations". Metaphorically speaking, it might be said that the gold medal was not awarded, Augusta Dejerine Klumpke took the silver, Dupré and André-Thomas shared the bronze, and Souques and Moutier each deserved a special mention. It might also be suggested that in 1908 the Society sketched out to a large extent the programme for research on aphasia for the century to come. (ABSTRACT TRUNCATE
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Historical Article
[History of the Société Française de Neurologie: 1975-1999].
The history of the French Society of Neurology during the past 25 years is briefly summarised, with special emphasis on the eminent role played by some of its members: Paul Castaigne, of immense stature, and Jean Cambier and Alain Guillard who for many years acted as General Secretary before becoming President. This is followed by a report analysing the scientific work of the Society during the century. ⋯ Other topics, however, such as multiple sclerosis, vascular pathology, and degenerative pathology are more frequently studied today than in the past. Lastly, an analysis is made of the Society's current membership, from which it is apparent that a special effort will be required on the part of all members to maintain the wide scientific influence that our Society has always exerted.