Revue médicale suisse
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Revue médicale suisse · May 2010
[Skin diseases in returning travelers: etiologies according to clinical presentation].
Dermatoses are one of the three most common causes of health problem in returning travelers. These dermatoses include infections, environmental diseases (sunburns, arthropod-related reactions) and superficial injuries. ⋯ Travelers abroad must be appropriately vaccinated against tetanus and specifically instructed to avoid arthropods bites and sun overexposure. Travel first aid kits should include antibiotics effective against bacterial skin infection, oral antihistamines and corticosteroid ointments.
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In some patients with refractory epilepsy, no resective surgery of the epileptogenic zone can be offered. This is the case when for instance the epileptogenic zone is located in an eloquent region (motor, language or visual) or when there are several epileptogenic zones. ⋯ Among these procedures, we review briefly here vagus nerve stimulation, the various brain stimulations procedures, multiples subpial transsections, and the corpus callosotomy. For each procedure, we will discuss its indication and outcome.
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Epilepsy surgery is possible in specific cases of localisation-related pharmaco-resistant epilepsy and can often lead to seizure-freedom condition. A presurgical diagnostic workup is necessary to localise the epileptic focus and assess the risks of post-operative neurological or cognitive deficits. ⋯ All patients suffering from pharmaco-resistant epilepsy should be referred to an expert centre to confirm the diagnosis and evaluate the possibility of epilepsy surgery. In children, early epilepsy surgery can allow better continuation of cognitive development and education.