[Percutaneous sacral thermorhizotomy to treat equinism of spastic cerebral palsy children]. / Thermorhizotomie sacrée percutanée pour équinisme spastique de l'enfant infirme moteur cérébral.

We propose to evaluate the effect of sacral percutaneous thermorhizotomy on cerebral palsy children. A prospective study including 29 children followed by a multidisciplinary team was conducted from 1990 to 2000. A thermal radiofrequency lesion of the first sacral root was obtained by percutaneous puncture of the posterior intervertebral foramen with evaluation by stimulation of the best motor response for the minimal threshold (<0.5 volts). The efficacy of the lesion was evaluated by testing and modification of the stimulation threshold obtained (x 2). The results on spasticity was evaluated using the Held score and the functional effect on walking, and classified as "good" (9 cases), "efficacy" (6 cases) and "nil" (4 cases). Indications of the procedure are discussed during the walking acquisition period and growing period of the cerebral palsy child.

[Isolated cerebral calcifications after prophylactic treatment of cerebromeningeal involvement of acute lymphoblastic leukemia: relation of psycho-intellectual sequelae]. / Calcifications cérébrales isolées après traitement prophylactique des atteintes cérébro-méningées de la leucémie aiguë lymphoblastique de l'enfant: rapport avec les séquelles psycho-intellectuelles.

Intracranial calcifications were demonstrated by CT scan in 5 children after complete remission of acute lymphoblastic leukemia (ALL). Initial treatment included prophylactic irradiation of central nervous system and intrathecal methotrexate. Behavioral abnormalities or learning difficulties were clinically apparent in all children at the time of the radiologic examination. Isolated intracranial calcifications represent one of possible cerebral sequelae that are to be found in 53% of children receiving treatment for ALL. No fine correlation between direct toxic effect of methotrexate or, post-radiation lesion, and neuro-psychological sequelae can be done. In an attempt to avoid some of this sequelae, suppression of cranial irradiation from ALL treatment protocols is now studied.

Fluoride treatment in corticosteroid induced osteoporosis.

Severe osteoporosis with multiple vertebral fractures occurred in two girls receiving prolonged high dose corticosteroids for relapsing dermatomyositis. Sodium fluoride, supplemented with calcium and vitamin D, helped control secondary osteoporosis in one case and should be considered as part of the curative treatment of corticoid induced osteoporosis.

[Dystonia musculorum deformans. Elements of a favorable development]. / Dystonie musculaire déformante. Eléments d'une évolution favorable.

The therapeutic benefits of a concomitant approach to the disease and to the patient's identity experienced by the authors is illustrated by this case of a child presenting with dystonia musculorum deformans and severe disturbances of identity. This work was part of a research program concerning the function of these approaches and the operative modalities of their combinations.