[Cerebral magnetic resonance imaging in iatrogenic Creutzfeldt-Jacob disease]. / Imagerie par résonance magnétique cérébrale dans la maladie de Creutzfeldt-Jakob iatrogène.

INTRODUCTION: We describe here the cerebral cerebral magnetic resonance (MRI) abnormalities observed in a case of iatrogenic Creutzfeldt-Jacob disease (CD). CASE: A 37 year-old man had been treated for pituitary dwarfism during adolescence with contaminated growth hormone. Neurological symptoms nearly two decades later suggested CJD. Cerebral MRI nine months after the onset of symptoms showed hypersignals similar to those observed in variant CJD (pulvinar sign). The diagnosis of CJD was confirmed by post-mortem examination. DISCUSSION: To our knowledge, this is the first case in which MRI revealed iatrogenic CD. The aspects are similar to those described for variant CJD.

[Lyme's disease. A clinical case observed in Western France (author's transl)]. / La maladie de Lyme. Un cas clinique observé en Eure-et-Loir.

The clinical story of a young woman with chronic erythema migrans followed by polyradiculoneuritis and recurrent oligoarthritis is reported. The story corresponds to the disease described by Steere et al. [7, 8, 9, 10] in 1976 and known in the U.S.A. as "Lyme's disease". The condition is epidemic and occurs during the summer. It begins with skin lesions characteristic of chronic erythema migrans, which are consecutive to tick bite. This is followed, a few days or weeks later, by neurological disorders (aseptic meningitis, encephalitis, cranial nerve paralysis and/or polyradiculoneuritis), transient and recurrent attacks or arthritis mostly in the larger joints and, occasionally, conduction disorders in the heart. The course of the disease is that of an inflammatory condition. The presence of immune complexes in the serum and synovial fluid is suggestive of local and systemic immune reaction to a hypothetically viral agent introduced by the tick bite. The fact that the incidence of DR W2 antigen is greater in patients with severe lesions suggests individual predisposition.

Analysis of visual evoked responses in multiple sclerosis.

In Multiple Sclerosis (MS) the modification of the latency of visual evoked responses (VER's) shows sequels of the involvement of anterior optic tracts manifested by a retro-bulbar optic neuritis (RBON). This study was made on 102 patients with MS. The stimulus used the pattern reversal of a checkboard. The influence of the size and squares 8' and 20' chosen as stimulus has been first studied in patients with antecedents of RBON. Using the 8' squares, all eyes with a history of RBON had pathological VER's. When there is no clinical antecedent of RBON, this means of stimulation enabled us to detect sequels of RBON. In "definitive" and "probable" MS, 100% of patients had pathological VER's either for both eyes of a single eyes. In "possible" MS a sequel of RBON was demonstrated in 57% of this population without clinical antecedent of RBON. A correlation between VER's result and the ophthalmological examination (visual acuity, fundoscopic examination and acquired dyschromatopsie) was made. Although VER's are an excellent method for detecting the sequels of RBON in MS. VER's abnormalities have no etiological significance, they are observed in other neurological involvements of anterior optic tracts. These different points are discussed and a physiological interpretation of VER's abnormalities is proposed.

[Study of colour vision and visual evoked responses in multisclerosis diagnosis (author's transl)]. / Etude de la vision des couleurs et des potentiels évoqués visuels dans le diagnostic de la sclérose en plaques.

In a patient with suspected Multisclerosis (M.S.), the discovery of a lesion in the anterior optic tracks is of considerable diagnostic importance. If none of the classical clinical signs of optic neuritis can be found, the study of visual evoked responses (VER) and of colour vision is useful evidence for diagnosis. In a population of 102 patients having "possible", "probable" or "confirmed" M.S, we have compared the information provided by both these methods. 27 patients had MS with a known optic neuritis: the VER and colour vision of all of them was altered, either unilaterally or bilaterally. 75 patients had "possible" or "probable" MS without a history of optic neuritis. For 34,7%, the discovery of a dyschromatopsia showed a lesion in the optic nerve. In 68%, only the increased latency in VER demonstrated an optic neuritis. It should be noted that for all the patients with "probable" or "confirmed" MS, the VER latency was increased. The study of colour vision is therefore in our opinion, an excellent way of investigating anterior optic tracks lesions. When the study of colour vision is not sufficient, the recording of VER is a reliable technique and a very valuable acquisition in neuro-ophthalmology.

[Chloroquine neuromyopathy. One case in prophylactic maleriatherapy (author's transl)]. / Neuromyopathie à la chloroquine. Un cas au cours d'un traitement prophylactique antipaludique.

A case of neuromyopathy due to chronic chloroquine intoxication is reported. The neuromyopathy developped 9 months after malaria suppression therapy with chloroquine was started. The clinical picture was that of a peripherical neuropathy in the lower limbs and of a generalized myasthenic syndrome. Muscular biopsy showed typical pictures of "vacuolar myopathy". The metabolism of the drug was normal. The patient improved soon after chloroquine was discontinued.

[Comparative study of somatic and visual projections on the cerebral cortex of the normal adult rat, the rat enucleated at birth, and the young rat]. / Etude comparée des projections somesthésiques et visuelles sur le cortex cérébral du rat adulte normal, du rat énuclée des yeux á la naissance et du rat jeune

A comparative study of somatic and visual projections on the cerebral cortex of the adult of the normal rat or of the rat enucleated at birth, and of the young rat. This study was first designed to examine the developmental features of somate, sensory and visual projections to the rat cerebral cortex, together with their alteration as a consequence of early sensory deafferentation. We were led to a reevaluation of these projectins in the normal adult rat. This study specifically shows that topical projections exist, for both the somatic and the visual system. However, projections that are highly convergent in nature are present over most of the superolateral aspect of the cerebral cortex and we were unable to demonstrate any simple change resulting from early visual deafferentation.

[Recording of visual evoked potentials in the diagnosis of multiple sclerosis]. / Apport de l'enregistrement des potentiels évoqués visuels au diagnostic de la sclérose en plaques

The authors report the results of recording EVP obtained by pattern reversal in 20 controls and 43 patients with "established", "probable" or "possible" MS on the basis of MacAlpine's criteria. Whilst the latency of the wave 1 of the EVP appeared stable in the controls (107.5 msec +/- 7.46), lengthening of the latency of the EVP was seen in 77p. 100 of cases, confirming involvement of the visual pathways, though bulbar neuritis had been known clinically in only 28 p. 100 of patients. The value of this method of recording EVP in contributing to the diagnosis of DS is discussed.

[Multiple intracranial arterial aneurysm of mycotic appearance. Repeated vascular embolic accidents. Myxoma of the left atrium]. / Anévrysms artériels multiples intracraniens d'sspect mycotique. Accidents vasculaires répétitifs d'allure embolique. Myxome de l'oreillette gauche

The authors describe a case of myxoma of the left auricle disclosed by repeated cerebral embolism and multiple aneuryms of mycotic appearance of the cerebral arteries in a woman exhibiting no cardiac symptoms. The immediate post-operative results were excellent. In the light of 7 similar cases in the literature, diagnostic and prognostic points are analysed.