[Isolated pulmonary hypertension and pergolide]. / Hypertension artérielle pulmonaire isolée et pergolide.

Pergolide, an ergot-derived dopamine agonist prescribed since the late 1980's mainly in Parkinson's disease and restless leg syndrome has recognized fibrosis side effects, affecting the pleural, pericardial and retroperitoneal systems. Pergolide-induced valvulopathies were first reported in 2002. We present here the history of a patient developing an isolated pulmonary hypertension related to the intake of pergolide. The dyspnea related to the pulmonary hypertension as well as the echocardiographic abnormalities improved after treatment replacement. Valvulopathies and pulmonary hypertension were previously described under appetite-suppressant drugs after years of clinical use, in a similar way.

Electrodiagnosis of demyelinating neuropathies.

The inflammatory demyelinating neuropathies constitute a significant proportion of the acquired polyneuropathies. Major progress in finding the causes and in the treatment of these neuropathies has been made over the last decade. Early recognition is of paramount importance, because timely and appropriate treatment can largely reduce morbidity and disability. Electrodiagnosis plays a key role in the detection and characterization of the inflammatory demyelinating neuropathies. Electrodiagnostic criteria for primary demyelination have therefore been developed. They are empirically based on changes of nerve conduction parameters in populations of patients with a confirmed clinical and laboratory diagnosis of inflammatory demyelinating neuropathy. The challenge consists of defining criteria sets that are highly specific but also as sensitive as possible. Most of the hereditary demyelinating neuropathies are part of Charcot-Marie-Tooth disease type 1. The pattern of nerve conduction abnormalities usually provides valuable clues for the distinction from chronic inflammatory demyelinating neuropathies.

[Bilateral ageusia after left insular and opercular ischemic stroke]. / Agueusie bilatérale après accident vasculaire cérébral ischémique insulaire et operculaire gauche.

Gustatory disorders after ischemic stroke is an uncommon event, generally occurring unilaterally, ipsilateral or contralateral to the stroke depending on the site of the lesion. We report a patient who developed bilateral agueusia after a unilateral insular stroke. This 70-year-old right-handed man developed a sudden onset left opercular syndrome in March 1999 with right hemiphyosethesia. Magnetic resonance imaging revealed a left insular and opercular stroke. Anarthria, swallowing and sensorial disorders regressed in a few weeks, but taste disturbances led to a 6 kg weight loss. After six months, the symptoms disappeared. To our knowledge, 32 cases of taste disorders after stroke have been reported. For most of the cases, the agueusia was unilateral. Our case illustrated the predominance of the left cortical hemisphere for taste perception in the right-handed subject.