Peri-ictal water drinking and other ictal vegetative symptoms: Localizing and lateralizing the epileptogenic zone in temporal lobe epilepsy? Two case reports and review of the literature.

Peri-ictal behavior disorders can be helpful in localizing and lateralizing seizure onset in partial epilepsies, especially those originating in the temporal lobe. In this paper, we present the case of two right-handed women aged 36 and 42 years who presented with partial seizures of mesial temporal type. Both of the patients had drug resistant epilepsy and undergone presurgical evaluation tests including brain magnetic resonance imaging, video-EEG monitoring and neuropsychological testing. The two patients had hippocampal sclerosis in the right temporal lobe and exhibited PIWD behavior concomitant with right temporal lobe discharges documented during video-EEG recordings. Anterior temporal lobectomy was performed in one case with an excellent outcome after surgery. The patient was free of seizures at 3 years follow-up. We reviewed other publications of peri-ictal autonomic symptoms considered to have a lateralizing significance, such as peri-ictal vomiting, urinary urge, ictal pilo-erection. Clinicians should search for these symptoms, even if not spontaneously reported by the patient, because they are often under-estimated, both by the patients themselves and by physicians. Additionally, patients with lateralizing auras during seizures have a significantly better outcome after epilepsy surgery than those without lateralizing features.

[Neuromarketing: When marketing meet neurosciences]. / Neuromarketing : lorsque neurosciences et marketing se rejoignent.

INTRODUCTION: The emergence of brain imaging in recent years has been accompanied by an alliance between neuroscientists and marketers. This collaboration gave birth to "neuromarketing", a new field that uses imaging techniques with the aim of resolving marketing issues. STATE OF THE ART: Several studies have shown that pleasure felt at the sight of a product or after its consumption, is activated by a reward system involving ventral striatum. Since then, marketers seeking exploit this data and have found that some marketing actions can generate added satisfaction in a placebo-like manner. However, neuromarketing suffer from many limits that are a barrier to its development and its scope is restricted. PERSPECTIVES: Through this article, we attempt to give an overview on neuromarketing and its neural correlates while provide a perspective toward the use of field for less commercial purposes. CONCLUSION: The neuromarketing is a new field which efficiency is not proven. Its results must be interpreted with caution.

[Primitive aspergillosis of the posterior cerebral fossa in immunocompetent patient]. / Aspergillose primitive de la fosse cérébrale postérieure chez un patient immunocompétent.

Cerebral aspergillosis arises in the great majority of cases during an invasive aspergillosis with hematogene scattering from the lung hurts. The cerebral, not rare location is one of the worse criteria forecast during the invasive aspergillosis. We report the case of patient who was hospitalized in the neurosurgery department for syndrome of increased intracranial pressure, hemiparesis and cerebellar syndrome in febrile context. The radiological exploration objectified a collection of the posterior fossa. A stereotactic biopsy was performed. It collected fragments biopsy and pus. The pathological and microbiological analysis allowed the identification of Aspergillus fumigatus. The originality of this observation comes from the rare location in the posterior fossa of aspergillosis and because the patient is immunocompetent and no primary location is found. The patient presents however a viral hepatitis B of fortuitous discovery. He is put under treatment by amphotericin B. The evolution is marked by meningitis comment-diversion. Antibiotics are prescribed, and then the patient is operated for total ablation of the tumor. He dies following an osmolar coma associated with thrombopenia and a secondary renal insufficiency due to his treatment by the amphotericin B.

[Primary hydatid cyst of the parotid gland]. / Kyste hydatique parotidien primitif.

INTRODUCTION: The hydatid cyst is an anthropozoonosis due to the development of the Echinococcus granulosus tapeworm larva in humans. Its intraparotid localization is extremely rare. CLINICAL CASE: A 10-year-old-male patient was admitted for an isolated renitent swelling of the left parotid region having grown for several months. Cervical ultrasonography revealed a left parotid cystic mass, characterized by a double wall, and a small daughter cyst. The CT-scan typically showed the absence of enhancement after iodine contrast medium injection. The imaging-based diagnosis of a hydatid cyst was supported by positive hydatid serology, and confirmed by histological analysis of the cyst. No other hydatid location was found (chest and abdominal). DISCUSSION: In spite of its rarity, hydatid cyst can be a diagnosis in case of parotid cystic masses. Ultrasonography is the first examination to be performed; it must be completed by CT-scan or even better by MRI. Once the diagnosis of hydatid cyst is confirmed, a chest radiograph and an abdominal ultrasonography should be performed, to screen for other localizations. Surgical resection is the gold standard treatment.

[Os odontoideum: clinical and radiological aspects]. / Os odontoïdeum : aspects cliniques et radiologiques.

Few reports of os odontoideum have been made. We report two cases where this affection was revealed by cervical pain and hemiparesis in one case and acute tetraparesis in the other. Patients with os odontoideum usually present with neurological signs, but some have only cervical pain and some others remain asymptomatic. Radiological exams, including radiograms, cervical scanner and MRI lead to the diagnosis. Different surgical treatment can be proposed to symptomatic patients. Prophylactic surgical treatment is not indicated.

[Sneddon's syndrome: 15 cases with cerebral angiography]. / Le syndrome de Sneddon: étude de 15 cas avec artériographie cérébrale.

Sneddon's syndrome is a rare disease defined by the presence of ischemic cerebrovascular events associated with livedo reticularis. We report a retrospective study of fifteen cases, thirteen women and two men, mean age of 37.93+/-9.77 years. All patients presented one or more cerebral infarcts. Six patients had dementia. Brain magnetic resonance imaging showed several cortical infarcts with white matter involvement. Cerebral angiography performed in all patients, showed a distal arteriopathy in twelve and thrombosis of the right carotid internal artery in one. One patient had antiphospholipid antibodies. Ten patients were treated with antiplatelet agents and five with anticoagulants. The course was favorable in eight patients and stationary in three. Four patients had several recurrent infarcts, one when anticoagulants were discontinued, one taking an anti-sludge-platelet agent and two who were not initially taking any treatment.

[Neuropsychological and magnetic resonance imaging findings in five patients after carbon monoxide poisoning]. / Troubles cognitifs dus à l'intoxication oxycarbonée: étude neuropsychologique et IRM de 5 cas.

INTRODUCTION: Carbon monoxide (CO) poisoning has been shown to result in cognitive impairments. These disorders have rarely been reported. The present study aimed to evaluate these disturbances in five patients with a neuroanatomical study. METHODS: There were two men and three women with an average of 25 years old. Patients were explored several months after acute CO poisoning. Neuropsychological testing was administered to assess memory, intellectual, executive, visual-spatial and constructional functions, language, praxis and gnosis. Cerebral magnetic resonance imaging (MRI) was performed in all patients using axial, sagittal and coronal slides with T1 and T2 weighted and flair images. None of the subjects had hyperbaric oxygen. They received 7, 5 mg bromocriptine per day. RESULTS: All patients presented cognitive disorders including marked impairment in long term memory with a severe defect in recall performance in comparison to recognition memory. Visual memory was more affected than the verbal one. There were also moderate disturbances in intellectual, executive, visual-spatial and constructional functions. One patient presented alexia agraphia, severe visual disturbances, constructional and dressing apraxia. Four patients had depression and one psychic akinesia. Cerebral MRI studies revealed that all patients had bilateral pallidal necrosis, bilateral hippocampal and moderate cortical atrophy. Fornix atrophy was found in 2 patients and corpus mammillary atrophy in 3 patients. Others lesions were also found: bilateral cerebellar in two cases and cortical in three cases. Treatment with bromocriptine was effective in three cases. There was no improvement in the patients treated 14 months and 5 years following CO poisoning. CONCLUSION: Neuropsychological impairments in CO poisoned subjects include memory, intellectual, executive, and visuospatial defects. In addition to pallidal necrosis, which is a typical feature of CO poisoning, hippocampal and cortical atrophy are often present. Bromocriptine can improve the cognitive disorders.

[Kahler's disease presenting with a solitary cranial vault plasmacytoma]. / Maladie de Kahler révélée par un plasmocytome solitaire de la voûte.

INTRODUCTION: Solitary plasmocytoma is rarely located in the cranial vault. Usually observed, in elderly patients, occurrence during adolescence is extremely rare. We report the case of a 16-year-old patient presenting a cranial vault solitary plasmocytoma which revealed Kahler disease. CASE REPORT: A 16-year-old patient consulted for a frontal tumefaction becoming painful with diplopia. The cranio-encephalic radiography and the MRI showed a tumoral process involving cranial vault; biopsy revealed a solitary plasmocytoma. Search for multiple myeloma was negative. Six months later, a disease of Kahler was declared. CONCLUSION: Clinical and biological follow-up of cranial plasmocytoma is necessary, because progression to multiple myeloma is possible as in our observation. Imaging and particularly MRI are needed to specify the axial seat of the tumoral process and its relationship with the nervous and vascular structures.

[Maffucci syndrome: an historical case]. / Le syndrome de Maffucci: à propos d'un cas historique.

We report a case of Maffucci syndrome in a 24-year-old patient, diagnosed thanks to the data of the clinical examination, the imagery and the histology. The clinical, radiological and evolutionary aspects are discussed, as well as the various therapeutic means.

[Occipital osteosarcoma of a 33 years old man: a case report]. / Ostéosarcome occipital chez un homme de 33 ans: à propos d'un cas.

Cranial localization of osteosarcoma is rare, representing only 0,7-3% of cranial primary tumours. The authors present the case of a 33 year old man with occipital osteosarcoma diagnosed by CT scan, MRI and angiography. The radiological features of this pathology are discussed.

[Tumor of the maxilla presenting as primary hyperparathyroidism]. / Tumeur maxillaire révélant une hyperparathyroïdie primitive: à propos d'un cas.

Brown tumors are classic bony lesions of hyperparathyroidism. They usually occur in severe forms with osteolytic subperiosteal lesions. Facial bones are a rare localization: 2% of all cases. The aim of this study was to report a case of multiple craniofacial location of brown tumors and to discuss, within a review of the literature, the role of imagery in the diagnosis of this disease.

[Neuro-imaging of tuberous sclerosis]. / Neuro-imagerie de la sclérose tubéreuse de Bourneville.

Tuberous sclerosis is a phakomatosis with central nervous system manifestations characterized by 4 lesions detectable on neuro-imaging: tubers, white matter abnormalities, subependymal nodules and subependymal astrocytomas. The first three are benign lesions composed of by identical cytological lesions varying only in size and location. At CT, enhancement of subependymal nodules is usually considered as evidence of transformation to subependymal giant cell astrocytoma. This latter poses the problem of its relative benignity: hydrocephalus source of morbidity or even mortality. From a series of 22 cases, the authors review the characteristics of these abnormalities.

CT of primary muscle diseases.

Seventy-five patients with a variety of muscular dystrophies were studied using computed tomography (CT). At least 11 slices were taken in each patient, from the forearm to the lower leg. Sufficient information was obtained to provide some CT characteristics of several dystrophies, including Duchenne muscular dystrophy, facioscapulohumeral syndrome, limb-girdle muscle myopathies, and myopathic dystrophies. CT promises to be of increasing value in these areas in the future.

Correlative anatomic and CT study of the lumbar lateral recess.

The lumbosacral nerve roots and their relation to the lateral recess in the lumbar region were studied by computed tomography both in anatomic specimens from six cadavers and in vivo in 100 patients with or without disk herniation. The anatomic and tomodensitometric correlations are discussed. The normal morphology and contents of the lumbar spinal canal can be used as a guide to radiologic diagnostic exploration, which in turn can indicate the etiology and extent of lumbar sciatica and the course of treatment.