Written production in a case of locked-in syndrome with bilateral corticopontic degeneration.

Patients in locked-in syndrome show normal or near normal mental abilities that contrast with the limited motor capacity that hinders voluntary communication. However, eye movements and blinking are usually preserved and can be used to establish a communication system. We report an exceptional case of locked-in syndrome. The aetiology was basilar thrombosis consecutive to a cervical manipulation. In addition, brain MRI performed 23 years later showed a ventral pontine stroke with bilateral corticopontic degeneration. In this study the patient was able to produce written output using a chin-controlled Morse system decoded by a computer. A detailed linguistic analysis of text written over 20 years by the patient was carried out. The data demonstrate that improvements in language performance can be observed even in patients with brain lesions in areas associated with high-level cognitive processes. The data show a decrease of typing, grammatical and lexical errors over time, use of less frequent words, and an increase of more complex linguistic structures. This paper adds to previous findings confirming the value of daily practice and rehabilitation to enhance quality of life in this group of patients.

[Granulomatous hypersensitivity angiitis of Churg and Strauss's syndrome : favorable outcome in one case]. / L'angéite granulomateuse allergique de Churg et Strauss.

A further case of granulomatous hypersensitivity angiitis (syndrome described by Churg and Strauss) is reported. Clinical, biological, and histological features (asthma, blood eosinophilia, necrotizing angiitis lesions, extravascular eosinophilic and granulomatous infiltrates) differentiate this affection from other necrotizing angiitis diseases, particularly from polyarteritis nodosa. Unusual features in this case were its favorable course, and the remission following combined corticoid and cyclophosphamide treatment. Diagnostic, clinical and histological criteria which distinguish Churg and Strauss's angiitis from other necrotizing angiitis affections are described, and current pathogenic hypotheses discussed.

[Contribution of contra-immunoelectrophoresis to the diagnosis of acute pneumococcal pneumopathies: report on 37 cases (author's transl)]. / Intérêt de la contre-immuno-électrophorèse dans le diagnostic des pneumopathies aiguës à pneumocoques. A propos de 37 cas.

Employed since 1971, contra-immunoelectrophoresis is a microbiological technique now recognised as being of increasing value. Used in 37 cases of pneumococcal lung infections its diagnostic reliability was 81% the technique being of particular interest in that it enabled a positive diagnosis in lung infections previously treated by antibiotics. Though performed in only a small number of cases, this method was able to confirm the frequency of pneumococcal infections. The technique can now be considered to be well established, the production of specific anti-serums, approaching type-specificity, being possible. Fairly simple to perform, and giving rapid results (within hour) it requires a minimum of apparatus and is a standard procedure that should be employed in all microbiological medical laboratories. Of undeniable diagnostic value, it should be associated with conventional bacteriological tests, which though essential sometimes give insufficient data.