[Autism and neuroscience]. / Autisme et neurosciences.

The understanding of autism has improved with neurosciences, especially with genetics, molecular biology and cerebral neuroimaging. This trouble looks much more heterogenous than expected, from a clinical and an etiological point of view as well. No clear pathopsychological model about the syndromes of the autistic spectrum can so far be proposed but several scientific breakthroughs seem interesting.

Speech arrest with stimulation may not reliably predict language deficit after epilepsy surgery.

The authors present a patient in whom electrical cortical stimulation of the posterior temporal cortex induced speech arrest, comprehension deficits, and other language-related impairments. This area was ultimately resected because of persistence of a severe seizure disorder. No postoperative aphasia was observed despite the cortical stimulation results, and the patient is since seizure free. These findings question the well-established principle that corticography directly reflects local cortical functions in all patients.

[Benefits of a new galenic form of levodopa and benserazide in the treatment of patients with Parkinson disease]. / Nutzen einer neuen galenischen Form von Levodopa und Benserazid für die Behandlung von Parkinson-Patienten.

We describe a new, water-soluble formulation of levodopa plus benserazide (Madopar LIQ) for the treatment of Parkinson's disease. Two dosage strengths are available: 100 mg levodopa plus 25 mg benserazide and 50 mg levodopa plus 12.5 mg benserazide. Pharmacokinetic data show that levodopa absorption is more rapid than with standard Madopar, resulting in a shorter time to peak plasma concentration. Other pharmacokinetic values are comparable to those obtained with the standard formulation. We discuss the clinical advantages of this new water-soluble formulation, particularly when the patient requires rapid onset of action for morning or circadian akinesia. The indications of this formulation in patients with dysphagia and in other clinical situations, e.g. during the postoperative period and for levodopa dosage adjustment in ambulatory care, are discussed.

[Mental suffering IN patients with parkinsonism]. / Les souffrances psychiques des malades parkinsoniens.

Comprehensive treatment of patients with parkinson's disease demands that not only motoric dysfunctions but also psychosocial aspects have to be considered. The scope of this review is to cover not only the frequent dementia and depressive states associated with this disease, but also the drug-induced behavioral abnormalities, insomnia, conflicts with those providing care and implications for professional activities. The fundamental pathophysiological and psychopathological mechanisms are explained and illustrated by examples.

[Imidazopyridines, an alternative to benzodiazepines]. / Les imidazopyridines, une alternative aux benzodiazépines.

Imidazopyridines are a new class of molecules comprising so far a pure hypnotic agent--zolpidem, and an anxiolytic alpidem. The biochemical mode of action and the clinical characteristics are discussed with particular reference to benzodiazepines.

Acute encephalopathy due to thiamine deficiency (Wernicke's encephalopathy) in a chronic hemodialyzed patient: a case report.

We report the case of a patient with terminal renal disease on chronic hemodialysis who developed acute thiamine deficiency as confirmed by erythrocyte transketolase determinations. The patient presented with a confusional state and severe memory disturbances, but other classical features of Wernicke's encephalopathy were absent. Almost all central nervous system symptoms rapidly disappeared after thiamine therapy. Therefore the possibility of thiamine deficiency must be considered in patients on chronic dialysis who present with central nervous system disturbances, even if all of the classical features of Wernicke's encephalopathy are not present.

[Sarcoidosis: apropos of a case of isolated myopathy]. / Sarcoïdose: à propos d'un cas de myopathie isolée.

We report the case of a 69 year old female, who in 1979 presented with a granulomatous myositis confirmed by muscular biopsy. The histology is typical for sarcoidosis, but tests on other organs remained negative for eight years. Up to 1987, 79 cases of sarcoid myopathy have been published in medical journals, of which 44% had an isolated muscular involvement. We discuss the differential diagnosis, the histology, pathology, etiology and the manifestations shown by the EMG of this rare illness, as well as our patient's peculiar signs.