Practice of stereoelectroencephalography (sEEG) in drug-resistant epilepsy: Retrospective series with surgery and thermocoagulation outcomes.

OBJECTIVE: The aim of this study was to determine the success rate of sEEG in locating the epileptogenic zone (EZ) in patients with pharmaco-resistant epilepsy. Secondary objectives were to analyze sEEG-related morbidity and outcomes for post-sEEG thermocoagulation and cortical resection. METHODS: Data were collected on 49 sEEGs from 46 consecutive patients between 2010 and 2018. Following sEEG, either resective or palliative surgery with vagus nerve stimulation was performed. In 8 patients, EZ thermocoagulation was performed before EEG leads were withdrawn. Outcomes were collected based on the Engel and ILAE outcome scales. RESULTS: sEEG was contributive in 45 of 49 recordings, with a success rate of 92% in locating the EZ. Minor complications, such as transient neurologic deficit and electrode implantation failures, occurred in 6%. One major complication occurred, with death due to atypical late hematoma. Thermocoagulation was performed in 8 patients and stopped or significantly reduced seizure frequency in 7 (88%). Outcome of surgical resection (n=33) was good, with 20 (61%) seizure-free patients and 32 (97%) with definite improvement. CONCLUSIONS: Our findings suggest that sEEG is an effective technique for EZ location in patients with drug-resistant epilepsy. sEEG was contributive in up to 92% of patients, allowing thermocoagulation and/or surgical resection that resulted in seizure-freedom in two-thirds and seizure-reduction in one-third of cases. This study highlights the need for strict selection of implantation candidates, with strong initial hypothesis as to EZ location.

Drugs with potential cardiac adverse effects: Retrospective study in a large cohort of parkinsonian patients.

INTRODUCTION/OBJECTIVE: Drugs with potential cardiac adverse effects are commonly prescribed in Parkinson's disease (PD). To describe demographic and clinical characteristics in a group of PD patients with cardiac events and to evaluate risk factors. PATIENTS AND METHODS: We sampled 506 consecutive PD patients (211 women/295 men), median age 68.3±10.6 years (range 36-95) and median disease duration 11.2±6.5 years (range 1-49). Medications with potential cardiac effects, i.e. QT prolongation (citalopram, escitalopram, venlafaxine, sertraline, domperidone, amantadine, solifenacin), ventricular arrhythmia (rivastigmine, clozapine, midodrine, sildenafil, tadalafil) and ischemic heart disease (rasagiline, entacapone, tadalafil) were recorded. Demographic and clinical data were collected prospectively; cardiac events were obtained retrospectively. RESULTS: Twenty-four patients (4.7%) (9 women/15 men) presented a cardiac event. Fifteen (62.5%) patients had dysautonomia, 4 (16.6%) a history of heart disease and 8 (33.3%) were taking one or more drugs with a definite potential cardiac adverse effect. Age (75.9±6.6 yr vs. 67.8±11 yr), disease duration (14.7±3.6 yr vs. 11±6.5 yr), dysautonomia (62.5% vs. 24.5%) and dementia associated with PD (37.5% vs. 14.6%) were significantly higher in the group with cardiac events (P<0.05). Cofactors increasing the risk for cardiovascular events were age and dysautonomia. DISCUSSION/CONCLUSION: Our results indicate that the neurodegenerative process in Parkinson's disease is associated with a higher risk of cardiovascular complications.

Chizé virus, a new phlebovirus isolated in France from Ixodes (Trichotoixodes) frontalis.

A new phlebovirus (Bunyaviridae family, Phlebovirus genus), provisionally designed Chizé virus, was isolated from a nymph of Ixodes (Trichotoixodes) frontalis collected on a wren (Troglodytes troglodytes) found dead in the Chizé forest, western France. Chizé virus produced a lethal encephalitis in one-day-old mice and cytopathic effect (CPE) in Vero cells. Extracellular particles with a mean diameter of 105 nm with surface spikes characteristic of Uukuniemi (UUK) serogroup viruses were observed in Vero cells. Chizé virus reacted in complement-fixation test with several UUK serogroup viruses but was readily distinguished from all registered viruses in the serogroup. I. frontalis is highly specific for birds and unlikely to transmit Chizé virus to humans or domestic animals; the pathogenicity of the new virus to wild birds remains to be clarified.

Spiroplasma turonicum sp. nov. from Haematopota horse flies (Diptera: Tabanidae) in France.

Strain Tab4cT, a helical prokaryote that was isolated from the body of a Haematopota sp. fly collected in Champchevrier, Indre-et-Loire, Touraine, France, was found to be a member of the class Mollicutes. The cells of strain Tab4cT were small, motile helices that were devoid of a cell wall. The organism passed through filters with mean pore diameters as small as 0.20 mm. Strain Tab4cT grew rapidly in liquid SP-4 medium at both 30 and 37 degrees C. The organism fermented glucose but did not hydrolyse arginine or urea, and did not require serum for growth. In preliminary electrophoretic analyses, the cell protein patterns of strain Tab4cT were distinct from those of 14 other spiroplasmas found in mosquitoes, deer flies and horse flies from Europe and the Far-East. In reciprocal metabolism inhibition and deformation serological tests, employing antigens and antisera representative of spiroplasma groups I-XXXIII (including all sub-groups), plus ungrouped strains BARC 1901 and BARC 2649, no serological relationship with Tab4cT was found. The G + C content of the DNA of strain Tab4cT was about 25 +/- 1 mol% and its genome size was 1.305 kbp. It is proposed that spiroplasma strain Tab4cT be assigned to group XVII (presently vacant) and that strain (ATCC 700271T) is the type strain of a new species, Spiroplasma turonicum.

Three spiroplasmas isolated from Haematopota sp. (Diptera:Tabanidae) in France.

On August 1991, three spiroplasmas (Tab 2A, Tab 2B and Tab 4C) were isolated from Haematopota sp. flies collected from Indre-et-Loire, France. Isolations were made at 28 degrees C in MD1 medium from ground individual flies, but not from external washings. All isolates adapted well to SP4 medium at 30 and 37 degrees C and were triple cloned before serological identification. Using the cross deformation test, the 3 isolates were compared with 42 known spiroplasmas isolated from diseased plants, flowers, various insects and ticks belonging to 25 serological groups. Each isolate cross-reacted with others and exhibited weak 1-way reactions with TABS-2 or PLHS-1, two spiroplasmas isolated in the United States from respectively Tabanus abactor Philip and Panorpa helena L, a scorpion-fly. These results suggest that Tab 2A, Tab 2B and Tab 4C together with TABS-2 and PLHS-1 may represent, members of a new serological supergroup.

Serological and molecular characterization of Mesoplasma seiffertii strains isolated from hematophagous dipterans in France.

Three strains of nonhelical mollicutes previously isolated in France from two different mosquitoes and one tabanid fly were designated strains Ar 2328 (isolated from Aedes detritus), Ar 2392 (isolated from Aedes caspius), and CP 13 (isolated from Chrysops pictus). All of these strains exhibited properties of the genus Mesoplasma, a recently described genus of non-sterol-requiring mollicutes isolated from plants and insects. The results of metabolism inhibition and growth inhibition tests revealed that these strains and Mesoplasma entomophilum TAC or Mesoplasma florum L1 were not serologically related, but all three dipteran strains reacted strongly with Mesoplasma seiffertii F7T (T = type strain) antibodies. Using metabolism inhibition and growth inhibition tests, we found that the dipteran strains were related to each other and to strain F7T but were not identical. We also found that they were able to multiply and persist in the central nervous systems of suckling mice inoculated intracerebrally, a property that makes their use as biological control agents for pest dipterans inadvisable. Scanning electron microscopy revealed marked differences in the morphologies of the colonies of the different strains on SP4 solid medium. The levels of DNA-DNA homology for strains Ar 2328, Ar 2392, CP 13, and F7T were more than 70%, indicating that these strains are closely related members of the same species, M. seiffertii. In addition, one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that each strain produced about 40 protein bands. This technique also revealed differences between strains. Using the coefficient of Smeath-Jacquart, we constructed a dendrogram that allowed us to estimate of the levels of relatedness of these four strains. The results which we obtained were confirmed by two-dimensional protein electrophoresis results.

[Tick-transmitted arbovirus in Maghreb]. / Arbovirus transmis par des tiques au Maghreb.

The problem of arbovirus infections in Maghreb has been relatively neglected in the pst in spite of a rich diversity of biotopes, the presence of potential reservoirs and vectors, and their position on the flight path of the Palearctic-african bird migration systems, western branch. Moreover, West Nile virus has been isolated from southern Algeria since 1968. From 1979 to 1989, ticks were collected from wild birds, pigeons, bats, rodents, poultry, camels, wild boars, domestic mammals and man, and assayed for viruses. On the whole, 424 ticks were virologically studied from Morocco, 582 from Algeria and 601 from Tunisia. Four tick-borne arboviruses have been isolated so far: three from Morocco, Soldado (Nairovirus), Essaouria (Orbivirus) and Kala Iris (Orbivirus) from Ornithodoros (A.) maritimus ticks parasitizing marine birds, and one from Tunisia, Tunis (Phlebovirus), from Argas reflexus hermanni infesting domestic pigeons. Soldado virus may infect man working into colonies of gulls for ornithological or entomological purposes and this infection is associated with a self-limited febrile illness and pruritus. In addition, antibody to Essaouira virus was detected in a wild rodent in Morocco. On the contrary it is unlike that Tunis virus may infect man because A. r. hermanni is a strickly ornithophilic tick. However, Uukuniemi group antibody has been previously evidenced in wild rodents in Tunisia. Finally, it is not excluded that other, more pathogenic, arboviruses such as Congo-Crimean haemorrhagic fever might be accidentally introduced in this sensitive geographical area.

Tunis virus: a new Phlebovirus from Argas reflexus hermanni ticks in Tunisia.

A new Phlebovirus provisionally named Tunis virus has been isolated from Argas reflexus hermanni ticks parasitizing domestic pigeons. It is the first isolation of an arbovirus from Tunisia and the fourth tick-borne virus to be isolated from the Moghreb following Soldado, Essaouira and Kala Iris in Morocco. The pathogenic potential of this virus is briefly discussed according to the behaviour of its vector and previous serosurveys in the country.

Essaouira and Kala iris: two new orbiviruses of the Kemerovo serogroup, Chenuda complex, isolated from Ornithodoros (Alectorobius) maritimus ticks in Morocco.

Essaouira and Kala Iris viruses were isolated from Ornithodoros (Alectorobius) maritimus ticks parasitizing yellow-legged gulls (Larus cachinnans) on the coast of Morocco in 1979 and 1981, respectively. Serological evidence indicates that these two viruses are new members of the Chenuda complex within the Kemerovo serogroup of the genus Orbivirus. Ecological, pathological, morphological, and physicochemical properties are compatible with these findings. The infectivity of these viruses for man and animals, including seabirds, remains unknown.

A rickettsia-like organism from Ixodes uriae ticks collected on the Kerguelen Islands (French Subantarctic Territories).

A rickettsia-like microorganism was isolated in suckling mice from Ixodes uriae ticks collected from penguins breeding on Mayes Island, Kerguelen Archipelago, French Subantarctic Territories. At isolation, this agent mimicked a tick-borne arbovirus. Finally, electron microscopy studies of infected suckling mouse livers showed the presence of inclusions filled with pleomorphic microorganism in the cytoplasm of some hepatocytes, sometimes dividing by binary fission and thus of obviously non-viral nature. No firm serological relationship was demonstrated with Chlamydia psittaci, C. trachomatis, C. pneumoniae, Coxiella burnetti, Cowdria ruminentium, Ehrlichia canis, E. phagocytophila, E. risticii or the WSU/1044 agent. The exact taxonomic position of the "Mayes" agent remains to be clarified.

[Spiroplasma from Tabanidae capable to multiply and to persist in the central nervous system in mice]. / Un spiroplasme de Tabanidae capable de se multiplier et de persister dans le système nerveux central de la souris.

Using alternate passages of cultivation in vitro at 37 degrees C and in suckling mice following intracerebral inoculation, a tabanid spiroplasma was demonstrated capable of multiplication and persistence in mice for 6 successive passages, without production of specific antibody. This is the first report of a spiroplasma from a common flying haematophagous arthropod shown to produce persistent infection of a mammal.

Multiplication and persistence of Spiroplasma melliferum strain A56 in experimentally infected suckling mice.

Strain A56 of the bee pathogen Spiroplasma melliferum was isolated from a honeybee (Apis mellifera) during ecological studies on mosquito spiroplasmas in Savoie (France). When inoculated intracerebrally (i.c.) into 48-h old suckling mice, this strain was found to replicate to very high titres and to persist in brain for up to 9 months in one individual. We attempted to increase the "neurotropism" of A56 by sequential i.c. passages. During the first two passages, multiplication of the organisms was observed at very high titres in suckling mouse brain (10(7) to 10(11) CCU/ml) generally without the appearance of antibody, thus mimicking the so-called "immunological tolerance" phenomenon. Intracerebral multiplication of A56 decreased during the third passage (10(2) to 10(4) CCU/ml) and ceased during the fourth passage. Spiroplasma multiplication in brain was apparently well tolerated, since brain lesions were minimal and clinical symptoms were limited to a clear, but only rarely significant, delay in growth curves of inoculated versus non-inoculated mice. Progressive spongiform encephalopathy was never observed. Strain A56 S. melliferum appears as the second spiroplasma, after the tick-derived Spiroplasma mirum capable of multiplying in both invertebrate and vertebrate hosts.

Spiroplasma (Mollicutes: Spiroplasmataceae) pathogenic for Aedes aegypti and Anopheles stephensi (Diptera: Culicidae).

Intrathoracic inoculation with the mosquito spiroplasma, Spiroplasma taïwanense Abalain-Colloc et al., was found to reduce significantly the survival of adult male and female Aedes aegypti (L.) and Anopheles stephensi Liston. This spiroplasma also reduced significantly the flight capacity of adult female Ae. aegypti 5-8 d after inoculation and adult female An. stephensi 4 d after inoculation. Adult female An. stephensi were incapable of flight 5 d after inoculation. As such, S. taïwanense joins Bacillus thuringiensis and B. sphaericus as bacteria known to be pathogenic for mosquito vectors.

[Basic research on the use of mosquito spiroplasmas in the control of the major tropical diseases transmitted by mosquitoes]. / Bases expérimentales pour l'utilisation de spiroplasmes de moustiques dans la lutte contre les grandes endémies tropicales transmises par des moustiques.

An increasing number of experimental findings suggest that Spiroplasma taiwanense (Class Mollicutes) has considerable potential for inclusion in integrated mosquito vector control programmes. These experimental findings are outlined in conjunction with preferred strategies for its eventual use as a biological control agent.