[2012: news in neurology]. / Neurologie.

In 2012, intramuscular midazolam appears as effective as intravenous lorezepam for the first line treatment of convulsive status epilepticus. Perampanel, a new anti-epileptic drug, will be soon available. Two oral treatments are now available for stroke prevention in atrial fibrillation setting. The methylphenidate and the Tai Chi could increase the walk capacity of patients suffering from Parkinson disease. A comprehensive cardiac work-up is essential for some congenital myopathy. A new drug against migraine seems free from vasoconstrictive effect. Antioxidants are harmful in Alzheimer disease. Some oral medication will be available for multiple sclerosis.

[Therapeutic advances in neurology]. / Neurologie.

This article summarizes the main therapeutic advances of 2010 in the field of neurology. It focuses on aspects that are likely to change the care of patients in clinical practice. Among these, we discuss the new oral treatments that have proved to be effective in multiple sclerosis, the results of two large studies comparing endarterectomy and stenting in carotid stenosis, novel therapeutic approaches for the treatment of non-motor symptoms in Parkinson's disease as well as the results of several pharmacological studies in the field of epilepsy.

[Therapeutic advances in neurology]. / Neurologie.

The neurology field has been greatly improved in 2008. The therapeutic window of intravenous thrombolysis for acute ischemic stoke is extended to 4 h 30. New studies show that the clinical progression of Parkinson's disease might be slowed by some medication. Deep brain stimulation may be beneficial early in the course of the disease. Tysabri and Fingolimod in multiple sclerosis are discussed. The pharmacopoeia for epilepsy is in constant development with new products recently released in Switzerland. CGRP receptor antagonists are about to be launched as a promising acute migraine treatment. The pharmacological approach in amyotrophic lateral sclerosis patients might be improved according to research results.

[Acute migraine treatment]. / Traitement de la crise migraineuse.

Migraine is a chronic neurological disorder of recurring and painful episodic headache. Migraine is often associated with functional impairment and leads to important costs in lost productivity. Migraine is underrecognized and undertreated. Diagnosis is based on the reporting headache characteristics and associated symptoms. The physical and neurological examinations are normal. Several drugs are used for acute migraine treatment. Non-narcotic analgesics and NSAIDs can be useful, but a new class of selective 5 HT 1B/1D agonists, known as the triptans, is now commonly prescribed. The efficacy of the treatment can be increased by early administration in an attack.

Anomia for people's names, a restricted form of transient epileptic amnesia.

A 37-year-old man consulted after two episodes of transient anomia for people's names over a period of 6 months. The first episode lasted about 10 min and was restricted to an inability to remember his 2-year-old son's first name. The second, was limited to an inability to recall his daughter's first name for 5 min with clear abnormal experiential quality. Witnessed descriptions of the attacks confirmed the absence of any other cognitive impairment or motor automatisms. The neurological examination was normal except for hyposmia. Inter-ictal cognitive evaluation was normal apart from the anomia for people's names or retrieval of names of familiar people in his childhood on definition and on famous faces naming test. A wake electroencephalograph showed left temporal epileptiform abnormalities, following hyperpnea. On magnetic resonance imaging, quantitative analysis revealed a mildly decreased volume of the left hippocampus. The diagnosis of transient epileptic amnesia (TEA) was considered and the patient did not recur for 6 months under lamotriginum. Thus anomia for people's names may be the sole clinical manifestation of TEA. Such a clinical presentation may easily be overlooked. Treatment may prevent further recurrence and the installation of more important and permanent autobiographical memory impairment. Our observation may suggest an isolated system not only for people's knowledge, but for people's naming. It is consistent with the notion of proper name as pure referring expression.

[Atypical cases of acute headaches of cerebrovascular origin]. / Cas atypiques de céphalées aiguës d'origine cérébrovasculaire.

Acute headaches can be an important signal of a cerebrovascular event. In some cases, as illustrated in this article, such headaches may have the same characteristics as migraine or be the main feature of unusual types of cerebrovascular disease. Headache should not be underestimated since misdiagnosis of cerebrovascular disease can lead to serious consequences.

[Sentinel headache: a premonitory symptom too often unrecognized in intracranial ruptured aneurysm]. / Céphalée sentinelle: symptôme prémonitoire trop souvent méconnu d'une rupture d'anévrisme intracrânien.

Headache is a common complaint in emergency departments, but only a small percentage of patients have a serious disease. Nevertheless, some forms of headache, such as "warning headaches", need special attention. By far the most common symptom associated with aneurysmal minor bleed (warning leak) is a sudden headache that is considered to be a warning symptom of impending aneurysmal rupture. In the presence of sudden severe headache with or without meningeal signs or nausea, subarachnoid hemorrhage should always be considered. Recognition of these warning headaches probably offers the best opportunity of reducing the otherwise serious mortality and morbidity of aneurysmal subarachnoid hemorrhage. This report describes 7 non-consecutive patients presenting warning headaches before major aneurysm rupture. Based on our experience and a review of the literature, we recommend a management algorithm for patients presenting with sudden severe headache.

Delayed segmental axial dystonia of the trunk on standing after lumbar disk operation.

We report four patients with various degrees of chronic, tonic, mildly painful, or non-painful, kyphoscolioses in orthostatism, which developed weeks, or months, after one or several laminectomies for lumbar disk hernia, in the absence of recurring radicular pain or acute lumbar pain. No family history or personal antecedent, of focal or generalized dystonia was found and the dystonia was not seen in any of the four patients pre-operatively, or during the immediate post-operative period. Only ill-defined lumbar 'discomfort', unlike their pre-operative lumbago, was reported by the patients, before and during the occurrence of the pathologic trunk posture on standing. Asymmetric lumbar muscle tonic contraction and hypertrophy was found on physical examination. In all patients, the kyphoscoliosis was maximal when standing, partially disappeared when seated, and completely when lying down. One patient responded well to clonazepam, but the other three showed no improvement with either clonazepam or local injections of botulinum toxin; L-dopa was ineffective in all cases, and trihexiphenidyle in three.

[Stabilization treatments of migraine]. / Traitements stabilisateurs de la migraine.

Pathophysiology and principles for diagnosis of migraine, in particular ways to obtain an accurate history between attacks, are presented in the introduction. Identification of migraine triggers is an extremely important part of migraine therapy. Selected pain-relieving drugs should include primarily simple analgesics and antiemetics, while sumatriptan should be reserved mainly for severe migraine attacks. Pharmacotherapy, psychological and physical therapy are all components of a systemic approach to the treatment of migraine. To discontinue overused medication is the first step in the prevention of migraine. A number of available drugs are able to reduce the frequency and severity of migraine attacks. Several considerations should be evaluated before symptomatic and prophylactic therapies are introduced. Our strategies are based on experience collected during the treatment of 82 patients.

[Symptomatology of ischemic carotid complications]. / Sémiologie des accidents ischémiques carotides.

Clinical features of the carotid artery syndromes are reviewed. Limited infarction cause typical clinical syndromes. However, in most cases, embolic occlusion is multiple and produces various clinical syndromes.

[Monomelic ischemic neuropathy caused by subclavian artery obstruction]. / Neuropathie ischémique monomélique par occlusion de l'artère sous-clavière.

A case study of acute ischemic monomelic neuropathy due to occlusion of the right subclavian artery is reported. The occlusion was embolic. Clinical examination showed sensory loss and severe distal weakness of the limb without obvious muscle necrosis. EMG showed motor and sensory nerve axon loss, chiefly distally. Despite surgical intervention, the neurological damage was irreversible.