Rev Neurol France
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In two men presenting with muscle weakness and disturbances of equilibrium neurophysiological examination by repeated stimulations revealed responses suggestive of Lambert-Eaton syndrome. In the first month of the disease very high levels of anti-Hu antibody were found in the serum and CSF, betraying a malignant lesion. This was confirmed by autopsy 4 months later in one patient and by bronchial biopsy 16 months later in the other patient. Both had small-cell lung carcinoma associated with paraneoplastic encephalomyelitis.
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Review Case Reports
[Neurosarcoidosis with meningoencephalitis and tumoral granuloma].
A 24-year old woman had neurosarcoidosis with meningoencephalitis and frontal granuloma. After corticosteroid therapy for two years, CT showed that the granuloma had nearly disappeared and that there was a hydrocephalus.
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Review Case Reports
[Bilateral thalamic glioma. A clinicopathological study of 2 cases].
Two cases of bilateral thalamic glioma in a 70 year-old man and a 8 year-old boy, documented by MRI and pathological data are reported. Such tumors are rare. Early symptoms may be misleading, with intellectual impairment or psychiatric disorders together with a normal CT scan. MRI and pathological findings support the view that bilateral thalamic gliomas represent a particular clinico-pathological entity among thalamic tumors.
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Neuropathic pain, i.e., pain resulting from functional changes in peripheral and central pathways subsequent to injury to the peripheral nervous system, offers a most difficult challenge to therapy. To date, only the antidepressants and the anticonvulsants have shown any effectiveness, albeit incomplete and inconsistent, and many questions remain unanswered: What are the exact indications for the antidepressants? What component of neuropathic pain do they relieve, and through which mechanisms? Which type of antidepressants should be prescribed? A first-generation tricyclic? Or a new compound with a selective action on serotonin reuptake? What are the effective dosage and duration of the treatment? What is it mechanism of action? What other antalgic effects do carbamazepine and baclofen possess apart from their action on trigeminal neuralgia? The opiates are generally considered to be without effect, but recent clinical and experimental findings seem to point otherwise. In the meantime, following a few simple rules will optimize the benefit of drug treatment in neuropathic pain: treatment tailored to individual cases; adequate dosage and duration of treatment. However, it is from the near future that breakthroughs are being expected, dues to the multiplication of animal models and more accurate analysis; new clinical evaluation tools which help in distinguishing the different mechanisms underlying the various aspects of pain; the development of new substances, such as capsaicin, local anesthetics, anti-inflammatory agents (NSAIDs for example); and better defined methodological conditions for therapeutic trials.