Acquisitions thérapeutiques 2003: Neurologie

Cet article présente les principales acquisitions thérapeutiques 2003 dans le domaine de la neurologie. L'accent est mis sur les implications pour la pratique clinique quotidienne, avec des recommandations basées autant que possible sur des preuves (evidence-based). Dans les maladies cérébrovasculaires et dans les démences, les résultats de plusieurs études randomisées suggèrent qu'il faut parfois traiter les patients avec des antihypertenseurs et des hypolipémiants, même s'ils ne sont ni hypertendus ni hypercholestérolémiques. L'acquisition principale dans le domaine de la sclérose en plaques est l'homologation de la mitoxantrone au printemps dernier, pour les formes graves de la maladie. Des progrès ont été réalisés dans le traitement de certaines formes de dystrophies musculaires, et des méta-analyses ont permis de clarifier l'efficacité des traitements dans les polyradiculoneuropathies inflammatoires. L'évolution de la prise en charge des mouvements anormaux est marquée par l'essor de la stimulation cérébrale profonde.

Neurologie et voyages

Le mal de voyage, l'insomnie, les troubles du sommeil, la fatigue, le jet-lag et des troubles sensitifs transitoires sont des symptômes très fréquents lors des voyages et pour la plupart banals. Les maladies neurologiques déclenchées ou causées par le voyage sont rares et incluent des accidents vasculaires cérébraux (AVC) liés aux emboles paradoxaux après un voyage prolongé en avion, des crises d'épilepsie ou des troubles du sommeil déclenchés par le décalage horaire, des symptômes de décompression lors de la plongée ou montée en altitude. Dans cet article sont aussi discutées les maladies liées à la haute altitude(céphalée de haute altitude, mal aigu des montagnes), des troubles neurologiques liés à la déshydratation et à la chaleur ainsi que les infections acquises lors de voyages.

Neurologie [Therapeutic advances in neurology].

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.

Neurologie [Therapeutic advances in neurology].

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.

Crises non épileptiques psychogènes: le défi des troubles fonctionnels en neurologie

Psychogenic non epileptic seizures (PNES) look like epilepsy, but are not accompanied by the electrophysiological alterations found in epilepsy. The diagnosis requires a complex process at the interface between neurology and psychiatry. Diagnostic restitution to the patient and treatment of the condition should be a collaboration between neurologist and psychiatrist including as much as possible a general practitioner. Vulnerability and triggering psycho-social factors, as well as frequent psychiatric co morbidity implicate that psychiatric-psychological care is needed in a majority of situations, however this cannot be done without a strong "somatic back-up" with rapid access to somatic facility for advice and care when needed. The neurological presentation of the disease, with psychiatric causes underlying the condition, bear the risk for the patient that neither neurological nor psychiatric care is offered. Current knowledge about the condition is still scarce, but the field is progressively enriched by studies with stronger methodologies. Recent neuroimaging studies open fascinating avenues on our understanding of the interplay between emotional regulation, representation of the self, and dissociative symptoms. These new avenues help our understanding of these disorders which challenge classical frontiers between neurology and psychiatry. In this paper we try to formulate a framework for the care of patient with dissociative disorders including NEPS.

Revue des hospitalisations du Service de neurologie du CHUV en 1997

La présente étude s'inscrit dans la continuité des revues d'hospitalisation déjà conduites au CHUV. Elle consiste à documenter la pertinence des admissions et des journées d'hospitalisation dans le Service de neurologie pour les patients admis entre le 1er octobre 1996 et le 30 mars 1997. Soutenue par le Fonds de performance vaudois, cette étude pousuit trois buts: 1. vérifier l'applicabilité du protocole de Gertman et Restuccia au contexte de la neurologie; 2. élaborer un instrument de détection des journées non justifiées; 3. identifier les mesures permettant de diminuer le taux de journées non justifiées (...). [Table des matières] 1. Matériel et méthode. 1.1. Protocole princeps. 1.2. Protocole adapté. 1.3. Analyse des causes de délai. 2. Résultats : exhaustivité de la cueillette de données. 3. Discussion et conclusions. 4. Annexes : 1. Limites temporelles du critère C15. 2. Soins requis (PNR). 3. Formulaire de saisie. 4. Responsabilités des délais. 5. Distribution des critères. 6. Causes de délai.

Neurologie [Neurology]

In this review, we present a choice of the principal therapeutic advances in neurology that have been published in 2007. The purpose here is not to provide an exhaustive catalogue of each study of that took place over the last year, but rather to highlight those that might be the most relevant for clinical practice.

Autoanticorps en neurologie: implications cliniques [Autoantibodies in neurological diseases: clinical implications]

Autoantibodies are defined as antibodies directed against self antigens, i.e., against a normal antigenic endogenous tissue constituent. They can be the immediate cause of the neurological syndrome or be detected as an epiphenomenon of the pathogenic process. Autoantibodies are often considered useful biomarkers for the improvement of diagnostic accuracy, for the staging of disease progression or for the follow up of a biological response to a therapeutic intervention. The purpose of this article is to review the autoantibodies that are available to investigate immune-mediated neurological conditions. The detection of some of these autoantibodies may help the clinician to establish a definite diagnosis which may further facilitate the therapeutic decision.

Neurologie [Neurology].

In 2015, cerebral stimulation becomes increasingly established in the treatment of pharmacoresistant epilepsy. Efficacy of endovascular treatment has been demonstrated for acute ischemic stroke. Deep brain stimulation at low frequency improves dysphagia and freezing of gait in Parkinson patients. Bimagrumab seems to increase muscular volume and force in patients with inclusion body myositis. In cluster-type headache, a transcutaneous vagal nerve stimulator is efficient in stopping acute attacks and also reducing their frequency. Initial steps have been undertaken towards modulating memory by stimulation of the proximal fornix. Teriflunomide is the first oral immunomodulatory drug for which efficacy has been shown in preventing conversion from clinical isolated syndrome to multiple sclerosis.

Index philosophique : philosophie et sciences annexes : biologie, neurologie, psychiatrie : publication de la Revue de philosophie / par N. Vaschide,... et von Buschan,...

1903 (A2).

Index philosophique : philosophie et sciences annexes : biologie, neurologie, psychiatrie : publication de la Revue de philosophie / par N. Vaschide,... et von Buschan,...

Périodicité : Annuel

Index philosophique : philosophie et sciences annexes : biologie, neurologie, psychiatrie : publication de la Revue de philosophie / par N. Vaschide,... et von Buschan,...

1902 (A1).