Zur Casuistik der Erkrankungen des Central-nervensystems

Ohne Zusammenfassung     

Ein seltener Fall von partieller Agenesie des Kleinhirnwurmes

Ohne Zusammenfassung     

Beitrag zur Syphilis des Gehirns und der Hypophysis und zur Differentialdiagnose zwischen der Tuberculose und Syphilis des Central-nervensystems

Ohne ZusammenfassungIm Auszug auf der Versammlung mitteldeutscher Psychiater und Neurologen am 25. September 1903 in Leipzig vorgetragen und demonstrirt.Meinem verehrten Chef, Herrn Geh. Medicinalrath Dr. Weber spreche ich für die Ueberweisung dieses Falles zur Bearbeitung meinen ergebensten Dank aus.     

Die multiple Sklerose des Centralnervensystems

Ohne Zusammenfassung     

Atteinte multiple des nerfs crâniens : atteinte multiple des nerfs crâniens au cours du tétanos céphalique. À propos d’une observation et revue de la littérature

Introduction

Cephalic tetanus is the most serious form of localized tetanus. It associates trismus with impairment of one or more cranial nerves. It was a rare condition, whose diagnosis can raise several problems.

Case report

A 49-year-old-man presented multiple and unilateral cranial nerve involvement revealing cephalic tetanus.

Conclusion

This case illustrates the importance of considering cephalic tetanus when patients present cranial nerve palsy associated with injury.     

Ueber die multiple Carcinomatose des Centralnervensystems

Ohne ZusammenfassungMeinem Lehrer und Chef, Herrn Geheimrath Prof. Dr. Hitzig, spreche ich für die gütige üeberlassung des Materiales und das dieser Arbeit entgegengebrachte Interesse meinen verehrungsvollen Dank aus.     

Le problème des cooccurrences des DYS…

For one child, combination of DYS may report: associated school symptoms in case of dual task; association of school symptoms referring to a same cognitive origin; several cognitive problems…; be careful with child in trouble may seem inattentive… This distinction has very practical consequences for teachers and parents.     

Construction des liens et continuité des soins à l’adolescence

In childhood the intra-psychological world needs continuity so that internal and external relationships may build up in adolescence. If a normal adolescence is characterised by a transformation of relationships, a pathological adolescence may be understood as a partial, or more global failure of the capacity to transform these relationships that were well, or less well established during childhood. Taking care of these adolescents requires taking into account this manner of defining the pathology at this age and, of course, one should not iatrogenically reinforce the failure to transform or set up these relationships.     

Évaluation des besoins des patients et éducation thérapeutique

Therapeutic education aims at helping patients acquire of maintain competencies they need to cope with chronic illness. It goes further than simple information because its objective is to improve autonomy and quality of life, not just treatment observance. Therapeutic education is an important instrument for psychiatric rehabilitation, notably in foster home care. Because of the various possible themes of therapeutic education, our institution worked toward the identification of situation needing a structured program of therapeutic education. A pluridisciplinary group was set up, aiming at building structured therapeutic education programs and following their implementation. This group built a questionnaire for mental health team members, care givers and patients. Mental health team members expressed their views during a focus group. They identified several issues such as: food and overweight, digestive problems, medication side effects, smoking, diabetes. The questionnaire was sent by post to foster caregivers: 63% of them answered. Sixty-four percent of the answers identify one or several problems encountered by patients: lack of information concerning treatment (27%), stress due to vexation (26%), medication side effects (18%), lack of information concerning mental illness (9%). Twenty-four patients were interviewed, expressing their difficulties: over sedation, loneliness and boredom, anxiety, food, information concerning medication and mental illness. Patients expressed specific needs: Food and overweight, information on medication and illness, activities, smoking cessation. This questionnaire, requiring approximately 45 minutes interview, was living positively by patients. This preliminary inquiry led to identification of difficult themes for therapeutic education: medication and illness, smoking, nutritional balance. In order to both identify unmet needs, we decided to use an instrument developed in Lausanne, called ELADEB (Lausanne instrument to evaluate patients’ needs and difficulties)     

Aspects cliniques, radiologiques, pronostiques et thérapeutiques des lésions démyélinisantes extensives

Background

Demyelinating diseases presenting with a tumefactive demyelinating lesion (TDL) raise questions about classification, diagnosis, prognosis, and treatment. Their long-term course is not well described in literature.

Patients/methods

In a retrospective study, we describe the main characteristics of 29 patients with TDLs. In a case control study, we compared two cohorts of multiple sclerosis (MS) patients: 24 MS patients with TDL versus a reference cohort of patients with relapsing remitting MS. We compared the extended disability status score (EDSS) concerning the first demyelinating event (DE) with TDL, EDSS score at the end of follow-up and treatment intake. The objective was to discuss the prognosis and the management of TDL.

Results

In our study, the prognosis was better for patients with non-prevalent TDL (first DE without TDL) compared with patients with prevalent TDL (first DE with TDL) and was not different compared with the MS reference cohort. At the end of follow-up, there was no significant difference between patients treated with immunosuppressors after a first DE with TDL and patients with classical MS. The EDSS at the end of follow-up was statistically more severe for untreated patients after a first DE with TDL than for classical MS patients (P = 0.0047).

Discussion

The prognosis of patients with TDL is difficult to assess because of its multifactorial nature (underlying disease and treatment impact). In our cohort, outcome of MS patients whose first severe DE involved a TDL was better when they received an early immunosuppressive treatment.     

Devenir à long terme,chez l’adulte,des arthrodèses du couple de torsion

Arthrodesis always jeopardizes the joints either over, or below the site of surgery. One hundred and twenty triple arthrodesis of hind foot have been performed during a period of over 20 years. Too many patients were lost for follow-up to have a scientific approach of the end result. But some very long follow-up can give an idea of the risk of ankle arthritis. It is definitively better to perform this kind of surgery on non-ambulatory or community walker patients; for those who have a good ambulatory potential, it is mandatory to correct all the axis problems of their whole lower limb to keep a functional way of walking.     

Certaines caractéristiques des nouvelles parentalités favorisent-elles la violence des enfants ?

The profound changes of marriage and parenting, both in terms of their legal and their symbolic frame of reference and in terms of the ways in which they are actually put into practice, have led to a dramatic transformation in the environment in which today's children are brought up. Within the family, the media now occupy an increasingly large part of children's lives, both in the information they provide for children's understanding of the world and in the models of behaviour or values they present, which in the last resort constitute the values of contemporary western society. The different parameters of this environment contribute in part to a more frequent and widespread expression of violence on the part of children and teenagers : the principle of authority has been replaced by the principle of consensus as a basis for organising the way family life functions and hedonism has become a core value in family life whilst duty has been pushed into the background. Dominant individualism implies a significant loss of interest in society and its demands (the social contract). The result is a diminution in the instinctual limitations and a significant boost to environmental forces, in particular those of the media (c.f. advertising), a reduction in the strength of the superego and an ideal of self which is poorly defined.