Répondre à la douleur des enfants atteints de paralysie cérébrale

With SPARCLE studies, the prevalence of pain in children with cerebral palsy is now better known: 60% of children aged 8 to 12-years-old and amounts to 69% in adolescents 13 to 17-years-old. The pain relief was also identified as a priority issue in a prospective study of la Fondation Motrice published in 2009. Yet iatrogenic pain is under-treated in this population although many assessment tools are validated. The use of assessment tools requires good knowledge of their psychometric properties and limitations. But pain assessment is not limited to the application of a scale. Current knowledge regarding the pain expression and ability to cope in this population are essential. International guidelines stress the importance of a multidisciplinary approach from assessment to management, in way to increase the synergistic effects of several therapeutic options (pharmacological and non-pharmacological). Finally, it also seems worthwhile to question our representations of pain reported by those with atypical development.     

Autisme,jeux sérieux et robotique : réalité tangible ou abus de langage ?

The number of studies focusing on the use of information technology and robotics for individuals with autism has been rising steeply over the last 15 years. Here, we briefly summarize the hope, but also the issues, of 2 domains we consider the most exciting: (1) the computation of serious game aiming at training specific skills (emotion recognition, social interaction); (2) interaction with robotic platforms. We will detail two projects in which we worked as partners, JeMIME for serious games, and Michelangelo for human-robot interaction. We conclude that the potential benefit of the use of information technology and robotics for individuals with autism is enormous given what was achieved in less than 15 years. However, limitations are numerous and clinical validation still lacking.     

Approche étiologique de la paralysie cérébrale à Parakou au Nord du Bénin : étude cas-temoins

BackgroundCerebral palsy is a well-recognized neurodevelopmental condition beginning in early childhood and persisting through the lifespan. The associated factors were not well known in Africa.ObjectiveWe aimed to assess the factors associated to the cerebral palsy at Parakou.MethodsIt was a case-control study included 34 children with cerebral palsy matched to 102 controls. We had collected information about pregnancy history, early conditions in their life, and data from the lifestyle of their parents. The association between cerebral palsy and those factors was estimated with odds ratio and their confidence interval by using a logistic regression model.ResultsThe mean age was 5.4 ± 3.1 years old. The main clinical features of the children with cerebral palsy were the gait disorders (91.2 %), aphasia or speech disturbance (85.3 %), motor deficit (82.3 %) and epilepsy (58.8 %). In the multivariate analysis the associated factors were: no follow up of the pregnancy (OR: 5.9 [1.4–25.0]); acute disease during the pregnancy (OR: 7.6 [1.5–38.5]), resuscitation at the birth (OR: 16.7 [3.2–100.0]), the stay at the neonatology unit (OR: 25.0 [5.0–100.0]).ConclusionThis study suggested that the cerebral palsy can be explained by the pregnancy condition and it follow up at Parakou.     

La télé-rééducation devient-elle incontournable ? Les 10 avantages de la musculation à haute intensité en distanciel pour l’accompagnement de personnes atteintes de paralysie cérébrale

High-intensity strength training for cerebral palsy patients can be highly effective via tele-habilitation and greatly improve patients’ quality of life. On 17 March 2020, started the lockdown of the French population to prevent the spread of COVID-19. These drastic health measures have disrupted scheduled and traditional face-to-face rehabilitation sessions. Health practitioners quickly adapted to this new normal and offered live and recorded sessions. Thanks to that, the cerebral palsy patients could maintain their physical strength and mobility as well as the benefits gained in previous sessions. While this online rehabilitation support is mainstream in other countries, it is relatively new in France. Considering its benefits, it should become standard practice whenever it is appropriate. Firstly, we will discuss the pros and cons of tele-rehabilitation. Then, we will address the root cause of the cerebral palsy patients’ muscular weakness, followed by the multiple benefits of high-intensity strength training. Finally, we will show that high-intensity strength training is well suited to be delivered via tele-rehabilitation.     

Re-institutionnalisation ou désinstitutionnalisation ? Regards croisés entre la France et l’Argentine : à propos des réglementations en santé mentale

Objective

While psychiatry has never been defined as guaranteeing the law, its purpose socially and historically has been defined as protecting society from its most intolerable by-products. We will see how the evolution in the treatment of insanity in France and its influence on Argentinian psychiatry has brought us today to very different and even opposite situations in the area of mental health policies in these two countries.

La vasomotricité cérébrale du point de vue clinique et thérapeutique

Résumé Les auteurs rapportent 82 observations d'hémiplégie d'origine vasculaire traitées par le blocage chirurgical ou pharmacodynamique du sympathique cervical. Les résultats observés sont dans l'ensemble décevants. Cependant, des améliorations incontestable et par-fois spectaculaires peuvent être obtenues par l'infiltration stellaire, chez des malades vus très précocement, dans les six heures qui suivent le début de leur affection.

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Zusammenfassung Die Autoren berichten über 82 Fälle von Hemiplegien vasculärer Genese, die durch chirurgische oder pharmakodynamische Blockade des cervikalen Sympathicus behandelt wurden. Die erzielten Resultate sind im allgemeinen enttäuschend. Immerhin können unbestreitbare und oftmals unglaubliche Besserungen durch Infiltration des Ganglion stellatum bei Kranken erzielt werden, die frühzeitig, in den ersten sechs Stunden nach Beginn des Insults, der Behandlung zugeführt werden.