Les troubles de la marche et de l’équilibre dans les syndromes parkinsoniens « plus »

The degenerative Parkinsonian “Plus” syndromes form a heterogeneous spectrum of pathologies comprising multiple system atrophy, progressive supranuclear palsy, Lewy body disease and cortico-basal degeneration. Their developmental profile is distinguished from that of Parkinson's disease by the early appearance of gait and balance disorders, isolated freezing of gait, primary progressive freezing of gait or an isolated or “pure” akinesia. The origin of these symptoms however remains poorly understood. The association of nigrostriatal dopamine neuron loss with either cortical lesions, in the case of cortico-basal degeneration and Lewy body disease, and/or of the brainstem, in the case of progressive supranuclear palsy, explains both the severity of the motor symptoms and the lack of, or minimal, improvement following levodopa therapy. Other symptomatic drug and surgical treatments have been proposed, but with generally disappointing results. Physiotherapeutic techniques targeting balance control can bring some temporary improvements.     

Intérêts et limites des échelles d’évaluation de la douleur chez l’enfant en situation de handicap

Accessing to a management of pain is now considered as peoples’ fundamental right. The pain should be evaluated before being treated. Pain is always a subjective phenomenon. Assessing pain of those who express in a singular way is a great challenge. Children and adolescents with intellectual disabilities, with cerebral palsy or with autism are now recognized as sensitive to pain as well as anyone. If some of them are able to use self-report tools, we have to apply disability-adapted scales to others. Like any assessment tools, they have advantages and limitations. We need to know them in order to make appropriate use for the care of vulnerable people.     

« Drapeaux rouges » : quand s’alarmer, quel examens demander ?

The diagnosis of Parkinson's disease (PD) requires ruling out other causes of parkinsonism. Among various “other” causes of parkinsonism, neurodegenerative causes or “atypical parkinsonism” are the most difficult to diagnose. Most common diseases are “synucleinopathies”: multiple system atrophy and dementia with Lewy bodies and “tauopathies”: progressive supranuclear palsy and corticobasal degeneration. Unexpected or atypical signs and symptoms for PD, also called “red flags” along with absent or poor or short-lived levodopa response may be a clue for the diagnosis. Some tests may also support the diagnosis, among them, structural (MRI) and functional brain imaging, autonomic function tests and urodynamics, oculographic recordings and neuropsychological work-up, are the most useful.     

Évaluation du risque de récidive en Belgique francophone : données préliminaires d’analyse factorielle de la « Sex Offender Recidivism Appraisal Guide » (SORAG) et de la Statique-99

In order to assess the internal structure of risk assessment of sexual recidivism of the Sex Offender Risk Appraisal Guide (SORAG), and the STATIC-99, a principal components analysis followed by promax rotation was conducted. In a data set including adults forensic sex offenders, three interpretable components were identified both with the SORAG (n = 79) and the STATIC-99 (n = 254): “past criminal behaviour”, “demographic characteristics”, and “antisocial personality” for the SORAG and “criminal past behaviour”, “aggressor-victim relationship” and “sexual offence” for the STATIC-99. Prospective data were available (SORAG: n = 133; STATIC-99: n = 137). For both instruments, the “criminal past behaviour” factor was the only one predicting general recidivism, violent recidivism and sexual recidivism.