Carlos Benaim - Academia.edu (original) (raw)
Papers by Carlos Benaim
Annales de Réadaptation et de Médecine Physique, 1997
Annals of physical and rehabilitation medicine, 2014
Time to inpatient follow-up care and rehabilitation: Survival analysis for benchmarking purposes ... more Time to inpatient follow-up care and rehabilitation: Survival analysis for benchmarking purposes Délais d'admission en soins de suites et réadaptation : l'analyse de survie au service du benchmarking
Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique, 2005
To describe the incidence, circumstances, and consequences of falls in patients admitted in a reh... more To describe the incidence, circumstances, and consequences of falls in patients admitted in a rehabilitation ward after a stroke. Prospective monitoring of falls over four years in a neurological rehabilitation unit. Use of fall registry. age < 75 years, admission < 45 days after stroke onset, single stroke of 1 cerebral hemisphere (nonlacunar) or of the brain stem. Only falls due to loss of balance were considered; falls caused by a seizure or syncope were not considered. Of 217 consecutive patients with the inclusion criteria, 34 had fallen at least once (15.7%) and 10 twice (4.1%). Fall incidence, defined as the number of falls per patient per day was 2.2 per thousand. Half of the patients fell the first three weeks after admission. Most falls involved getting to or from the wheelchair or the bed; 1 patient had recovered minimal postural abilities at the gym but was not independent. Traumatic lesions were noted in 13 patients: they were minor in nine and severe in four, inc...
Annales de chirurgie de la main et du membre supérieur : organe officiel des sociétés de chirurgie de la main = Annals of hand and upper limb surgery, 1999
The semiology of the hand after brain damage is really rich. Its clinical evaluation remains quit... more The semiology of the hand after brain damage is really rich. Its clinical evaluation remains quite difficult and must be integrated in the neuro-orthopedic and cognitive context. Deficiency, neuropsychological, analytic and functional status, must be assessed before any surgical decision aiming the improvement of prehension. Neuropsychological evaluation precise the hemispheric specialization: right hemisphere lesions conduct to unilateral spatial neglect while left hemispherical lesions determine language troubles and gesture impairment (apraxia). The analytical evaluation describes motor and sensitive function and assesses spasticity and pain. Concerning the functional assessment, the Enjalbert's score seems to be the most adapted to the upper limb. The assessment of hand deficiency and its origin is necessary to orientate the surgical decision and includes the Zancolli classification for the fingers and wrist and the House classification for the thumb. These classification us...
Revue neurologique, 1999
In the light of studies published in the last ten years, we have suspected a differential influen... more In the light of studies published in the last ten years, we have suspected a differential influence of the sides of hemispheric cerebral lesions on posture and balance. A study was aimed at verifying this hypothesis, the method of which being original because many possible confounding factors such as age, sex as well as topography and size of the brain lesion have been taken into account in the statistical analysis. Inclusion criteria were: right-handed patients, first stroke, no previous disease which might have affected balance. Their postural abilities (ranging from 0 to 36) were assessed 90 +/- 3 days after stroke onset on a clinical scale. This clinical assessment was used here because it could be easily performed in all patients, irrespective of the severity of their impairment. Lesion locations were determined using the Atlas by Talairach and Tournoux and the number of cerebral areas altered gave an estimation of the lesion size. The first fifty patients consecutively admitte...
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris, 1998
Different techniques of stabilometric signal analysis have been used in order to study the adapta... more Different techniques of stabilometric signal analysis have been used in order to study the adaptation of the fine postural control system to the wearing of corrective glasses with or without prisms. The comparison between the results obtained with conventional techniques and those obtained with non-linear dynamic methods demonstrates the better efficiency of the latter. These results confirm that the postural system behaves as a non-linear dynamical system and may explain the outstanding sensitivity of the fine postural system to small perturbations.
Revue neurologique, 1996
The aim of this study is to investigate general intellectual and memory performances at the secon... more The aim of this study is to investigate general intellectual and memory performances at the secondary (3 weeks to 4.5 months) and late (10 to 16 months) stages following rupture of anterior communicating artery aneurysms (AACA). Twenty one patients presenting with selective lesion within frontal, or cingulate, callosal, caudate, basal forebrain areas were evaluated. At the secondary stage, the analysis of the general intellectual capacities revealed a drop of performance, prominent on performance IQ, which was more severe than the learning deficit. Specific cognitive evaluations revealed increase of the execution time, but performance was relatively preserved: in the Stroop test, focused attention disorder was moderate: the modified Wisconsin Card Sorting test was correctly performed in most cases; significant deficits of verbal short-term memory, long-term verbal and visuo-spatial learning, and access to semantic memory were observed. At the late stage, general intellectual perform...
Revue neurologique, 1995
A case of amnesia with preferential disorder of verbal recall, associated to a limited infarct of... more A case of amnesia with preferential disorder of verbal recall, associated to a limited infarct of the left superior, external and anterior thalamus, is reported. This lesion involved the anterior and middle dorso-lateral nuclei and the centrolateral nucleus, sparing most of the structures classically incriminated in diencephalic amnesia. At the initial stage, the patient presented discrete language impairment and severe deficit of semantic processing, which later recovered. At the late stage, the anterograde and retrograde amnesia principally concerned the recall of verbal information used in daily life, verbal learning using short-term and long-term recall, questionnaires evaluating retrograde memory and requiring the evocation of proper names. Verbal priming was also affected. Verbal recognition was preserved. Evocation of the most recent events of the personal life was also impaired. Confrontation of this case with others previously reported suggests that various thalamic amnesia...
European Journal of Orthopaedic Surgery & Traumatology, 2005
Reliability and reproducibility of two radiological pelvic parameters are tested: thickness (leng... more Reliability and reproducibility of two radiological pelvic parameters are tested: thickness (length of the segment defined by the middle of the upper endplate of the sacrum to the middle of the bi-coxo-femoral axis) and pelvic incidence (angle defined by the perpendicular line to the centre of the upper endplate of the sacrum and the thickness line). These two parameters provide a pelvis description and assess the relation between pelvis and spinal curves. The anatomical reliability of these radiological parameters was not achieved. The values of these two parameters from X-ray versus direct measurement on 12 anatomical specimens are compared.
Annales de Réadaptation et de Médecine Physique, 1996
REsumE-La qualit6 de vie est un concept multidimensionnel sans definition agr66e. Les questionnai... more REsumE-La qualit6 de vie est un concept multidimensionnel sans definition agr66e. Les questionnaires ont 6t6 dEveloppEs en accord avec les donnEes les plus partagEes, mais apparaissent pEremptoires en imposant des categories de rEpnnse. O'Boyle a dEvelopp6 un plan d'Evaluation individualis6 de la qualit6 de vie, le SEIQoL (Schedule for Evaluation of Individual Quality of Life). Les auteurs prEsentent le SEIQoL et les rEsultats d'une Etude comparant I'ISPN (Indice de Sant6 Perceptuelle de Nottingham) et le SEIQoL dans une population de patientes ostEoporodques. qualit~ de vie / ~valuation individuelle Summary-An approach to the quality of life: specified evaluation. Quality of life is a multidimensional concept without any approved definition. Questionnaires have been developed in harmony with the most shared datum, but they ?? by imposing types of responses. O'Boyle developed the Schedule for Evaluation of Individual Quality of Life (SEIQoL) which takes into account the subjective dimension of the quality of life. The authors submit the SEIQoL and the results of a study comparing the French version of the Nottingham Health Profile to the SEIQoL in a population of osteoporotic patients.
Objectif: D~terminer les caracteristiques cin~matiques, cin~tiques, de la marche de sujets &ges s... more Objectif: D~terminer les caracteristiques cin~matiques, cin~tiques, de la marche de sujets &ges sains, non-chuteurs, et d~terminer les caracteristiques infracliniques predictives de chute.
Stroke, 2004
Background and Purpose— The Aphasic Depression Rating Scale (ADRS) was developed to detect and me... more Background and Purpose— The Aphasic Depression Rating Scale (ADRS) was developed to detect and measure depression in aphasic patients during the subacute stage of stroke. Methods— Six experts selected an initial sampling of behavioral items from existing depression rating scales. Stroke patients (aphasic and nonaphasic) were assessed with these items by the rehabilitation staff, with the Hamilton Depression Rating Scale (HDRS) for nonaphasic patients only, by a psychiatrist, and by the rehabilitation staff with Visual Analog Scales (VAS). A second item selection was conducted after a regression algorithm was run including VAS as independent variables (criterion validity) and after their factorial structure was analyzed with a principal component analysis (factorial validity). The construct validity was evaluated with respect to the other depression assessments. A threshold for the diagnosis of depression was computed with respect to the psychiatrist’s diagnosis. Interrater and test-...
Annals of Physical and Rehabilitation Medicine, 2014
Introduction.-Post-stroke aphasia makes it difficult to assess cognitive deficiencies. We thus de... more Introduction.-Post-stroke aphasia makes it difficult to assess cognitive deficiencies. We thus developed the CASP, which can be administered without using language. Our objective was to compare the feasibility of the CASP, the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in aphasic stroke patients. Material and methods.-All aphasic patients consecutively admitted to seven French rehabilitation units during a 4-month period after a recent first left hemispheric stroke were assessed with CASP, MMSE and MoCA. We determined the proportion of patients in whom it was impossible to administer at least one item from these 3 scales, and compared their administration times. Results.-Forty-four patients were included (age 64 AE 15, 26 males). The CASP was impossible to administer in eight of them (18%), compared with 16 for the MMSE (36%, P = 0.05) and 13 for the MoCA (30%, P = 0.21, NS). It was possible to administer the CASP in all of the patients with expressive aphasia, whereas the MMSE and the MoCA could not be administered. Administration times were longer for the CASP (13 AE 4 min) than for the MMSE (8 AE 3 min, P < 10 À6) and the MoCA (11 AE 5 min, P = 0.23, NS). Conclusion.-The CASP is more feasible than the MMSE and the MoCA in aphasic stroke patients.
Annals of Physical and Rehabilitation Medicine, 2015
Revue Neurologique, 2009
Polyneuropathies associated with IgM paraproteinemia and anti-myelin associated glycoprotein (MAG... more Polyneuropathies associated with IgM paraproteinemia and anti-myelin associated glycoprotein (MAG) antibodies (MAG-PN) have to be differentiated from chronic inflammatory demyelinating polyneuropathies. In a retrospective study, we have analyzed clinical, electrophysiological, biological and pathological data from MAG-PN patients. Seven male and six female patients were followed in the department for a mean 2 years (0.5-6.5 years). Mean age at diagnosis was 61 years (44.5-85.5 years). Patients had symmetrical bilateral paresthesia (11/13) and hypoesthesia (11/13) prominent in the lower limbs. Nine patients developed gait ataxia and four patients had moderate distal weakness in the lower limbs. Mean Overall Neuropathy Limitation Scale was 2.3 (0-5). Nerve conduction study showed demyelinating features though delayed distal motor latency on median (206 % of normal value) and ulnar nerves (150% of normal value). Seven out of thirteen patients had at least two nerves with terminal latency index below 0.25. IgM paraproteinemia was of undetermined significance in ten cases and three patients had non-Hodgkin lymphoma. IgM deposits and widening of the peripheral myelin were observed in 5/7 sural nerve biopsies. Anti-MAG antibodies were detected in the sera of all patients using enzyme-linked immunosorbent assay and in 8/12 patients using western blot analysis. MAG-PN have distinctive clinical, electrophysiological and pathological features. It is a chronic, slowly progressive, predominantly sensory and ataxic neuropathy. Disability is usually moderate. Electrophysiological study shows distal demyelinating process and is highly suggestive of MAG-PN in more than one half of our patients. Several techniques may detect anti-MAG antibodies, they have to be associated to improve sensitivity and specificity of the test.
Annals of Physical and Rehabilitation Medicine, 2014
Upper limb function / Annals of Physical and Rehabilitation Medicine 57S (2014) e178-e180 graspin... more Upper limb function / Annals of Physical and Rehabilitation Medicine 57S (2014) e178-e180 grasping and manipulation strategies in hemiparetic patients and complement assessment using standard clinical scales. Project supported by Labex SMART (supported by ANR within the "Investissements d'Avenir programme" ANR-11-IDEX-0004-02).
Annals of Physical and Rehabilitation Medicine, 2014
Fonctionnalité du membre supérieur / Annals of Physical and Rehabilitation Medicine 57S (2014) e1... more Fonctionnalité du membre supérieur / Annals of Physical and Rehabilitation Medicine 57S (2014) e181-e182 Objectif.-CIPASS (Chronic IPAS in Stroke) est un nouveau protocole de neuromodulation proposant des sessions PAS (Paired Associative Stimulation) de façon répétitive à des patients victimes d'AVC. L'objectif est de prouver un effet durable (3 jours) de l'augmentation de la plasticité cérébrale pour les muscles extenseurs du poignet (ECR) associé à une amélioration fonctionnelle. Méthodes.-Le PAS consiste en une combinaison de 2 stimulations : électrique et TMS (0,1 Hz) pendant 30 minutes. Cette étude est randomisée, en double-insu contre placebo. Au totoal, 24 patients (PAS : n = 12 and Placebo : n = 12). Une session de stimulation PAS est appliquée de façon quotidienne (5 jours). Résultats.-Nos résultats ont mis en évidence, 3 jours après la fin du protocole (J8), une importante augmentation de la surface du PEM pour le groupe PAS (+ 125 % ± 218 %) comparée au groupe Placebo (+ 28 % ± 83 %). L'augmentation du FMMS groupe PAS (+ 5,3 ± 4,5 patients) par rapport au groupe Placebo (+ 4,5 ± 3,8 patients) à j8. Discussion.-CIPASS semble induire une modification de l'excitabilité corticale durable (> 3 jours) pour le groupe A. Cette étude nous permettra de mieux comprendre les phénomènes de plasticité cérébrale et de prouver l'intérêt de CIPASS comme adjuvent thérapeutique.
Annales de Réadaptation et de Médecine Physique, 1997
Annals of physical and rehabilitation medicine, 2014
Time to inpatient follow-up care and rehabilitation: Survival analysis for benchmarking purposes ... more Time to inpatient follow-up care and rehabilitation: Survival analysis for benchmarking purposes Délais d'admission en soins de suites et réadaptation : l'analyse de survie au service du benchmarking
Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique, 2005
To describe the incidence, circumstances, and consequences of falls in patients admitted in a reh... more To describe the incidence, circumstances, and consequences of falls in patients admitted in a rehabilitation ward after a stroke. Prospective monitoring of falls over four years in a neurological rehabilitation unit. Use of fall registry. age < 75 years, admission < 45 days after stroke onset, single stroke of 1 cerebral hemisphere (nonlacunar) or of the brain stem. Only falls due to loss of balance were considered; falls caused by a seizure or syncope were not considered. Of 217 consecutive patients with the inclusion criteria, 34 had fallen at least once (15.7%) and 10 twice (4.1%). Fall incidence, defined as the number of falls per patient per day was 2.2 per thousand. Half of the patients fell the first three weeks after admission. Most falls involved getting to or from the wheelchair or the bed; 1 patient had recovered minimal postural abilities at the gym but was not independent. Traumatic lesions were noted in 13 patients: they were minor in nine and severe in four, inc...
Annales de chirurgie de la main et du membre supérieur : organe officiel des sociétés de chirurgie de la main = Annals of hand and upper limb surgery, 1999
The semiology of the hand after brain damage is really rich. Its clinical evaluation remains quit... more The semiology of the hand after brain damage is really rich. Its clinical evaluation remains quite difficult and must be integrated in the neuro-orthopedic and cognitive context. Deficiency, neuropsychological, analytic and functional status, must be assessed before any surgical decision aiming the improvement of prehension. Neuropsychological evaluation precise the hemispheric specialization: right hemisphere lesions conduct to unilateral spatial neglect while left hemispherical lesions determine language troubles and gesture impairment (apraxia). The analytical evaluation describes motor and sensitive function and assesses spasticity and pain. Concerning the functional assessment, the Enjalbert's score seems to be the most adapted to the upper limb. The assessment of hand deficiency and its origin is necessary to orientate the surgical decision and includes the Zancolli classification for the fingers and wrist and the House classification for the thumb. These classification us...
Revue neurologique, 1999
In the light of studies published in the last ten years, we have suspected a differential influen... more In the light of studies published in the last ten years, we have suspected a differential influence of the sides of hemispheric cerebral lesions on posture and balance. A study was aimed at verifying this hypothesis, the method of which being original because many possible confounding factors such as age, sex as well as topography and size of the brain lesion have been taken into account in the statistical analysis. Inclusion criteria were: right-handed patients, first stroke, no previous disease which might have affected balance. Their postural abilities (ranging from 0 to 36) were assessed 90 +/- 3 days after stroke onset on a clinical scale. This clinical assessment was used here because it could be easily performed in all patients, irrespective of the severity of their impairment. Lesion locations were determined using the Atlas by Talairach and Tournoux and the number of cerebral areas altered gave an estimation of the lesion size. The first fifty patients consecutively admitte...
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris, 1998
Different techniques of stabilometric signal analysis have been used in order to study the adapta... more Different techniques of stabilometric signal analysis have been used in order to study the adaptation of the fine postural control system to the wearing of corrective glasses with or without prisms. The comparison between the results obtained with conventional techniques and those obtained with non-linear dynamic methods demonstrates the better efficiency of the latter. These results confirm that the postural system behaves as a non-linear dynamical system and may explain the outstanding sensitivity of the fine postural system to small perturbations.
Revue neurologique, 1996
The aim of this study is to investigate general intellectual and memory performances at the secon... more The aim of this study is to investigate general intellectual and memory performances at the secondary (3 weeks to 4.5 months) and late (10 to 16 months) stages following rupture of anterior communicating artery aneurysms (AACA). Twenty one patients presenting with selective lesion within frontal, or cingulate, callosal, caudate, basal forebrain areas were evaluated. At the secondary stage, the analysis of the general intellectual capacities revealed a drop of performance, prominent on performance IQ, which was more severe than the learning deficit. Specific cognitive evaluations revealed increase of the execution time, but performance was relatively preserved: in the Stroop test, focused attention disorder was moderate: the modified Wisconsin Card Sorting test was correctly performed in most cases; significant deficits of verbal short-term memory, long-term verbal and visuo-spatial learning, and access to semantic memory were observed. At the late stage, general intellectual perform...
Revue neurologique, 1995
A case of amnesia with preferential disorder of verbal recall, associated to a limited infarct of... more A case of amnesia with preferential disorder of verbal recall, associated to a limited infarct of the left superior, external and anterior thalamus, is reported. This lesion involved the anterior and middle dorso-lateral nuclei and the centrolateral nucleus, sparing most of the structures classically incriminated in diencephalic amnesia. At the initial stage, the patient presented discrete language impairment and severe deficit of semantic processing, which later recovered. At the late stage, the anterograde and retrograde amnesia principally concerned the recall of verbal information used in daily life, verbal learning using short-term and long-term recall, questionnaires evaluating retrograde memory and requiring the evocation of proper names. Verbal priming was also affected. Verbal recognition was preserved. Evocation of the most recent events of the personal life was also impaired. Confrontation of this case with others previously reported suggests that various thalamic amnesia...
European Journal of Orthopaedic Surgery & Traumatology, 2005
Reliability and reproducibility of two radiological pelvic parameters are tested: thickness (leng... more Reliability and reproducibility of two radiological pelvic parameters are tested: thickness (length of the segment defined by the middle of the upper endplate of the sacrum to the middle of the bi-coxo-femoral axis) and pelvic incidence (angle defined by the perpendicular line to the centre of the upper endplate of the sacrum and the thickness line). These two parameters provide a pelvis description and assess the relation between pelvis and spinal curves. The anatomical reliability of these radiological parameters was not achieved. The values of these two parameters from X-ray versus direct measurement on 12 anatomical specimens are compared.
Annales de Réadaptation et de Médecine Physique, 1996
REsumE-La qualit6 de vie est un concept multidimensionnel sans definition agr66e. Les questionnai... more REsumE-La qualit6 de vie est un concept multidimensionnel sans definition agr66e. Les questionnaires ont 6t6 dEveloppEs en accord avec les donnEes les plus partagEes, mais apparaissent pEremptoires en imposant des categories de rEpnnse. O'Boyle a dEvelopp6 un plan d'Evaluation individualis6 de la qualit6 de vie, le SEIQoL (Schedule for Evaluation of Individual Quality of Life). Les auteurs prEsentent le SEIQoL et les rEsultats d'une Etude comparant I'ISPN (Indice de Sant6 Perceptuelle de Nottingham) et le SEIQoL dans une population de patientes ostEoporodques. qualit~ de vie / ~valuation individuelle Summary-An approach to the quality of life: specified evaluation. Quality of life is a multidimensional concept without any approved definition. Questionnaires have been developed in harmony with the most shared datum, but they ?? by imposing types of responses. O'Boyle developed the Schedule for Evaluation of Individual Quality of Life (SEIQoL) which takes into account the subjective dimension of the quality of life. The authors submit the SEIQoL and the results of a study comparing the French version of the Nottingham Health Profile to the SEIQoL in a population of osteoporotic patients.
Objectif: D~terminer les caracteristiques cin~matiques, cin~tiques, de la marche de sujets &ges s... more Objectif: D~terminer les caracteristiques cin~matiques, cin~tiques, de la marche de sujets &ges sains, non-chuteurs, et d~terminer les caracteristiques infracliniques predictives de chute.
Stroke, 2004
Background and Purpose— The Aphasic Depression Rating Scale (ADRS) was developed to detect and me... more Background and Purpose— The Aphasic Depression Rating Scale (ADRS) was developed to detect and measure depression in aphasic patients during the subacute stage of stroke. Methods— Six experts selected an initial sampling of behavioral items from existing depression rating scales. Stroke patients (aphasic and nonaphasic) were assessed with these items by the rehabilitation staff, with the Hamilton Depression Rating Scale (HDRS) for nonaphasic patients only, by a psychiatrist, and by the rehabilitation staff with Visual Analog Scales (VAS). A second item selection was conducted after a regression algorithm was run including VAS as independent variables (criterion validity) and after their factorial structure was analyzed with a principal component analysis (factorial validity). The construct validity was evaluated with respect to the other depression assessments. A threshold for the diagnosis of depression was computed with respect to the psychiatrist’s diagnosis. Interrater and test-...
Annals of Physical and Rehabilitation Medicine, 2014
Introduction.-Post-stroke aphasia makes it difficult to assess cognitive deficiencies. We thus de... more Introduction.-Post-stroke aphasia makes it difficult to assess cognitive deficiencies. We thus developed the CASP, which can be administered without using language. Our objective was to compare the feasibility of the CASP, the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in aphasic stroke patients. Material and methods.-All aphasic patients consecutively admitted to seven French rehabilitation units during a 4-month period after a recent first left hemispheric stroke were assessed with CASP, MMSE and MoCA. We determined the proportion of patients in whom it was impossible to administer at least one item from these 3 scales, and compared their administration times. Results.-Forty-four patients were included (age 64 AE 15, 26 males). The CASP was impossible to administer in eight of them (18%), compared with 16 for the MMSE (36%, P = 0.05) and 13 for the MoCA (30%, P = 0.21, NS). It was possible to administer the CASP in all of the patients with expressive aphasia, whereas the MMSE and the MoCA could not be administered. Administration times were longer for the CASP (13 AE 4 min) than for the MMSE (8 AE 3 min, P < 10 À6) and the MoCA (11 AE 5 min, P = 0.23, NS). Conclusion.-The CASP is more feasible than the MMSE and the MoCA in aphasic stroke patients.
Annals of Physical and Rehabilitation Medicine, 2015
Revue Neurologique, 2009
Polyneuropathies associated with IgM paraproteinemia and anti-myelin associated glycoprotein (MAG... more Polyneuropathies associated with IgM paraproteinemia and anti-myelin associated glycoprotein (MAG) antibodies (MAG-PN) have to be differentiated from chronic inflammatory demyelinating polyneuropathies. In a retrospective study, we have analyzed clinical, electrophysiological, biological and pathological data from MAG-PN patients. Seven male and six female patients were followed in the department for a mean 2 years (0.5-6.5 years). Mean age at diagnosis was 61 years (44.5-85.5 years). Patients had symmetrical bilateral paresthesia (11/13) and hypoesthesia (11/13) prominent in the lower limbs. Nine patients developed gait ataxia and four patients had moderate distal weakness in the lower limbs. Mean Overall Neuropathy Limitation Scale was 2.3 (0-5). Nerve conduction study showed demyelinating features though delayed distal motor latency on median (206 % of normal value) and ulnar nerves (150% of normal value). Seven out of thirteen patients had at least two nerves with terminal latency index below 0.25. IgM paraproteinemia was of undetermined significance in ten cases and three patients had non-Hodgkin lymphoma. IgM deposits and widening of the peripheral myelin were observed in 5/7 sural nerve biopsies. Anti-MAG antibodies were detected in the sera of all patients using enzyme-linked immunosorbent assay and in 8/12 patients using western blot analysis. MAG-PN have distinctive clinical, electrophysiological and pathological features. It is a chronic, slowly progressive, predominantly sensory and ataxic neuropathy. Disability is usually moderate. Electrophysiological study shows distal demyelinating process and is highly suggestive of MAG-PN in more than one half of our patients. Several techniques may detect anti-MAG antibodies, they have to be associated to improve sensitivity and specificity of the test.
Annals of Physical and Rehabilitation Medicine, 2014
Upper limb function / Annals of Physical and Rehabilitation Medicine 57S (2014) e178-e180 graspin... more Upper limb function / Annals of Physical and Rehabilitation Medicine 57S (2014) e178-e180 grasping and manipulation strategies in hemiparetic patients and complement assessment using standard clinical scales. Project supported by Labex SMART (supported by ANR within the "Investissements d'Avenir programme" ANR-11-IDEX-0004-02).
Annals of Physical and Rehabilitation Medicine, 2014
Fonctionnalité du membre supérieur / Annals of Physical and Rehabilitation Medicine 57S (2014) e1... more Fonctionnalité du membre supérieur / Annals of Physical and Rehabilitation Medicine 57S (2014) e181-e182 Objectif.-CIPASS (Chronic IPAS in Stroke) est un nouveau protocole de neuromodulation proposant des sessions PAS (Paired Associative Stimulation) de façon répétitive à des patients victimes d'AVC. L'objectif est de prouver un effet durable (3 jours) de l'augmentation de la plasticité cérébrale pour les muscles extenseurs du poignet (ECR) associé à une amélioration fonctionnelle. Méthodes.-Le PAS consiste en une combinaison de 2 stimulations : électrique et TMS (0,1 Hz) pendant 30 minutes. Cette étude est randomisée, en double-insu contre placebo. Au totoal, 24 patients (PAS : n = 12 and Placebo : n = 12). Une session de stimulation PAS est appliquée de façon quotidienne (5 jours). Résultats.-Nos résultats ont mis en évidence, 3 jours après la fin du protocole (J8), une importante augmentation de la surface du PEM pour le groupe PAS (+ 125 % ± 218 %) comparée au groupe Placebo (+ 28 % ± 83 %). L'augmentation du FMMS groupe PAS (+ 5,3 ± 4,5 patients) par rapport au groupe Placebo (+ 4,5 ± 3,8 patients) à j8. Discussion.-CIPASS semble induire une modification de l'excitabilité corticale durable (> 3 jours) pour le groupe A. Cette étude nous permettra de mieux comprendre les phénomènes de plasticité cérébrale et de prouver l'intérêt de CIPASS comme adjuvent thérapeutique.