Chassoux F.,Sainte Anne Hospital |
Chassoux F.,Center Hospitalier Sainte Anne |
Daumas-Duport C.,Sainte Anne Hospital |
Daumas-Duport C.,University of Paris Descartes
Epilepsia | Year: 2013
Dysembryoplastic neuroepithelial tumors (DNTs) belong to the surgically treatable long-term epilepsy-associated group of tumors. Based on cortical specimens provided through epilepsy surgery at Sainte-Anne hospital, three histologic subtypes (simple, complex, and nonspecific) have been described. Electroclinical data, imaging, intralesional recordings (stereo- electroencephalography [EEG]) and histologic correlations have been recently reviewed in order to assess the relationship between the epileptogenic zone (EZ), the tumor, and associated focal cortical dysplasia (FCD), and to determine optimal strategy for curing epilepsy. Based on a large series (78 patients, 50 male, aged 3-54 years, temporal location 73%, nonspecific forms 68%), we found similar electroclinical data in all DNT subtypes, and demonstrated that magnetic resonance imaging (MRI) features allow differentiation of histologic subtypes. Type 1 (cystic/polycystic-like) always corresponded to complex or simple forms, whereas type 2 (nodular-like) and type 3 (dysplastic-like) corresponded to nonspecific forms. It is notable that we demonstrated intrinsic epileptogenicity in all cases, but found that the EZ differed significantly according to MRI subtype, colocalizing with the tumor in type 1 MRI, including perilesional cortex in type 2 MRI, and involving extensive areas in type 3 MRI. The main prognostic factors for favorable outcome (83% of seizure-free patients) were complete tumor and EZ removal, short epilepsy duration, and lack of cortico-subcortical damage. According to these findings, surgical resection may be restricted to the tumor in type 1 MRI but should be more extensive in other MRI subtypes, especially in type 3 MRI. This MRI-based scheme may be helpful for optimal resection in epilepsy due to DNTs. In addition, we emphasize that early surgery is crucial in curing epilepsy. © 2013 International League Against Epilepsy.
Even C.,Center Hospitalier Sainte Anne |
Weintraub D.,University of Pennsylvania
Psychiatry and Clinical Neurosciences | Year: 2010
Aims: The aims of this study were to assess the epidemiological, phenomenological, and pathophysiological evidence that suggests the specificity of depression associated with Alzheimer's disease (AD). Methods: We reviewed the English-language literature. Results: Depression occurs significantly more often in patients with AD than in the general elderly population. While development of depression in response to the disability and emotional stress of AD may be a contributory factor in some patients, several studies showed that depression was not, or was only seldom, related to self-awareness of AD and these studies could not explain the high prevalence figures. To overcome the overlapping phenomenology of the two diseases, specific diagnostic criteria have been developed for depression in this context. Mixed findings have come from neuropathological and neuroimaging studies, with some evidence linking the underlying neural substrate of AD and depression, suggesting an overlapping cause of primary depression and depression comorbid with AD. Few randomized controlled trials for depression associated with AD have been conducted, with rather poor results for the use of antidepressants. Conclusions: Currently, depression associated with AD is not considered a separate disorder by regulatory authorities and is unlikely to be considered as such in the near future. Several obstacles remain to support such a specific position, including the heterogenous nature of depression in general and within AD itself, the lack of a distinct set of symptoms, and limited treatment. Journal compilation © 2010 Japanese Society of Psychiatry and Neurology.
Even C.,Center Hospitalier Sainte Anne |
Even C.,French Institute of Health and Medical Research |
Weintraub D.,University of Pennsylvania |
Weintraub D.,Parkinsons Disease and Mental Illness Research
Journal of Affective Disorders | Year: 2012
Background: Clinical lore and research have suggested for a long time that depression and PD are closely related. We examined the validity of depression associated with PD (dPD) as a specific subtype of depression according to face validity, descriptive validity, construct validity and predictive validity. Methods: The English literature was reviewed after searching the MEDLINE database up to June 2010. Results: There appears to be three possible subtypes of comorbid depression: 1) patients who would have been depressed even if they had no PD (nonspecific-casual comorbid dPD), 2) patients who would have been depressed if they had had another disabling medical illness (nonspecific- reactive comorbid dPD) 3) those for which depression is directly related to the underlying pathophysiology of PD (specific comorbid dPD). These latter patients may more often present with particular clinical characteristics (descriptive validity): absence of history of depression or only within 5 years prior to onset of PD, absence of guilty thoughts and self-blame, absence of suicidal behavior, right-sided onset. However, dPD is only partly responsive to dopamine replacement and cannot be solely explained by dopamine deficiency. Other neurotransmitter systems are affected in PD and are involved in the pathophysiology of dPD. Their relative involvement however may differ from that in idiopathic depression (i.e.: lesser involvement of serotonergic systems). Limitations: Therapeutic data are limited to few controlled trials. Conclusions: Further research may allow differential diagnosis between dPD subtypes (i.e.: those who do and do not result from the underlying pathophysiological process of PD) and help inform treatment choice. © 2011 Elsevier B.V. All rights reserved.
Perouse de Montclos M.-O.,Center hospitalier Sainte Anne
Archives de Pediatrie | Year: 2011
Child psychiatry consultations specialised in filiation and international adoption help adopted children with psychological troubles and their adoptive parents. Regardless to this experience and to recent issues in the fields of attachment and narrativity, psychotraumatism and transcultural, some psychological risk factors for internationnally adopted children are described, requiring specialised psychological help. © 2011.
Roussely B.,Center Hospitalier Sainte Anne
Soins Cadres de Sante | Year: 2016
An announcement usually becomes unpopular when it is perceived uniquely in terms of the events. However, when a systemic approach is adopted, the announcement takes on new, meaningful dimensions. The announcement may remain unpopular without it necessarily being rejected. The systemic approach of an interpretive framework, by making sense, changes the way announcements are received, whether they are unpopular or popular. © 2016 Elsevier Masson SAS.
Guedj-Bourdiau M.-J.,Center hospitalier Sainte Anne
Annales Medico-Psychologiques | Year: 2011
Home confinement is, at first, a limitation to the family home and then almost exclusively within the bedroom, with social withdrawal, and more or less marked retreat of family relationships; so the rhythm of sleep and meals is not anymore in adequation with the usual domestic cycle. Nowadays, an immoderate use of computers and Internet is almost always associated to this confinement. We use the terms of confinement, social withdrawal, Housebound syndrome, Hikikomori, for former or current descriptions, in various countries, and not only in Japan. On the nosographic level, the associated use of the Internet cannot clearly be called addiction, but these events are sometimes considered as part of various diseases taking into account the particularities of culture, sometimes as a distinct syndrome for future DSM. Regarding 21 cases of these young people that we have met at home, after one, or more, visits of their families, who came by their own to ask for help in an emergency department, we observed that such conduct and confinement tend to recur. It is why, making contact with these young people, and the question of hospitalization can be usefully discussed. © 2011 Elsevier Masson SAS.
Petitjean F.,Center hospitalier Sainte Anne
Annales Medico-Psychologiques | Year: 2011
This article aims to review current data concerning the therapeutical benefits of psychoeducation for schizophrenic patients and their siblings. Clinical and psychological dimensions such as relapses, quality of life and insight are considered. Many international studies have demonstrated the link between psychoeducation and clinical improvement. In France, we should go on promoting psychoeducation because we still face some resistances to the implementation of psychoeducation programs in some care structures. © 2011 Elsevier Masson SAS.
Akinetic mutism and bilateral pallidal lesion following hydroxyzine poisoning. A case study [Mutisme akinétique et lésion bipallidale après intoxication médicamenteuse à l'hydroxyzine. À propos d'un cas]
Rubio M.,Center hospitalier Sainte Anne
Evolution Psychiatrique | Year: 2016
Aims: When managing a suicide-attempting patient, the psychiatrist needs to exclude all possibilities of neurological sequellae that might alter or explain the psychiatric presentation. Methods: We present a case-study of intentional hydroxyzine poisoning and a review of the literature on akinetic mutism (AM) and bilateral pallidal lesion (BPL). Results: This case illustrates a clinical situation in which cerebral imagery reoriented the psychiatric management in favour of neurological rehabilitation treatment. The language disturbance, initially interpreted as a manifestation of psychotic negativity, evolved following the discontinuation of the usual treatment from mutism to motor aphasia. Cerebral MRI concluded to a recent BPL. Retrospective interpretation of the initial clinical presentation led to the diagnosis of AM secondary to post-anoxia encephalopathy. Discussion: AM, first described in 1943, is not well-known among psychiatrists, since it belongs to the area of neurology. Yet this diagnosis enables an accurate description of our patient's behaviour. AM is distinct from catatonia by way of certain behavioural features, but above all by the absence of any psychopathological development. This raises the issue of the anatomical-clinical correlation between a behavioural manifestation and a detectable lesion. The causal relationship between the clinical semiology of MA and the radiological semiology of BPL is compromised by the clinical polymorphism of patients with BPL and the anatomical or radiological polymorphism of AM. Conclusion: Like catatonia, AM raises the question of the borderline between neurology and psychiatry. The poor anatomical-clinical correlation and the prognostic uncertainty suggest the need to reappraise AM from a psychopathological and nosographic viewpoint. © 2015 Elsevier Masson SAS.
Calvet D.,University of Paris Descartes |
Calvet D.,Center Hospitalier Sainte Anne |
Mas J.-L.,University of Paris Descartes |
Mas J.-L.,Center Hospitalier Sainte Anne
Current Opinion in Neurology | Year: 2014
PURPOSE OF REVIEW: This review discusses current evidence on patent foramen ovale (PFO) closure compared with medical therapy alone in the prevention of stroke recurrence in patients with a PFO-associated cryptogenic stroke. RECENT FINDINGS: The Risk of Paradoxical Embolism group built a 10-point Score, based on clinical parameters, that estimates the probability of finding a PFO in a patient with cryptogenic stroke and the probability that a PFO discovered in the setting of cryptogenic stroke is related to stroke vs. incidental.Three recent randomized clinical trials failed to demonstrate the superiority of PFO closure over medical treatment alone in preventing stroke recurrence in patients aged 18-60 years who have had a cryptogenic stroke or transient ischemic attack. SUMMARY: Stronger evidence in favor of PFO closure is needed before recommending this procedure outside of a clinical trial. Results of ongoing trials are much awaited. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.
Dubois A.-M.,Center hospitalier Sainte Anne
Annales Medico-Psychologiques | Year: 2010
The Centre d'Étude de l'Expression at the Sainte-Anne Mental Health Hospital is a particular unit of the hospital in the university clinic. This centre is specialized in psychotherapy through art, and there are 30 workshops of art therapy per week. The techniques used are painting, modeling, music, dance, theatre and creative writing. Each workshop is conducted by a professional specialized in art therapy and has much experience in this field. The way of being admitted into the workshops of art therapy is systematic. It is the same for all the workshops. Patients with nutritional problems are often capable of verbally expressing themselves at a good level. However, for them, the use of speech is not a way of communicating, neither with themselves nor with others. No verbal and artistic psychotherapies are then very useful and specific. © 2010 Elsevier Masson SAS.