B Nater

University Hospital of Lausanne, Lausanne, Vaud, Switzerland

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Publications (25)104.18 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: In 2014, breastfeeding during maternal antiepileptic therapy seems to be safe for the children and can be recommended. Intravenous thrombolysis by Alteplase improves the outcome after a stroke if administered within 4.5 hours and it is also recommended in elderly population over 80 years. ProSavin genic therapy for Parkinson disease is under investigation. The Transcranial Magnetic Stimulation (TMS) has an analgesic effect in neuropathic pain as well as an antidepressant effect. Antagonists of calcitonin gene-related peptide can have a beneficial role in migraine prevention. Diagnostic biomarker panels for Alzheimer disease are under investigation. Oral teriflunomide and dimethyl fumarate (BG-12) for relapsing multiple sclerosis treatment are now available in Switzerland.
    Revue médicale suisse 01/2015; 11(456-457):91-6.
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    ABSTRACT: In 2013, perampanel is approved as an add-on treatment for generalised and focal seizures in pharmaco-resistant epilepsy. New anticoagulants are superior to antivitamin K in stroke secondary prevention in case of atrial fibrillation. DBS remains a valid therapeutic option for advanced Parkinson's disease. Intranasal ketamine seems to reduce the intensity of severe migraine aura. High concentrations of topic capsaicin improve post-herpetic neuralgia. In Alzheimer's disease, statins might deteriorate cognitive functions. Oral immuno-modifing treatments for relapsing remitting multiple sclerosis have shown to slow cerebral atrophy progression at two years.
    Revue médicale suisse 01/2014; 10(412-413):78-81.
  • COMPAS, Edited by Jacques Cornuz, Olivier Pasche, Tessa Kermode-Noppel, 01/2014: chapter 39: pages 531–44; Médecine & Hygiène., ISBN: 978-2-88049-354-7
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    ABSTRACT: In 2012, intramuscular midazolam appears as effective as intravenous lorezepam for the first line treatment of convulsive status epilepticus. Perampanel, a new anti-epileptic drug, will be soon available. Two oral treatments are now available for stroke prevention in atrial fibrillation setting. The methylphenidate and the Tai Chi could increase the walk capacity of patients suffering from Parkinson disease. A comprehensive cardiac work-up is essential for some congenital myopathy. A new drug against migraine seems free from vasoconstrictive effect. Antioxidants are harmful in Alzheimer disease. Some oral medication will be available for multiple sclerosis.
    Revue médicale suisse 01/2013; 9(368):62-5.
  • Bernard Nater · Catherine Dozier
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    ABSTRACT: Chronic primary headache often cause significant interference with function and quality of life despite acute and preventive medicines. New treatments are emerging for pharmacologically intractable cluster headache and migraine. Occipital nerve stimulation in chronic cluster headache and botulinum toxin in chronic migraine represent the most promising therapies.
    Revue médicale suisse 05/2012; 8(339):937-8, 940-1.
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    ABSTRACT: This article summarizes the main therapeutic advances of 2010 in the field of neurology. It focuses on aspects that are likely to change the care of patients in clinical practice. Among these, we discuss the new oral treatments that have proved to be effective in multiple sclerosis, the results of two large studies comparing endarterectomy and stenting in carotid stenosis, novel therapeutic approaches for the treatment of non-motor symptoms in Parkinson's disease as well as the results of several pharmacological studies in the field of epilepsy.
    Revue médicale suisse 01/2011; 7(277):50-6.
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    ABSTRACT: This article summarize principal news about treatments in the different specialities in neurology. We don't pretend to be exhaustive and to make a detailed analyse of all treatments, and preferred to present pertinent therapeutic advances, with an evidence-based point of view. We also mentioned some negative studies, to balance our purpose.
    Revue médicale suisse 01/2010; 6(231):37-45.
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    ABSTRACT: The neurology field has been greatly improved in 2008. The therapeutic window of intravenous thrombolysis for acute ischemic stoke is extended to 4 h 30. New studies show that the clinical progression of Parkinson's disease might be slowed by some medication. Deep brain stimulation may be beneficial early in the course of the disease. Tysabri and Fingolimod in multiple sclerosis are discussed. The pharmacopoeia for epilepsy is in constant development with new products recently released in Switzerland. CGRP receptor antagonists are about to be launched as a promising acute migraine treatment. The pharmacological approach in amyotrophic lateral sclerosis patients might be improved according to research results.
    Revue médicale suisse 02/2009; 5(185):39-44, 46-8.
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    ABSTRACT: Acute non-traumatic headache is a frequent complaint in emergency primary care. In the majority of cases, the cause is a primary headache, which can be invalidating, but should not lead to additional investigations. Secondary headaches are rare but their diagnosis is essential to avoid potentially lethal consequences. In practice, a primary headache may be difficult to differentiate from a secondary headache, especially if the initial management does not follow a systematic approach. We have adapted evidence-based guidelines to improve the diagnostic management of patients presenting acute headache. We propose an algorithm that facilitates the systematic screening of alert signs with a focused patient history and clinical exam. In the presence of red flags, appropriate complementary exams are needed to rule out a secondary headache.
    Revue médicale suisse 09/2008; 4(167):1741-6.
  • F Regli · B Nater
    Revue medicale de la Suisse romande 02/2000; 120(1):81-3.
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    ABSTRACT: We report a female patient presenting with trigeminal neuropathy; further investigations allowed to diagnose a primary Sjögren's syndrome. A short literature review about epidemiology, clinical aspects and pathophysiology follows. In our case the unusual detection of a trigeminal lesion in MRI points to a peripheral aetiology of this clinical manifestation. In presence of a trigeminal neuropathy one should always consider the possibility of an autoimmune collagen disease.
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    ABSTRACT: We report four patients with various degrees of chronic, tonic, mildly painful, or non-painful, kyphoscolioses in orthostatism, which developed weeks, or months, after one or several laminectomies for lumbar disk hernia, in the absence of recurring radicular pain or acute lumbar pain. No family history or personal antecedent, of focal or generalized dystonia was found and the dystonia was not seen in any of the four patients pre-operatively, or during the immediate post-operative period. Only ill-defined lumbar 'discomfort', unlike their pre-operative lumbago, was reported by the patients, before and during the occurrence of the pathologic trunk posture on standing. Asymmetric lumbar muscle tonic contraction and hypertrophy was found on physical examination. In all patients, the kyphoscoliosis was maximal when standing, partially disappeared when seated, and completely when lying down. One patient responded well to clonazepam, but the other three showed no improvement with either clonazepam or local injections of botulinum toxin; L-dopa was ineffective in all cases, and trihexiphenidyle in three.
    Journal of the Neurological Sciences 12/1997; 152(2):193-7. DOI:10.1016/S0022-510X(97)00186-X · 2.26 Impact Factor
  • B Nater
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    ABSTRACT: Acute headaches can be an important signal of a cerebrovascular event. In some cases, as illustrated in this article, such headaches may have the same characteristics as migraine or be the main feature of unusual types of cerebrovascular disease. Headache should not be underestimated since misdiagnosis of cerebrovascular disease can lead to serious consequences.
    Revue medicale de la Suisse romande 10/1997; 117(9):687-90.
  • L Regli · B Nater · F Regli · N de Tribolet
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    ABSTRACT: Headache is a common complaint in emergency departments, but only a small percentage of patients have a serious disease. Nevertheless, some forms of headache, such as "warning headaches", need special attention. By far the most common symptom associated with aneurysmal minor bleed (warning leak) is a sudden headache that is considered to be a warning symptom of impending aneurysmal rupture. In the presence of sudden severe headache with or without meningeal signs or nausea, subarachnoid hemorrhage should always be considered. Recognition of these warning headaches probably offers the best opportunity of reducing the otherwise serious mortality and morbidity of aneurysmal subarachnoid hemorrhage. This report describes 7 non-consecutive patients presenting warning headaches before major aneurysm rupture. Based on our experience and a review of the literature, we recommend a management algorithm for patients presenting with sudden severe headache.
    Schweizerische medizinische Wochenschrift 05/1997; 127(16):668-74. · 1.68 Impact Factor
  • B Nater
    Revue medicale de la Suisse romande 09/1996; 116(8):587-9.
  • F Regli · B Nater · N Dworak
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    ABSTRACT: Pathophysiology and principles for diagnosis of migraine, in particular ways to obtain an accurate history between attacks, are presented in the introduction. Identification of migraine triggers is an extremely important part of migraine therapy. Selected pain-relieving drugs should include primarily simple analgesics and antiemetics, while sumatriptan should be reserved mainly for severe migraine attacks. Pharmacotherapy, psychological and physical therapy are all components of a systemic approach to the treatment of migraine. To discontinue overused medication is the first step in the prevention of migraine. A number of available drugs are able to reduce the frequency and severity of migraine attacks. Several considerations should be evaluated before symptomatic and prophylactic therapies are introduced. Our strategies are based on experience collected during the treatment of 82 patients.
    Praxis 10/1995; 84(38):1032-5.
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    ABSTRACT: Background. A number of studies have demonstrated the efficacy of oral anticoagulant therapy in reducing the risk of stroke and systemic embolism in patients with nonrheumatic atrial fibrillation, However, both the targeted and the actual levels of anticoagulation differed widely among the studies, and a number of studies failed to report standardized prothrombin-time ratios as international normalized ratios (INRs), We therefore performed an analysis to determine the intensity of oral anticoagulant therapy in nonrheumatic atrial fibrillation that provides the best balance between the prevention of thromboembolism and the occurrence of bleeding complications. Methods. We calculated INR-specific incidence rates for both ischemic and major hemorrhagic events occurring in 214 patients who received anticoagulant therapy in the European Atrial Fibrillation Trial, a secondary-prevention trial in patients with nonrheumatic atrial fibrillation and a recent episode of minor cerebral ischemia. Results. The optimal intensity of anticoagulation was found to lie between an INR of 2.0 and an INR of 3.9. No treatment effect was apparent with anticoagulation below an INR of 2.0, The rate of thromboembolic events was lowest at INRs from 2.0 to 3.9, and most major bleeding complications occurred with treatment at intensities with INRs of 5.0 or above. Conclusions. To achieve optimal levels of anticoagulation with the lowest risk in patients with atrial fibrillation and a recent episode of cerebral ischemia, the target value for the INR should be set at 3.0, and values below 2.0 and above 5.0 should be avoided.
    New England Journal of Medicine 07/1995; 333(1):5-10. · 54.42 Impact Factor
  • B Nater · J Bogousslavsky
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    ABSTRACT: Clinical features of the carotid artery syndromes are reviewed. Limited infarction cause typical clinical syndromes. However, in most cases, embolic occlusion is multiple and produces various clinical syndromes.
    La Revue du praticien 01/1994; 43(19):2457-63.
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    ABSTRACT: Several studies have established the value of anticoagulation for primary prevention of thromboembolic events in patients with non-rheumatic atrial fibrillation (NRAF). However, in patients with a recent transient ischaemic attack (TIA) or minor ischaemic stroke the preventive benefit of anticoagulation or aspirin remains unclear. Physicians in 108 centres from 13 countries collaborated to study this question. 1007 NRAF patients with a recent TIA or minor ischaemic stroke were randomised to open anticoagulation or double-blind treatment with either 300 mg aspirin per day or placebo (group 1, 669). Patients with contraindications to anticoagulation were randomised to receive aspirin or placebo (group 2, 338). The measure of outcome was death from vascular disease, any stroke, myocardial infarction, or systemic embolism. During mean follow-up of 2.3 years, the annual rate of outcome events was 8% in patients assigned to anticoagulants vs 17% in placebo-treated patients in group 1 (hazard ratio [HR] 0.53; 95% confidence interval [CI] 0.36-0.79). The risk of stroke alone was reduced from 12% to 4% per year (HR 0.34; 95% CI 0.20-0.57). Among all patients assigned to aspirin (groups 1 and 2), the annual incidence of outcome events was 15%, against 19% in those on placebo (HR 0.83; 95% CI 0.65-1.05). Anticoagulation was significantly more effective than aspirin (HR 0.60; 95% CI 0.41-0.87). The incidence of major bleeding events was low, both on anticoagulation (2.8% per year) and on aspirin (0.9% per year). No intracranial bleeds were identified in patients assigned to anticoagulation. We conclude that anticoagulation is effective in reducing the risk of recurrent vascular events in NRAF patients with a recent TIA or minor ischaemic stroke. In absolute terms: 90 vascular events (mainly strokes) are prevented if 1000 patients are treated with anticoagulation for one year. Aspirin is a safe, though less effective, alternative when anticoagulation is contraindicated; it prevents 40 vascular events each year for every 1000 treated patients.
    The Lancet 11/1993; 342(8882):1255-1262. DOI:10.1016/0140-6736(93)92358-Z · 45.22 Impact Factor
  • B Nater · F Regli
    Revue medicale de la Suisse romande 08/1993; 113(7):563-4.