O Gout

Publications (74)404.97 Total impact

• Article: [Free floating thrombus on carotid megabulb or suspended bulb: what kind of dysplasia?].

  E Ukkola-Pons, J-C Sadik, N Champtiaux, J Savatovsky, F Heran, O Gout, M Obadia
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  ABSTRACT: Floating carotid thrombi are a rare cause of stroke mostly associated with atheromatous plaques, cardiogenic emboli, arterial dissections and systemic diseases related to coagulopathic states or iron deficiency anaemia. We report the cases of two patients with stroke and carotid megabulb or suspended bulb associated with floating thrombus. These findings are rarely described probably related to a form of arterial dysplasia and seem to be responsible of local haemodynamic modifications.
  Revue Neurologique 06/2011; 168(1):53-6. · 0.49 Impact Factor
• Article: Mural aortic thrombi, what else?

  N Benyounes, M Obadia, O Gout
  Revue Neurologique 04/2011; 167(11):859-61. · 0.49 Impact Factor
• Article: Non compaction cardiomyopathy: a rare cause of cerebral infarction in a young adult.

  N Benyounes, M Obadia, O Gout
  Revue Neurologique 03/2011; 167(4):356-7. · 0.49 Impact Factor
• Source

  Available from: cnrs.fr

  Article: Prior suggestive symptoms in one-third of patients consulting for a "first" demyelinating event.

  O Gout, C Lebrun-Frenay, P Labauge, G E Le Page, P Clavelou, S Allouche
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  ABSTRACT: To evaluate the prevalence of prior inflammatory events in patients consulting for a first inflammatory neurological event and improve early diagnosis of multiple sclerosis. During the initial visit, the neurologist gave patients a self-administered questionnaire containing 72 questions regarding previous symptoms lasting >24 h. During the follow-up visit, the neurologist validated the symptoms and collected information about the current attack. The cohort included 178 patients (74% women, mean age (SD) 33.7 (10.1) years). The main reason for the initial visit was visual disturbance and sensory troubles in limbs. Mean (SD) global Expanded Disability Status Scale score was 1.4 (1.1), 46% of brains MRIs were positive according to Barkhof-Tintoré criteria, 41% had abnormal white blood cell count in cerebrospinal fluid and 71% had immunoglobin G oligoclonal bands. Prior symptoms suggestive of demyelination were reported by 79 patients (44%), validated by the neurologist for 70% (55 patients) and identified only by the neurologist in four patients. Sequelae were observed in 14 patients with validated prior symptoms (26%). The self-administered questionnaire showed an overall sensitivity of 93% and specificity of 80% for identifying patients with prior symptoms suggestive of demyelination. A patient-administered questionnaire subsequently validated by the neurologist demonstrated that 33% of patients consulting for a first demyelinating event had prior symptoms suggestive of central nervous system demyelination that had gone unnoticed, and almost 70% had either sequelae of prior demyelination or McDonald criteria for dissemination in space. Such a questionnaire could be a useful tool for earlier diagnosis of multiple sclerosis.
  Journal of neurology, neurosurgery, and psychiatry 03/2011; 82(3):323-5. · 4.87 Impact Factor
• Article: [Intracranial hypertension and lupus].

  E Maillart, A Gueguen, M Obadia, A Moulignier, C Vignal-Clermont, O Gout
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  ABSTRACT: Idiopathic intracranial hypertension (IH) occurs most commonly in women and overweight subjects. It must be reported associated to general diseases, like systemic lupus erythematosus (SLE). We report an observation of a patient with lupus complicated by glomerulonephritis and IH. A 29 years old woman, without overweight, was followed for a SLE with skin and arthritic involvement . Four years after onset, a renal complication appeared with severe nephrotic syndrome. Six weeks after, bilateral papillar oedema was discovered, revealing an IH, as the patient was treated by oral steroids at 1mg/kg/d and bimonthly intravenous cyclophosphamide. The patient was completely asymptomatic. Brain MRI with veino-RMN was normal, without cerebral venous thrombosis. Lumbar punction showed an elevated opening pressure of 30,5 cmH(2)0 but with normal cerebrospinal fluid (CSF) contents. Evacuation of 30 mL of CSF and immunosuppressive treatment allowed symptoms regression. Twenty-seven cases of IH associated to SLE with nephritis have been reported in literature. Young women are more frequently involved with in half of cases a diffuse proliferative glomerulonephritis. Predisposing factors, like anaemia, must be associated. IH allows SLE diagnose in more than the third of the cases. Then, SLE has to be searched as an etiology of IH, in particular in non-obese patients and when nephritis is associated.
  Revue Neurologique 03/2011; 167(6-7):505-10. · 0.49 Impact Factor
• Article: High-risk syndrome for neuromyelitis optica: a descriptive and comparative study.

  N Collongues, R Marignier, H Zéphir, F Blanc, S Vukusic, O Outteryck, M Fleury, A Ruet, F Borgel, E Thouvenot, [......], B Audoin, M Debouverie, P Labauge, O Gout, W Camu, D Brassat, B Brochet, P Vermersch, C Confavreux, J de Seze
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  ABSTRACT: Neuromyelitis optica (NMO) frequently begins with a monofocal episode of optic neuritis or myelitis. A concept named high-risk syndrome (HRS) for NMO has been proposed for patients with monofocal episodes and NMO-IgG antibodies. To describe HRS patients and compare them with NMO patients. We identified 30 patients with HRS: 18 with extensive myelitis (HRM) and 12 with optic neuritis (HRON), in a database pooling patients from 25 centres in France. Clinical, laboratory/magnetic resonance imaging (MRI) data and outcome were analysed and compared with a national cohort of 125 NMO patients extracted from the same database. Mean follow-up was 4.8 years. Mean age at onset was 42.8 years (range: 12.4-70) with a female:male ratio of 0.9. Asymptomatic lesions were report on visual evoked potentials in 4/8 tested HRM patients and on spinal cord MRI in 2/7 HRON patients. Three patients died, two owing to a cervical lesion. HRS and NMO patients had similar clinical/paraclinical data, except for a predominance of men in the HRS group and a later mean age at onset in the HRM subgroup. The description of HRS patients is compatible with a monofocal form of NMO. Asymptomatic lesions could be included in a new set of NMO diagnostic criteria.
  Multiple Sclerosis 01/2011; 17(6):720-4. · 4.26 Impact Factor
• Article: Magnetic resonance spectroscopy findings in a case of hyperglycaemic hemianopia.

  A Guez, M Obadia, F Lafitte, S Nwing Tin, F Héran, O Gout
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  ABSTRACT: Patients with nonketotic hyperglycaemia may present with neurological manifestations, including hemianopia. Thus far, the pathophysiology of such neurological events remains unknown, although the findings on magnetic resonance imaging (MRI) may help to elucidate the underlying mechanisms. This report describes a patient who had an episode of homonymous hemianopia, which coincided with a state of nonketotic hyperglycaemia. Initial MRI showed hypointense areas on T2-weighted and FLAIR sequences, involving the internal portion of the right occipital cortex and adjacent white matter, with mild hyperintensity on diffusion-weighted imaging. Magnetic resonance spectroscopy revealed significant increases in cerebral metabolites. Dramatic clinical and neuroimaging improvements were progressively observed over 3 weeks, following rehydration and normalization of blood glucose levels with insulin therapy. In this patient, magnetic resonance spectroscopy was used in combination with other neuroimaging methods and clinical evidence to suggest that hyperosmolality leading to intracellular dehydration in localized brain regions should be considered a potential underlying mechanism responsible for reversible neurological symptoms in nonketotic hyperglycaemia.
  Revue Neurologique 03/2010; 166(8-9):737-40. · 0.49 Impact Factor
• Source

  Available from: Bruno Barroso

  Article: Neuromyelitis optica in France: a multicenter study of 125 patients.

  N Collongues, R Marignier, H Zéphir, C Papeix, F Blanc, C Ritleng, M Tchikviladzé, O Outteryck, S Vukusic, M Fleury, [......], D Rodriguez, S Wiertlewski, D Laplaud, F Borgel, P Tourniaire, J Grimaud, B Brochet, P Vermersch, C Confavreux, J de Seze
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  ABSTRACT: There have been few epidemiologic studies on neuromyelitis optica (NMO) and none used the recent 2006 diagnostic criteria. Here we describe the clinical, laboratory, MRI, and disability course of NMO in a French cohort of 125 patients. We performed an observational, retrospective, multicenter study. Data were collected from September 2007 through August 2008, corresponding to the endpoint of the study. We identified 125 patients fulfilling the 2006 NMO criteria. Selection was made using hospital files and a specific clinical questionnaire for NMO. Mean age at onset was 34.5 years (range 4-66) with a mean disease duration of 10 +/- 7.8 years at the endpoint. The patients were mainly (87%) Caucasian, with a female:male ratio of 3:1. In 90% of cases, the association of optic neuritis, longitudinal extensive myelitis, and a Paty-negative initial brain MRI was sufficient to fulfill the supportive criteria. Eighty-eight percent of patients were treated with immunosuppressive therapies. Median delay from onset to Expanded Disability Status Scale (EDSS) score 4 was 7 years; score 6, 10 years; and score 7, 21 years. The first episode of myelitis was immediately followed by an EDSS score > or = 4 in 37.3% of cases, and a severe residual visual loss was observed in 22% of patients after the first episode of optic neuritis. Multivariate analysis did not reveal any predictors of a poor evolution other than a high number of MRI brain lesions at diagnosis, which were predictive of a residual visual acuity < or = 1/10. Our demographic data provide new data on disability in patients with neuromyelitis optica, most of whom were receiving treatment.
  Neurology 03/2010; 74(9):736-42. · 8.31 Impact Factor
• Article: [Susac syndrome: study of five cases].

  E Maillart, R Deschamps, A Moulignier, C Vignal-Clermont, M Obadia, Y Le Mer, L Laloum, O Gout
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  ABSTRACT: Susac syndrome is a rare microangiopathy, responsible for small cerebral, retinal and cochlear infarcts. The classic clinical triad includes multiple neurologic signs (from headaches to coma), retinal branch occlusions and sensorineural hearing loss. We report a series of five patients with Susac syndrome followed in our department from 1997 to 2007. There were four women and one man (mean age at onset: 35.2 years). Clinical symptoms at onset were neurological (n=1), ophthalmological (n=1), auditory (n=1) and clinical triad (n=2). Neurologic symptoms included encephalopathy (n=2), headache (n=5), transient ischemic attacks (n=1). Brain MRI showed T2 lesions in the white and grey matter, corpus callosum and gadolinium-enhanced punctiform lesions. Cerebrospinal fluid contained an elevated protein level in three cases. Immunologic treatments (steroids [n=4], cylophosphamid [n=3], intravenous immunoglobulins [n=5]) associated with aspirin and/or oral anticoagulants, despite early relapses (n=2), led to dramatic clinical improvement (n=5). Due to its polymorphism the SS is difficult to diagnose when the clinical triad is lacking. In the absence of clinical trial and consensus treatment is empiric and based on supposed pathogenesis.
  Revue Neurologique 02/2009; 165(6-7):575-82. · 0.49 Impact Factor
• Article: [Use of mitoxantrone in early multiple sclerosis with malignant disease course. Observational study in 30 patients with clinical and MRI outcomes after one year].

  S Ory, M Debouverie, E Le Page, J Pelletier, I Malikova, O Gout, E Roullet, P Vermersch, G Edan
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  ABSTRACT: In an observational multicenter study, we analyzed retrospectively 30 patients with malignant form of multiple sclerosis (MS) treated with mitoxantrone the year following the first neurological event. The 30 patients were selected according to Weinshenker criteria of malignant MS (either a "catastrophic" relapse or a quickly aggressive form). We compared clinical and MRI findings the year before with the year following mitoxantrone onset treatment: annualized relapse rates (ARR), EDSS score and percentage of patients with gadolinium enhancing lesions on MRI. A total of 87 relapses were observed in the 5.7 months before and 10 during the year following onset of mitoxantrone treatment. The ARR decreased by 95% (6.0+/-2 before and 0.3+/-0.7 after). Twenty-four patients (80%) were relapse-free one year after onset of mitoxantrone treatment. The EDSS score improved in 87% of MS patients and the mean EDSS decreased by 1.9. Ninety-seven percent had at least gadolinium enhancing lesions before the start of mitoxantrone treatment as compared to 17% after. In our experience, mitoxantrone had a rapid and strong impact on the malignant forms of MS with a short disease duration. In this MS subgroup, mitoxantrone should be considered as an early treatment option.
  Revue Neurologique 07/2008; 164(12):1028-34. · 0.49 Impact Factor
• Article: [Bilateral papilledema: prospective study of fifty patients].

  R Deschamps, C Dehais, F Heran, M Obadia, L Laloum, C Fechner, C Vignal-Clermont, O Gout
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  ABSTRACT: In this prospective study, we report fifty consecutive cases of bilateral papilledema without neurosurgical or obvious ophthalmologic etiology, referred to our institution between January 2005 and March 2007. Lumbar puncture with opening CSF pressure measurement distinguished two groups of patients: Group 1 (n=39) with and Group 2 (n=11) without intracranial hypertension. In Group 1, 9/39 patients presented secondary intracranial hypertension mainly due to cerebral venous thrombosis. In 30 patients, after complete investigations, a diagnosis of idiopathic intracranial hypertension was made: as commonly reported, patients were predominantly overweight (96.7% with body mass index>25kg/m2) young (mean age=27.6 years) and women (96.7%). Eleven patients with intracranial hypertension had no headaches. In Group 2, the most common diagnosis was bilateral non-arteritic anterior ischemic optic neuropathy, but rare causes have been identified.
  Revue Neurologique 01/2008; 164(1):42-6. · 0.49 Impact Factor
• Article: Immunosuppressive therapy is more effective than interferon in neuromyelitis optica.

  C Papeix, J-S Vidal, J de Seze, C Pierrot-Deseilligny, A Tourbah, B Stankoff, C Lebrun, T Moreau, P Vermersch, B Fontaine, O Lyon-Caen, O Gout
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  ABSTRACT: To determine long-term treatment (LTT) of neuromyelitis optica (NMO), we retrospectively reviewed therapies of 26 patients with NMO followed in five French neurological departments. To assess LTT efficacy, the probability of relapse free after LTT was analysed. Patients were divided into two groups according to the first treatment receiving interferon beta (IFN Group, seven patients) or immunosuppressants (IS Group, 19 patients). The probability of relapse was significantly lower in the IS Group (P =0.0007). From our results, interferon beta is not recommended, and one of the best current therapeutic options for NMO appears to be immunosuppressants.
  Multiple Sclerosis 04/2007; 13(2):256-9. · 4.26 Impact Factor
• Article: [Neuro-ophthalmologic initial presentation of sarcoidosis].

  C Lamirel, I Badelon, O Gout, K Berthet, F Héran, L Laloum, I Cochereau, A Gaudric, M-G Bousser, C Vignal-Clermont
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  ABSTRACT: To describe different forms of neuro-ophthalmologic onset of sarcoidosis: clinical signs, means of diagnosis, treatment, and progression. Retrospective study of 13 patients with neuro-ophthalmologic initial onset of sarcoidosis diagnosed in three departments between 1997 and 2003. There were ten women and three men, with a mean age of 36 years. Six patients suffered from diplopia. In three cases, the cavernous sinus was involved; the three other patients with diplopia had meningoradiculitis. Nine patients had infiltration of the anterior visual pathway: the optic nerve was involved in five cases, the chiasm in two cases, and two patients had papilledema. Two patients also had both symptoms. The dosage of the angiotensin-converting enzyme level was evaluated in 11 patients and was elevated in six cases. Nine patients underwent a lumbar puncture; the cerebrospinal fluid protein was high in seven cases. Chest radiography and CT were abnormal in nine cases of 11. Ten patients had histological proof of sarcoidosis; the three others had enough evidence to support this diagnosis. All of them were treated with systemic corticosteroids. The diplopia improved for the six patients. Among the seven patients with optic nerve or chiasmal infiltration, one recovered completely, two were partially improved, and four remained stable. Diplopia and anterior visual pathway abnormalities can be the manifestation of initial onset of sarcoidosis; therefore this diagnosis must be kept in mind when these frequent neuro-ophthalmologic signs are encountered. Complementary exams, mainly biopsy of the involved areas with histological analysis, are needed to confirm this diagnosis. Corticosteroid treatment is generally followed by improvement, but relapses may occur.
  Journal francais d'ophtalmologie 04/2006; 29(3):241-9. · 0.51 Impact Factor
• Article: Idiopathic acute transverse myelitis: application of the recent diagnostic criteria.

  J de Seze, C Lanctin, C Lebrun, I Malikova, C Papeix, S Wiertlewski, J Pelletier, O Gout, C Clerc, C Moreau, G Defer, G Edan, F Dubas, P Vermersch
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  ABSTRACT: Despite an extensive diagnostic workup, some cases of acute transverse myelitis (ATM) remain of unknown etiology and have been referred to as "idiopathic" by the Transverse Myelitis Consortium group. In a retrospective study of 288 patients with ATM, 45 cases (15.6%) met the criteria for idiopathic ATM. The patients formed a relatively homogeneous group in terms of clinical and MRI data, but the prognosis was highly variable.
  Neurology 01/2006; 65(12):1950-3. · 8.31 Impact Factor
• Article: Hepatitis B vaccination and central nervous system demyelination: an immunological approach.

  E Piaggio, A Ben Younes, S Desbois, O Gout, A Tourbah, O Lyon-Caen, R S Liblau
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  ABSTRACT: Demyelination events or multiple sclerosis following hepatitis B virus (HBV) vaccination have been reported. We therefore compared the T-cell response to HBsAg in patients with CNS demyelination following HBV vaccination and in HBV-vaccinated healthy individuals. Our data showed no differences in terms of T-cell proliferation or cytokine production between these groups and may help to allay concerns that HBV vaccination might trigger a deleterious immune response.
  Journal of Autoimmunity 03/2005; 24(1):33-7. · 7.37 Impact Factor
• Article: [Current opinion 2004: The relationship between multiple sclerosis and hepatitis B vaccination in adults].

  O Gout, O Lyon-Caen
  Revue Neurologique 01/2005; 160(12):1147-9. · 0.49 Impact Factor
• Article: [Managing an ophthalmic migraine].

  C Papeix, N Guépratte, O Gout, D A Lebuisson
  Journal Français d Ophtalmologie 05/2003; 26(4):427-30. · 0.51 Impact Factor
• Article: [Sub-cortico-frontal encephalopathy and choreic movements related to recombinant interferon-alpha 2b].

  A Moulignier, S Allo, B Singer, M F Monge-Strauss, R Zittoun, O Gout
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  ABSTRACT: Interferon (IFN)-alpha is associated with central nervous system (CNS) side effects such as depression and suicide ideation, somnolence, confusion, drowsiness, psychomotor slowing, memory impairment and visual disorientation. More severe complications are uncommon and include frank paranoia, dementia, coma, seizures and neuropathy. With the increasing long-term and extensive use of interferon (IFN)-alpha several new neurologic adverse effects have been recognized. We report on two patients who developed severe subcortico-frontal impairment, associated in one case with choreic movements, after a long-term treatment with IFN-alpha 2b for hematologic malignancies. Our patients rapidly and completely recovered from their cognitive and motor symptoms after the discontinuation of the drug. The same neurologic symptoms reappeared when we attempted to reintroduce lower doses of IFN-alpha in one case. Although little is known regarding IFN-alpha actions in the CNS, several possible mechanisms may underlie its neurotoxicity and might result from complex direct and indirect effects involving brain vasculature, neuroendocrine system, neurotoxic secondary cytokines'release and neurotransmitters.
  Revue Neurologique 06/2002; 158(5 Pt 1):567-72. · 0.49 Impact Factor
• Article: [Acute optic neuritis: clinical and MRI prognostic factors. Study of fifty patients].

  R Deschamps, O Gout, B Fontaine, M H Rigolet, E A Cabanis, O Lyon-Caen, A Tourbah
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  ABSTRACT: The objective of this study was to evaluate the risk of visual outcome after acute optic neuritis (ON) in relation to clinical and MRI findings. Fifty cases of acute ON within one month were retrospectively studied. MRI with Short Tau Inversion Recovery (STIR) sequence of the optic nerve were obtained with a median time onset of 9 days after ON. Mean age of patients was 32.8 years, mean initial visual acuity was 3/10 and orbital pain was present in 86 percent100 of patients. The STIR sequence revealed lesion in 88 percent 100 of acutely symptomatic optic nerves. An initial low visual acuity (less than 2/10), the absence of orbital pain and involvement of the intracanalicular portion of the optic nerve on STIR sequence were statistically correlated with a poorer visual outcome (respectively p=0.0041, p=0.035 and p=0.011).
  Revue Neurologique 05/2002; 158(4):446-52. · 0.49 Impact Factor
• Article: Interferon-beta treatment in patients with childhood-onset multiple sclerosis.

  Y Mikaeloff, T Moreau, M Debouverie, J Pelletier, C Lebrun, O Gout, J M Pedespan, C Van Hulle, P Vermersch, G Ponsot
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  ABSTRACT: We present a report of the use of interferon-beta before 18 years of age in 16 patients with childhood-onset multiple sclerosis. This study demonstrated that the treatment is safe and well tolerated.
  Journal of Pediatrics 10/2001; 139(3):443-6. · 4.11 Impact Factor