Urinary disorders in adults patients with cerebral palsy (CP) are not well known. We described them from our cohort of adult CP patients followed in our unit of Physical Medicine and Rehabilitation. This a retrospective study from 94 patients, describing urinary symptoms, complications and urodynamic datas. Ninety-four patients were included, 52 men (55%), mean age 33.5 ± 12 years, mean motor level GMFCS 4, 35 (37%) living in institution. Fixty-six patients (60%) had urinary symptoms (17 storage symptoms, 8 voiding symptoms, 31 both storage and voiding symptoms), and had a worse motor level than the asymptomatic patients (GMFCS 4 versus GMFC 3, P < 0.001). Forty-two patients (45%) had one or several urinary complications: 20 (21%) urinary infection, 18 (19%) renal failure, 17 (18%) ureteral or renal morphological damages. Urinary complications were diagnosed in 3 asymptomatic patients. Thirty-one patients had urodynamic examination, in which overactive urethral sphincter was the most frequent abnormalitie found in 24 patients. The UD in CP patients are not rare, they can be responsible from complciations. They require systematic screening and appropriate treatment.

Background: Dystonia and spasticity are common symptoms in children with Cerebral Palsy (CP), whose management is a challenge to overcome in order to enable the harmonized development of motor function during growth.Aim: To describe botulinum toxin A (BTX-A) use and efficacy as a treatment of focal spasticity in CF children in France.Methods: This prospective observational study included 282 CP children mostly administered according to French standards with BTX-A in lower limbs. Realistic therapeutic objectives were set with parents and children together before treatment initiation and assessed using the Visual Analogue Scale (VAS). Child management was recorded and the efficacy of injections was assessed during a 12-month follow-up period by physicians (Modified Ashworth Scale, joint range of motion, Physician Rating Scale, Gillette Functional Assessment Questionnaire and Gross Motor Function Measure-66) and by patients/parents (Visual Analogue Scale).Results: BTX-A treatment was administered in different muscle localizations at once and at doses higher than those recommended by the French Health Authorities. Children were treated in parallel by physiotherapy, casts and ortheses. Injections reduced spasticity and improved joint range of motion, gait pattern and movement capacity. Pain was reduced after injections. BTX-A administration was safe: no botulism-like case was reported. The log of injected children who were not included in the study suggested that a large population could benefit from BTX-A management.Conclusions: We showed here the major input of BTX-A injections in the management of spasticity in CP children. The results are in favor of the use of BTX-A as conservative safe and efficient treatment of spasticity in children, which enables functional improvement as well as pain relief. (C) 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Les troubles vésicosphinctériens dans la sclérose en plaques (SEP) sont fréquents. La symptomatologie urinaire est polymorphe et le traitement le plus souvent médicamenteux. Le cathétérisme intermittent (CI), traitement de référence chez le blessé médullaire, fait partie de l’arsenal thérapeutique. Le but de cette étude était d’évaluer prospectivement en intention de traiter l’observance, la satisfaction et l’impact sur la qualité de vie du CI chez les patients atteints d’une SEP.

Le terme « polyhandicap lra a été retenu dans le texte de la loi du 11 février 2005. Il n’est donc plus possible d’ignorer les besoins spécifiques des personnes concernées. Cet article propose une mise au point générale sur la prise en charge médicale et paramédicale et montre l’importance d’un suivi multidisciplinaire et coordonné tout au long de la vie, en lien étroit avec la famille et les intervenants médicaux et éducatifs.

In the SU(2)L × U(1)Y standard electroweak theory coupled with the Einstein gravity, new topological configurations naturally emerge, if the spatial section of the universe is globally a three-sphere (S3) with a small radius. The SU(2)L gauge fields wrap the space nontrivially, producing homogeneous but anisotropic space. As the universe expands, large electric and magnetic fields are produced. The electromagnetic field configuration is characterized by the Hopf map.