Neurologist and pediatrician.
PhD in Science (physical option)
Authorisation in management research.
For 8 years, a member of the Scientific Council of the French-language clinical Neurophysiology Society.
Workplace from 1980 to 2013: The Department of neurophysiology of the CHU in Rouen, France.
During This period, I was responsible for the activity of Neuropaediatriciany of the CHU in Rouen and the Department of Epilepsy.
In 1995, acquisition of my first transcranial magnetic stimulation device and start of the management of patients with functional neurological disorders.
Since 2013: Activity dedicated only to magnetic stimulation of neurological functional disorders.
Mov Disord. 2010 Jul 30;25(10):1501-4. doi: 10.1002/mds.23187
Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation.
Chastan N1, Parain D.
Psychogenic paralysis presents a real treatment challenge. Despite psychotherapy, physiotherapy, antidepressants, acupuncture, or hypnosis, the outcome is not always satisfactory with persistent symptoms after long-term follow-up. We conducted a retrospective study to assess clinical features and to propose an alternative treatment based on repetitive transcranial magnetic stimulation (rTMS). Seventy patients (44 F/26 M, mean age: 24.7 +/- 16.6 years) experienced paraparesis (57%), monoparesis (37%), tetraparesis (3%), or hemiparesis (3%). A precipitating event was observed in 42 patients, primarily as a psychosocial event or a physical injury. An average of 30 stimuli over the motor cortex contralateral to the corresponding paralysis was delivered at low frequency with a circular coil. The rTMS was effective in 89% of cases, with a significantly better outcome for acute rather than chronic symptoms. In conclusion, motor cortex rTMS seem to be very effective in patients with psychogenic paralysis and could be considered a useful therapeutic option.
Neurophysiol Clin. 2014 Oct;44(4):425-31. doi: 10.1016/j.neucli.2014.04.004. Epub 2014 May 15.
Large-field repetitive transcranial magnetic stimulation with circular coil in the treatment of functional neurological symptoms.
Parain D1, Chastan N2.
Patients with functional neurological symptoms (FNS) are frequently encountered by neurologists and are difficult to treat. Symptoms are multiple and may appear concurrently or successively in the same patient. To date, few studies have been published on focal repetitive transcranial magnetic stimulation (rTMS) in FNS. This type of stimulation induces a focal current, vertically in the cortex. Results are contradictory, probably because it is difficult to identify a limited cortical area that triggers these symptoms. We assessed the efficacy of another type of rTMS: large-field stimulation by means of a circular coil covering a surface area approximately 20 times greater and inducing a circular current tangentially to the cortex.
We analysed two studies on the efficacy of large-field rTMS in functional paralysis and in functional movement disorders. The efficacy of large-field rTMS was very marked in these two studies.
PERSONAL NON-PUBLISHED STUDIES:
We reported several open series, including patients with functional sensory loss, functional visual loss, and non-epileptic seizures.
For all patients, one or several sessions of 60 stimuli with circular coil were carried out with a protocol depending on the symptoms.
The efficacy of large-field rTMS was dramatic in all patient series. Additionally, we discuss the possible involved mechanism: placebo effect, cognitive behavioural effect or neuromodulatory effect.
According to the data from these different studies, large-field rTMS could be a new therapy for patients with FNS. However, controlled studies are mandatory.
1. Vagus nerve stimulation for drug-resistant epilepsy: a
European long-term study up to 24 months in 347 children. Orosz I, McCormick
D, Zamponi N, Varadkar S, Feucht M, Parain D, Griens R, Vallée L, Boon P, Rittey
C, Jayewardene AK, Bunker M, Arzimanoglou A, Lagae L. Epilepsia. 2014
Oct;55(10):1576-84. doi: 10.1111/epi.12762. Epub 2014 Sep 17.
2. Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation. Chastan N, Parain D. Mov Disord. 2010 Jul 30;25(10):1501-4. doi: 10.1002/mds.2318
3. Continuous EEG monitoring in adults in the intensive care unit (ICU) André-Obadia N, Parain D, Szurhaj W. Neurophysiol Clin. 2015 Mar; 45(1):39-46. doi: 10.1016/j.neucli.2014.11.003. Epub 2015 Jan 15.
4. French guidelines on electroencephalogram. André-Obadia N, Sauleau P, Cheliout-Heraut F, et al. Neurophysiol Clin. 2014 Dec;44(6):515-612. doi: 10.1016/j.neucli.2014.10.001. Epub 2014 Nov 11
5. Large-field repetitive transcranial magnetic stimulation with circular coil in the treatment of functional neurological symptoms. Parain D, Chastan N. Neurophysiol Clin. 2014 Oct;44(4):425-31. doi: 10.1016/j.neucli.2014.04.004. Epub 2014 May 15.
6. Epilepsy surgery program in Tunisia: an example of a Tunisian French collaboration. Mrabet Khiari H, Khemiri E, Parain D, Hattab N, Proust F, Mrabet A. Seizure. 2010 Mar;19(2):74-8. doi: 10.1016/j.seizure.2009.11.010. Epub 2010 Jan 19.
7. Treatment of primary headache in children: a multicenter hospital-based study in France. Cuvellier JC, Donnet A, Guégan-Massardier E, Nachit-Ouinekh F, Parain D, Vallée L; Céleste Study Group. J Headache Pain. 2009 Dec;10(6):447-53. doi: 10.1007/s10194-009-0158-7. Epub 2009 Sep 22.
8. Emergency and intensive care unit management of status epilepticus in adult patients and children (new-born excluded). Société de réanimation de langue française experts recommendations. Outin H, Blanc T, Vinatier I; le groupe d'experts. Rev Neurol (Paris). 2009 Apr;165(4):297-305. doi: 10.1016/j.neurol.2009.01.048. Epub 2009 Mar 17.
9. Management of convulsive status epilepticus in infants and children. Hubert P, Parain D, Vallée L. Rev Neurol (Paris). 2009 Apr;165(4):390-7. doi: 10.1016/j.neurol.2008.11.009. Epub 2009 Mar 4.
10. Evaluation of brivaracetam, a novel SV2A ligand, in the photosensitivity model. Kasteleijn-Nolst Trenité DG, Genton P, Parain D, Masnou P, Steinhoff BJ, Jacobs T, Pigeolet E, Stockis A, Hirsch E. Neurology. 2007 Sep 4;69(10):1027-34.
11. Migraine aura lasting 1-24 h in children: a sequence of EEG slow-wave abnormalities vs. vascular events. Parain D, Hitzel A, Guegan-Massardier E, Lebas A, Blondeau C, Fédina I, Feray D, Véra P, Mihout B. Cephalalgia. 2007 Sep;27(9):1043-9. Epub 2007 Jul 30
12. Classification conundrums in paroxysmal dyskinesias: a new subtype or variations on classic themes? Pourfar MH, Guerrini R, Parain D, Frucht SJ. Mov Disord. 2005 Aug;20(8):1047-51.
13. Epilepsy and migraine. Parain D. Rev Med Suisse Romande. 2003 Sep;123(9):573-5.
14. Mechanism of intrachromosomal triplications 15q11-q13: a new clinical report. Vialard F, Mignon-Ravix C, Parain D, Depetris D, Portnoï MF, Moirot H, Mattei MG. Am J Med Genet A. 2003 Apr 30;118A(3):229-34.
15. Severe myoclonus-dystonia syndrome associated with a novel epsilon-sarcoglycan gene truncating mutation. Maréchal L, Raux G, Dumanchin C, Lefebvre G, Deslandre E, Girard C, Campion D, Parain D, Frebourg T, Hannequin D. Am J Med Genet B Neuropsychiatr Genet. 2003 May 15;119B(1):114-7.
16. Vagal nerve stimulation in tuberous sclerosis complex patients. Parain D, Penniello MJ, Berquen P, Delangre T, Billard C, Murphy JV. Pediatr Neurol. 2001 Sep;25(3):213-6.
17. Photosensitive epilepsy and television epilepsy. Parain D, Blondeau C. Arch Pediatr. 2000 Jan;7(1):87-90.
18. Epilepsies and video games: results of a multicentric study. Badinand-Hubert N, Bureau M, Hirsch E, Masnou P, Nahum L, Parain D, Naquet R. Electroencephalogr Clin Neurophysiol. 1998 Dec;107(6):422-7.
19. Risk of recurrence after a single, unprovoked, generalized tonic-clonic seizure. Boulloche J, Leloup P, Mallet E, Parain D, Tron P. Dev Med Child Neurol. 1989 Oct;31(5):626-32.
20. Positive rolandic sharp waves and periventricular leukomalacia in the newborn. Marret S, Parain D, Samson-Dollfus D, Jeannot E, Fessard C. Neuropediatrics. 1986 Nov;17(4):199-202.
21. Electroencephalograms in basilar artery migraine. Parain D, Samson-Dollfus D. Electroencephalogr Clin Neurophysiol. 1984 Nov;58(5):39