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Query: UMLS:C0004134 (ataxia)
 15,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute disseminated encephalomyelitis, an inflammatory and demyelinating disorder of central nervous system white matter, typically occurs following childhood viral infections. Although CT may demonstrate abnormalities, many children have normal CT studies in spite of widespread neurologic abnormalities. We report a series of five patients with the typical clinical presentation of disseminated encephalomyelitis who were studied using magnetic resonance imaging (MRI). In each case the children presented with progressive subacute neurologic abnormalities including headache, diplopia, ataxia, hemiparesis, seizures, dysarthria, and/or coma. CT was nondiagnostic. MRI clearly demonstrated multifocal white matter lesions of the cerebrum, brainstem, and cerebellum which corresponded to clinical signs. The patients improved dramatically with corticosteroid therapy. MRI showed progressive resolution of multifocal lesions in conjunction with clinical improvement.
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PMID:MRI in children with postinfectious disseminated encephalomyelitis. 395 36

After reviewing the literature, a personal series of 10 adult patients with cerebellar infarction diagnosed by CT scan is described. The clinical picture in young adult men is characterized by rapid onset of headache, vomiting, vertigo, ataxia and blurred vision. After this sudden onset the patients may present a stable course or a rapid or delayed onset of brain stem compression, revealed by impairment of consciousness. CT scan is the diagnostic method of choice. The correlation between angiographic and CT localization of the infarction is not good. For therapy the following policy is suggested: in alert and clinically stable patients: medical treatment (mannitol, glycerol, dexamethason), ICP and serial CT monitoring; in alert patients with hydrocephalus or mass effect: medical treatment and monitoring as mentioned before; ventricular drainage if ICP surpasses 350 mm H2O; in patients with impaired consciousness and hydrocephalus or mass effect: immediate ventricular drainage. If it is not followed by prompt improvement of the level of consciousness, an emergency suboccipital craniectomy with removal of the infarcted tissue should be done.
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PMID:Surgical management of acute cerebellar infarction. 398 89

Seventeen patients with computed tomographic (CT) evidence of a solitary cerebellar metastasis were studied. In 11 of 17 cases, neurologic symptoms preceded systemic evidence of carcinoma. Initial neurologic symptoms included gait instability (13 cases) and headache and vomiting (four cases). All patients had evidence of gait or limb ataxia on neurologic examination. Fourteen patients underwent craniotomy and subsequent irradiation, and three had radiotherapy without initial surgical biopsy. One patient with lung carcinoma had clinical and CT evidence of intracranial recurrence 14 months later but no evidence of widespread systemic carcinoma. Fifteen patients later showed evidence of systemic carcinoma but then died without subsequent development of recurrent cerebellar dysfunction or other neurologic abnormalities. Furthermore, in six of these patients with widespread systemic carcinoma, scans taken two to six months after completion of surgery and/or radiation therapy for the solitary metastasis showed no evidence of recurrent intracranial disease.
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PMID:Solitary cerebellar metastases. Clinical and computed tomographic correlations. 398 9

We conducted a pilot study of fluzinamide in 15 adults with refractory partial seizures. After a baseline period, fluzinamide was added to the existing regimen of phenytoin and carbamazepine and increased to maximum tolerated dose. Common side effects included dizziness, diplopia, ataxia, headache, nausea, and rash, resulting in patient withdrawal in six cases. Seizures became less frequent in four of the nine patients who completed the 8-week trial.
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PMID:Pilot study of fluzinamide (N-methyl-3-[3-(trifluoromethyl)phenoxy]-1-azetidinecarboxamide) in refractory partial seizures. 402 65

The patient was a 31-year-old female who complained of headache and gait disturbance and admitted to our hospital on January 14, 1983. Familiar history revealed that her mother died of hemorrhage from hemangioblastoma in area postrema. Neurological examination revealed bilateral papilledema, right cerebellar sign and ataxia. Other neurological and clinical examinations were normal. CT-scan showed a right cystic cerebellar lesion and a right intraventricular lesion suggestive of hemangioblastomas. Right vertebral angiography demonstrated two vascular tumors lying in the right cerebellar hemisphere and right trigone of the lateral ventricle. Operation was performed on January 28, 1983. The histological diagnosis were hemangioblastomas.
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PMID:[A case of concomitant posterior fossa and supratentorial hemangioblastomas]. 403 17

Four cases of gliomatosis cerebri are reported that demonstrate the variability of the clinical course. A review of these and 32 cases from the literature revealed that the most striking finding was change in personality and mental status. Hemiparesis, ataxia, papilledema, headache, seizure, and brainstem signs were the next most common clinical findings. Laboratory and radiographic tests, including angiography and pneumoencephalography, often showed only minor and nonspecific changes in the face of profound mental deterioration. Increased intracranial pressure usually occurred late but was probably an important factor of the terminal course in most patients. The pathologic changes were typical, with diffuse infiltration of astrocytoma cells through brain stem, subcortical white matter, and, to a lesser extent, cerebral cortex.
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PMID:Gliomatosis cerebri. Report of four cases and review of the literature. 449 66

Neurological involvement occurred in every one of a series of 30 patients with an insulinoma. The episodic nature of the hypoglycaemia caused symptoms and signs to fluctuate and often led to delay in diagnosis (mean length of history was 3 years). The commonest feature at first presentation was confusion (20 instances), but as the illness evolved, coma (16 instances) and convulsions (8 instances) became more frequent. Objective weakness was found in 7 patients, with 3 examples of hemiparesis and 2 each of paraparesis and monoparesis; in all, the weakness resolved over a period of 1 hr to 3 days when normoglycaemia was maintained. Other neurological features included subjective visual disturbances, headache, dysarthria and ataxia. 220 patients with an insulinoma from 7 series in the literature were reviewed. The high incidence of neurological features was confirmed, with confusion (152 cases), coma (82 cases) and convulsions (58 cases) predominating. Visual disturbances were common, though not accurately quantified in some series. Objective evidence of weakness on the other hand was reported in only 6 of the 222 patients. Other less common symptoms included headache (18 instances) and peripheral paraesthesiae (14 instances). In the 7 series reviewed, as in our own, it was found that in any one patient, each episode of hypoglycaemia was accompanied by the same symptom complex. The presence of an insulinoma should be considered in any patient with unusual, or inexplicable neurological features, particularly when they are intermittent. The diagnosis can be confirmed by demonstrating an inappropriately high circulating insulin level, for the ambient blood glucose concentration.
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PMID:Neurological aspects of insulinomas. 609 Oct 78

A 72-year-old woman, previously in good health, suffered for 2 years from attacks of a complex neuropsychiatric syndrome lasting from 2 days to 4 weeks. These episodes, which were followed by intervals of nearly complete recovery, were usually marked by fever, headache, mental confusion, vomiting ataxia, anisocoria, epileptic seizures and stiffness of the neck. Neuroradiological investigation revealed only slight ventricular dilatation. In 13 CSF examinations, there was reduced glucose, increased protein, considerable rise of the IgG index and constant oligoclonal bands. There was also an increase of polymorphonuclear leucocytes, lymphocytes or epithelial-like cells. As all microbial, viral or mycotic tests were negative and the patient recovered, the case was considered to be benign recurrent meningitis of Mollaret. The nosological position of this rare disease, as well as its probable pathogenetic mechanisms, are discussed.
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PMID:A case of benign recurrent meningitis of Mollaret. 616 85

Basilar impression was found in three members of one family. The mother showed an asymptomatic deformity, her eldest son complained of headache, drop-attacks, nystagmus, unilateral ophthalmoplegia, and ataxia; the middle son presented with headache, nystagmus, and hemiparesis. Magnetic resonance (MR) imaging demonstrated convexobasia of various degrees with elevation of the upper spine and malformation of the occipital bone. The medulla oblongata and the pons were flattened and dislocated backward in two cases. Chiari malformation was present in one case and mild hydrocephalus in another. A comparison of MR with CT imaging demonstrates some advantages of the former method in the assessment of the neural structures directly involved in basilar impression.
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PMID:MR imaging of familial basilar impression. 647 Feb 65

The case of a 16-year-old boy with occipital headache, diplopia, ataxia, and weakness in the lower extremities of 1-month duration is reported. Slowness of mentation, speech, and motor action was also present. Massive chronic hydrocephalus was indicated by an enlarged head. The prominent clinical features suggested involvement of the brainstem, and contrast studies showed compression of the brainstem and a filling defect posteriorly at C1-2. Brainstem auditory evoked potential latency suggested bilateral lesions of the brainstem. Posterior fossa decompression confirmed the presence of an Arnold-Chiari malformation, with the cerebellar tonsils as low as C-3. The fourth ventricle was microdissected and opened. Remarkable clinical and evoked potential recovery ensued over several months. Clinical-anatomic and anatomic-physiologic correlations in Arnold-Chiari malformation are discussed.
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PMID:Clinical and electrophysiologic recovery in Arnold-Chiari malformation. 662 43


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