Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient development deteriorating mental status, quadriparesis, and severe pseudobulbar palsy with the inability to speak or swallow following orthotopic liver transplantation (OLT). Subsequently, abnormalities were found in the pons on MRI that were consistent with central pontine myelinolysis (CPM). Marked recovery occurred following transfer to the rehabilitation medicine service. Seven months following development of CPM, a mild dysarthria has persisted, but full ambulation has returned. Although no significant fluctuations in serum sodium were seen perioperatively, multiple risk factors associated with the development of CPM were present, including end-stage liver disease, a history of alcohol abuse, malnutrition, hypoxia, and use of cyclosporin medication postoperatively. This case demonstrates that the development of CPM may occur following OLT despite meticulous attention to serum sodium concentrations. We conclude that CPM is multifactorial in nature. There can be a great variation in its clinical course.
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PMID:Central pontine myelinolysis after liver transplantation: a case report. 757 24

Acquired (non-Wilsonian) hepatocerebral degeneration (AHCD) is an irreversible neurological condition characterized by dementia, dysarthria, and motor disturbances. It has been described in patients with severe liver disease of many causes, and notably in patients with surgically or spontaneously created porto-systemic shunts. We report a case of AHCD in a patient with end-stage liver disease due to alcohol abuse and hepatitis C. In addition, this patient showed pathologic evidence of the less commonly reported "shunt myelopathy" in the absence of a surgically created porto-systemic shunt. The myelopathy was associated with a dramatic vacuolation involving especially the deep motor cortex. Electron microscopy suggested that the vacuolation was due mainly to disruption of abnormal astrocytes.
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PMID:February 2000: Dementia with motor dysfunction in a patient with liver disease. 1076 52

Chronic ethyl alcohol abuse is associated with different types of neurological involvement. We report a 51-year-old woman with alcoholic encephalopathy, neuropathy and autonomic dysfunction. After the alcohol abuse of about thirty years, gait disturbance, dysphagia and dysarthria progressively worsened. We thought that the disease was caused by poor nutrition due to chronic alcohol abuse and vitamin B1, B12 deficiency. Her neurological symptoms and signs improved after discontinuation of alcohol and nutritional treatment.
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PMID:[A case of alcoholic multiple nervous system degeneration]. 1079 21

Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with the demyelination of extrapontine areas of the central nervous system. Although the etiology and pathogenesis are unclear, CPM is usually associated with hyponatremia or its rapid correction, and chronic alcoholism is also a common underlying condition. We observed a 43-year-old man with diabetes mellitus who developed central pontine and extrapontine myelinolysis with no apparent evidence of hyponatremia, serum hyperosmolality or associated rapid correction, or history of alcohol abuse. On admission, the patient was lethargic with dysarthria, dysphagia, and mild tetraparesis and his face and lower extremities were severely edematous. Laboratory examination showed normoglycemia and normonatremia, although hypokalemia, elevated HbA1c, and nephrotic syndrome were also present. Magnetic resonance imaging (MRI) revealed abnormal signal intensity in the pons, the deep layers of the cerebral cortex, and the adjacent white matter consistent with central pontine and extrapontine myelinolysis. Generalized edema was reduced by the use of diuretics and extracorporeal ultrafiltration without significant changes of serum sodium or osmolality. His consciousness level and paresis gradually improved within a few weeks. Our patient is a rare case of CPM associated with diabetes without apparent evidence of sodium or glucose imbalances.
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PMID:Central pontine and extrapontine myelinolysis associated with type 2 diabetic patient with hypokalemia. 1581 68

Marchiafava-Bignami disease (MBD) is a rare central nervous system disorder of an unknown etiology strongly associated with alcoholism. MBD primarily affects the corpus callosum leading to confusion, dysarthria, seizures and frequently to death. About 250 cases of different races and nationalities, mostly alcoholics have been reported. We report a single-case study of a 43-year-old woman with the history of severe alcohol abuse, who demonstrated typical picture of Marchiafava-Bignami disease (MBD) with fatal course. We reviewed the literature on cases of MBD.
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PMID:[Marchiafava-Bignami disease]. 1720 61

Central pontine myelinolysis and extrapontine myelinolysis are rare demyelinating diseases of the central nervous system. These diseases are related frequently to rapid correction of hyponatremia. They have also been described in association with other underlying conditions such as alcoholism and malnutrition. In the present study, we report a case of central pontine and extrapontine myelinolysis with acute hepatic dysfunction. The patient had no apparent evidence of hyponatremia and no history of alcohol abuse. On admission, the patient was lethargic; dysphagia, dysarthria, and quadriplegia were noted. Laboratory examination showed significantly increased transaminase without hyponatremia. Magnetic resonance imaging revealed abnormal signal intensities in the pons and thalamus. Consciousness level and clinical symptoms improved gradually within a week. We suggest that acute hepatic dysfunction may play an important role in the development of central pontine myelinolysis and extrapontine myelinolysis.
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PMID:Central pontine and extrapontine myelinolysis associated with acute hepatic dysfunction. 2208 Mar 94

A 56-year-old woman with a history of alcohol abuse was found at home amidst empty wine bottles with somnolence and severe dysarthria. MRI of the brain revealed selective demyelination of the corpus callosum, consistent with Marchiafava-Bignami disease.
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PMID:[A woman without speech]. 2255 54

An elderly woman was transferred for biopsy of a pontine lesion. Her condition, including gait disturbances, truncal ataxia, and dysarthria-presumed to be due to severe alcohol abuse-had deteriorated during treatment of ambulatory-acquired pneumonia. No electrolyte abnormalities were noted during hospitalization. However, the neuroimaging findings were in line with central pontine myelinolysis, typically sparing the peripheral pontine fibers. Although extremely rare, pontine myelinolysis can occur in the presence of normal electrolyte levels. Thus, imaging findings should not be misinterpreted as pontine neoplasms, and patients should not undergo stereotactic biopsy-a procedure that could result in disastrous morbidity.
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PMID:Pontine Neoplasm or Myelinolysis Despite Normal Sodium Levels. 3241 40