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)

Peduncular hallucinosis (PH) is a syndrome of hallucinations and brainstem symptoms which has only been described in single case reports. A detailed analysis of five patients was undertaken to investigate the clincial characteristics, hallucinations and behavioural abnormalities of PH in greater detail. Frequent clinical symptoms were oculomotor disturbances, impaired arousal, dysarthria and ataxia. In the chronic stage, sleep-wake cycle disturbances were common. Hallucinations were naturalistic, complex, scenic, mostly visual, but also combined visual-acoustic or visual-tactile and recurred stereotypically over months. Patients experienced their hallucinations as genuine and were unable to discriminate their percepts from reality. Neuropsychological testing disclosed severe impairments of episodic memory, occasionally coupled with confabulatory behaviour. By contrast, memory for hallucinations remained intact. Deficits of attentional and executive functions were found in a subgroup of patients. Associated abnormal behaviours were common, comprising confusion, delusional misidentification for persons and places, and loss of disease awareness. PH appeared after focal lesions in various regions, such as the midbrain, thalamus and pons. These findings document that subcortical, brainstem-related hallucinations are vivid, recurring percepts that have a strong naturalistic character and are often associated with cognitive and behavioural abnormalities. It seems likely that brainstem hallucinosis is caused by damage to ascending reticular systems and thalamocortical circuits. Available observations suggest that PH compromises cognitive functions which enable us to differentiate between illusionary percepts and reality, a reality monitoring system.
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PMID:Peduncular hallucinosis: a syndrome of impaired reality monitoring. 1700 30

A 72-year-old woman was admitted to our hospital because of dysarthria, dysstasia, and diplopia. Examination demonstrated wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome, dysarthria, truncal ataxia, and dysmetria of the four limbs. Cranial MR images demonstrated an acute infarct in the paramedian, lower midbrain-pontine tegmentum. Peduncular hallucinosis was observed during the first several days of hospitalization. Myorhythmia (skeletal myoclonus) appeared as early as day 15 and has persisted to date, with a frequency of approximately 1.5 Hz on the head and chin, and 3.5 Hz on the left upper extremity. Cranial MR images 5 months after onset demonstrated bilateral inferior olivary hypertrophy, while palatal tremor appeared later. Only a limited number of case reports are available in which myorhythmia emerged as early as in our case after the onset of a brain infarct.
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PMID:[Myorhythmia emerging on day 15 in a case of an infarction in the midbrain-pontine tegmentum]. 1788 43