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)

It has been recognized that small intracerebral hemorrhage not uncommonly produced lacunar syndromes. In this study, we examined cases of intracerebral hemorrhage presenting as lacunar syndromes. Of 174 cases with recent intracerebral hemorrhage, 19 presented with a lacunar syndrome: 4 presented with pure motor hemiparesis, 5, ataxic hemiparesis, 3, dysarthria-clumsy hand syndrome, 7, sensorimotor stroke, and, none, pure sensory stroke. The sites of hemorrhage were capsular in 11, putamenal in 6, and pontine in 2. In these 19 patients, 17 were hypertensive, and the signs characteristic of parenchymal hemorrhage, e.g., gradual onset, headache, nausea, vomiting and stiff neck, were absent or very rare. Computed tomography revealed that one third of the patients had one or more non-symptomatic lacunae in the basal ganglia, the corona radiata or the anterior limb of the internal capsule. These observations suggests that hypertensive intracerebral hemorrhage causes lacunar syndrome more often than previously considered and is apt to manifest ataxic hemiparesis and sensorimotor stroke. Computed tomography is the only way of differentiating hemorrhagic "lacunar" syndrome from lacunar infarct.
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PMID:Lacunar syndrome due to intracerebral hemorrhage. 400 60

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 65-year-old woman with known breast carcinoma developed headaches, followed shortly by disequilibrium, vertical diplopia and dysarthria. Cranial computerized tomography (CCT) demonstrated a dense, irregularly enhancing pontine lesion with associated mass effect. She received dexamethasone (Decadron) and radiotherapy and subsequently expired. Postmortem examination disclosed a ruptured brain stem arteriovenous malformation within a massive hemorrhage along with necrotic atypical cells suggestive of metastatic disease.
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PMID:Brain stem vascular malformation simulating a hemorrhagic metastasis: report of a case with pathologic correlation. 648 86

A 9-year-old boy developed ataxia, right transient hemiparesis, left transient hemichorea, dysarthria and swallowing difficulties with left velar paralysis following two transient episodes of vomiting, headache and dizziness. Angiography demonstrated an occlusion of the distal part of the basilar artery. Thirty-six previously reported cases of vertebro-basilar arterial occlusion in children were reviewed, with particular regard to possible etiologies.
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PMID:Vertebro-basilar arterial occlusion in childhood--report of a case and review of the literature. 667 Jul 13

Complications from mydriatic and cycloplegic drugs are rare compared with their extensive use. Adverse effects are often related to dosage or other factors. The ocular complications include increased intraocular pressure, pigmentation of the conjunctiva and cornea, pigment in the anterior chamber, lacrimal duct blockage, macular edema, corneal endothelium damage, hyperemia, allergy, discomfort, and blurred vision. The systemic complications are those common to sympathomimetic and parasympatholytic drugs and include tachycardia, hypertension, headache, faintness. pallor, trembling, excessive sweating, palpitations, arrhythmias, confusion, hallucinations, drowsiness, ataxia, flushed skin, high fever, dysarthria, thirst, dry mouth, convulsions, disorientation, nervousness, coma, and death. An understanding of all possible side effects is of paramount importance to those using these drugs in the treatment of anticholinesterase poisoning. This review is intended as a ready reference to the adverse effects of mydriatic and cycloplegic drugs.
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PMID:Mydriatic and cycloplegic drugs: a review of ocular and systemic complications. 703 29

A 42 years old woman was noticed to have an abnormal shadow in the left lower field of lung at the time of periodical chest radiographic examination in July 1979. She didn't show any signs or symptoms of inflammation such as fever, increased rate of blood sedimentation, leukocytosis and so on by that time. Four weeks prior to admission she started to complain of mild but continuous headache and then developed anorexia, dysarthria and weakness in the right half of the face. She was admitted to the Kyoto University Hospital on September 14, 1979. On admission, slight bilateral papilledema, right hemiparesis and total dysphasia were present. She was afebrile and no abnormal finding in serological examination was shown. A heterogenously enhanced mass was demonstrated by CT scan in the left posterior frontal lobe, which was surrounded by severe cerebral edema. A provisional diagnosis of metastatic tumor from the lung was made. At the time of craniotomy, an abscess cavity was found and aspirated. Then the radical extracapsular ablation and external decompression was carried out. Histologically many Nocardia species were identified in the abscess cavity. The patient was treated by administration of a mixture of trimethoprine and sulfamethixazole (Bakter), and minocycline. Subsequently the developed Corynebacterial epidural empyema which was successfully evacuated two months after the first operation. She had been placed on Baktar for ten months since the second operation. She presented no sign of recurrence in six months after the cessation of drugs.
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PMID:[Nocardia brain abscess: a case report (author's transl)]. 707

Thirty-four patients were submitted to the conventional cervical myelography by administration of metrizamide (Amipaque) through three routes (lumbar 23, suboccipital 6, C1-C2 lateral 5). After the injection of metrizamide (4-11 ml, 170-250 mgI/ml), all procedures of the cervical myelography were done as soon as possible within 9 minutes. The adverse reactions of Amipaque were observed in 29 cases (85%) out of 34 cases initially 1 hour after cervical myelography and disappeared completely in an average of 16 hours. The total number of the side effects was 140 incidences such as meningeal irritation (headache 18, nausea 17, vomiting 17), cerebellar signs (dizziness 11, dysarthria 8, tremor 5, bradylalia 2, dysmetria 2, tipsy feeling 2, dysdiadochokinesis 1), autonomic signs (flushing 7, pale face 4, fever 4, sweating 2, hiccup 2, fatigability 2, micturition disturbance 1), sensory signs (exacerbation of numbness 6, perioral numbness 3, back pain 1, chest pain 1), motor signs (focal muscle spasm 5, exacerbation of paresis 4, areflexia 1), psychiatric signs (dysphasia 3, disturbance of consciousness 2, euphoria 1, persecutory delusion 1) and muddiness 7. We observed that waxing and waning of side effects correlated tightly with transient cortical penetration of dye in CT and cortical dysfunction mainly slowing of the background activity and slow wave burst in EEG. According to high frequency of side effects in our study, we suggest that a greater incidence of side effects may result when high concentration of Amipaque comes in contact with the cerebral cortex by using an inadequate fluoroscopic table which has only fixed one plane image and rough positioning control. Slow absorption into blood stream may affect appearance and maintenance of side effects. In order to decrease side effects after Amipaque cervical myelography, we propose that we should introduce a mobile rotating chair coupled with high power image and chose C1-C2 lateral route using 1500-1700mgI of Amipaque.
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PMID:[Side effects of metrizamide (Amipaque) cervical myelography (author's transl)]. 711 May 15

In the present survey, we investigated the side effects of anticonvulsants in 248 epileptics who had been taking medicine for a long time. About half of the patients had been given anticonvulsant treatment for more than 11 years. The main results were as follows: Subjective symptoms: many kinds of gastrointestinal symptoms, general fatigability and sleepiness. slight pain in bones, joints or muscles and headache were found. Neurological symptoms: finger tremor at rest, diminished or decreased ankle reflex, and cerebellar symptoms such as ataxic gait, dysarthria, nystagmus and diplopia were found. Other clinical symptoms: gingival hyperplasia, hirsutism, dermatitis and edema were observed. Biochemical examinations: indicated that the total bilirubin was decreased in 4.4%, serum AL-P was elevated in 26.2%, the total serum cholesterol increased above 200 mg/dl in 17.7% and decreased below 150 mg/dl in 8.9%, and serum P and K were reduced in 31.5% and 2.4%, respectively. Hypocalcemia was found in only four cases (1.6%). Hematological examinations: serious disturbances were not found in hematopoietic functions, although prothrombin time was delayed in 18 of 40 patients examined.
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PMID:Study of the side effects of long-term anticonvulsant treatment. 721 11

We present a rare case of thalamic germinoma with crossed aphasia in a dextral. A patient, 17-year-old righat-handed male, was admitted to Nippon Medical School Hospital with chief complaints of headache, abnormality of visual field and speech disturbance. There were pigmentations on the back of hand, foot and the perineum. Neurological examination revealed left homonymous hemianopsia, right slight degree of ptosis, left facial palsy, a mild paresis of the left upper extremity and motor aphasia. Right carotid angiography showed marked unrolling and midline shift of right anterior cerebral artery. CT scan revealed ring-like high density area in the right thalamic region, which was enhanced after constant infusion. Brain scintigraphy also showed an abnormal accumulation at the same site. The hen-egg sized tumor of 40 g. weight was almost totally removed by the right fronto-parietal craniotomy. The tumor was characterized histologically by the so-called two cell pattern with teratomatous components. As postoperative treatment local injection of adriamycine, irradiation and immunotherapy with picibanil were performed, and then left hemiparesis was markedly improved without sign of recurrence. Language evaluation was performed after operation. There were dysarthria, remarkable word amnesia, paraphasia and perseveration. Repetition was also impaired. His speech function was concluded to be a mixed type aphasia mainly composed of Broca's aphasia. The speech function of thalamus and crossed aphasia with dextrales were discussed.
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PMID:[A case of thalamic germinoma with crossed aphasia in a dextral (author's transl)]. 743 99

This is a report of unruptured aneurysms with occlusion of the basilar artery. A 61-year-old female was admitted to our hospital because of dysarthria and numbness of her left face. Angiography revealed occlusion of the basilar artery and severe arteriosclerosis of the bilateral cerebral carotid arteries. Pcom was not visualized on bilateral carotid angiogram. These neurological signs were considered to be derived from vertebrobasilar insufficiency by occlusion of the basilar artery. Right STA-SCA anatomosis was performed to prevent brain stem infarction. Postoperative angiography showed a good filling of both PCA and SCA by collateral circulation via a right STA and an unruptured basilar top aneurysm. Seven months after the bypass surgery, angiography disclosed that the basilar top aneurysm was visualized clearly, and its size was unchanged. The fact that there was no thrombus formation in the aneurysm was considered to be due to ticlopidine, and the hemodynamic changes after the bypass surgery were suspected to have increased the intraaneurysmal pressure. Therefore we performed neck clipping of the basilar top aneurysm by using a right pterional approach. Two years after the second operation, the patient complained of severe headache and vomiting. CT scan showed subarachnoid hemorrhage, and angiography demonstrated a newly developed aneurysm which might have ruptured on left internal carotid anterior choroidal artery bifurcation. Emergency neck clipping of the second aneurysm was performed, and the patient showed a good postoperative course. The newly developed second aneurysm might have been caused by severe arteriosclerosis and hypertension in addition to hemodynamic stress.
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PMID:[A case of growing up aneurysms with occlusion of basilar artery]. 766 40


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