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 boy, 4 years, 9 months of age, presented with acute hemiplegia, lethargy, ataxia, and dysarthria 24 hours prior to the eruption of typical varicella exanthem. Magnetic resonance imaging findings were typical of multiple cerebral ischemic infarcts. It is suggested that during the period of secondary viremia varicella zoster virus invaded the cerebral blood vessels causing vasculopathy and cerebrovascular infarcts.
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PMID:Pre-eruptive neurologic manifestations associated with multiple cerebral infarcts in varicella. 777 18

We report a case of pulmonary embolism complicated by paradoxical cerebral embolism in a patient with atrial septal aneurysm and patent foramen ovale. The patient was a 65-year-old obese woman, admitted because of sudden development of right-sided hemiplegia and dysarthria. In the few days before hospitalization she noted painful edema of the right leg and suffered from increasing dyspnea. Echo-Doppler examination of the venous bed confirmed the clinical suspicion of deep vein thrombosis. A pulmonary scan showed multiple perfusion defects in both lungs. On cerebral computerized tomography there were two non-haemorrhagic infarct zones. Contrast transesophageal echocardiography revealed a type II atrial septal aneurysm with right-to-left shunting through a patent foramen ovale. The patient was treated by warfarin, followed by implantation of a caval filter, with a good outcome. Paradoxical embolism may be more common than currently thought. In cases of pulmonary embolism, a careful check for clinical symptoms indicative of a possible paradoxical embolism should be performed and, consequently, a search for possible atrial septal aneurysm or patent foramen ovale.
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PMID:[Paradoxical embolism in a patient with aneurysm of the interatrial septum]. 792 85

Here we report a 47-year-old man with dissecting aneurysm of the basilar artery who developed Foville's syndrome due to upper pons involvement. At first he had an abrupt onset of dysarthria and weakness in his left upper and lower extremities during his work. Neurological examination on admission revealed mild disturbance of consciousness, absent light reaction on the left side, hypesthesia of the left face, absent gag reflex, dysarthria, and left hemiparesis with ataxia. On the second hospital day he developed paralysis of conjugate eye movement to the right, left central facial palsy, and left hemiplegia, and hyperhidrosis of the left side of the body. He was diagnosed to have superior pons type of Foville's syndrome. Computed tomography showed low density area in the right upper pons, and the basilar artery had marked lateral shift, dilatation, and calcification. Vertebral angiography demonstrated dissecting aneurysm of the basilar artery. Although it is very rare that dissecting aneurysm of the basilar artery causes the brain stem symptoms, its possibility should be considered when computed tomography shows marked lateral shift, dilatation, and/or calcification of the basilar artery.
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PMID:[A case of dissecting aneurysm of the basilar artery presented as superior pons type of Foville's syndrome]. 856 44

We reported a case of cerebral infarction in a young adult following an abuse of cocaine and other drugs. A 27-year-old male was admitted to our hospital because of the abrupt onset of right hemiplegia and dysarthria. Brain CT and MRI examinations showed cerebral infarction in the region of the left caudate head and the left corona radiata. Cerebral angiography revealed total occlusion at the origin of the left middle cerebral artery, with neither vascular malformation nor atherosclerotic change. There were no obvious causes that might lead to cerebral infarction in young adults, including potential cardiac sources of embolism, abnormalities of blood coagulation, or collagen vascular diseases. From his history we learned he had started abusing cocaine and other drugs at the age of 16 years, and that he had been addicted to these drugs up to at least 2 months earlier than the onset of cerebral infarction, so we suggested his drug abuse might have affected the occurrence of cerebral infarction. We would like to emphasize that using 'drugs' should be taken into consideration as a possible cause of cerebral infarction in young adults.
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PMID:[A case of cerebral infarction in a young adult following an abuse of cocaine and other drugs]. 872 Mar 40

We examined a patient with alternating hemiplegia of childhood (AHC) who had over a 23-year history of AHC to investigate the origin of the neurological deterioration with increasing age. Hemiplegic attacks had occurred consistently at a frequency of a few per week since infancy, and he first experienced attacks of cerebellar ataxia at the age of 23 years. Intellectual impairment, dysarthria, dystonic posturing, and a wide-based gait had been slowly progressive, but they had been stable since he turned twenty. The electromyographic response to transcranial magnetic stimulation was normal between attacks and showed reversible alteration during an attack. MRI revealed slight dilatation of the lateral ventricles, and MR angiography showed normal cerebral blood flow. Proton MR spectroscopy between attacks showed normal peak area ratios for N-acetyl groups, choline-containing compounds, and creatine and phosphocreatine, and it also demonstrated no lactic peak. 123I-IMP SPECT between attacks demonstrated diffuse cerebral hypoperfusion despite no evidence of ischemic change in the above MR study. These results suggest that the slowly progressive neurological deficits are due to the primary underlying pathology rather than the secondary neuronal loss as a result of frequent ischemic attacks.
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PMID:Alternating hemiplegia of childhood: report of a case having a long history. 913 95

We reported five patients having presented only with clumsy hand and dysarthria which resulted from motor paresis confined to one side of the fingers and the ipsilateral face and tongue. All of them were right-handed, and their manifestation was transient. They had no abnormalities of muscle tonus and sensation, and no ataxia. The features of these cases differed from those of the dysarthria-clumsy hand syndrome because of absence of ataxia, and could be distinguished from pure motor hemiplegia by a motor paresis with cheiro-oral topography. MRI examinations showed a localized lesion at the border between internal capsule and corona radiata (two cases), or in the corona radiata just over this region (three cases). In the former cases in which the internal capsule was involved, we confirmed the lesion in the genu and anterior half of the posterior limb of the internal capsule. The lesion was on the left side in all five patients. It has been known that the pyramidal tract consists of the large and small fibers. The large ones are localized in the posterior part of the posterior limb of the internal capsule, and the damage of them produces sustained and serious motor paralysis. The small ones are widely distributed in the genu and the posterior limb of the internal capsule. The findings of our study suggest that the small fibers have adjacent somatotopy for the hand and mouth in the region of the genu and the anterior part of the posterior limb of the internal capsule, and that the damage of them may lead to mild, transient motor paresis without spasticity.
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PMID:[Motor paresis with cheiro-oral topography due to small infarct in the internal capsule or the corona radiata]. 914 66

We present a case of right middle cerebral artery occlusion after a controlled ovarian hyperstimulation regimen and cryopreserved embryo transfer (ET) in a previously healthy 22-year-old woman. The patient suffered from nausea and progressive abdominal distension 8 days after ET. Under the diagnosis of ovarian hyperstimulation syndrome, she was treated with hypertonic solution, albumin infusion, and paracentesis, with some improvement. Left hemiparesis and dysarthria occurred suddenly on the fourth day of hospitalization, 11 days after ET. The neurologic deficits progressed to complete hemiplegia within a few hours. Computed tomography of the head showed infarction in the territory of the right middle cerebral artery. Magnetic resonance angiography revealed occlusion of the main trunk of the right middle cerebral artery. Laboratory studies showed leukocytosis with neutrophil predominance and a hypercoagulable state. The pregnancy was terminated because of progressive tachycardia, dyspnea, and increased abdominal girth despite supportive treatment. The neurologic deficits remained stationary at the time of discharge. This case emphasizes that the recent advent of ovulation induction and assisted reproductive techniques is a newly recognized cause of devastating cerebral infarction in otherwise healthy women.
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PMID:Ischemic stroke in a young woman with ovarian hyperstimulation syndrome. 970 Feb 49

Mr. Duffy is 83 years old and is admitted to rehabilitation 4 weeks after a right thalamic cerebral vascular accident (CVA). He has dysphagia, dysarthria, left hemiplegia, and is moderately-severely confused. He pulls out his nasogastric feeding tube and his physician decides not to reinsert it because of significant nasal tissue necrosis. The team recommends a gastrostomy tube for nutrition because of Mr. Duffy's lack of alertness and high risk for aspiration. Mr. Duffy has a Living Will that states he does not wish to have his life sustained with a feeding tube. He does not have a formal Durable Power of Attorney for Health Care. His wife has dementia and their daughters are making decisions for both parents. They are not sure about his wishes in this particular circumstance, but report that he said of a relative who died of cancer, "things went on too long because of that feeding tube." After 3 days, Mr. Duffy is more alert, and during a discussion about tube feedings he says, "I'll go for the works." His fluctuating alertness level prevents him from responding to this question again. His daughters feel he would not want the tube and suggest waiting to see if his swallowing improves in the next week before making a decision.
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PMID:Interpreting a living will after stroke. 1042 Jun 59

A 60-year-old hypertensive woman had a pontine hemorrhage that caused slight right hemiplegia, deep sensory disturbance on her right side and dysarthria. Three months after the stroke, she was transferred to our hospital for rehabilitation. Approximately 6 months later, she gradually began to complain of the visual oscillation. Continual, unceasing conjugate vertical/rotatory eye movements were observed. Fixation was momentary at best because of an inability to dampen the spontaneous eye movements. Electrooculography (EOG) showed bilateral vertical/rotatory sinusoidal eye movements of 2.5 Hz frequency and 10- to 35-degree amplitude. Both vertical and horizontal optokinetic nystagmus were absent. Caloric stimulation did not evoke any responses bilaterally. There were no rhythmical movements at similar frequencies in other parts of the body such as palatal myoclonus. MRI revealed not only hematoma mainly at the dorsal pontine tegmentum but also hypertrophy of the inferior olive nucleus, suggesting disruption of the central tegmental tract. Lesions of this tract may be one cause of pendular nystagmus. Several drug therapies were investigated for the nystagmus. There was no response to baclofen 15 mg. Trihexyphenidyl 4 mg was discontinued because of drug-induced hallucinations. Tiapride 600 mg and phenobarbital 90 mg were each slightly effective in reducing both frequency and amplitude of nystagmus. Treatment with clonazepam 1 mg resulted in the striking disappearance of nystagmus. She was aware of this and no longer experienced oscillopsia. Despite the visual benefit, however, the patient did not wish to continue this drug because of drowsiness and muscle relaxation. The potential long-term therapeutic application of clonazepam should be further investigated. To our knowledge, there have been no reports of successful treatment in acquired pendular nystagmus with clonazepam. Therefore, based on this favorable experience, it is suggested that clonazepam should be added to the list of potential therapies for pendular nystagmus.
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PMID:[Acquired pendular nystagmus after pontine hemorrhage]. 1065 2

Lacunar infarcts represent a stroke subgroup with controversial risk factors. Lacunar syndromes may be divided into two groups: the classic group (pure motor hemiplegia, pure sensory stroke, ataxic hemiparesis, dysarthria-clumsy hand syndrome, sensorimotor stroke) and the miscellaneous group including all other lacunar syndromes. We studied risk factors of 200 consecutive patients with symptomatic lacunar infarcts diagnosed by magnetic resonance imaging. This study tested whether lacunar infarcts represent a homogeneous subgroup of strokes or not. Using descriptive and bivariate statistics, we found that the prevalences of arterial hypertension and cigarette smoking are lower in the miscellaneous group. Analysis of variance shows a significant difference in age between subgroups without interaction of sex. Nevertheless, using multivariate analysis, we did not find a difference between subgroups. Thus, lacunar infarcts seem to be a homogeneous subgroup of strokes, and the miscellaneous group of lacunar infarcts may be included into the lacunar infarct group and not into the vertebrobasilar large-artery infarct group.
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PMID:Risk factors for lacunar infarcts. 1097 Oct 25


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