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)

Headache associated with moyamoya disease (HAMD) is common in moyamoya disease. However, the characteristics and classification of HAMD are largely unknown. We present a case of a 39-year-old woman with HAMD. To characterize and classify the features of this syndrome, the patient was asked to complete a 4-month diagnostic headache diary. There was a total of 15 ictal days. All episodes were without aura. The headache was more commonly pressing (10/15), mild to moderate in severity (14/15), unchanged by physical activity (11/15), and associated with photophobia (10/15). The International Headache Society Classification was utilized to determine that eight episodes met criteria for probable migraine without aura, while seven episodes met criteria for probable frequent episodic tension-type headache. We identified four other case reports of HAMD with partial descriptions of the characteristics. When combined with our patient, the median age was 34 years old (range 6-49, SD 16). Four were female, while the patient with cluster headache was male. The median time from headache onset to diagnosis with moyamoya disease was 9.5 months (range 0-192, SD 88.0). Headaches were described as migraine with aura in two of five cases, hemiplegic migraine in one of five, and cluster headache in one of five. The highest intensity was described as severe in three of three cases, in which headache intensity was reported. Meanwhile, nausea, vomiting, and photophobia were present in two of three cases, where these features were reported, while nausea without vomiting was seen in one of three cases. In all five cases, patients had other neurological symptoms, such as paresis, seizures, visual disturbances, dysarthria, allodynia, ptosis, and unilateral restless leg syndrome. In conclusion, HAMD can present as migraine without aura. It can be the first presenting symptom of moyamoya disease. The headache features are not diagnostic; hence, early neurovascular imaging should be considered in patients with new onset, refractory migraine-like headache, especially in the setting of other neurological symptoms to exclude underlying moyamoya disease. Further reports using headache diaries are needed to better characterize HAMD as well as to determine whether headache with tension-type features is also part of this condition.
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PMID:Headache associated with moyamoya disease: a case story and literature review. 2001 51

A 60-year-old housewife noticed sudden onset left hemiparesis. On admission, she had left hemiparesis, more severe in the lower limb. A brain CT scan at this time was normal. After a few days, her hemiparesis was almost diminished, however, she had ataxia on the left side without paresis. She had no facial weakness and dysarthria.
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PMID:A patient with ataxia with a normal brain CT on admission. 2106 99

We report on a 27-year-old female patient who developed a progressive neurological disorder (anisocoria, dysarthria and facial nerve paresis) after participating in a marathon race. She was admitted to a maximum care level hospital after endotracheal intubation with a provisional diagnosis of intracranial bleeding. Imaging studies (computed tomography and computed tomographic angiography) revealed basilar artery occlusion. A successful outcome was achieved following thrombolysis within two hours of the initial onset of symptoms.
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PMID:[Neurological deterioration following a marathon - atypical manifestation of basilar artery occlusion]. 2112 Jul 68

Abnormal copper metabolism has been linked with neurological disorders, such as Wilson and Menkes disease. Another disorder causing symptoms similar to copper metabolism disorder is Niemann-Pick type C. However, a definite pathophysiological connection between Niemann-Pick type C and copper metabolism disorders has never been established. The authors present an adolescent with an unusual presentation of copper deficiency-dysarthria, ataxia, and vertical gaze paresis, without significant cognitive degeneration or pathological magnetic resonance imaging (MRI). The patient was found to carry 2 mutations in the NPC1 gene. A possible link, explaining how copper deficiency might induce the Niemann-Pick phenotype might involve overproduction of cholesterol and inhibition of acid sphingomyelinase. We suggest that copper metabolism disorders be included in the differential diagnosis for ataxia and dysarthria, even in cases with unusual presentations. Moreover, should the connection between copper and Niemann-Pick be validated, screening for copper metabolism disorders may be advisable in Niemann-Pick type C patients and vice-versa.
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PMID:An unusual presentation of copper metabolism disorder and a possible connection with Niemann-Pick type C. 2127 8

Isolated hypoglossal nerve paresis due to mechanical compression from a vascular lesion is very rare. We present a case of a 32-year-old man who presented with spontaneous abrupt-onset dysarthria, swallowing difficulty and left-sided tongue atrophy. Brain computed tomographic angiography and magnetic resonance imaging of the brainstem demonstrated an abnormal course of the left vertebral artery compressing the medulla oblongata at the exit zone of the hypoglossal rootlets that was relieved by microvascular decompression of the offending intracranial vertebral artery. This case supports the hypothesis that hypoglossal nerve palsy can be due to nerve stretching and compression by a pulsating normal vertebral artery. Microvascular decompression of the intracranial nerve and careful evaluation of the imaging studies can resolve unexpected isolated hypoglossal nerve palsy.
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PMID:Resolution of isolated unilateral hypoglossal nerve palsy following microvascular decompression of the intracranial vertebral artery. 2155 37

This study investigated how intelligibility scores of a speaker with bilateral facial paresis differed in auditory-only and auditory-visual presentation modes. A speech sample was collected and movies were created in both auditory-only and auditory-visual modes. These movies were presented to listeners who were unfamiliar with the speaker (n=20) with 10 of the listeners randomly assigned to the auditory-only listening mode and 10 assigned to the auditory-visual mode. Listeners transcribed what they heard and also completed a scale to determine the strategies used to understand this speaker's utterances. Results of ANOVA revealed that intelligibility in the auditory-visual condition was significantly greater than intelligibility for the auditory-only condition. Listeners reported utilizing many strategies to transcribe the speaker's utterances and listeners in the auditory-visual mode utilized cognitive strategies significantly more than listeners in the auditory-only mode. Findings of this study highlight the importance of visual information provided to listeners, as well as the types of strategies that listeners may use or be taught to use in understanding speakers with dysarthria.
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PMID:Utilization of visual information and listener strategies in intelligibility impairment related to bilateral facial paresis. 2168 45

We report a 68-year-old man who exhibited mild dysarthria and mild right hemiparesis resulted from hypoperfusion of the left hemisphere. An MR angiography showed a severe stenosis at the second portion of left middle cerebral artery (MCA). After the beginning of treatment, the patient suffered from hoarseness, followed by breathing failure. The laryngeal fiber exhibited right vocal cord paresis. Unilateral cortico-bulbar tract dysfunction does not typically cause vocal cord palsy. However, several cases indicate the involvement of a dominant projection from the contralateral cortico-bulbar tract to the vocal cord. In the present case, hypoperfusion of the left hemisphere might have temporarily produced right vocal cord palsy, considering the stenosis of the left MCA.
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PMID:Transient vocal cord palsy caused by hypoperfusion of unilateral hemisphere. 2211 35

A 30-year-old man with brainstem cavernoma experienced hemorrhage and was operated in 2008. Six months after the operation, the patient presented with new complaints of left arm tremor namely Holmes' tremor. Neurological examination also revealed left-sided internuclear ophthalmoplegia, left-sided mild paresis, and increased deep tendon reflexes of the left upper extremity, truncal ataxia, and dysarthria. Brain magnetic resonance imaging showed a postoperative cavity and gliosis at the level of the superior and inferior colliculus in the right tegmentum and right red nucleus with extension to the substantia nigra. Fahn-Tolosa-Marin tremor rating scale (TRS) for his left upper extremity (Part A, score 6) was 11 for the proximal and the distal arm. After the failure of medical treatment, the patient underwent right globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. There were no side effects related to the stimulation. Final TRS months after operation was 3 for the proximal and 4 for the distal arm.
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PMID:Unilateral thalamic Vim and GPi stimulation for the treatment of Holmes' tremor caused by midbrain cavernoma: case report and review of the literature. 2331 30

We report a 55-year-old patient, presenting with paresis, muscle atrophy and dysarthria, all symptoms accordable to definite amyotrophic lateral sclerosis (ALS). However, MRI and cerebrospinal fluid show abnormalities typical of multiple sclerosis (MS). On the basis of this case report, we discuss possible overlaps between both diseases by comparing clinical and paraclinical features including laboratory, radiological and electrophysiological diagnostics. As genetic, as well as environmental, factors are assumed to be involved in the development of both the diseases, literature is reviewed according to similar cases, results of autopsies and possible parallels in pathogenesis. In summary, based on the data currently available, the hypothesis of ALS being a neurodegenerative multisystem disorder, a common pathophysiological pathway or, alternatively, a random comorbidity of ALS and MS in this patient has to be discussed.
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PMID:Concomitant amyotrophic lateral sclerosis and paraclinical laboratory features of multiple sclerosis: coincidence or causal relationship? 2334 76

Methotrexate used in the treatment of acute lymphocytic leukemia, can cause neurotoxicity, including a rare presentation with hemiparesis. We describe two teenagers, who during the implementation of the M phase of the protocol, suffered hemiparesis, facial paresis and dysarthria which quickly reversed. Leukemia involvement of the central nervous system and stroke, were ruled out. We briefly review the pathophysiology of methotrexate neurotoxicity, the characteristics of the focal paresis presentation and magnetic resonance image findings.
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PMID:[Hemiparesis and facial palsy caused by methotrexate]. 2378 2


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