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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Paroxysmal syndromes do not occur frequently in the course of multiple sclerosis, but require diagnostic considerations of particular nature. The pathogenesis and clinical aspects of a) cerebral convulsions, b) (usually appearing unilaterally) tonic brain stem seizures, c) narcoleptic attacks, d) hemiballismus, e) acute attacks of vertigo, f) paroxysmal dysarthria, g) trigeminal neuralgia are discussed.
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PMID:[Paroxysmal syndromes in multiple sclerosis (author's transl)]. 82 88

Syringobulbia is a term which has been clinically applied to brain stem symptoms or signs in patients with syringomyelia. Syringobulbia clefts are found on investigation or at necropsy caused by cutting outwards of the CSF under pressure from the fourth ventricle into the medulla. These should be differentiated from the ascending syringobulbia which may occur from upward impulsive fluid movements in a previously established syringomyelia. Clinical analysis of 54 patients suggests that bulbar features are most often found with neither of the above mechanisms but are due to the effects of pressure differences acting downward upon the hind-brain with consequent distortion of the cerebellum and brainstem, traction on cranial nerves or indentation of the brain-stem by vascular loops. The commonest symptoms in the 54 patients were headache (35), vertigo (27), dysphonia or dysarthria (21), trigeminal paraesthesiae (27), dysphagia (24), diplopia (16), tinnitus (11), palatal palsy (11) and hypoglossal involvement (11). Careful attention to hydrocephalus is advisable before craniovertebral surgery, but the decompression of the hindbrain and the correction of craniospinal pressure dissociation remains the mainstay of surgical treatment. The results of careful surgery are good, 45 of the 54 cases reported improvement. Most of the reported deterioration occurred in a few patients who did conspicuously badly.
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PMID:Syringobulbia: a surgical appraisal. 147 91

The common signs of hypoglycemia include: tachycardia, diaphoresis and vertigo which may be associated to disturbances of the consciousness. Occasionally, focal neurological signs occur with conservation of consciousness which are erroneously interpreted as cerebral vascular disease. An insulin dependent diabetic patient is presented with an initial diagnosis of transient ischemic attack (TIA) with right hemiparesis and dysarthria associated to hypoglycemia (35 mg %) whose remission occurred following the correction of glycemia. The different physiopathogenic mechanisms were also revised postulating (selective neuronal vulnerability, vasospasms and subjacent vascular disease) and the need for considering this diagnosis must be emphasized in those diabetic patients with focal neurological symptoms.
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PMID:[Hypoglycemic hemiparesis]. 161 Jun 4

Cerebellar infarcts have long been underrecognized both clinically and neuroradiologically. In approximately a quarter of cases, they are oedematous and may require, unlike other cerebral infarcts, a sometimes life saving surgery when there are signs of brain stem compression. Benign infarcts are more frequent, but inaugural symptoms are identical: vertigo, headache, vomiting, unsteadiness, and dysarthria of sudden onset. Brain stem and occipital symptoms can be associated and are sometimes prominent. The infarct can be shown by CT but MRI is the method of choice for early recognition, precise delineation, and detection of associated brain stem infarcts. Prognosis is good when the infarct is restricted to the cerebellum, and poor when the brain stem is involved, a fact which should be taken into account in the surgical decision making. Cardiac emboli are the leading cause followed by atherothrombotic occlusions. These are usually located in the intracranial part of the vertebral artery and less frequently in the lower basilar artery, and are therefore inaccessible to prophylactic vascular surgery.
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PMID:[Cerebellar infarction]. 841 82

A 68-year-old woman had an abrupt onset of severe headache, nausea, vertigo, difficulty in standing and dysarthria. A CT scan of the brain disclosed bilateral symmetrical round infarctions involving the middle cerebellar peduncles. She exhibited marked limb ataxia, gait ataxia, dysarthria and transient gaze nystagmus. Occlusion of the right vertebral artery associated with a stenosis of the basilar artery just proximal to the origin of the anterior inferior cerebellar arteries shown in angiograms were thought to be the cause.
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PMID:A case of bilateral cerebellar peduncle infarction. 194 54

The experience of 500 transcranial Doppler (TCD) sonographies at Siriraj Hospital between April 1988- June 1989 were reported. The indications for TCD study were hemiplegia 156 (31.20%), vertigo 119 (23.80%), transient ischemic attack (TIA) 26 (5.20%), hemihypalgesia 14 (2.80%), dysarthria-dysphagia syndrome 13(2.60%), visual problem 13(2.60%), syncope 10(2.00%), memory loss 8(1.60%), aphasia 6(1.20%), carotid bruit 6(1.20%), miscellaneous (artereovenous malformation, aneurysm, arteritis, carotico-cavernous fistula, tinnitus, etc) 25(5.00%), and healthy subjects 92(18.4%). Abnormal TCD studies were found in various conditions of different percentages, i.e. 91.03 per cent in hemiplegia, 76.47 per cent in vertigo, 65.38 per cent in TIA, 71.43 per cent in hemihypalgesia, 61.54 per cent in dysarthria - dysphagia syndrome, 38.46 per cent in visual problem and 30.43 per cent in normal subject. TCD is noninvasive, safe and painless. It is a useful screening test for prophylaxis of cerebrovascular disease in the elderly.
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PMID:Transcranial Doppler ultrasonography: experience of 500 patients. 228 86

In a 37-year-old female patient complaining of increasing pain in the neck and occiput, chiropractic manipulations at the cervical vertebral column were associated with ischaemias of the brain stem presenting as vertigo, transient "locked-in" syndrome followed by vomiting, and sensorimotor hemiparesis. Digital subtraction angiography (DSA) revealed complete obstruction of the right and slight dissection of the left vertebral artery. The symptoms receded within a few days after heparinisation with 1000 IU/h intravenously. A 39-year-old female patient developed vertigo, nystagmus, tetraparesis and dysarthria two days after chiropractic intervention because of refractory pain in the neck and occiput. DSA showed embolism of the basilar artery and extensive dissections of the vertebral arteries. The basilar artery was completely recanalized after local intraarterial fibrinolysis with 50,000 IU urokinase. During the further course of treatment the symptoms receded under heparin and phenprocoumon over a period of 8 months, except for hemiparesis on the left side especially affecting the arm. Trivial traumas can result in dissections of the vertebral arteries. Severe neck pain is a frequent, typical early symptom. Hence, patients with cervical vertebral column syndromes should receive chiropractic treatment only after careful diagnosis.
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PMID:[Dissections of the vertebral artery following cervical chiropractic manipulations]. 232 65

Central nervous system is rarely involved in progressive systemic sclerosis (PSS) unless there are concomitant abnormalities in renal or lung function or hypertension. A 72-year-old woman with typical PSS developed cerebellar bleeding. Medical history records revealed, she had noted the onset of Raynaud's sign on her upper extremities at the age of 37. This was followed by necrosis and repeated infection, and as a result, shortening of her fingers in her 40's. The disease progressed and involved lower extremities, and then face and body in her 50's. Aortic valve stenosis was diagnosed at 69 year old, cardiac myopathy at 70 and at the age of 71 infectious dermatitis in both inguinal regions. Mild anemia, hypoalbuminemia and the decrease of serum Fe were discovered in June 1988. At the same time, prolonged ESR, positive C-reactive protein, RA, and anti-nuclear-antibody were also noticed. A chest roentgenogram revealed pulmonary fibrosis. Systemic hypertension was not noticed on the clinical course. She developed an onset of vertigo and vomiting in the morning of August 8, 1988. Consequently, she was brought to our hospital. She was alert but a physical examination showed a swallowing disturbance, dysarthria, right cerebellar ataxia, nystagmus and hypertension (192/100 mmHg). A CT examination on admission revealed a slightly low density area in right cerebellar hemisphere without mass effect. She was treated with dextran and mannitol and her condition improved on the 6th day of her admission. She was alert and blood pressure calm down to 120/70 mmHg without the use of anti-hypertension drugs on August 21.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of progressive systemic sclerosis associated with a hemorrhagic infarction of the cerebellum]. 235 21

Fourteen patients with symptoms of vertebrobasilar insufficiency caused by vertebral artery stenosis in the distal first portion underwent surgical reconstruction. They ranged in age between 42 and 73 years, with a median age of 57 years. Their symptoms included vertigo, dysarthria, syncope, hemiparesis, and homonymous quadrant anopsia. The etiologies of the stenoses involved kinking in 12 cases and mechanical compression due to cervical sympathetic nerve, osteophyte, or fibrous bands in two cases. Digital subtraction angiography revealed that stenosis was maximal at systole and minimal at diastole in six of eight cases. In two of the 14 cases, stenosis was not demonstrated in the neutral position, but stenosis of the left vertebral artery appeared when the head was rotated to the right. Surgical procedures involved 13 decompressions of the vertebral artery and one subclavian artery-vertebral artery bypass using the saphenous vein. Postoperatively, 12 cases of miosis and one of asymptomatic phrenic nerve palsy were observed, but there were no serious complications. All but two patients had complete resolution of their symptoms. Stenosis due to kinking and/or mechanical compression disappeared in all cases after decompression of the vertebral artery. The effects of arterial pulse and neck rotation on vertebral artery stenosis in the distal first portion are discussed.
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PMID:[Extracranial surgery of vertebrobasilar insufficiency. Reconstruction of the vertebral artery in the distal first portion]. 247 9

Transient global amnesia (TGA) is an unusual form of the amnestic syndrome, clinically characterized by profound disturbance of short-term memory with preservation of immediate recall and long-term memory. Spontaneous recovery is the rule and is usually complete within several hours. The etiology of TGA is not clear. It is considered to be caused by transient ischemia confined to the medial temporal lobe, an area supplied by branches of the vertebrobasilar system. Basilar artery migraine is a well-known syndrome, first described by Bickerstaff. Besides pulsating headache, the dominant symptoms are vertigo, ataxic gait, tinnitus, dysarthria, paraeshesia in the hands, homonymous hemianopsia and sometimes drop-attacks. These symptoms are associated with vertebrobasilar system dysfunction. In this paper, three migraine patients, suffering from one episode of TGA, were reported. All patients were women. Case 1 was a 48-year-old woman with a history of common migraine. Case 2 was a 48-year-old woman with a history of classic migraine. Case 3 was a 59-year-old woman with a common migraine. Family history of migraine exists in case 1 and case 3. Their migrainous attacks began in their twenties and thirties. They suddenly suffered migraine with the symptoms of vertebrobasilar dysfunction. These symptoms are ataxic gait (Case 1, 2, 3), dysarthria (Case 1, 2), vertigo (Case 1, 3) and homonymous hemianopsia (Case 1, 3). Simultaneously three patients had TGA. Duration of retrograde amnesia were about twenty-four hours (Case 1), about thirty minutes (Case 2) and about three hours (Case 3).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Basilar artery migraine associated with transient global amnesia]. 262 11


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