Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Outcomes in self-care following rehabilitation in 226 patients were correlated with 11 stroke syndromes, reflecting several pathophysiologic disturbances subsequent to either infarction or hemorrhage in cerebral or vertebro-basilar vessels. Self-care was scored on a 20-point scale for bed movements, transfers, feeding, dressing, personal hygiene, and bathing. Interjudge error among therapists did not exceed 2.5%. Mean score in left cerebral infarction without aphasia was used as a referent value. Scores in left cerebral infarction with aphasia and right parietal lobe syndrome with and without spatial agnosia were similar to the referent. Brain stem dysfunction with spasticity and right cerebral infarction with paresis and spatial agnosia fell below the referent value (Pless than 0.05). Higher levels were achieved in the syndromes of left and right anterior cerebral artery territories, brain stem dysfunction with ataxia, and left parietal lobe syndrome with comprehension aphasia, although t-values were not significant. Length of stay among the 11 groups was fairly uniform except for the group with brain stem dysfunction with spasticity and the group with left hemiplegia with spatial agnosia. These groups indicated rather severe disabilities. Aside from neurologic dysfunction the range of scores was influenced by associated cardiopulmonary involvement.
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PMID:Neurophysiologic syndromes in stroke as predictors of outcome. 68 54

A 74-year-old right-handed man with multiple cerebral infarction who presented with dementia simulating dementia of Alzheimer type (DAT) is reported. He had been well until April 20, 1987 when he developed transient right hand palsy lasting overnight. Eleven days later, he became confused, disorientated, and amnestic. He was admitted to this hospital on June 8. Physical examination revealed hypertension (170/90mmHg). On neurological examination, his consciousness was clear but he was demented. He showed disorientation, amnesia, and urinary incontinence. His most prominent symptom was disturbance of speech, including fluent aphasia and alexia with agraphia. Additionally, he showed ideomotor apraxia, construction apraxia, right-left agnosia, finger agnosia, and acalculia. On July 9, he had a transient attack of right hemiplegia with confusion. The brain CT scan performed on admission was unremarkable except for cavum septi pellucidum and a small low density area in the right basal ganglia. However, single photon emission computed tomography (SPECT) by 123I-labeled N-isopropyl-p-iodoamphetamine disclosed hypoperfusion of the cerebral blood flow in the border zones of the temporoparietal and frontal lobes on the left. A follow-up brain CT scan taken one month later demonstrated low density in the new areas corresponding to hypoperfusion shown by SPECT. Although the clinical features of the present case resembled those of DAT, dementia in this case was regarded as the result of multiple cerebral infarction since it occurred acutely with mild motor deficits, and brain CT scans and SPECT showed lesions indicating focal cerebral ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Multi-infarct dementia clinically simulating dementia of Alzheimer type. A comparison with angular gyrus syndrome]. 278 20

A forty years old woman with hysterical deafness is reported. Chief complaints were bilateral hearing loss. Nothing particular was found in her past and family history. In 1977, on the 11th day of May, she was admitted to A city hospital because of headache and paresis of right limb. As angiography revealed an aneurysms of her anterior communicating artery, she was undertaken the surgery of clipping and coating of the aneurysms. Post-operatively, left hemiparalysis appeared and paresis of right limb developed because of spasm of right middle cerebral artery. On the 14th day of August, ventricular-peritoneal shunt's operation was performed. As soon as she recovered from postoperative coma, she complained of bilateral hearing loss. Because pure tone audiometry demonstrated complete loss of her hearing, she was referred to ENT department of Teikyo University Hospital. Findings were as follows: 1) She had a queer way of hearing because she could understand to hear limited persons' speech (her doctor and husband). 2) Pure tone audiometry showed complete loss of her hearing but the thresholds of auditory brain stem responses were 15 dB and those of slow vertex responses were 45 dB. These results suggested no lesion in cochlea and brain stem. 3) Rorschach test and sentence complete test were performed. The results of these tests suggested hysterical state or neurotic state. 4) Total intelligent quotients by WAIS were 69 which indicated borderline level. However, this value appeared to be incorrect because she was uncooperative. 5) CT scan revealed low density areas at right temporo-parietal lobes and left temporal lobe which were localized and small. Our findings suggested hysterical deafness but not auditory agnosia. During three years, she was referred to several hospitals for rehabilitation but didn't become well at all. On the third year of the onset, her husband became sick and admitted to her room of the same hospital. During that period, suddenly, she talked her hearing to improve and the pure tone audiometry demonstrated decrease in threshold. In conclusion, this event could give a final diagnosis of hysterical deafness but not auditory agnosia.
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PMID:[A case of hysterical deafness]. 711 92

A 75 year-old woman was admitted with a left hemiplegia resulting from an infarct in the right middle artery's territory. Her manual preference was ambiguous from early childhood. She presented with severe bilateral apraxia, autotopoagnosia, finger agnosia, and left spatial neglect. There was, however, no aphasia nor agraphia. When the patient attempted to perform gestures on order, she compulsively produced oral or written language. In this very unusual case, dominance for gesture and dominance for language were strictly independent, each ensured by one hemisphere. The patient's performances in gestual activities, especially dissociation between automatic and voluntary movements, and compulsive linguistic productions, are discussed in relation to this functional lateralization. We suggest that the propositional nature of the responses required in test conditions could activate either voluntary language in the left cerebral hemisphere, or voluntary gestures in the right. A competition between the two hemispheres could explain the patient's linguistic apraxic or behavior in response to orders. Autotopoagnosia, an uncommon symptom, could interfere with apraxia, but is not directly responsible.
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PMID:[Apraxia and autotopoagnosia without aphasia or agraphia with compulsive language activity in right hemispheric lesion]. 786 78

We have observed that patients who suffer from hemiplegia after a cerebral stroke, tend to remove their clothes although it is not necessary to change them while they are in hospital. Not only does this activity make it difficult to manage the ward and carry out rehabilitation, but it also often becomes problematic for home care once the patient has been discharged from hospital. However, there have been no previous reports on this activity. In this study, we examined the characteristics pertaining to clothes removal in hemiplegic patients under home care. The subjects were chronic-stage, cerebral stroke hemiplegic patients hospitalized in the rehabilitation ward of this hospital since the first initial seizure. Once it was established that environmental factors, such as room temperature, were not the primary reason for the patients to try to remove their clothes, the patients were closely monitored and the circumstances under which they tried to remove their clothes (location, time and type of clothes removed) were recorded to examine the relationship among age, sex, side affected by paralysis, higher cortical function, motor paralysis and ADL. Thirty-five percent of the patients, mostly women, usually tried to remove their clothes and the tendency was for them to incompletely remove their tops without reason while they were confined to bed or sitting on the bed. This activity was also prevalent among patients with accompanying diminished intellectual function, left hemiplegia, and left unilateral spatial agnosia. The acquired level of ADL by FIM in the group in which this activity was observed was low, except regarding meals. Thus, it was inferred that in stroke hemiplegic patients being taken care of at home the removal of clothes was related to a diminished intellectual function or ADL, which suggested the importance of family guidance based on observations of the patient's behavior in the ward. Targeting a greater number of subjects, we would like to conduct further studies on home-care measures to deal with this activity.
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PMID:[Characteristics of hemiplegic outpatients with stroke who try to remove their clothes unnecessarily]. 1178 1

The aim of this research was to identify, analyze and classify disorders in behavior which occur in the use of mirrors in patients with right cerebral damage presenting left visual spatial hemiplegia. This work was based on models of visual information processing. Seven controls and eleven patients with right cerebral damage performed a test involving grasping of an object using only specular information from a conventional mirror and then from an inverted mirror. The controls grasped up all the cubes straight away. They only experienced minor difficulty with the inverted mirror, mainly in relation to lateral displacement. The patients revealed a variety of behaviors: 1) searching for and trying to seize the object in the conventional and/or inverted mirror, 2) inversion of the paralysed side (left versus right) in the inverted mirror or the appearance of a visual spatial hemiplegia, 3) modifications in the order of grasped (from right to left, from left to right, or at random), 4) directional anomalies in the horizontal plane linked (or not) with disorders in the use of the anteroposterior space. The results of this study confirm that the patients have abnormal behavior in mirror spaces. While the characteristics of this behavior shows analogies with those described in the non-recognition of objects and/or defects in the processing of visual information for localising objects in space, they can be disassociated from them, and constitute separate syndromes. Specific terminology and taxonomy for the clinical forms of mirror agnosia and specular agnosia, of mirror paralysis and specular paralysis, and of specular ataxia are proposed.
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PMID:[Disorders of the processing of spatial information in patients with right cerebral lesions and left hemi-neglect]. 1291 75

The aim of this study was to investigate auditory cortex function in the context of auditory stimuli in a patient with auditory agnosia due to bilateral lesions confined to the auditory radiations. A male patient experienced mild left temporal hemiplegia because of right putaminal hemorrhage at the age of 43 years. Thereafter he recovered completely but hypertension persisted. When he was 53 years old, he suffered left putaminal hemorrhage and went into a coma. After recovering from the coma and right hemiplegia he could hear but could not discriminate speech sounds. Brain CT and MRI demonstrated small bilateral lesions confined to the auditory radiations. Magnetoencephalography demonstrated the disappearance of middle latency responses and auditory-evoked potential studies showed a very small Pa peak. In contrast, a positron emission tomography study demonstrated a marked increase in blood flow in the bilateral auditory cortex in response to both click and monosyllable stimuli. It is speculated that the auditory cortex receives functional projections from the cochlea via non-specific pathways in the cerebral hemispheres.
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PMID:Magnetoencephalography and positron emission tomography studies of a patient with auditory agnosia caused by bilateral lesions confined to the auditory radiations. 1630 86

After a cerebral infarction, some patients acutely demonstrate contralateral hemiplegia, or aphasia. Those are the obvious symptoms of a cerebral infarction. However, less visible but burdensome consequences may go unnoticed without closer investigation. The importance of a thorough clinical examination is exemplified by a single case study of a 72-year-old, right-handed male. Two years before he had suffered from an ischemic stroke in the territory of the left posterior cerebral artery, with right homonymous hemianopia and global alexia (i.e., impairment in letter recognition and profound impairment of reading) without agraphia. Naming was impaired on visual presentation (20%-39% correct), but improved significantly after tactile presentation (87% correct) or verbal definition (89%). Pre-semantic visual processing was normal (correct matching of different views of the same object), as was his access to structural knowledge from vision (he reliably distinguished real objects from non-objects). On a colour decision task he reliably indicated which of two items was coloured correctly. Though he was unable to mime how visually presented objects were used, he more reliably matched pictures of objects with pictures of a mime artist gesturing the use of the object. He obtained normal scores on word definition (WAIS-III), synonym judgment and word-picture matching tasks with perceptual and semantic distractors. He however failed when he had to match physically dissimilar specimens of the same object or when he had to decide which two of five objects were related associatively (Pyramids and Palm Trees Test). The patient thus showed a striking contrast in his intact ability to access knowledge of object shape or colour from vision and impaired functional and associative knowledge. As a result, he could not access a complete semantic representation, required for activating phonological representations to name visually presented objects. The pattern of impairments and preserved abilities is considered to be a specific difficulty to access a full semantic representation from an intact structural representation of visually presented objects, i.e., a form of visual object agnosia.
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PMID:[Associative visual agnosia. The less visible consequences of a cerebral infarction]. 2140 Sep 59

Japanese encephalitis, the commonest Arbovirus encephalitis, has been endemic in many parts of Asia, the Pacific Islands, and India; also, there have been many epidemics. Most of the post JE cases have been associated with neurological and neuropsychiatric deficits but have not been properly classified and followed. Practically all the previous studies were in children or young adults. The aim of this study, involving only adult cases, the largest ever being reported, has been to follow the 688/1,199 survivors of JE patients out of 1,282 of acute cases admitted during four epidemics for a period of 14 years after properly classifying the sequelae. This prospective study was conducted in B.R.D. Medical College Gorakhpur (India), involving 665/688 post JE cases with neuropsychiatric deficits from four epidemics of 1978, 1980, 1988 and 1989 which were properly classified in nine groups. While the first epidemic of 1978 was being studied, more disastrous episodes flared up and the patients were subsequently added. Hence, the total duration of this prospective study was from November 1978 to December 2003. There were 14 defaulted initially from 688 followed (23/688 without sequelae and 665/688 with neuropsychiatric deficits), and later 130 were lost from time to time at various stages of follow up. Four out of 23/688 discharged without any deficit had to be readmitted for bizarre movements, assaultative behaviour and euphoria without fever and altered sensorium. All of them improved by symptomatic treatment. Progressive improvement occurred in all the parameters consisting of psychological disturbances, higher cerebral dysfunction, speech disorders (dysphonia, dysarthria, dysphasias, apraxia and agnosia), extra pyramidal, pyramidal features, and hypothalamic disturbances, cranial nerves including pupils and fundi and seizures. Maximum cases improved between 6 months (55%) to 1 year (78%). Only some features improved between 5 to 14 years. Four patients of hemiplegia remained bed ridden. Some non disabling features like dysarthria and corticospinal features without paralysis persisted in 5% (95% improved) and 74% (26% improved) respectively. One patient with bizarre movement and nine with marked tremors could not regain normalcy. A large number of patients of JE are left with several minor or gross residual neuropsychiatric and neurological features after the acute phase. In this series also the discharged patients with neurological deficits who were quite disabled initially and needed constant care by family members and also those who required some help intermittently improved with passage of time and eventually returned to normal life. Some of them were left with non-disabling residual neurological signs even after 14 years. Fourteen of 544 (3%) could not return to their livelihood.
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PMID:Japanese encephalitis (JE) part II: 14 years' follow-up of survivors. 2168 33