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

Dysphagia is more frequently observed in patients with neurologic diseases (stroke, bulbar or pseudo-bulbar syndrome, amyotrophic lateral sclerosis, cranial trauma). Furthermore, the presence of this pathology is obviously more frequently noted in the light of the increase in the length of the human life span. It has become evident that alternative feeding procedures such as the nasogastric tube or gastrostomy may bring about complications and deprive patients of the oral phase of deglutition which plays a leading role in stimulating digestive functions. The Authors report a systematic research on the rehabilitation aspects of neurogenous dysphagia. All the patients studied underwent a neurological examination and oropharyngeal functional evaluation using echo-videorecording of the oral phase of deglutition and fluoro-videorecording of the pharyngeal phase. The data obtained allowed for the selection of five patients considered suitable for the rehabilitation program. One of them had a multi-infarct encephalopathy, two a spastic hemiplegia f.b.c., a fourth a cerebellar syndrome and the last a sequela of meningioma removal of the ponto-cerebellar angle with peripheral paralysis of the right VII, IX, X, XI cranial nerves. This last patient also underwent a crico-pharyngeal myotomy. Therapy consisted in making the patient sensitive to swallowing movements and in training them to assume a compensatory posture as well as functional rehabilitation of the organs involved in deglutition. The first datum emerging from the study is the lack of etiological homogeneity found in the cases treated with evident variability in different deglutition organ impairment, even though there was the common denominator of the dysphagia symptom. With regard to the results obtained, there was a complete resolution in one patient, while in the other four there was such an improvement as to allow the patients a safe autonomous oral assumption of food. The positive results obtained are not only linked to the recovery of damaged organs, but also to the development of compensatory strategies such as the choice of appropriate food consistency and the assumption of postures which protect the respiratory tract from aspiration and favor crico-pharyngeal relaxation.
 ...
PMID:[Rehabilitation of oro-pharyngeal dysphagia of neurogenic etiology using radiological examination: preliminary results]. 163 72

Distinct chronic posttraumatic syndromes, ascribed to neurological deficits of patients suffering severe head injuries and being in prolonged coma, are much less frequently encountered in the literature than acute traumatic syndromes. The major components of the posttraumatic midbrain syndrome, resulting from compressive necrosis or vascular infarction at the midbrain level, are ipsilateral cerebellar signs (the predominant one being intention tremor), contralateral pyramidal signs (the predominant one being a spastic-dystonic hemiparesis), dysarthria, and mild to moderate intellectual impairment. Significant bilateral cerebellar dysfunction following head injury, without pyramidal, extrapyramidal, or pseudobulbar signs, constitutes a posttraumatic cerebellar syndrome. Its most disabling component, namely posttraumatic intention tremor, may be alleviated by thalamotomy. Following severe closed head injury, an infrequently encountered posttraumatic entity of dystonic hemiplegia or hemiparesis, which may be alleviated by thalamotomy, can occur, but does not have a specific neuroanatomical basis. Intention tremors following severe head injuries, rarely associated with hydrocephalus and without other significant cerebellar findings, can develop as a dysfunction of the cerebellofugal outflow system. While chronic posttraumatic syndromes can be complex and difficult to treat, cerebellar stimulation has been utilized ipsilaterally to modulate limb spasticity, and bilateral ventrolateral cryothalamectomies staged 4-6 months apart have been successful in alleviating severe (intractable) intention tremors.
 ...
PMID:Rehabilitative neurosurgery: posttraumatic syndromes. 262 1

The authors report a case of Parry-Romberg disease with predominantly facial left atrophy, seizures, amnesic aphasia, mental retardation, right hemiplegia and hemianesthesia, and cerebellar syndrome. The rarity of cerebellar atrophy (only one case thus far reported in the literature surveyed) is emphasized, as well as the correlation between the clinical abnormalities and the computerized axial tomography of the skull.
 ...
PMID:[Progressive facial hemiatrophy: report of a case]. 646 49

A 52-year-old woman developed headache with fever followed after several days by a left hemiplegia, paralysis of the right IIIrd, Vth, and VIIth cranial nerves, and a right cerebellar syndrome. The CSF contained 48 white cells/mm3 and 0,80 g/l of proteins. Blood and CSF cultures were negative. In spite of an early massive antibiotic therapy, successive CT scans demonstrated the development of a voluminous rhombencephalic abscess. Clinical improvement occurred only after 1 month of treatment. The diagnosis of listeriosis, suggested clinically, was confirmed by elevated levels of antibodies to listeria Monocytogenes serotype 01 (1/80 to 1/1 280). Signs regressed slowly and hemiplegic sequelae persisted. A review of the literature demonstrated the rare nature of listerian abscesses in the CNS: in 6 of the 9 cases reported the patients were immunodepressed and the abscess was located in the cerebral hemispheres. The elective rhombencephalic lesion of listerian encephalitis may also apply to abscesses, which can develop in previously healthy subjects. The clinical picture is that of a solitary brain stem abscess with a fatal outcome whatever the nature of the germ. Van Gilder, Allen and Lesser (1974) published the first report of a case that recovered after surgical drainage. The present case is the only one of the 6 cases reported in the literature in which a favorable outcome was obtained by antibiotic therapy.
 ...
PMID:[Large listerial abscess of the brain stem. Favorable effect of antibiotic therapy]. 687 77

We report eight cases of brain tuberculoma. The clinical presentation was polymorphous: partial epilepsy (n=4), headache (n=3), hemiplegia (n=1), meningitis (n=1), cerebellar syndrome (n=1). Six patients also had pulmonary tuberculosis, one had tuberculosis of the genital organs, and one had HIV co-infection. The brain CT scan and MRI were highly contributive to diagnosis and follow-up. Despite good compliance with an anti-tuberculosis regimen for at least 14 months, the course was favorable in only six patients. Adjunction of corticosteroids led to radiological improvement. Assessment of cell immunity demonstrated a diminished immunomodulator ratio. Cerebral tuberculoma should be searched for in patients with unexplained neurological manifestations and several intracerebral lesions, particularly if pulmonary or visceral tuberculosis and/or immunodepression is part of the clinical picture.
 ...
PMID:[Cerebral tuberculomas]. 1367 25

The brainstem is an uncommon site of a brain abscess. Such lesions, which were invariably fatal, changed with the arrival of computed tomography and magnetic resonance imaging (MRI). These not only helped in the diagnosis but also in treatment management. A 51-year old patient was diagnosed of widespread pontomesencephalic abscess. He was admitted with a clinical picture of dizziness, headache and involvement of multiple cranial nerves with near complete ophthalmoplegia and cerebellar syndrome in the side of the lesion and contralateral hemiplegia. Microbiologic investigations were negative and the medical management decided was broad spectrum antibiotic and periodic MRI controls. The length of the lesion decreased (from 4 cm in diameter to 0.5 cm) with progressive improvement of the neurological deficits. Treatment of large brainstem abscesses includes primary antibiotic therapy combined with stereotaxic drainage, but in individual cases empirical medical therapy can be effective. Sequential MRI examinations are very important for monitoring treatment efficacy.
 ...
PMID:[Widespread brainstem abscess resolved with medical therapy]. 1732 39