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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study investigated the importance of the side of weakness and sex of the patient in patient outcome after stroke. It was based upon 162 consecutive acute stroke patients attending a rehabilitation unit. Results suggest that functional recovery was not influenced by the factors investigated, provided that measurements were made at set times poststroke. However, patients with right hemiplegia attended rehabilitation longer so they appeared to have made a better functional recovery when activity of daily living (ADL) ability was measured at discharge. Although right hemiplegia was associated with aphasia and left hemiplegia with spatial disorder and loss of sitting balance, these associations were not strong enough to affect functional recovery. Sex of the patient had no significant effect upon either the frequency of initial deficits or upon outcome, and there was no obvious interaction between the two variables (side and sex) and outcome.
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PMID:Stroke: influence of patient's sex and side of weakness on outcome. 647 82

Static and dynamic lung volumes, maximum respiratory pressures and lung compliance and resistance were registered in 54 subjects with hemiplegia or hemiparesis after stroke. These measures of ventilatory function were related to the degree of motor impairment and to the interval between stroke and investigation. In general ventilatory function, particularly parameters depending upon expiratory force, was restricted. This was most pronounced in subjects with severe hemiplegia while those with hemiparesis had only small changes. Since dynamic lung volumes (corrected for volume loss), lung compliance and resistance were all normal, it is evident that intrinsic lung function was unaffected. Inspiratory capacity - but no other measured variables of respiratory function - was lower six months after the stroke than earlier. It is suggested that expiratory muscle dys-coordination and weakness caused expiratory dysfunction while the less pronounced inspiratory restriction may be caused by muscular dysfunction and, as time goes by, by rib cage contracture.
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PMID:Restrictive ventilatory dysfunction in stroke: its relation to locomotor function. 658 33

Of 135 patients seen two weeks following a stroke and followed up for one year, 69 had a right hemiplegia and 66 left-sided weakness. Disturbance of the level of consciousness at the onset and confusion following the stroke were more common in those with right hemiplegia. Confusion, when present, improved more often in those with right hemiplegia. Neither severity nor functional outcome was associated with laterality. Elderly patients with right hemiplegia were more likely to be admitted to hospital, and of those admitted there were significantly more patients with a right hemiplegia admitted to general wards and of those with left hemiplegia to geriatric units. Radios, but not television, were more often used by those patients with left hemiplegia. Most bedside containers were placed on the patients right side irrespective of the side of the lesion.
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PMID:Stroke: does side matter? 710 Jul 74

Stenosis of the intracranial internal carotid artery by other tumors than meningiomas and pituitary adenomas is a rare occurrence. We present here a case with craniopharyngioma, which developed severe stenosis of the intracranial internal carotid artery 7 years following partial removal and irradiation. This severe stenosis of the intracranial internal carotid artery would result from combination of compression of the arterial walls against the surrounding bony structures and radiation effect on the arterial walls. A 29-year-old male was found to have a craniopharyngioma, which was treated by partial removal in 1971. He had suffered bilateral optic atrophy, right homonymous hemianopsia and panhypopituitarism. Angiography revealed elevation of the A-1 and opening of the carotid siphon on both sides. He had a course of 5,000 rads of Lineac irradiation in 1972. He showed no clinical improvement. He became totally blind in 1976. He was admitted again in 1979, because of left sided weakness and Korsakoff syndrome. Examination disclosed that there were bilateral optic atrophy, left hemiplegia with hyperreflexia and pathological reflexes, hypesthesia in the left side of the face and Korsakoff syndrome, chiefly consisting of confabulation. Angiography showed that the right internal carotid artery was markedly elevated and stenosed. The left internal carotid artery was elevated and the left A-1 was stenotic. The territory of the left distal anterior cerebral artery was filled from the anterior falx artery of the ophthalmic artery. The right A-1, M-1 and M-2 were filled through the left A-1. The territory of the right anterior cerebral artery was filled through the right posterior pericallosal artery and that of the right middle cerebral artery was partly filled through the posterior temporal and occipito-parietal arteries of the posterior cerebral artery. A right superficial temporal-middle cerebral artery bypass surgery was performed with some clinical improvement.
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PMID:[Stenosis of the intracranial internal carotid artery by a craniopharyngioma: report of a case]. 713 1

A primary cerebral rhabdomyosarcoma is reported in a 51-year-old female. She noticed progressive weakness of the left leg in September 1977 and underwent craniotomy for a brain tumor in Tokyo Metropolitan Okubo General Hospital. At the operation the tumor was located on the medial aspect of the right frontal lobe, being attached to the falx. The tumor was 6.0 x 5.0 x 4.0cm in size and subtotally removed. Shortly after operation, she developed a left-sided hemiplegia and was referred to our Kanagawa Rehabilitation Center. During rehabilitation she developed disturbance in recent memory, orientation and speaking. A second operation was done in June 1978, revealing obvious recurrence. A well demarcated extramedullary gray and soft tumor, 7.0 x 5.0 x 3.5cm in size, was found in the previously operated site, being attached to the falx. It was subtotally again. Following surgery her clinical condition was temporally improved. Four months following surgery, however, she developed signs of increased intracranial pressure and died in October 1978 in spite of having chemotherapy and irradiation. Autopsy was not permitted. The tumor was diagnosed as rhabdomyosarcoma with light and electron microscopies and several investigation revealed no primary lesion in elswhere except for the cranium. The histological documentation is also presented and discussed.
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PMID:[A case of primary cerebral rhabdomyosarcoma (author's transl)]. 729 Mar 34

The traditional association between anosognosia for hemiplegia and the right hemisphere was investigated in 31 patients with unilateral temporal lobe pathology during intracarotid sodium amytal testing (ISA) before epilepsy surgery. Recall of arm weakness was examined by questioning at the end of the test, when memory for items presented during the hemiplegia was also examined. Significantly more patients were amnesic for left arm weakness than for right. Amnesia for right arm weakness (and speech arrest) was significantly associated with pathology in the temporal lobe on the non-injected side and with impaired recognition of the memory items. Amnesia for left arm weakness was independent of both. Examination of cases where injection was contralateral to a hemisphere without pathology, and which showed normal memory capacity under ISA conditions, revealed that 87% recalled right arm weakness, but only 22% recalled left arm weakness. Awareness of arm weakness during left hemiplegia was examined in nine patients. Five of them were not aware of the weakness. Three of the four others could not subsequently recall it. By inference from the generally unimpaired recall of right arm weakness, following left hemisphere inactivation by amytal, an intact right hemisphere is capable of both recognizing right arm weakness and mediating its subsequent recall. In contrast, the left hemisphere was aware of left arm weakness only in approximately 50% of cases and even when there had been awareness usually could not mediate its subsequent recall. The suggestion is made that the right hemisphere may have a specific mnestic function for arm weakness, and presumably for hemiplegia, additional to the gnostic function.
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PMID:Awareness of and memory for arm weakness during intracarotid sodium amytal testing. 789 7

By analogy with ophthalmic migraine, hemiplegic migraine is defined by the occurrence during the attacks of unilateral weakness. This simple definition is however far from reflecting the wide range of clinical situations reported under this term. Familial hemiplegic migraine (FHM) is a well individualized autosomal dominant condition. Attacks start in childhood, adolescence, or early adulthood. They invariably include a unilateral weakness lasting 30 to 60 minutes and almost always associated with visual, sensory, or speech disturbances. They are occasionally very severe with a dense hemiplegia, confusion, coma or fever, but they always completely recover. Brain neuroimaging is normal. In 20% of the families, migraine is associated with permanent neurological signs, mainly nystagmus and cerebellar ataxia. FHM is a genetically heterogeneous condition, with half of the families linked to chromosome 19 and the other half in which this link is excluded. By contrast to FHM, which is a well defined entity, other varieties of so called hemiplegic migraine do not deserve to be individualized as such. They include attacks of migraine with typical aura when a unilateral weakness is part of the aura, severe hemiplegic attacks similar to those reported in FHM but sporadic, migrainous infarcts with hemiplegia, and, for some authors, alternating hemiplegia of childhood. The pathogenesis of all these conditions and of migraine itself remaining largely unknown, it is currently impossible to know whether or not they share common pathophysiologic mechanisms. The identification of the gene on chromosome 19 and the discovery of other genes will be major steps to elucidate this question.
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PMID:[Hemiplegic migraine]. 789 22

The cause of anosognosia for hemiplegia (AHP) remains unclear. Weakness is detected when there is a mismatch between the expectancy of movement and the sensory perception of movement. The feed-forward hypothesis of AHP posits that there is a failure of detection because there is a loss of motor intention and expectancy of movement. We tested motor intention by measuring the activation of proximal muscles (pectoralis majoris) while subjects squeezed a dynamometer with each hand. We tested a group of normal controls, a group of patients with hemiparesis, a patient with neglect, a patient with resolved AHP, and a patient with persistent AHP. The patient with AHP did not contract either of his pectoralis muscles when asked to squeeze with his contralesional, paretic hand, yet he contracted both of them when squeezing the dynamometer with his ipsilesional hand. Normal controls, hemiparetic controls, and the patient with hemispatial neglect contracted both pectorales when asked to squeeze with each hand. The pattern of activation seen in the patients with persistent AHP and resolved AHP demonstrates a loss of motor intention and lends support to the feed-forward hypothesis of AHP.
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PMID:Anosognosia for hemiplegia: an electrophysiologic investigation of the feed-forward hypothesis. 793 25

Among 1575 patients with an acute stroke, 63 (4%) were found to have a leg-predominant weakness. The cerebral lesions were situated in (i) the anterior cerebral artery (ACA) territory in 12 cases, including one patient with a thrombosis of the sagittal sinus; (ii) the middle cerebral artery (MCA) territory in nine cases; (iii) both territories (not watershed) in two cases; (iv) the internal capsule in 18 cases, of which six cases had lesions in the ponto-peduncular or pontine; (v) other brainstem regions in 10 cases; (iv) the thalamus in two cases. Four were not precisely classified. In short, 41 were hemispheric and 18 were in the brainstem or thalamus. Lesions restricted to the rear portion of the medial part of the precentral gyrus caused a contralateral predominantly distal leg weakness. The weakness was severe with little improvement. Lesions involving the medial part of the premotor cortex, the supplementary motor area (SMA) and the rear portion of the medial part of the precentral gyrus caused a contralateral, severe leg-predominant hemiplegia, distally predominant and a less severe proximal weakness of the arm. Recovery was much better for the arm than for the leg. Lesions affecting the medial part of the premotor cortex, the SMA and sparing the precentral gyrus caused a contralateral hemiparesis predominating on the leg but predominating proximally on both leg and arm. Recovery was good for leg and arm. There were 22 infarcts due to ACA or MCA occlusion, one due to superior sagittal sinus occlusion, 18 lacunes and five haemorrhages.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Leg weakness due to stroke. Site of lesions, weakness patterns and causes. 818 60

We report 22 cases of alternating hemiplegia of childhood. In addition to repeated episodes of hemiplegia lasting from a few minutes to several days, the disease was characterized by an onset before 18 months of age, the occurrence of tonic or dystonic attacks, nystagmus, dyspnea and other autonomic phenomena, and the development of cognitive impairment and of a choreoathetotic movement disorder. All the patients also had episodes of quadriplegia that occurred either when a hemiplegia was shifting from one side to the other or as an isolated manifestation. Such episodes were often severe and followed by developmental deterioration. In all children, sleep consistently relieved both weakness and associated paroxysmal phenomena, but these would reappear 10 to 20 minutes after the children awakened, during long-lasting episodes. Although six patients also had epileptic seizures, the condition seems to be distinct from epilepsy, and the clinical features and poor outcome differentiate it from migraine. Treatment with the calcium-entry blocker flunarizine was partially effective.
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PMID:Alternating hemiplegia of childhood. 849 42


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