Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a very rare case of 7 year-old-girl who had a pontine glioma with supratentorial meningeal involvement. She complained severe headache with meningeal irritation. She showed fluctuating cranial nerve impairment of the both abducens and glosopharyngeal nerves but no signs of weakness or facial paresis. She also reported two episodes of generalized convulsion with unconsciousness during admission. MRI disclosed a hypointensity intrinsic brainstem mass with an enhancing exophytic component in the prepontine cistern and a sharp contrast uptake is disclosed in the left-meninges of the supratentrial structures. An open biopsy was performed and diagnosed as a high grade astrocytoma.
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PMID:[Brainstem glioma with supratentorial meningeal dissemination--a case report]. 128 96

We examined potential clinical and pathologic correlates of seizures among the 3,291 children in the Childhood Brain Tumor Consortium database. Fourteen percent had seizures prior to their hospitalization for a brain tumor. Among children who had a supratentorial tumor, seizures occurred in 22% of those less than 14 years of age. The prevalence of seizures increased to 68% of older teenagers. Among children with an infratentorial tumor, the prevalence of seizures was relatively constant at 6% over all age groups. The onset of seizures began more than one year prior to surgical tumor removal in over half of the children aged five or more with supratentorial tumors, significantly longer than for those of the same age with infratentorial tumors. Almost all children (98.9%) with an infratentorial tumor and seizures had at least one other symptom and more than three-fourths of them had at least three. Eighty-nine percent of children with a supratentorial tumor and seizures had at least one other symptom and more than one-half had at least three symptoms. Regardless of whether the tumor was above or below the tentorium, confusion or stupor and coma were more common in children with seizures than in children without seizures. Among children with supratentorial tumors, symptoms of a declining academic performance or an abnormality of personality, speech, walking, or sensation were significantly more frequent in children with seizures, while visual symptoms (other than visual loss or diplopia) and nausea or vomiting were less frequent. Among children with supratentorial tumors, those who had seizures were more likely to have paralysis of an arm, hand, or face, confusion or stupor, or coma and less likely to exhibit irritability, papilledema, optic atrophy, decreased visual acuity, pupillary abnormalities, or abducens paresis. Among children with infratentorial tumors, those with seizures were significantly less likely to have truncal ataxia, but more likely to experience confusion, stupor, or coma. In the supratentorial compartment, astrocytoma (nos), protoplasmic astrocytoma, anaplastic astrocytoma, and ependymoma were more frequently associated with seizures than was craniopharyngioma. No infratentorial tumor type was more or less likely to be associated with seizures. All common tumor types that were represented in both the supratentorial and the infratentorial compartment except astrocytoma (nos) were associated with significantly greater rates of seizures when located in the supratentorial compartment. The tumor location with the highest incidence of seizures was, as expected, the superficial cerebrum. More than 40% of the children with such tumors had seizures.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Epidemiology of seizures in children with brain tumors. The Childhood Brain Tumor Consortium. 154 79

A collection of symptoms and signs indistinguishable from ocular myasthenia can be caused by an intracranial mass. We illustrate this condition with the case of an adolescent girl with neurofibromatosis type 1 and a dorsal midbrain astrocytoma. At presentation, she had fatigable ptosis, upgaze paresis, and a positive "lid twitch" sign. Radiation therapy resulted in marked reduction of her signs, confirming that the muscle fatigue was central in origin. We discuss the possible mechanisms of this central fatigability.
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PMID:Midbrain myasthenia: fatigable ptosis, 'lid twitch' sign, and ophthalmoparesis from a dorsal midbrain glioma. 156 51

we report a patient with Wallenberg's syndrome caused by glioma of the lateral medulla oblongata, and review the literature for Wallenberg's syndrome associated with neoplastic disease. A 46-year-old man was admitted because of progressive dysphagia and vertigo. Neurological examination revealed atypical symptoms and signs of Wallenberg's syndrome on the right side, hypalgesia on the second and third divisions of the left trigeminal nerve, paresis of the right palate and uvula, and ataxia of the right extremities. Although CT showed no abnormality in the posterior fossa, MRI demonstrated a mass with abnormal signal intensities in the right dorsolateral portion of the medulla. Biopsy specimens showed astrocytoma (grade III). Based on the present case and a review of 10 previously reported cases of Wallenberg's syndrome caused by neoplastic disease, the clinical features of this syndrome are characterized by gradual development and steady progression of symptoms, non-classical or atypical symptomatology, numerous additional symptoms and signs depending on the site and size of tumors, and poor prognosis.
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PMID:[Wallenberg's syndrome caused by a brain tumor--a case report and literature review]. 216 89

This report is a retrospective analysis of 83 adults (greater than 16 years of age) with histologically proven or presumed primary neoplasms of the thalamus, hypothalamus, midbrain, pons, and medulla. Patients were treated with combined surgery and postoperative irradiation or with irradiation alone at the Washington University Medical Center (St. Louis, MO) from January 1950 through December 1984. Histologic analysis confirmed the diagnosis of tumor in 21, including nine with well-differentiated astrocytoma, four with astrocytoma with anaplasia, and eight with glioblastoma multiforme. Overall and disease-free survivals at 5 years were 28.7 and 23.2%, respectively. A statistical analysis was performed to ascertain the prognostic importance of the following variables: age, race, gender, duration of symptoms, cranial nerve paresis, primary site, extent of surgery, histology, and irradiation dose. The only factor identified by univariate analysis to be critical for survival was primary location of disease. Patients with supratentorial (thalamus/hypothalamus, midbrain) tumors had a 10-year disease-free survival of 15.4% compared to 29.6% for those with infratentorial (pons, medulla) tumors (P = 0.07). Patients with lesions of the pons had a 5-year disease-free survival of 35.8% compared to 13.8% for those with tumors of the thalamus (P = 0.05). Increasing irradiation dose was not correlated with superior survival. Factors evaluated but established to be insignificant were age (P = 0.27), race (P = 0.63), gender (P = 0.27), duration of symptoms (P = 0.19), cranial nerve paresis (P = 0.71), histologic type (P = 0.16), and extent of surgery (P = 0.94). Follow-up for 13 surviving patients ranged from 2.6 to 28.7 (mean, 12.0) years. Neurologic deficits in surviving patients were absent in 15% (two of 13), mild in 62% (eight of 23), and moderate in 23% (three of 13). One case of brain radionecrosis was identified (6000 cGy, 200 cGy daily).
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PMID:Prognostic factors and results of therapy for adult thalamic and brainstem tumors. 272 May 63

A case of anaplastic astrocytoma associated with pituitary adenoma is reported. The patient was a 33-year-old male, who was admitted with complaints of sensory aphasia, slight left motor paresis, and visual field defects. Neurological examination disclosed sensory and motor aphasia, Gerstmann's syndrome, slight left motor paresis, right homonymous hemianopsia, and bilateral choked discs. Computed tomography revealed a low density mass lesion with slight enhancement in the left temporal region and a ring-like enhanced mass lesion in the suprasellar region. In MRI, both the left temporal and the suprasellar lesions are depicted as low signal intensity areas in T1 weighted imaging, but as high signal intensity areas in T2 weighted imaging. Craniotomy was performed and both tumors were almost totally removed. The tumor in the left temporal region was diagnosed as anaplastic astrocytoma and the other in the suprasellar region was diagnosed as chromophobe adenoma. Multiple primary intracranial tumors of different cell types are rare. About a hundred cases can be found in medical literature. More than two thirds of them are cases of glioma associated with meningioma, but other combinations of tumors are extremely rare. We now report this case of astrocytoma associated with pituitary adenoma. In the literature, there are only 5 cases of similar combination. It is believed that astrocytoma and pituitary adenoma are histologically different. In three of five reported cases, the tumors were in close proximity to each other, but it is doubtful that their close proximity was related to the fact that they developed concurrently.
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PMID:[A case of anaplastic astrocytoma associated with pituitary adenoma]. 322 1

Brain tumors are, after leukemias, the most frequent fatal neoplasms of infancy. The clinical features and symptoms are often markedly different from those observed in the adult forms, according to the peculiar anatomy and behaviour of the child. Persistent headache, vomiting, astenia , behavioral alterations may be the precocious findings. Later, some more specific and suggestive signs such as strabismus, dyplopia , fast head size increase, funduscopic alterations, ataxia, paresis and nystagmus may be observed. On their appearance a prompt diagnostic work-up should be performed. The tumors of the posterior fossa (cerebellar astrocytoma and medulloblastoma, brainstem glyoma , hependimoma in decreasing order of frequency) generally cause precocious symptoms because of the small dimension of the subtentorial space; the presence in this region of several fundamental nuclei and pathways may explain how also small tumors may cause severe deficits. Supratentorial tumors (astrocytoma, malignant glyoma , hependimoma , craniofaringioma ) often show a more prolonged latency and may begin with signs of endocranial hypertension, seizures, or sometimes with hormonal troubles according to the involved anatomic structures. Hypothalamic astrocytoma is responsible of an extreme weight loss as far as to a cachetic status, due to the hyperincretion of GH. Finally, plexus papilloma, dermoid, optic nerve glyoma , oligodendroglyoma , germinoma, teratoma are responsible of a small number of child brain tumors, with different localization and symptomatology.
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PMID:[Clinical course of brain tumors in childhood]. 673 95

A 21 year old man with a five month history of facial paresis, diplopia, and gait disturbance diagnosed with a brain stem tumor at another institution was evaluated. Computed tomography, magnetic resonance imaging, clinical and laboratory evaluations suggested a pontine astrocytoma, and the mass was excised. Pathological diagnosis was a tuberculoma confirmed by postoperative positive Mantoux testing. CT and MRI appearances of tuberculomas have been described, but can not differentiate them completely from other tumors such as astrocytomas. Because the incidence of tuberculomas has increased in recent years and they may mimic exophytic tumors of pons, it is important to include pontine tuberculoma in the differential diagnosis of pontine tumors.
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PMID:A pontine tuberculoma mimicking an exophytic brain stem tumor. 812 91

The authors report a series of 10 children under 15 years of age with primary intraspinal neoplasm who underwent surgical resection from 1981 to 1994. The tumors consisted of 4 intramedullary tumors (myxopapillary ependymoma, pilocytic astrocytoma, subpial liporna, cavernous angioma), 2 intradural extramedullary tumors (2 neurinomas), and 4 extradural tumors (ganglioneuroma, chordoma, osteochondroma, rhabdomyosarcoma). The initial symptoms in these patients were gait disturbance (50%), weakness of lower extremities (50%), pain (40%), weakness of upper extremities (10%), and tetraparesis (10%). The neurological findings on admission in these patients revealed motor paresis (90%), sensory disturbance (60%), abnormality of deep tendon reflex (60%), pathological reflex (30%), neurogenic bladder (30%), and Lasegue's sign (10%). All patients were treated surgically; laminectoy was performed in 8 patients, laminoplasty in one patient, and transoral approach in one patient. Five patients (50%) underwent a grossly total resection, 3 (30%) had a subtotal resection, and 2 (20%) had a partial resection. Mean follow-up period was 5.6 years. One (10%) patient died due to recurrence and dissemination of the tumor at eight months after surgery in a case of rhabdomyosarcoma. 9 (90%) have had no recurrent tumor and have improved neurologically. In 4 patients (40%) spinal deformity developed, and 2 patients required operative treatment for the spinal deformity. We emphasized the advantage of laminoplasty to prevent postoperative spinal deformity in children.
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PMID:[Clinical study of intraspinal neoplasms in children]. 875 72

We reported a case of a 32-year-old female who had a transient mutism after resection of a malignant astrocytoma in the left frontal lobe. Preoperatively magnetic resonance (MR) imaging revealed a cystic tumor in the left frontal lobe. The patient underwent surgery. She was alert but did not speak immediately after surgery. She could follow verbal commands, comprehend written language, and write letters. She had no cranial nerve or extremity paresis. Seven days postoperatively, she began to say simple words, and one month postoperatively she could talk normally. Postoperative MR imaging revealed a hypointensity area on T1 weighted image in the frontal lobe including a part of the anterior cingulate cortex and the anterior part of the corpus callosum. It appears that a dominant hemisphere lesion of both the anterior cingulate cortex and the corpus callosum may be responsible for the development of postoperative mutism.
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PMID:[Transient mutism after resection of left frontal lobe astrocytoma in adult: case report]. 899 Apr 70


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