ABSTRACT
A case is presented in which sensory ataxic neuronopathy developed after serologically proven infection with Rickettsia conorii and continued to be progressive after appropriate antibiotic treatment. Electrophysiological studies showed decreasing sensory nerve conduction velocities ending with the absence of sensory nerve action potentials as well as peripheral and cortical somatosensory evoked potentials. Histological studies revealed a profound loss of myelinated fibres due to primarily axonal degeneration. The clinical course and the electrophysiological and histological findings suggest primary involvement of the dorsal root ganglion. Peripheral neuropathy due to infection with R. conorii is rare and usually of the mixed motor and sensory type. We believe this to be the first report of sensory ataxic neuronopathy associated with R. conorii infection.
Subject(s)
Ataxia/etiology , Boutonneuse Fever/complications , Peripheral Nervous System Diseases/etiology , Aged , Ataxia/physiopathology , Boutonneuse Fever/diagnosis , Female , Ganglia, Spinal/physiopathology , Humans , Peripheral Nervous System Diseases/physiopathologySubject(s)
Aneurysm, Infected/etiology , Endocarditis, Bacterial/complications , Intracranial Aneurysm/etiology , Adult , Aneurysm, Infected/diagnostic imaging , Cerebral Angiography , Endocarditis, Bacterial/etiology , Humans , Intracranial Aneurysm/diagnostic imaging , Male , Streptococcal Infections , Streptococcus pyogenes , Tomography, X-Ray ComputedSubject(s)
Health Planning , Health Priorities , Philosophy, Medical , Health Surveys , Humans , NetherlandsABSTRACT
Some of the patients with homonymous hemianopia are unaware of any visual defect, whereas others perceive this defect more of less consciously. Analysis of the CT scans of 41 cases showed that patients who are partially or fully aware of the hemianopia have purely occipital lesions. The patients who were not aware of the visual defect were found to have larger and more anteriorly situated lesions. Parietal lesions or lesions interrupting the associative pathways to the primary or secondary visual association cortex are considered to be responsible for the lack of awareness of the defect.
Subject(s)
Awareness , Cognition , Hemianopsia/psychology , Brain Diseases/complications , Hemianopsia/diagnostic imaging , Hemianopsia/etiology , Humans , Occipital Lobe , Parietal Lobe , Temporal Lobe , Tomography, X-Ray ComputedABSTRACT
In recent years the name of Brown-Séquard has been assigned to syndromes caused by spinal cord damage differing widely in extension. On the basis of a review of more than 600 published cases, we propose that Brown-Séquard-plus syndromes be distinguished from the pure Brown-Séquard syndrome. This distinction is shown to be justified on clinical, anatomic, and historical grounds. Two case histories are reported herein to illustrate the essential differences between these syndromes.
Subject(s)
Hemiplegia/diagnosis , Paraplegia/diagnosis , Aged , Female , Hemiplegia/classification , Hemiplegia/etiology , Humans , Hypesthesia/diagnosis , Hypesthesia/etiology , Male , Middle Aged , Pain/diagnosis , Pain/etiology , Paraplegia/classification , Paraplegia/etiology , Spinal Cord Diseases/classification , Spinal Cord Diseases/diagnosis , Spinal Cord Diseases/etiology , SyndromeSubject(s)
Prisoners/psychology , Torture , Violence , Fear , Human Rights , Humans , Refugees/psychologyABSTRACT
A 69-year-old woman suffered transient global amnesia as a complication following coronary angiography. Three reports have been described earlier. The etiology of this condition is discussed. Possibly, this complication is overlooked in some cases.
Subject(s)
Amnesia/etiology , Angiography/adverse effects , Coronary Angiography , Aged , Cerebral Angiography/adverse effects , Contrast Media/adverse effects , Female , HumansABSTRACT
Visual suppression of caloric nystagmus was studied in five patients with hereditary ataxia before and after administration of physostigmine. All patients had an initial abnormal ocular fixation index that improved after physostigmine was given. The data indicate that there is a partly reversible disturbance of visual-vestibular interaction in patients with hereditary ataxia, caused by an impairment of a central cholinergic mechanism.
Subject(s)
Cerebellar Ataxia/drug therapy , Nystagmus, Pathologic/drug therapy , Physostigmine/therapeutic use , Vestibule, Labyrinth/physiopathology , Vision, Ocular/physiology , Adult , Aged , Cerebellar Ataxia/genetics , Cerebellar Ataxia/physiopathology , Cholinergic Fibers/physiology , Fixation, Ocular , Humans , Male , Middle Aged , Nystagmus, Pathologic/physiopathologyABSTRACT
This is the second report of a case in which a uterine myoma, one of the most common benign tumours of women, was the cause of a lumbosacral plexus neuropathy. The possibility of uterine myoma should be considered in the differential diagnosis of neuropathy of the lumbosacral plexus in women.
Subject(s)
Lumbosacral Plexus , Myoma/complications , Uterine Neoplasms/complications , Aged , Electromyography , Female , Humans , Myoma/diagnostic imaging , Myoma/surgery , Nervous System Diseases/etiology , Nervous System Diseases/physiopathology , Pain , Tomography, X-Ray Computed , Uterine Neoplasms/diagnostic imaging , Uterine Neoplasms/surgerySubject(s)
Basal Ganglia Diseases/history , Eponyms , Meige Syndrome/history , France , History, 19th Century , History, 20th Century , HumansABSTRACT
We studied a patient with transcortical motor aphasia resulting from a traumatic interhemispheric left frontal hematoma. The aphasia was caused by compression exerted by the hematoma on the left supplementary motor area, which is known to have a function in speech. This cause of a transcortical motor aphasia has not been described earlier.
Subject(s)
Aphasia, Broca/etiology , Aphasia/etiology , Cerebral Hemorrhage/complications , Hematoma/complications , Aphasia, Broca/diagnosis , Cerebral Hemorrhage/diagnosis , Female , Hematoma/diagnosis , Humans , Middle AgedABSTRACT
A persistent blink reflex to light (BRL) was observed in a patient who became comatose after a cardiac arrest. Postmortem examination revealed severe hypoxic ganglion cell necrosis of the cerebral and cerebellar cortex, the basal ganglia, the hypothalamus, nuclei in the brain stem, and the superior colliculi. The pretectum was unaffected. These findings suggest that the afferent fibers of the BRL enter the brain stem not in the superior colliculus, but in the pretectum.