Diazepam therapy of verbal auditory agnosia.

A 7-year-old girl suffered from a gradual loss of her ability to understand speech. But she had normal hearing and understood various environmental sounds. Brain computerized axial tomography showed normal, but electroencephalogram revealed spike and wave activity from temporal leads, especially on the left side. She was diagnosed as having verbal auditory agnosia. The treatment consisted of diazepam therapy. One year after the onset, her impaired auditory comprehension dramatically improved with the use of diazepam. The dichotic listening test revealed a left ear advantage for both environmental sounds and spoken words. The results seemed to suggest that in this patient the right hemisphere might be functioning as a speech center instead of the left one.

Paroxysmal speech disorder following left frontal brain damage.

The patient was a 61-year-old female who suffered from the sudden attack of a speech disorder. The episodes of speech disorder lasted for less than 1 min, but occurred several times a day, paroxysmally. A CT revealed a low density area on the surface of the left frontal lobe and an EEG showed an abnormal wave at the frontoparietal area, more dominantly on the left. This condition was diagnosed as a kind of epilepsy. The paroxysmal speech disorder occurred very often during the 2 months after the first episode. However, with therapy using anticonvulsives and antibiotics, the condition began to improve after 4 months and disappeared completely after 6 months. It is assumed that the inflammatory change which occurred at the frontal lobe stimulated the supplementary motor area paroxysmally, and subsequently the speech disorder occurred as a kind of epilepsy.

[A case of mild obesity accompanied by epicardial fat deposition].

A 61-year-old woman with low grade obesity index complained of general fatigue. Cardiomegaly had been present since the age of 45. According to a roentgenogram on admission, her cardia-thoracic ratio was 61%. Pericardial effusion was strongly suspected because of extra echo spaces on both posterior and anterior walls, and unsynchronized echocardiograph waves of epicardium and pericardium. However, values of dynamic CT measured at areas equivalent to the extra echo spaces were -120. On admission, T1-emphasized MRI image showed a high signal density in those areas. After significant weight reduction, the abnormal values and signs of the clinical examinations, as well as the patient's complaints were attenuated or disappeared. Together with these results, cardiomegaly of the patient was diagnosed to be due to excessive fat deposit between the epicardium and cardiac muscle. Dissociation between mildness of obesity index and excessive deposition of fat in the pericardium was discussed from the point of view of body mass index and time course of fat deposition.

Right unilateral spatial neglect of the left brain-damaged patients.

Right unilateral spatial neglect (USN) was investigated on three left brain-damaged patients suffering from the right homonymous hemianopsia and hemiplegia. A test battery consisted of visuo-constructive praxis; 1) putting blocks into a box, 2) bisecting a horizontal line, 3) figure drawing, 4) drawing of a dial plate and 5) copying drawing. The investigation revealed that USN of left brain-damaged patients resulted from 1) generally impaired mental function, 2) right unilateral sensory deprivation and 3) right hemiplegia. It was guessed that, as for a patient with right homonymous hemianopsia and hemiplegia, his attention would be attracted toward the left hand, and then he would be apt to neglect the right side. Right USN was not so prominent compared with the left one of right hemispheric lesion. However, it is suggested that if clinicians examine carefully the visuo-constructive function in addition to aphasia on left brain-damaged patients, right USN appears greater in some cases.

Functional significance of the corpus callosum based on the analysis of rhythmic capabilities in the split-brain patients.

We carried out our Systematic Rhythm Test for the Brain-Damaged Patients named "The Asian Rhythm Test" on our four patients with lesions of the corpus callosum, and analyzed their rhythmic capabilities--their performances in rhythm perception (auditory distinction) and in rhythm expression (rhythm-tapping)--in accordance with the neuropsychological model proposed in 1980 by us. All our partial split-brain patients showed the abnormal one-ear inferiority (superiority) and the one-hand inferiority under our testing conditions. The patients with lesions of the anterior corpus callosum showed the interhemispheric (the left-to-right) transfer-dysfunction of motor-programming information, while the patient with the lesion of the posterior corpus callosum showed the interhemispheric transfer-dysfunction of auditory information. The patients with lesions including the truncus showed the interhemispheric integration-loss in the process of rhythm perception and its expression. And moreover, we could see the specific auditory interruption between the ipsilateral and the contralateral systems in the patient with the lesion including the anterior commissure. Based on these our findings, the roles of the corpus callosum and the anterior commissure were discussed.

Intelligibility of distorted speech sounds shifted in frequency and time in normal children.

Distorted speech sounds were presented to normal children aged 4-11 years and to young adults in such a way that 20 monosyllables were distorted with a 'speech stretcher' which produced frequency expansion and compression and also time expansion and compression. The experiment was performed to observe the intelligibility of such distorted speech sounds and the development of the discrimination ability in normal children. The results were as follows: (1) discrimination decreased sharply with increasing frequency change in both frequency-expanded and frequency-compressed speech; (2) discrimination was relatively unaffected by time expansion. However, with time compression there was a gradual decrease in discrimination at 50% time compression followed by a rapid deterioration at 75% time compression; (3) for a given percentage of distortion, frequency shift degraded intelligibility of speech sounds more severely than time shift, and (4) discrimination ability clearly increased with age in normal children. There was no significant difference between boys and girls.