Headache and epilepsy: a case report of the unusual association of cluster headache and epilepsy.
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Cluster Headache↗
Biomedical subjects
L A Vignolo
Publications and source records attributed to L A Vignolo.
Simple reaction time to lateralized visual stimuli is not related to the hemispheric side of lesion.
The effect of a single brain lesion on Reaction Times (RTs) to unpatterned visual stimuli was studied in 20 right brain-damaged (RBD) and 19 left brain-damaged (LBD) patients with single small vascular lesions confined to one hemisphere and free of visual field defects and of significant neuropsychological abnormalities (e.g. aphasia or hemineglect). The stimulus was presented in the field either ipsilateral or contralateral to the brain lesion. The stimulus location was either blocked in each hemifield or randomly alternating between fields. RTs in RBD patients were not statistically different from RTs in LBD patients. Intrahemispheric site of the lesion also was irrelevant for the lengthening in RTs. Responses to blocked presentations were faster than to random presentations. Responses to the hemifield contralateral to the brain lesion were slower than to ipsilateral hemifield, and the difference was unrelated to the absolute values of RTs. It is concluded, in contrast to other reports, but in agreement with the more recent literature, that there is no hemispheric dominance for RTs.
Aphasia, Broca↗
Immunological and gadolinium-DTPA MRI evaluation of relapsing remitting multiple sclerosis.
The levels of lymphocytes, blood lymphocytes subsets (CD3+, CD4+, CD8+, DR+, CD25+, CD4+, CD45RA+, CD4+, CD29+ cells) and sIL-2r of 10 patients affected by relapsing-remitting multiple sclerosis were serially studied. The identification of the activity of the disease was made by gadolinium-DTPA (Gd-DTPA) MRI. The immunological determinations and the MRI of the brain and spinal cord were performed every 14th day for a period of three months. No significant difference of the immunological values were found between the presence and the absence of Gd-DTPA enhancing areas, except lymphocytes (p < 0.05). These immunological parameters, evaluated in the peripheral blood, are not a marker of disease activity in relapsing-remitting MS patients.
Adult↗
Neuropsychological assessment in multiple sclerosis: a follow-up study with magnetic resonance imaging.
Nineteen moderately impaired patients with clinically definite multiple sclerosis and an initially relapsing-remitting course were included in a neuropsychological and magnetic resonance imaging (MRI) follow-up study. The average test/re-test interval was about 2 years. The neuropsychological findings were indicative of a very mild overall impairment; the patients, as a group, showed no evidence of cognitive deterioration in the follow-up period. A numerical estimation of the severity of cerebral demyelination shown by MRI did not indicate a significant change. No correlation between cognitive performance variations and MRI changes was found.
Adult↗
Somesthetic-visual matching disorders in right and left hemisphere-damaged patients.
Forty-nine patients with recent right (RHD) and left (LHD) hemispheric vascular lesions were compared on a task of somesthetic-visual matching of meaningful objects and of meaningless shapes. A selective impairment for shapes was found in RHD subjects, while LHD patients were impaired in object matching. This double dissociation conforms to the classical distinction between apperceptive and associative agnosia, and extends to the somesthetic modality the "double dissociation" between left and right hemispheric lesions and associative and apperceptive recognition disorders, which has been found in other modalities of agnosia.
Adult↗
Significantly higher levels of soluble interleukin 2 in patients with relapsing-remitting multiple sclerosis compared with healthy subjects.
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Adult↗
A case of "crossed aphasia" in which the integrity of the left hemisphere is assessed by MRI.
We describe a 65-year-old right-handed (on the Edinburgh Inventory Test) woman who developed left hemiplegia and language disturbances after right hemisphere lesion. She showed global aphasia and left spatial neglect. To our knowledge, this is the first case of so called "crossed aphasia" in which the integrity of the left hemisphere is assessed by Magnetic Resonance Imaging (MRI). The association of aphasia and neglect is briefly discussed.
Aged↗
Aphasia due to lesions confined to the right hemisphere in right handed patients: a review of the literature including the Italian cases.
We review most of the work published, to our knowledge, between 1880 and 1988 on aphasia due to right cerebral lesions in right-handed patients ("crossed aphasia"). We summarize the 87 cases found in chronological order within defined groups, dealing in greater detail with the less well-known cases in English-language publications and with the cases from other sources that we consider most representative and convincing. The 87 cases fall into three groups on the following criteria: right-handedness (on standardized tests), absence of left-handers in the family, left hemisphere integrity. Group 1 comprises cases that are unreliable because the handedness data are missing and/or because left hemisphere lesions were known to be present or probably were so. Group 2 comprises cases with full clinical data but no formal test of handedness, with familial cases of left-handedness and/or without satisfactory evidence of left hemisphere integrity. Groups 3 comprises the 26 reliable cases, that is those with proven right-handedness, no left-handers in the family and with proven hemisphere integrity. We discuss the implications of these cases.
Adolescent↗
Neuropsychological assessment in patients with relapsing-remitting multiple sclerosis and mild functional impairment: correlation with magnetic resonance imaging.
Forty one moderately impaired patients with clinically confirmed multiple sclerosis (MS) and a relapsing-remitting course were submitted to a neuropsychological battery and magnetic resonance imaging (MRI) to correlate the neuropsychological performances with the degree of cerebral demyelination. The neuropsychological results were indicative of a very mild overall impairment. The patients were subdivided into two groups (extensive periventricular demyelination or discrete lesions on MRI) and the results of neuropsychological tests compared. Patients with extensive periventricular demyelination had an inferior performance on concept formation, non-verbal reasoning and verbal memory tests.
Adolescent↗
Role of MRI in the diagnosis of Mills syndrome.
We report the case of a 69 year old man who presented hemiplegia with an ascending spread suspected to be a primary form of Mills syndrome. The patient underwent MRI, which showed multiple lacunar infarcts of the periventricular and subcortical white matter. We recommend that patients with a suspected primary form of Mills syndrome should be studied with MRI.
Aged↗
Absence of a correlation between T lymphocyte subsets and clinical activity in relapsing-remitting multiple sclerosis.
Cytofluorographic analysis of CD3+, Tac+, HLA-DR+ peripheral blood lymphocytes and CD4/CD8 ratio was performed monthly, over a 10-month period, in a group of 16 patients with multiple sclerosis (MS). No correlation was found between clinical relapses and fluctuations in the lymphocyte subsets, although patients who were in remission throughout the study showed a number of CD3+ cells and a CD4/CD8 ratio significantly lower than those in normal controls. We concluded that changes in peripheral blood lymphocyte subsets are not related to the disease process and their measurement is not helpful in monitoring the illness.
Adult↗
Lesion detection in MS patients with and without clinical brainstem disorders: magnetic resonance imaging and brainstem auditory evoked potentials compared.
The findings of the present study can be summed up in the following points: (1) brainstem auditory evoked potentials (BAEP), as compared with magnetic resonance imaging (MRI), has a greater capacity and a lower cost in disclosing brainstem plaques both in MS patients with symptoms or signs of actual brainstem involvement and in clinically silent ones. This makes BAEP a useful technique for the neurologist, who can confirm the clinical suspicion of a brainstem lesion and follow the evolution of the disease in the patient. (2) The sensitivity of BAEP is lower than that of MRI as far as the anterior lesions of the brainstem are concerned. (3) MRI is more specific than BAEP, inasmuch as several types of injuries can alter the BAEP, while the demyelinating plaque has a specific image and can only be confused with little lacunar infarcts. (4) Plaques that produced symptoms or signs in the past can eventually disappear and be no longer detected by a subsequent MRI.
Adolescent↗
Jargonagraphia: clinical and neuropsychological correlates.
Jargonagraphia (i.e., fluent, unintelligible writing with abundant paragraphias and preserved mechanics of writing) is considered to be an infrequent symptom of Wernicke's aphasia. Six cases fulfilling the definition of jargonagraphia were found in a retrospective series of 1076 consecutive aphasics and the neuropyschological and clinical correlates of this phenomenon were analysed. Jargonagraphia was not qualitatively uniform, and its appearance seems to be conditioned by the interaction of an increased "impulse to write" with disrupted language mechanisms.
Adult↗
Resumption of gainful employment in aphasics: preliminary findings.
We report preliminary data on aphasic patients who, in spite of their language problems, have succeeded in finding a reasonably satisfactory occupational resettlement. Patients who: (a) still had a moderate to sever aphasia, (b) had resumed a gainful employment requiring interpersonal communication, were recalled for a check-up and assessed with: (1) a comprehensive aphasia test: (2) a semistructured interview including detailed questioning about the type and reaction to aphasia, the type of work before the onset of aphasia, the type of current work with particular emphasis on the patients' compensatory mechanisms and emotional reactions. Results comprise 10 cases up to date. One case is described in detail. Findings indicate that the ability to resume a gainful occupation is often greater than could be expected on the sole basis of formal language examination. Findings are discussed from a neuropsychological, social and rehabilitation point of view.
Adult↗
Myasthenic crisis during intravenous iodinated contrast medium injection.
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Adult↗
Aphasia does not always follow left thalamic hemorrhage: a study of five negative cases.
Five right-handed patients suffering from a recent CT-assessed left posterior thalamic hemorrhage are reported. In all patients a standard language examination performed within one month after stroke onset did not reveal aphasic disturbances. While the present series argues for the role of intrathalamic lesion localization, a review of the literature suggests that lesion site per se does not always account for the presence or absence of aphasia in the individual case. The importance of reduced blood flow and metabolism in cortical areas which appear undamaged on CT scan is briefly discussed.
Aged↗
Unexpected CT-scan findings in global aphasia.
The clinical-CT scan correlation was studied in 37 stroke patients with global aphasia. The time between stroke and language examination was between 21 and 60 days; the time between stroke and CT scan was equal to or longer than 21 days. It was found that while 22 patients harboured the expected large lesions including Broca's and Wernicke's areas, 8 had anterior lesions sparing Wernicke's area, 3 had posterior lesions sparing Broca's area, and 4 had deep lesions centered on the insula and lenticular nucleus. These findings suggest that global aphasia, albeit apparently simple from the semeiological viewpoint (also due to its severity), does in fact include different clinical entities. However, no clear-cut correlation was found between either subtype of speech production or severity, and locus of the lesion (except that deep lesions were associated with somewhat milder forms). An interesting finding, i.e. that all 8 patients with anterior lesions were females, while the 3 posterior ones were male, is briefly discussed in terms of possible differential organization of language functions in the two sexes.
Adult↗