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At least 253 records · Page 14Linked to original sources
PubMed1998

Startle epilepsy with infantile hemiplegia: report of two cases improved by surgery.

PURPOSE: To study the effectiveness of surgical therapy on 2 patients with startle epilepsy with infantile brain damage (SEIBD), a rare but distinctive epileptic syndrome characterized by motor seizures resistant to antiepileptic drugs (AEDs). METHODS: The patients with SEIBD both had hemiplegia, due to gross contralateral hemispheric lesions, and suffered from tonic postural seizures, frequently provoked by sudden unexpected somatosensory stimuli on the paretic side of the body. These attacks occasionally caused the patients to drop to the floor, and mild-to-moderate injuries had been sustained; they were resistant to all currently available AEDs. Consequently, these daily drop attacks severely restricted the patients' social lives and school participation. Both patients underwent corpus callosotomy and resection of epileptogenic premotor and supplementary motor lesions. One patient also underwent additional multiple subpial transections of the primary sensorimotor area. RESULTS: Seizures, as well as quality of life, improved dramatically in both patients after surgery. CONCLUSIONS: Startle epilepsy with infantile hemiplegia is a distinct epileptic syndrome characterized by structural brain damage restricted primarily to one hemisphere, large ipsilateral epileptogenic lesions involving the perisensorimotor area, refractory startle-provoked drop attacks, and a good response to epilepsy surgery.

Adolescent↗
PubMedDate not supplied

Laryngeal hemiplegia in draft horses. A review of 27 cases.

Case records of 27 draft horses with laryngeal hemiplegia were reviewed. Twenty-one horses were treated by ventriculectomy with or without prosthetic laryngoplasty, and 17 owners were contacted to determine the results. Fifteen horses improved after surgery and were able to perform to the owners' expectations. Performance improved significantly and hospitalization was shorter after ventriculectomy alone. Results of this study indicate that the clinical signs of exercise intolerance and excessive inspiratory noise associated with left laryngeal hemiplegia in draft horses can be treated successfully by ventriculectomy without prosthetic laryngoplasty.

Animals↗
PubMed1985

Immediate spasticity with acute hemiplegia is a sign of basal ganglia hemorrhage.

Acute appearance of hemiparesis or hemiplegia with initial marked spasticity was observed in 8 stroke patients. All had intracerebral hematomas and in 7 it was located in the region of the basal ganglia. By contrast, none of 121 hemiplegic patients with hemispheric ischemic stroke hospitalized during the same period had increased muscle tone in the involved limbs at stroke onset. Study indicates that association of hemiplegia with immediate spasticity at stroke onset is a clinical clue to a possible deeply located intracerebral hematoma.

Aged↗
PubMed1993

Hemiplegia in posterior cerebral artery strokes.

Hemiplegia is an unusual presenting feature of posterior circulation strokes. We report five cases who presented with hemiplegia and in whom CT scans revealed evidence of infarcts in posterior cerebral artery territory.

Adult↗
PubMed1994

Evaluation of partial arytenoidectomy as a treatment for equine laryngeal hemiplegia.

The efficacy of partial arytenoidectomy was assessed in 6 Standardbred horses, with surgically induced laryngeal hemiplegia, at rest (Period A) and during exercise at speeds corresponding to maximum heart rate (Period C) and 75% of maximum heart rate (Period B). Peak expiratory and inspiratory airflow rate (PEF and PIF), and expiratory and inspiratory transupper airway pressure (PUE and PUI) were measured and expiratory and inspiratory impedance (ZE and ZI) were calculated. Simultaneously, tidal breathing flow-volume loops (TBFVL) were acquired using a respiratory function computer. Indices derived from TBFVL included airflow rates at 50 and 25% of tidal volume (EF50, IF50, EF25, and IF25) and the ratios of expiratory to inspiratory flows. Measurements were made before left recurrent laryngeal neurectomy (baseline), 2 weeks after left recurrent laryngeal neurectomy (LRLN) and 16 weeks after left partial arytenoidectomy coupled with bilateral ventriculectomy (ARYT). After LRLN, during exercise Periods B and C, Z1 and the ratio of EF50/IF50 significantly increased and PIF, IF50 and IF25 significantly decreased from baseline values. At 16 weeks after ARYT, Z1 returned to baseline values during Periods B and C. Although PIF, IF50, IF25, PEF/PIF, and EF50/IF50 returned to baseline values during Period B, these indices remained significantly different from baseline measurements during Period C. After ARYT, TBFVL shapes from horses during Period C approached that seen at the baseline evaluation. Partial arytenoidectomy improved upper airway function in exercising horses with surgically induced left laryngeal hemiplegia, although qualitative and quantitative evaluation of TBFVLs suggested that some flow limitation remains at near maximal airflow rates. These results indicate that, although the procedure does not completely restore the upper airway to normal, partial arytenoidectomy is a viable treatment option for failed laryngoplasty and arytenoid chondropathy in the horse.

Animals↗
PubMed1998

[A case of brain abscess accompanied with sudden-onset hemiplegia as initial manifestation].

A 58-year-old male experienced a sudden stroke-like onset of right hemiplegia and numbness of his right upper limb while engaged in his desk-work on April 7, 1997. He had a past history of diabetes mellitus and hyperlipidemia. On admission, he had no fever and the blood pressure was 140/70 mmHg. General physical examination was unremarkable. Neurological examination showed 4/5 strength of his right unilateral extremities and numbness of his right upper limb. Clinical features and computed tomography (CT) without contrast medium at the onset of hemiplegia suggested a stroke. Seven days after admission, his consciousness worsened and body temperature fluctuated between 37 and 38 degrees C. Subsequent Gd-enhanced magnetic resonance (MR) which demonstrated an irregular shaped ring-enhancement lesion and lumbar puncture 9 days after admission was compatible with the diagnosis of brain abscess. Surgical drainage confirmed the presence of brain abscess due to alpha-streptococcus. It improved following surgical drainage and antibiotic therapy with PAPM.BP 2 g/day and PIPC 4 g/day. An afebrile patient of sudden stroke-like onset may be a rarity to be added to the differential diagnosis of brain abscess.

Acute Disease↗
PubMed1996

Psychiatric problems in children with hemiplegia: cross sectional epidemiological survey.

OBJECTIVE: To examine the prevalence and predictors of psychiatric problems in children with hemiplegia. DESIGN: Cross sectional questionnaire survey of an epidemiological sample with individual assessments of a representative subgroup. The questionnaire survey was repeated on school age subjects four years later. SUBJECTS: 428 hemiplegic children age 2 1/2-16 years, of whom 149 (aged 6-10 years) were individually assessed. MAIN OUTCOME MEASURES: Psychiatric symptom scores and the occurrence of psychiatric disorder. RESULTS: Psychiatric disorders affected 61% (95% confidence interval 53% to 69%) of subjects as judged by individual assessments and 54% (49% to 59%) and 42% (37% to 47%) as judged from parent and teacher questionnaires, respectively. Few affected children had been in contact with child mental health services. The strongest consistent predictor of psychiatric problems was intelligence quotient (IQ), which was highly correlated with an index of neurological severity; age, sex, and laterality of lesion had little or no predictive power. CONCLUSION: Though most hemiplegic children have considerable emotional or behavioural difficulties, these psychological complications commonly go unrecognised or untreated. Comprehensive health provision for children with chronic neurodevelopmental disorders such as hemiplegia should be psychologically as well as physically oriented.

Child↗
PubMed1975

"Pure" motor hemiplegia.

Attenuation of cerebral evoked responses after stimulation of the median nerve in the hemiplegic limbs suggested that an apparently pure motor hemiplegia in some patients may not have pure involvement of the corticospinal system. Frontoparietal metastasis, infarction in basis pontis and medullary pyramid, and occlusion of internal carotid artery in the neck resulted in pure motor hemiplegia in some individuals.

Adult↗
PubMed1976

Pure motor hemiplegia, medullary pyramid lesion, and olivary hypertrophy.

The case is presented of a 60 years old man who developed sudden right hemiplegia without other accompanying neurological signs and later a spastic hemiparesis. Neuropathological studies indicated an ischaemic lesion of the left medullary pyramid which was accompanied by hypertrophy of the left inferior olivary nucleus. An additional lesion, demyelination of the right gracile tract, is poorly explained. This case represents the second reported instance of pure motor hemiplegia due to a circumscribed lesion in the medullary pyramid and possibly an unique instance of olivary hypertrophy without obvious damage to the central tegmental tract, ipsilateral superior cerebellar peduncle, or contralateral dentate nucleus. The olivary hypertrophy is thought to have arisen from local damage to the termination of the central tegmental fibres at the left inferior olivary nucleus. The question of the development of spasticity in a pure pyramidal tract lesion is discussed.

Hemiplegia↗
PubMed1993

Hypoglycaemic hemiplegia: a repeat SPECT study.

During a hypoglycaemic right hemiplegia induced by a deliberate overdose of oral hypoglycaemics, brain CT and angiography revealed no abnormalities. SPECTs made one day and six days later showed relative hypoperfusion in the left hemisphere. Repeat SPECT study suggested that the left hemisphere was more vulnerable than the right in the cerebral blood perfusion. This vulnerability might provoke the right hemiplegia in a critical condition, such as severe hypoglycaemia.

Adult↗
PubMed1997

Impairment and recovery of left motor function in patients with right hemiplegia.

OBJECTIVE: To assess the motor function of the left, supposedly unaffected, limbs of patients with an acute right vascular hemiplegia. METHODS: Fifteen patients with an acute vascular right hemiplegia and 16 matched healthy controls were studied. Motor function of the left limbs of each patient was evaluated on days 20 and 90 after their stroke using four validated tools (hand dynamometer, isokinetic dynamometer, finger tapping, and nine hole peg test). RESULTS: There was a significant impairment of motor function of the left limbs of patients at day 20 compared with controls. The impairment had recovered almost completely at day 90 after the stroke. CONCLUSION: These results show the bilateral cerebral representation of the human motor system and suggest the participation of ipsilateral motor pathways in recovery after a stroke.

Aged↗
PubMed1985

Lowered ultraviolet minimal erythema dose in hemiplegia.

In view of recent reports of increased tanning in hemiplegic limbs, we have investigated ultraviolet (u.v.) minimal erythema dose (MED) in hemiplegia using the bilateral comparison technique. Seven of 10 patients had a lower MED in the hemiplegic arm compared to the normal side, the mean reduction being 16% (range 0-33%, P = 0.003). No patients had a higher MED in the hemiplegic arm. We review the literature regarding other non-neurological features of hemiplegia, in particular asymmetry of temperature, oedema, and finger clubbing, and we propose a vasomotor or trophic aetiology for these findings.

Erythema↗
PubMed1988

Cranial computed tomographic and electroencephalographic abnormalities in children with post-hemiconvulsive hemiplegia.

Twenty-five children with post-hemiconvulsive hemiplegia, who had had epileptiform discharges on EEG, were followed for over 5 years. Twenty-two of them developed the hemiconvulsion-hemiplegia-epilepsy syndrome. The computed tomographic (CT) findings were: marked hemispheric atrophy in 13 cases; moderate or slight hemispheric atrophy in 4; focal atrophy or porencephaly in 4, and a normal scan in 4. The electroencephalographic (EEG) findings showed residual asymmetry of hemispheric amplitudes in 15 cases. Epileptiform discharges on EEG were found on the ipsilateral side (the damaged hemisphere) in 13 cases, the contralateral side (the undamaged hemisphere) in 9, and on both sides in 3. As to the correlation between CT and EEG abnormalities, 8 of 13 cases with marked hemiatrophy on CT had contralateral epileptiform discharges on EEG, and the converse was more pronounced: 8 of 9 cases with contralateral epileptiform discharges had marked hemiatrophy on CT. Contralateral epileptiform EEG abnormalities were observed in the patient with severe hemispheric brain damage.

Adolescent↗
PubMedDate not supplied

Computed tomographic findings of good prognosis for hemiplegia in hypertensive putaminal hemorrhage.

Computed tomography (CT) findings were analyzed in 17 patients with hypertensive putaminal hemorrhage accompanied by hemiplegia which had subsided almost completely by conservative therapy within one month after the onset. In such patients a high density area was not seen at the level of the lateral ventricles on CT scan. To study the reason for this, the relationship between the extent of a hematoma and the level at which the pyramidal tract was destroyed was investigated. From consideration of the process of destruction of the pyramidal tract by a hematoma, it seemed that CT findings at the level of the bodies of the lateral ventricles, rather than at the level of the posterior limb of the internal capsule, were of value in evaluating the prognosis of hemiplegia in putaminal hemorrhage.

Adult↗
PubMed1996

Recurrent right hemiplegia associated with progressive ipsilateral carotid artery stenosis.

BACKGROUND: Ipsilateral sensory motor symptoms associated with carotid artery stenosis are rare, and few reports are available in the literature. CASE DESCRIPTION: We report the case of a 50-year-old man who presented with right hemiplegia that recurred 14 months later. A left hemisphere watershed infarction was detected. Repeated angiograms showed a left internal carotid occlusion and a right internal carotid stenosis that initially measured 50% and worsened to 80% after the second stroke. CONCLUSIONS: Repeated quantitative measurements of cerebrovascular reserve demonstrated the hemodynamic mechanism of the strokes and the role of a right internal carotid lesion in causing the recurrence of right hemiplegia.

Brain↗
PubMed1981

Function of the respiratory muscles in acute hemiplegia.

Electromyograms of the parasternal intercostal muscles and of the diaphragm were obtained with surface electrodes in 20 patients with early flaccid hemiplegia due to cerebrovascular accident. In most patients, a striking reduction in activity was observed during voluntary inspirations in both the intercostal muscles and the diaphragm on the side of the paresis. These findings suggest that in most persons the respiratory muscles are innervated primarily by decussated fibers. Dysfunction of the respiratory muscles might be implicated in the respiratory tract infections of patients with early hemiplegia.

Acute Disease↗
PubMed2005

Variability of specific airway resistance in patients with laryngeal hemiplegia.

OBJECTIVES: This study was designed to analyze whether respiratory flows and specific airway resistance (sRaw) depend on the degree of breathiness and on the position of the paralyzed vocal fold in laryngeal hemiplegia. METHODS: We performed a prospective study involving 55 patients affected by laryngeal hemiplegia. RESULTS: The paralyzed fold was in an intermediate position in 18 cases and in a paramedian position in 37. Breathiness was estimated with the GRBAS scale, and the patients were divided into four groups: B0 (12 patients), B1 (14), B2 (16), and B3 (13). Spirometry was used to measure the flow-volume loop, and body plethysmography was used to measure the sRaw at increasing respiratory frequencies (30 +/- 5, 60 +/- 5, and 90 +/- 5 breaths per minute). The mean inspiratory flows (PIF, FIF50) were lower than predicted (<80%) in all four groups; there was no significant intergroup difference. In all four groups, the mean FEF5o/FIF50 ratio was >1, as is typical of variable extrathoracic obstruction. The mean sRaw values increased with respiratory frequency, and the increase was higher in group B3, although the values varied widely. The frequency-dependent increase in the sRaw value was not significantly related to the degree of breathiness, nor to the position of the paralyzed fold. Furthermore, Spearman's coefficient did not reveal any correlation between the sRaw values and inspiratory flows, showing that plethysmography and spirometry explore different aspects of airway function. CONCLUSIONS: Respiratory flows and sRaw are not significantly influenced by either the degree of breathiness or the position of the paralyzed vocal fold.

Adolescent↗