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At least 289 records · Page 16Linked to original sources
PubMed1995

Anosognosia for hemiplegia: test of the personal neglect hypothesis.

OBJECTIVE: To test the personal neglect hypothesis of anosognosia for hemiplegia (AHP) using selective anesthesia of the right hemisphere. BACKGROUND: Although AHP most commonly follows right-hemisphere injury, the mechanism responsible for this hemispheric asymmetry has not been entirely elucidated. Because denial of ownership of parts on the contralesional side of one's body (personal neglect) also more commonly follows right-hemisphere damage, personal neglect might account for AHP. DESIGN/METHODS: AHP and personal neglect were assessed in 20 patients during right intracarotid barbiturate infusion. With vision restricted to the central field, patients were randomly presented with either their own hands or those of examiners matched for size, gender, and race. Patients were asked to read numbers placed on the hands to establish that hemianopia did not confound hand recognition. RESULTS: All subjects correctly read the numbers on all trials. Only 4 of 20 subjects misidentified their hands and denied awareness of left hemiplegia. All errors occurred for the left hand, indicating personal neglect. However, the 16 subjects without personal neglect also demonstrated AHP. CONCLUSION: Because AHP and personal neglect are dissociable, personal neglect cannot completely account for AHP.

Adult↗
PubMed1998

Congenital bilateral perisylvian polymicrogyria presenting as congenital hemiplegia.

We report three children with pure congenital hemiplegia found to have congenital bilateral perisylvian polymicrogyria (CBPP). None of our patients had the seizures, oromotor dysfunction, or cognitive impairment usually associated with CBPP. CBPP may be more common and heterogeneous than previously thought, is easily recognized by MRI, and should be included in the differential diagnosis of the young child presenting with congenital hemiplegia.

Cerebral Aqueduct↗
PubMed1999

A novel nonsense mutation in CACNA1A causes episodic ataxia and hemiplegia.

OBJECTIVE: To identify the disease-causing mutation and to characterize penetrance and phenotypic variability in a large pedigree with episodic ataxia type 2 (EA-2) previously linked to chromosome 19. BACKGROUND: Mutations in the CACNA1A gene on chromosome 19 encoding a calcium channel subunit cause EA-2, which is characterized by recurrent attacks of imbalance with interictal eye movement abnormalities. METHODS: The authors used single-strand conformation polymorphism (SSCP) analysis to screen for point mutations, and direct sequencing to identify mutations in CACNA1A. Allele-specific oligonucleotides were designed to detect the presence of the diseased allele in members of their pedigree as well as in normal control subjects. RESULTS: Reassessment of members of the pedigree revealed two notable clinical features. Diffuse weakness during attacks of ataxia was a prominent complaint. Two affected individuals had had episodic hemiplegia, one with typical migraine headaches. SSCP analysis revealed aberrant bands in exon 29 in affected members but not in normal control subjects. Direct sequencing of exon 29 identified a C-to-T change at position 4914 of the coding sequence of CACNA1A, predicting an early stop code at codon 1547. Two asymptomatic mutation carriers demonstrated the incomplete penetrance of this mutation. CONCLUSIONS: A nonsense mutation in CACNA1A causes episodic ataxia and complaint of weakness, and may be associated with hemiplegia.

Adolescent↗
PubMed1985

Evaluation of spinal cord stimulation for postapoplectic spastic hemiplegia.

We used spinal cord stimulation (SCS) in patients with postapoplectic spastic hemiplegia in an attempt to reduce the spasticity. Three patients with spastic hemiplegia due to apoplexia were selected for the treatment. Reduction of spasticity was observed 3 to 9 days after the stimulation. Electrophysiological evaluation of the spasticity from the H reflex revealed a remarkable improvement in all three patients. The mechanism of reduction of spasticity has not yet been clarified, although a direct or indirect effect on the reticulospinal tract is thought to play a role.

Aged↗
PubMed2006

Kinesio taping in stroke: improving functional use of the upper extremity in hemiplegia.

The purpose of this article is to present the Kinesio taping method used to improve the upper extremity function in the adult with hemiplegia. The article discusses various therapeutic methods used in the treatment of stroke patients to achieve a functional upper extremity. The only taping technique for various upper extremity conditions that has been described in the literature is the athletic taping technique. In this article, some interpretation is offered on proper assessment of the nonfunctional upper extremity, including the emphasis on postural alignment, trunk control, and scapula alignment. The Kinesio taping method in conjunction with other therapeutic interventions may facilitate or inhibit muscle function, support joint structure, reduce pain, and provide proprioceptive feedback to achieve and maintain preferred body alignment. Restoring trunk and scapula alignment after the stroke is critical in an effective treatment program for the upper extremity in hemiplegia.

Adult↗
PubMedDate not supplied

Gliclazide-induced hepatitis, hemiplegia and dysphasia in a suicide attempt.

The drugs used to treat diabetes mellitus are diverse and include several classes. One class is sulfonylureas which primarily cause serum glucose reduction by stimulating the release of preformed insulin from the pancreatic islets. Gliclazide, a second generation sulfonylurea, is used to control glycemic levels in non-insulin-dependent diabetes mellitus. We report a 14 year-old non-diabetic girl who developed hepatitis, hemiplegia and dysphasia after ingestion of an overdose of gliclazide (20 mg/kg/day) in a suicide attempt. Our purpose is to draw attention to the severity of gliclazide-induced neurological signs. To the best of our knowledge, gliclazide-induced hemiplegia and dysphasia have not been previously reported in the literature.

Adolescent↗
PubMed1996

The relation between crossed cerebellar blood flow and severities of hemiplegia: a technetium-(99m) hexamethylpropylene amine oxine SPECT study using Patlak plot method.

Crossed cerebellar diaschisis (CCD), decrease in crossed cerebellar blood flow (CCBF) (ml/100g/min), is often observed in the cerebral blood flow imaging of hemiplegic patients. We studied the relations between severities of hemiplegia and degrees of CCD. Severities of hemiplegia were evaluated by Brunnstrom stages (Br. stage) of lower limbs. Degree of CCD was evaluated as CCBF and asymmetry index (ASI) (%) of CCBF, which were calculated from technetium-(99m) hexamethylpropylene amine oxine ((99m)Tc HMPAO) SPECT study using Patlak plot method (Matsuda et al. 1992, 1993). We have studied twenty consecutive patients. The CCBF was significantly different between Br. stage II and IV (p = 0.0357), III and IV (p < 0.001) and III and V (p < 0.001). ASI was significantly different between II and IV (p = 0.0357), III and IV (p < 0.001) and III and VI (p = 0.0238). Both of CCBF and ASI of the group of II and III were significantly lower than those of the group of IV, V and VI (p = 0.0033 for CCBF and p = 0.0087 for ASI). We conclude that this study indicate a close correlation between the sevreties of hemplegia and the degrees of CCD.

Aged↗
PubMed2004

Stepping over obstacles to improve walking in individuals with poststroke hemiplegia.

For this study, we evaluated two training interventions for improving gait parameters in individuals with poststroke hemiplegia using a training methodology that required them to step over objects. Gait velocity, step length, ability to step over obstacles, and walking endurance were compared before and after 2 weeks of training and 2 weeks after cessation of training. Twenty subjects with poststroke hemiplegia completed six intervention sessions in which they were asked to step over either virtual objects while walking on a motorized treadmill or real foam objects on a 10 m walkway. With the virtual object training, if either foot collided with the virtual object, a tone sounded and a vibrotactile stimulus was applied to the colliding foot. All subjects tolerated the training sessions well, and no incidences of falling or undue cardiovascular responses occurred. The virtual obstacle training generated greater improvements in gait velocity compared with real training (20.5% vs. 12.2% improvement) during the fast walk test (p < 0.01). Improvements in gait velocity for both training methods were similar in the self-selected walk test (33.3% vs. 34.7% improvement). Overall, subjects showed clinically meaningful changes in gait velocity, stride length, walking endurance, and obstacle clearance capacity as a result of either training method. These changes persisted for 2 weeks posttraining. The inclusion of enhanced safety and visual augmentation may be responsible for the effectiveness of the virtual object intervention. These results demonstrate preliminary evidence for clinical effectiveness of obstacle training for improving gait velocity poststroke. In addition, these results provide evidence for enhanced clinical performance with virtual obstacle training.

Adult↗
PubMed2004

Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy.

Several converging lines of contemporary evidence suggest that weakness presents a more serious compromise to movement function in poststroke hemiplegia than spasticity. This review examines the clinical and functional phenomena of weakness in poststroke hemiplegia, currently available evidence identifying physiologic substrates contributing to weakness, and reports of early investigations involving high-resistance training targeted at improving strength and the transfer of strength to improvements in functional capacity. Based on this information, we describe some unsolved problems and indicate some likely lines of development to increase our knowledge regarding how resistance training can be included in effective stroke rehabilitation.

Exercise Movement Techniques↗
PubMed2003

Ventriculocordectomy reduces respiratory noise in horses with laryngeal hemiplegia.

REASONS FOR PERFORMING STUDY: Show and performance horse with laryngeal hemiplegia (LH) often present for excessive respiratory noise rather than significant exercise intolerance. Therefore, the goal of surgery in these horses is to reduce respiratory noise but there are no quantitative studies evaluating the effect of any upper-airway surgery in LH-affected horses. OBJECTIVE: To determine whether bilateral ventriculocordectomy (VC) reduces respiratory noise in exercising horses with laryngeal hemiplegia. METHODS: Six Standardbred horses with normal upper airways were used in this study. Respiratory sounds and inspiratory trans-upper airway pressure (Pui) were measured in all horses before and after induction of LH, and 30, 90 and 120 days after VC. In horses with LH, spectrogram analysis revealed 3 inspiratory sound formants centred at approximately 400, 1700 and 3700 Hz. Inspiratory sound levels (SL) and the sound intensity of the 3 inspiratory formants (F1, F2, F3 respectively) were measured using a computer-based sound analysis programme. RESULTS: In LH-affected horses, Pui, inspiratory SL and the sound intensity of F2 and F3 were significantly increased compared to baseline values. At 90 and 120 days after VC the sound intensities of F2 and F3 returned to baseline values. The Pui and SL, were significantly decreased compared to LH values, but remained different from baseline. CONCLUSIONS: VC effectively reduces inspiratory noise in LH-affected horses by 90 days following surgery. Inspiratory trans-upper airway pressures are improved 30 days following VC, but do not return to baseline values. POTENTIAL RELEVANCE: VC can be recommended as a surgical treatment of LH-affected horses if reduction of respiratory noise is the primary objective of surgery. Further studies are required to determine if variations of the surgical technique used in this study will have similar results.

Animals↗
PubMed1978

Treatment of aneurysmal hemiplegia with dopamine and mannitol.

Three patients with severe postoperative hemiplegia and one with hemiplegia following a subarachnoid hemorrhage are presented. None had hematomas. All were treated with dopamine-induced hypertension, mannitol, and large quantities of intravascular fluids. All showed a remarkable degree of clinical improvement, presumably secondary to an increase in cerebral blood flow.

Adult↗
PubMedDate not supplied

Congenital horner syndrome and hemiplegia secondary to carotid dissection.

A 5-month-old infant had right Horner syndrome and left hemiplegia. Magnetic resonance imaging confirmed smaller cerebral hemisphere and magnetic resonance angiography showed reduced blood flow in the internal carotid artery on the right. A diagnosis of congenital hemiplegia and carotid occlusion secondary to maternal trauma during pregnancy was made.

Accidents, Traffic↗
PubMed2006

[An explanatory model for health-promoting behaviors in patients living at home who have post stroke hemiplegia].

PURPOSE: A structural equation model was analyzed to explore the determinants of health-promoting behaviors in patients living at home in Korea who had post stroke hemiplegia. METHOD: Demographic characteristics, activities of daily living, religiosity, family support, self-efficacy, acceptance of disability, perceived barriers to health-promoting activities, depression, and health-promoting behavioral data was collected from 239 patients using self-report questionnaires. RESULT: Variables that have a direct effect on health-promoting behaviors were self-efficacy and family support. Depression, acceptance of disability, perceived barriers, activities of daily living and religiosity also influenced health-promoting behaviors in an indirect way. CONCLUSION: It is imperative to explore strategies for patients with post stroke hemiplegia to identify and maximize their resources, develop their self-efficacy, improve their emotional state, and enhance their physical activity and spiritual growth, which would maximize health-promoting behaviors.

Adult↗
PubMed1984

A comparative study on the presence of the asymmetrical tonic neck reflex in adult hemiplegia.

In this study, the intensity of the asymmetrical tonic neck reflex (ATNR) was measured in post-cerebrovascular accident (CVA) adults with hemiplegia and in neurologically intact adults to determine if the reflex exaggerated following CVA. Fourteen subjects with right and left hemiplegia were matched to neurologically intact subjects by age and sex and tested for the ATNR. Intensity of the reflex was measured using electromyography (EMG) biofeedback. The results indicate that no difference exists between the two groups in intensity of the reflex. The method of rotation used to elicit the reflex did significantly affect the strength of the muscle response. A possible explanation for observation of the reflex in the hemiplegic individual's movement and its significance in neuromuscular re-education programs is discussed.

Aged↗
PubMed1991

Contralateral hemiplegia following thoracic herpes zoster.

OBJECTIVE: To suggest interim therapeutic guidelines for stroke following truncal herpes zoster on the basis of the first reported Australian case, in a patient who showed good clinical response related temporally to antiviral therapy. CLINICAL FEATURES: A 70-year-old patient with no known underlying immune disorder presented with left-sided hemiplegia one week after right-sided truncal herpes zoster. In all probability the neurological deficit was due to large artery vasculopathy with thrombosis. INTERVENTION AND OUTCOME: Clinical improvement (not to pre-morbid levels) was noted soon after commencement of antiviral therapy with acyclovir. CONCLUSION: Stroke following herpes zoster may be a treatable condition. In view of the previously described occurrence of viral antigen within the walls of intracerebral vessels, the occasional progression of the syndrome over months, the generally low toxicity of acyclovir and the clinical response of the few patients treated with antiviral agents to date, early antiviral therapy in patients presenting with delayed contralateral hemiplegia associated with herpes zoster is recommended as prudent.

Acyclovir↗
PubMed2003

[Educational effects on radiological technology students of programs using a simulated aged person and hemiplegia patient].

A practical training program that enabled students to experience an aged person and hemiplegia patient was developed as part of the "Practice Program in Medical Imaging Technology," to help the students understand how to support patients in the X-ray examination setting. Eighty-three third-year radiological technology students participated in the program. During the hour-long course, they experienced a simulated program that contained various checkpoints. The students pointed out the difficulty patients had in going up and down stairs (51.8%) and their feelings of uneasiness and fear of blindness (36.1%). As a result of this practical training program, the students increased their understanding of how to support patients slated for X-ray examinations. However, certain problems became clear, such as students' insufficient experience and lack of practical guidance in supporting aged patients and those with hemiplegia at the time of X-ray examinations. This information will helpful for improving similar training programs to be held in the future.

Aged↗
PubMed2000

[Japanese encephalitis presenting with left hemiplegia and thalamic neglect--a case report].

This report concerns a 51-year-old right-handed man with Japanese encephalitis, showing left hemiplegia and left hemispatial neglect. On admission, he had a slight fever, mild consciousness disturbance, left hemiplegia, and left hemispatial neglect but no neck stiffness, headache nor nausea. He was treated on the basis of cerebral infarction, but his fever and consciousness disturbance worsened. We found pleocytosis (145/mm3) in the cerebrospinal fluid (CSF) and right thalamic edema on a brain CT scan obtained 4 days later. He was finally diagnosed as having Japanese encephalitis on the basis of an increase in anti-viral antibodies observed in paired CSF and serum samples. In the exacerbation phase, 123I-IMP single photon emission CT (SPECT) demonstrated a marked decrease in cerebral perfusion in the right hemisphere, while a brain MRI revealed irregular lesions localized the right thalamus (mainly posterior and medial parts), showing low intensity on T1-weighted and high intensity on T2-weighted images. In the recovery phase, asymmetrical perfusion was no longer observed on SPECT and the symptoms including the left hemispatial neglect had improved. These findings suggest that the left hemispatial neglect in this patient might been caused by the right thalamic lesion resulting in damage to the activating system of the right hemisphere. This case thus shows that acute onset of hemispatial neglect could be caused by cerebral encephalitis.

Cerebral Infarction↗