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PubMed1981

Praxis and writing of the left hand may be served by different callosal pathways.

A patient who had damage to the leftward outflow of the body of the corpus callosum experienced the development of agraphia, but not apraxia, of the left hand. In another case reported recently, a similar lesion produced the same intriguing dissociation. We suggest that the principal interhemispheric controls for praxis and for writing of the left hand operate at different levels of the corpus callosum.

Adult↗
PubMed1981

Can left-handed writing posture predict cerebral language laterality?

In terms of cerebral lateralization of function, left-handed persons represent a more heterogeneous group than right-handed persons. Some evidence suggests that left-handed subgroups can be identified on the basis of the following two types of writing posture: (1) inverted posture that indicates ipsilateral hemisphere language capability and (2) straight writing posture that indicates contralateral hemisphere language capability. A direct test of this hypothesis with an intracarotid amobarbital sodium injection failed to support these predictions. For clinical decisions in which the hemisphere subserving language is necessary, one should rely on direct assessment with the use of the amobarbital injection technique.

Adult↗
PubMed1983

Late language development in a child unable to recognize or produce speech sounds.

A boy with severe quadriplegia who neither recognized nor uttered speech sounds acquired language. Until the age of 6 years he was considered to be of severely subnormal intelligence. At age 6 years 9 months he was introduced to a manual sign system. Subsequently he was able to read, write, converse, and produce imaginative stories. Attention and memory were unimpaired and affective and social responsiveness developed appropriately. The case history demonstrates the selective effects of brain lesions that, despite extensive damage, may spare functional systems necessary for cognitive and linguistic development. It highlights the difficulty in diagnosing and evaluating the intellectual and affective potential of a multihandicapped child without functional hearing or speech and emphasizes the importance of sign language as a communication channel and prerequisite for the acquisition of reading and writing skills.

Aphasia↗
PubMed1984

Seizures, dyslexia, and dysgraphia of psychogenic origin.

Dyslexia and dysgraphia of various kinds are recognized sequelae of cerebral lesions. Although refusal to read or write may occur in a number of psychiatric disorders, to our knowledge dyslexia and dysgraphia as the sole manifestations of a psychogenic disorder have not previously been reported. Our patient had psychogenic symptoms, initially including seizures but subsequently consisting solely of dyslexia and dysgraphia.

Adult↗
PubMed1987

Left-hemisphere missile injury. A clinical and anatomical case study, with 25-year follow up.

A case is reported of left-hemisphere missile injury sustained in 1944. A stable pattern of selective loss (dysphasia, dyslexia, dysgraphia, and verbal memory impairment) and intact abilities (perceptual and spatial skills and nonverbal memory) was followed up for 25 years. No progressive or generalized intellectual deterioration to suggest interaction between this brain injury and normal aging was observed. The clinical and neuropsychological sequelae are related to the detailed postmortem findings.

Aphasia↗
PubMed1989

Lexical agraphia in Alzheimer's disease.

We studied spelling in 11 patients with senile dementia of the Alzheimer type (SDAT), and their performance was contrasted with that of normal controls. A consistent and specific pattern of linguistic agraphia was identified in the group with SDAT. Although patients with SDAT spelled regular words and nonwords as well as controls, they performed significantly worse when they spelled irregular words. These findings indicated an impairment of the lexical spelling system, consistent with the diagnosis of lexical agraphia. Our observations suggested a loss of word representations from the orthographic lexicon in SDAT and/or an inability to access these representations. However, phonological spelling (phoneme-grapheme conversion) was largely spared.

Aged↗
PubMed1991

Cognitive neuropsychology. Resolving enigmas about Wernicke's aphasia and other higher cortical disorders.

Cognitive neuropsychology is a young branch of neuroscience whose ancestral influences include a rich pool of experimental (eg, cognitive, psychology), theoretical (eg, epistemology), and clinical (eg, neurology, neuropsychology) disciplines. An essential principle of cognitive neuropsychology is that disorders of higher cortical functions can be understood in terms of breakdowns of one or more information-processing modules. Each module is the most basic element of intelligence that can be defined based on current knowledge. This approach is a refinement of-not a fundamental departure from-the 19th-century "localizationist" view of language disorders. Wernicke's aphasia, for example, classical attributed to a single cognitive deficit (loss of word sounds), is shown in this review to require damage to multiple distinct information-processing modules. Cognitive neuropsychology provides the tools for the type of fine-grained analyses of behavior that are needed to capitalize on recent advances in neuroimaging techniques, including the development of more sophisticated models of brain-behavior relationships.

Aphasia, Wernicke↗
PubMed2004

Mirror writing, left-handedness, and leftward scripts.

This minireview concerns a new observation on mirror writing. An uncommon form of writing, mirror writing is seen among healthy individuals, but it can also follow a variety of neurological diseases; it is nearly always carried out with the left hand and is more easily undertaken by left-handers. We have found that a particularly high prevalence of left-handed mirror writing has been reported among those whose native languages are traditionally written in a leftward direction, including Chinese, Japanese, and Hebrew. Innate left-handers and those whose languages are written leftward thus share an unusual facility for left-handed mirror writing, an observation that may have implications for understanding hemisphere specialization in relation to handedness.

Dominance, Cerebral↗
PubMed1984

Spastic dysphonia and essential (voice) tremor treated with primidone.

Primidone has been reported to be effective in reducing tremor in patients with benign essential tremor. There is at least one report that suggests that the medication may reduce voice tremor, a frequent component of the essential tremor syndrome. Three patients with spastic dysphonia of essential (voice) tremor and one with more typical essential (voice) tremor were treated with primidone and experienced no alleviation in the voice signs. The side effects experienced by all patients were consistent with those noted in previous reports. Primidone does not seem to be effective in treating essential voice tremor or spastic dysphonia of essential voice tremor.

Aged↗
PubMed1994

Pediatric medication order error rates related to the mode of order transmission.

OBJECTIVE: This study was undertaken to measure the medication error rates associated with verbal orders compared with handwritten and computer-entered orders in an acute-care children's hospital. METHODS: All medication and intravenous fluid orders for a 3-month interval were entered into a computer database. For the same interval, all errors pertaining to the transmission of a medication or intravenous fluid order were also entered into the database. Errors were detected by the hospital pharmacy, which continuously reviews all inpatient medication and intravenous fluid orders for potential errors before dispensing. Errors were also detected by nurses on the floors, who submit incident reports when medication or intravenous fluid errors occur. RESULTS: Verbal orders were associated with significantly lower error rates than either handwritten orders or computer-entered orders (2.6, 8.5, and 6.3 per 1000, respectively), with transcription errors and dosage errors in particular being reduced. Total error rates did not differ between residents and attending physicians. Error rates did not differ between verbal, written, and computer orders for medications with a low frequency of verbal orders and therefore presumed greater complexity. However, the verbal order error rates seemed more sensitive to order complexity than order error rates in general. CONCLUSIONS: The hypothesis that verbal orders are more prone to transmission error than written or computer orders is not supported by the findings in this study. Identifying medications with high levels of order complexity for restriction of verbal order use seems justified. Suggested guidelines for verbal order transmission are presented.

Child↗
PubMed1975

The interictal behavior syndrome of temporal lobe epilepsy.

A distinct syndrome of interictal behavior changes occurs in many patients with temporal lobe epilepsy. These changes include alterations in sexual behavior, religiosity, and a tendency toward extensive, and in some cases compulsive, writing and drawing. The concomitants of abnormal limbic acitivity therefore include behavior alterations as well as manifest seizures. The demonstration of interictal spike activity in temporal structures provides a pathophysiologic basis for this syndrome. The constellation of behavioral changes may be of great diagnostic value. In addition, it provides an example of a human behavioral syndrome assocaited with dysfunction at specific anatomic loci. The behavior syndrome of temporal lobe epilepsy may prove to be a useful model in studies on the neural substrates for behavior.

Adult↗
PubMed1977

Differentiation of alcoholics. Childhood history of minimal brain dysfunction, family history, and drinking pattern.

Alcoholics were differentiated into two subgroups on the basis of drinking patterns and subjective response to alcohol. Severe drinkers (primary alcoholics) retrospectively reported more symptoms of childhood minimal brain dysfunction than less severe drinkers (secondary alcoholics), psychiatric patients, and normals. The alcoholics as a group reported a greater incidence of familial alcohol abuse than the psychiatric subjects, but a difference on this factor was not observed between the primary and secondary subgroups. In terms of clinical status, the primary alcoholics presented Minnesota Multiphasic Personality Inventory profile more indicative of normality than the other groups, but scored significantly higher on the MacAndrew Alcoholism Scale. These findings are discussed in light of further delineating a specific subtype of alcoholism that may have a genetic-constitutional relationship with other pathological disorders.

Achievement↗