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PubMed1986

Comparison of manual data coding errors in two hospitals.

The routine manual encoding of pathological data, using the SNOP and SNOMED systems at two London teaching hospitals, was reviewed. The error rates in the two departments were compared and the causes analysed. The relative merits of SNOP and SNOMED were considered. Methods to optimise the efficiency of manual encoding are suggested and the importance of accuracy in coding is emphasised.

Documentation↗
PubMed1973

Language after dominant hemispherectomy.

Linguistic and related cognitive abilities were investigated two years after dominant left hemispherectomy for cerebral malignancy in a 12 year old female. Auditory comprehension of speech was superior to other modes of language abilities with expressive speech being the least developed. Findings suggested an isolation or non-communication between the systems for speaking and for writing and visual perception. It was concluded that language mechanisms in the right hemisphere were not just at a low level of development of the functions found in the dominant hemisphere but were modified as a result of interference by preexistent spatioperceptual systems.

Auditory Perception↗
PubMed1979

Primary writing tremor.

We describe a patient who complained of jerking of the right forearm on writing. Active pronation of his arm produced several beats of pronation/supination tremor. A burst of tremor also could be elicited by tendon taps to the volar surface of the wrist, to the finger extensors, and to pectoralis major, and by forcible supination of the wrist delivered by a torque motor. The subject's writing difficulty and tremor were temporarily abolished by partial motor point anaesthesia of pronator teres. We conclude that the tremor was caused by an abnormal response to muscle spindle input from pronator teres.

Adult↗
PubMed1982

Primary writing tremor treated by stereotactic selective thalamotomy.

Three cases with primary writing tremor were treated successfully by stereotactic selective thalamotomy centred mainly on the ventralis intermedius nucleus. They exhibited progressive coarse tremor of 5-7 Hz during writing, and Westphal's phenomenon on stretch, as the only neurological manifestations. Within the thalamus, a very high incidence of irregular burst discharges was recorded. These findings suggest that the writing tremor is an organic disorder.

Dominance, Cerebral↗
PubMed1983

Neglect dysgraphia.

A phonological dysgraphic syndrome is documented in a left handed man with a right-hemisphere lesion. His spelling was significantly affected by word length but neither word frequency nor the orthographical irregularity or word class proved to be relevant variables. Words were spelled equally efficiently forwards as backwards. A clear gradient of letter errors was shown to exist with letters on the left being mis-spelled more often than letters on the right of a word, irrespective of word length. These findings are discussed in terms of current models of spelling and their relevance to theories of unilateral neglect.

Attention↗
PubMed1984

The treatment of severe dystonia in children and adults.

Twenty-three children (aged less than 18 years) and 17 adults with severe widespread dystonia were treated with high doses of benzhexol (up to 130 mg daily introduced slowly over many weeks). Children tolerated higher doses (median 30 mg/day) than adults (median 20 mg/day). 52% of the children gained useful benefit, many (43%) without unwanted side effects. Such an approach was less successful in adults; 41% gained benefit, but only 35% had no side effects. Twelve adults with severe axial dystonia, and two children with life-threatening generalised dystonia were treated with a combination of a low constant dose of tetrabenazine to which were added pimozide and benzhexol as necessary. The dose of tetrabenazine was aimed at 75 mg daily; pimozide was increased (6 to 25 mg/day) until the dystonia was relieved or Parkinsonism and other side-effects prevented further increments; if necessary benzhexol (6 to 30 mg/day) then was added to control side-effects and to provide additional benefit. 75% of the adults with severe axial dystonia, and one of the two children with life threatening generalised dystonia gained useful benefit from this regime. It is concluded that high dose benzhexol is the present first treatment of choice for children with severe dystonia, and is worth a try in adults but with less expectation of success. When benzhexol treatment alone fails in adults with severe disabling axial dystonia, or in children with life-threatening generalised dystonia, combined therapy with tetrabenazine, pimozide and benzhexol may give valuable symptomatic relief.

Adolescent↗
PubMed1985

Writing tremor: its relationship to benign essential tremor.

Nine patients with tremor on writing and one patient with tremor only on swinging a golf club were investigated. None of the patients had any other neurological symptoms or signs. The frequency of the tremor ranged from 5 to 6 Hz. Rapid passive supination or pronation of the forearm by a torque motor evoked a short burst of alternating tremor in seven patients. The tremor was improved by alcohol or propranolol in six patients. These characteristics of writing tremor (and of other isolated action tremors) suggest that it is a variant of benign essential tremor.

Adult↗
PubMed1985

Increased co-activation of the upper limb muscles in writer's cramp.

Eleven patients with writer's cramp were studied during the performance of a series of writing and non-writing tasks. Their performance in the tasks and the intensity of contraction in the flexor and extensor muscles of the fingers and elbow (recorded electromyographically) were compared with the results from a group of matched normal controls. The patients showed highly significant increases in muscle activation especially in the triceps muscle which was overactive in all but one of the tasks undertaken. Psychometric testing showed no difference between patients and controls. The results support the view that writer's cramp is a form of focal dystonia in which the disorder of motor control is not confined to writing activities.

Adult↗
PubMed1986

Hypergraphia: a right hemisphere syndrome.

A new right hemisphere symptom is reported. Five stroke patients with lesions in the perisylvian cortico-subcortical or thalamic region of the right hemisphere produced linguistically correct but semantically loose writing. The behaviour was initiated by subtle prompting and continued semiautomatically. A possible mechanism underlying this hypergraphia is discussed.

Aged↗
PubMed1987

The aetiology of mirror writing: a new hypothesis.

Twenty-eight cases of mirror writing were seen during a period of three and a half years. These consisted of 12 patients with essential tremor, nine with Parkinson's disease, three with spino-cerebellar degeneration and four other cases. There were no cases of hemiparesis, aphasia, apraxia, agnosia or confusion. Fragmentary reversals were excluded from this study. Since essential tremor, Parkinsonian tremor and cerebellar tremor can be abolished by a stereotaxic produce applied to the thalamus, a common neural pathway via the thalamic nuclei may exist in these disorders. The existence is therefore proposed of some neural mechanism that controls the higher cerebral function of writing via the thalamus.

Dominance, Cerebral↗