1/85. magnetic resonance imaging findings in corticobasal degeneration.Two women (patient 1, 77 years old, and patient 2, 63 years old) with strong clinical evidence for corticobasal degeneration (CBD) are presented. Patient 2 was in an early stage of the disease with only a mild disability of her left hand. In addition to the clinical characteristics, both patients presented the typical cortical reflex myoclonus. magnetic resonance imaging studies for both patients revealed nearly identical hyperintense lesions somatotopic from the left-hand primary motor cortex (M1), extending to the midline and possibly supplementary motor area (SMA) in patient 2. To our knowledge, this has not been previously described in patients with CBD. These lesions may play a role in the etiology and the development of CBD with involvement of the M1 and may correspond to the underlying pathology of demyelination or gliosis.- - - - - - - - - - ranking = 1keywords = hand (Clic here for more details about this article) |
2/85. motor neuron disease-inclusion dementia presenting as cortical-basal ganglionic degeneration.The frontotemporal dementias are a group of relatively new and evolving clinical and pathologic entities. The predominant frontal-temporal atrophy causes a variety of clinical syndromes, usually dominated by disturbances in behavior, mood, and speech. The motor neuron disease-inclusion dementia (MNDID) subtype is characterized by the accumulation of specific intraneuronal ubiquitin-immunoreactive inclusions with the complete absence of tau immunoreactivity. We present a patient with the clinical and neuroimaging characteristics of a highly asymmetric neurodegenerative condition distinguished by limb rigidity, bradykinesia, dystonia with an alien limb phenomenon, cortical sensory findings, and limb apraxia. His premorbid diagnosis was cortical-basal ganglionic degeneration but he had the typical histologic features of a frontotemporal dementia of the MNDID subtype.- - - - - - - - - - ranking = 179.87795655442keywords = alien (Clic here for more details about this article) |
3/85. Interarticulator co-ordination in deaf signers with Parkinson's disease.Motor control deficits in signers with Parkinson's disease (PD) were examined through analysis of their production of American sign language (ASL) fingerspelling, which is sequential and rapid motor behavior that has theoretical models of its underlying structure. Free conversation of two Deaf signers with PD and two Deaf control signers was analysed. In addition, scripted productions of one control signer were also analysed and directly compared to the same productions by the signers with PD. A featural analysis of ASL fingerspelling and a frame-by-frame analysis of multiple articulator movements were used to examine the fingerspelled productions. On the basis of the featural analysis, the signers with PD showed a variety of error patterns, all of which reflected attempts to reduce the motoric demands of coarticulation and thereby facilitate ease of articulation. Signers with PD either held individual segments in a fingerspelling sequence for a long time (segmentation), blended adjacent segments into a single segment (sequential blending), or broke handshapes down sequentially into their component features (featural unraveling). The results of both the featural analysis and the frame-by-frame analysis show that the PD signers have difficulty co-ordinating the movements of independent articulators in complex sequences. For example, the movements of independent articulators for fingerspelling (the thumb, fingers, and wrist) were markedly farther apart in time and more variable for the signers with PD. In addition, the signers with PD used fewer wrist movements while fingerspelling. Such deficits are consistent with claims that patients with PD are impaired in their ability to use ongoing sensorimotor information to program multi-articulator movements.- - - - - - - - - - ranking = 0.5keywords = hand (Clic here for more details about this article) |
4/85. Alien hand sign after a right parietal infarction.Involuntary movements are unusual during or after acute stroke, and alien hand sign has not been reported after single parietal infarction. We report on a woman who presented with involuntary movements and a sense of alienness of her left upper limb following a right parietal infarction. This combination, that can meet the criteria for the 'alien hand syndrome', is rarely seen after acute lesions sparing the corpus callosum and the mesial frontal areas.- - - - - - - - - - ranking = 8016.770507351keywords = alien hand syndrome, hand syndrome, alien hand, alien, hand (Clic here for more details about this article) |
5/85. Patterns of motor control reorganization in a patient with mirror movements.OBJECTIVE: To explore motor control reorganization in a 40-year-old, left-handed patient with perinatally acquired mirror movements. methods: We performed simultaneous bilateral recordings of motor evoked potentials (MEPs) following focal transcranial magnetic stimulation (fTMS) and of central silent period (cSP) during unilateral voluntary contraction in abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles. RESULTS: For both muscles the MEP study showed bilateral fast-conducting corticospinal projections from the right undamaged hemisphere, and residual contralateral projections from the left hemisphere. The cSP findings differed in the two muscles: the mirror phenomenon was bilateral in the ADM, but present only on the right side in the APB muscles; the mirror activity of right ADM and APB muscles was inhibited only by fTMS of the ipsilateral right motor cortex; the mirror phenomenon in the left ADM muscle was inhibited only by fTMS of the contralateral right motor cortex. CONCLUSIONS: Mirror movements of right APB and ADM muscles were sustained by the ipsilateral connections from the undamaged motor cortex, while the mirror phenomenon in the left ADM muscle could be explained by hypothesizing a bilateral activation of motor cortices. This previously unreported electrophysiological picture demonstrates that different patterns of motor control may realize after perinatal cerebral lesions, even in different distal muscles of the same patient.- - - - - - - - - - ranking = 0.5keywords = hand (Clic here for more details about this article) |
6/85. alien hand syndrome: report of two cases.alien hand syndrome (AHS) refers to the occurrence of apparently purposeful movements in the hand which are independent of volitional control. Two subtypes of AHS have been proposed: frontal AHS, with grasp reflex and compulsive manipulation of tools by the dominant hand, and callosal AHS, which occurs in the nondominant hand and is characterized mainly by intermanual conflict. Here, we report two cases of frontal-type alien hand syndrome with symptoms of reflexive grasping, impulsive groping, and apraxia (in case 1), and compulsive manipulation of tools (in case 2). brain computed tomography revealed a left anterior cerebral artery (ACA) territory infarct and multiple small infarcts of both hemispheres in patient 1 and a left ACA infarct in patient 2. The involuntary movements were bothersome to these patients in their daily activities. Both patients attended conventional physical and occupational therapies, and patient 2 received additional biofeedback training. follow-up studies showed the spontaneous grasping behavior was still present in patient 1 and AHS had subsided in patient 2. We also describe a potentially effective technique involving biofeedback for patients with alien hand syndrome.- - - - - - - - - - ranking = 23276.749301318keywords = alien hand syndrome, hand syndrome, alien hand, alien, hand (Clic here for more details about this article) |
7/85. haloperidol-induced rhabdomyolysis without neuroleptic malignant syndrome in a handicapped child.A 6-year-old severely handicapped boy with haloperidol-induced mild rhabdomyolysis without neuroleptic malignant syndrome is reported. He had suffered from frontal lobe epilepsy, severe mental retardation and involuntary movements. To reduce the involuntary movements, oral administration of haloperidol was started. haloperidol was effective for the involuntary movements, and he became well. However, his urine was sometimes dark brown, and the myoglobin level in his urine was increased. After discontinuation of haloperidol, his urine never became dark brown. It was suspected that haloperidol might cause mild rhabdomyolysis without neuroleptic malignant syndrome. neuroleptic malignant syndrome is a rare but severe adverse effect of neuroleptics, and is usually accompanied by rhabdomyolysis. Although there have been a few adult cases presenting rhabdomyolysis without neuroleptic malignant syndrome, this patient might be the first child case with such symptoms. We have to pay attention to this syndrome when using haloperidol even in children.- - - - - - - - - - ranking = 2.5keywords = hand (Clic here for more details about this article) |
8/85. Involuntary masturbation as a manifestation of stroke-related alien hand syndrome.alien hand syndrome is a perplexing and uncommon clinical diagnosis. We report an unusual manifestation of alien hand syndrome in a 73-yr-old man with a right anterior cerebral artery infarct affecting the right medial frontal cortex and the anterior portion of the corpus callosum. We conclude that alien hand syndrome should be considered in patients who present with a feeling of alienation of one or both upper limbs accompanied by complex purposeful involuntary movement.- - - - - - - - - - ranking = 43234.70801486keywords = alien hand syndrome, hand syndrome, alien hand, alien, hand (Clic here for more details about this article) |
9/85. Post operative supplementary motor area syndrome: clinical features and outcome.The syndrome of the supplementary motor area (SMA) is not well recognized and its features can easily be confused with pyramidal weakness. The authors describe the SMA syndrome in six patients who underwent surgery for tumours located in the SMA, three in the dominant and three in the non-dominant hemispheres. All of them underwent complete resection of the anatomically described SMA, with partial (n = 4) or total resection (n = 2) of the tumour. In the postoperative period, all these patients exhibited reduction of spontaneous movements and difficulty in performing voluntary motor acts to command in the contralateral limbs, although the tone in the limbs was maintained or increased. The function of these limbs in serial automatic motor activities (for example, dressing and walking) was, however, relatively unaffected. speech deficits were seen in only one of three patients with the dominant SMA syndrome. Besides a severe impairment of volitional movements, the salient features of the deficits in this syndrome are hemineglect and dyspraxia or apraxia involving the contralateral limbs. All patients recovered their motor functions over varying periods of time ranging from one to a few weeks. Long-term follow-up (median 24 months) in five patients revealed complete return of function in the affected limbs. It is important to recognize the entity of the SMA syndrome and differentiate it from the deficits that result from operative damage to the motor cortex as the deficits associated with the former are likely to recover almost completely over a short period of time.- - - - - - - - - - ranking = 179.87795655442keywords = alien (Clic here for more details about this article) |
10/85. Loss of left-sided volitional movements caused by a combined lesion of the corpus callosum and right hemisphere:'initiation pseudohemiakinesia'.We report a right-handed patient who showed a marked loss of unilateral volitional movements of the left limbs after the onset of a cerebral infarction in the combined territories of the right anterior and middle cerebral arteries. The same limbs retained their mobility in acts requiring bilateral sides of the body. This left-sided abnormal behavior resembled motor neglect resulting from lateralized brain damage. Behavioral and neuroradiological findings presented by this patient, however, suggested that callosal disconnection was definitely involved in this symptomatology. We postulate that in this patient, the diseased right hemisphere could no longer initiate movements of the left limbs despite its potential ability to realize them, and that the injured callosum prevented the intact left hemisphere from initiating unilateral voluntary movements of the left limbs. We suggest that this so far undescribed symptomatology be called 'initiation pseudohemiakinesia' in order to be distinguished from other rare forms of unilateral voluntary movements like motor neglect, extinction or directional hypokinesia.- - - - - - - - - - ranking = 0.5keywords = hand (Clic here for more details about this article) |
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