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Neuropsychological Rehabilitation Jun 2018Phonological alexia and agraphia are written language disorders characterised by disproportionate difficulty reading and spelling nonwords in comparison to real words....
Phonological alexia and agraphia are written language disorders characterised by disproportionate difficulty reading and spelling nonwords in comparison to real words. In phonological alexia, it has been shown that, despite relatively accurate reading of words in isolation, text-level reading deficits are often marked and persistent. Specifically, some individuals demonstrate difficulty reading functors and affixes in sentences, a profile referred to as phonological text alexia. In this paper, we demonstrate an analogous manifestation of the phonological impairment on text-level writing and suggest the term "phonological text agraphia". We examined four individuals with phonological alexia/agraphia who also showed disproportionate difficulty writing well-formed sentences in comparison to their grammatical competence in spoken utterances. Implementation of a phonological treatment protocol resulted in significantly improved sublexical phonology skills as well as improvements in grammatical accuracy of written narratives. These findings support the notion of a common phonological impairment underlying nonword reading/spelling deficits and sentence-level difficulties.
Topics: Adult; Aged; Agraphia; Dyslexia; Female; Humans; Language Therapy; Male; Middle Aged; Neuropsychological Tests; Phonetics; Stroke; Treatment Outcome
PubMed: 27392251
DOI: 10.1080/09602011.2016.1199387 -
Neurology Jul 2015
Topics: Agraphia; Female; Handwriting; Humans; Middle Aged; Recovery of Function
PubMed: 26195237
DOI: 10.1212/WNL.0000000000001754 -
Cephalalgia : An International Journal... Apr 2023Headache with neurologic deficits and cerebrospinal fluid lymphocytosis, previously also termed pseudomigraine with temporary neurologic symptoms and lymphocytic... (Review)
Review
BACKGROUND
Headache with neurologic deficits and cerebrospinal fluid lymphocytosis, previously also termed pseudomigraine with temporary neurologic symptoms and lymphocytic pleocytosis, is a self-limiting syndrome characterized by moderate to severe headache associated with focal neurological deficits occurring in the context of lymphocytosis in the cerebrospinal fluid. As a consequence of its rarity, data regarding headache with neurologic deficits and cerebrospinal fluid lymphocytosis is sparse. Therefore, we conducted this review to analyze data related to 93 patients of headache with neurologic deficits and cerebrospinal fluid lymphocytosis, to characterize their demographics, clinical manifestations, investigations and treatment options.
METHODS
We performed a systematic review of cases reported through PubMed and Google scholar database, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Keywords used were 'Headache with Neurologic Deficits and cerebrospinal fluid lymphocytosis', 'Headache with neurologic deficits and cerebrospinal fluid lymphocytosis syndrome'. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool.
RESULTS
We analyzed a total of 93 cases of headache with neurologic deficits and cerebrospinal fluid lymphocytosis with a mean age of 28.8 years at onset. Seventy patients (75.2%) were adults, while 23 (24.7%) belonged to the pediatric age group. Comparing these groups, mean age at onset was 32.5 years and 14.3 years, respectively. The average duration of follow-up was 11.08 months. Thirty percent of patients experienced relapsing episodes of headache with neurologic deficits and cerebrospinal fluid lymphocytosis symptoms. The most common type of headache reported was unilateral severe throbbing episodic headache. Other associated symptoms included sensory deficit (60%) and motor deficits (54.8%). The least common symptoms were nystagmus and agraphia, which were reported in one patient each. Antiviral agents were a common treatment option in the acute phase (n = 23 patients [23.6%]), while Flunarizine was the most commonly used agent in the chronic setting (n = 3 patients [3.2%]). While most of the patients had normal brain magnetic resonance imaging, 20 patients had magnetic resonance imaging abnormalities, including (but not limited to) non-specific white matter lesions (eight patients) and meningeal enhancement (six patients). The most common electroencephalographic findings included diffuse and focal slowing. The mean cerebrospinal fluid opening-pressure was 240.5 mmHO. Cerebrospinal fluid protein was elevated in 59 (63.4%) patients, with a mean value of 114 mg/dL. Two patients in our cohort were found to have cerebrospinal fluid oligoclonal bands.
CONCLUSION
Headache with neurologic deficits and cerebrospinal fluid lymphocytosis tends to affect young individuals with a slight male predominance. Unilateral severe throbbing episodic headache with associated hemi-paresthesia and hemiparesis were the most common symptoms based on our review. Elevated cerebrospinal fluid opening-pressure can be seen in headache with neurologic deficits and cerebrospinal fluid lymphocytosis syndrome. Early recognition of the syndrome is paramount. Antivirals were found to be among the most widely used treatments in the acute setting. Magnetic resonance imaging of the brain is mostly normal. Diffuse and focal slowing were among the most common electroencephalographic findings. Cerebral flow abnormalities on perfusion scans are not uncommon in headache with neurologic deficits and cerebrospinal fluid lymphocytosis. Prospective studies with a larger sample size are needed to validate our findings and guide the clinical care of these patients.
Topics: Adult; Humans; Male; Child; Female; Lymphocytosis; Prospective Studies; Headache; Cerebrospinal Fluid Pressure; Brain
PubMed: 36856002
DOI: 10.1177/03331024231157694 -
Frontiers in Pediatrics 2021Pediatric acute-onset neuropsychiatric syndrome (PANS) is a condition defined by sudden onset of obsessive-compulsive symptoms and/or severe eating restrictions, along...
Pediatric acute-onset neuropsychiatric syndrome (PANS) is a condition defined by sudden onset of obsessive-compulsive symptoms and/or severe eating restrictions, along with at least two other cognitive, behavioral, or neurological symptoms. Its pathogenesis is unknown but it seems triggered by infections, metabolic disturbances, and other inflammatory reactions. PANS represents a neurodevelopmental problem and infant feeding can play a role. Breast milk is the ideal food for infants and influences children's brain, cognitive, and socio-emotional development. We enrolled 52 children diagnosed with PANS. We interviewed their parents in order to investigate perinatal history, infant feeding, neurologic development, and confounding factors like socio-economic status and region of origin. We subgrouped PANS patients into three subsets: those who only received human milk (HMO), those who only received infant formula, and those who received mixed feeding. The cohort is composed of 78.9% males, with a median age of 11 years (range 7-17). We found some neurodevelopmental problems (13.5%): walking disorders, ASD, ADHD, oppositional attitude, and delayed psychomotor development. We found scholar performance deficits (25%), including language problems like dysgraphia, dyslexia, and dyscalculia. The achievement of some milestones in the development of the infant is affected in 73.1% of cases. Breastfeeding is not homogeneously practiced in Italy because of social, economic, and cultural phenomena. The richest and the poorest families (100%) in the sample choose breastfeeding, probably with a different approach and for different reasons (awareness or need). In the group of PANS patients fed with HMO, compared to the rest of the patients, we registered fewer cases of growth problems (0 vs. 12.9%; = 0.14), school performance problems or the need for school support (19.1% vs. 29%; = 0.42), and a delay in the age of babbling/speaking (range 4-20 vs. 7-36 months; = 0.066). This is the first study that investigates the role of breastfeeding in the development of PANS. Promoting breastfeeding is important in the general population and also in PANS patients because it has an important social and global health impact, also during adult life. Further studies with a bigger population are needed to investigate the mechanisms underlying PANS and the role that breastfeeding may play in their short- and long-term neurodevelopment.
PubMed: 34307255
DOI: 10.3389/fped.2021.682108 -
Medical Journal of the Islamic Republic... 2016Dysgraphia as a problem with handwriting, affects student's performance in school activities and participation. The purpose of the study was to compare dexterity and...
Dysgraphia as a problem with handwriting, affects student's performance in school activities and participation. The purpose of the study was to compare dexterity and two-point discrimination of the hand between learning disabled students with dysgraphia and healthy students. Forty-three students with developmental dysgraphia and 55 normal students in grade two to four from special and regular schools participated in this study. Hand dexterity and static/dynamic discriminative touch were assessed via Purdue Pegboard and Two-Point Discriminator respectively. Significant differences were found in Purdue Pegboard scores between two groups except in doing the test with the left hand (p<0.05). Purdue Pegboard scores were significantly lower in left-handed children with dysgraphia compared to healthy children (p<0.05). There was no significant difference in dynamic two point discrimination between two groups of children (p>0.05). Static two-point discrimination of the thumb finger was significantly higher in children with dysgraphia (p<0.05). Hand dexterity affects handwriting performance in children with dysgraphia. There were no correlations between two-point discrimination and Purdue Pegboard scores of children with dysgraphia. Intervention should focus on other aspects of dexterity rather than sensory components. Hand dominancy also may be a factor influencing hand performance in dysgraphia.
PubMed: 28210599
DOI: No ID Found -
PloS One 2015Absence epilepsy (AE) is etiologically heterogeneous and has at times been associated with idiopathic dystonia.
BACKGROUND
Absence epilepsy (AE) is etiologically heterogeneous and has at times been associated with idiopathic dystonia.
OBJECTIVES
Based on the clinical observation that children with AE often exhibit, interictally, a disorder resembling writer's cramp but fully definable as dysgraphia, we tested the hypothesis that in this particular population dysgraphia would represent a subtle expression of dystonia.
METHODS
We ascertained the prevalence of dysgraphia in 82 children with AE (mean age 9.7) and average intelligence and compared them with 89 age-, gender- and class-matched healthy children (mean age 10.57) using tests for handwriting fluency and quality, based on which we divided patients and controls into four subgroups: AE/dysgraphia, AE without dysgraphia, controls with dysgraphia and healthy controls. We compared the blink reflex recovery cycle in children belonging to all four subgroups.
RESULTS
We identified dysgraphia in 17/82 children with AE and in 7/89 controls (20.7 vs 7.8%; P = 0.016) with the former having a 3.4-times higher risk of dysgraphia regardless of age and gender (odd ratio: 3.49; 95% CI 1.2, 8.8%). The AE/dysgraphia subgroup performed worse than controls with dysgraphia in one test of handwriting fluency (P = 0.037) and in most trials testing handwriting quality (P< 0.02). In children with AE/dysgraphia the blink reflex showed no suppression at short interstimulus intervals, with a difference for each value emerging when comparing the study group with the three remaining subgroups (P<0.001).
CONCLUSIONS
In children with AE, dysgraphia is highly prevalent and has a homogeneous, distinctive pathophysiological substrate consistent with idiopathic dystonia.
Topics: Adolescent; Agraphia; Case-Control Studies; Child; Dystonia; Epilepsy, Absence; Female; Handwriting; Humans; Male
PubMed: 26132164
DOI: 10.1371/journal.pone.0130883 -
Movement Disorders Clinical Practice May 2023
PubMed: 37205246
DOI: 10.1002/mdc3.13720 -
Pakistan Journal of Medical Sciences 2020Dealing with Dyslexia, Dysgraphia and Dyscalculia symptoms is a major challenge for teachers and school psychologists while addressing students' issues. The present...
OBJECTIVE
Dealing with Dyslexia, Dysgraphia and Dyscalculia symptoms is a major challenge for teachers and school psychologists while addressing students' issues. The present study was designed to examine the prevalence and comorbidity of specific learning disabilities (SLD) symptoms such as dyslexia, dysgraphia and dyscalculia in public and private schools of Lahore, Pakistan.
METHODS
This cross-sectional study was conducted in four schools of Lahore from June, 2019 to December 2019. We examined 666 participants (boys= 384, girls= 282) from two public (n=409) and two private (n=257) schools of Lahore with a mean age of 13 years (SD±1.44). Participants were assessed on Learning Disabilities Checklist (LDC) along with a demographic sheet. The data were analyzed by using descriptive statistics (frequencies and percentages) and inferential analyses of Chi Square test of association and Cohen's Kappa by using SPSS version 24.
RESULTS
Findings indicated that 39% participants showed SLD symptoms, 33% dyslexia, 48% dysgraphia and 45% dyscalculia symptoms. Significant co-morbidities were seen, such as 30% for dyslexia and dysgraphia symptoms, dyslexia and dyscalculia 26% and dysgraphia and dyscalculia as 36%. Variations in SLD, dyslexia, dysgraphia and dyscalculia symptoms were also seen across gender and schools with significant higher prevalence in public schools.
CONCLUSION
High prevalence of SLD symptoms and comorbidity in students was found which is alarming, particularly in public sector schools in Pakistan. SLD and dyslexia were higher for boys, whereas girls scored high on dysgraphia and dyscalculia. Therefore, there is great need of introducing screening measure of assessment of SLD and management strategies to deal with these issues.
PubMed: 33235593
DOI: 10.12669/pjms.36.7.2486 -
Psychiatria Danubina Dec 2023Cerebral maturation is characterized by different age-dependent molecular and cellular processes and follows a different course for grey matter (GM) and white matter...
Cerebral maturation is characterized by different age-dependent molecular and cellular processes and follows a different course for grey matter (GM) and white matter (WM). During brain development, a crucial point seems to be represented by the establishment of a hemispheric specialization with the left hemisphere dominant for language and motor control and the right hemisphere dominant for visuospatial processing and attention. Therefore, motor and cognitive development are strongly connected. Atypical motor development and lateralization can be associated with neurodevelopmental disorders, such as Language Disorder, Learning Disorders (Dysgraphia and Dyslexia), Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder. The aim of our research was to investigate the possible effects of intensive motor training on WM plasticity and writing skills in children with Developmental Dysgraphia through a tractography study of the main WM tracts. Considering the effect of training for the Mean Diffusivity (MD) over 18 WM tracts, in 6 collaborating dysgraphic patient MD decrease (-4.3%) and in 3 not. Intensive motor training affects both stimulated and not stimulated WM tracts and showed a double not-specificity: for not stimulated hemilate and for not directly stimulated WM tracts. Intensive motor training improves both some lateralized brain functions and intra- and inter-hemispheric connectivity in our patients with good compliance with motor treatment. Moreover, our findings have shown that WM plasticity improvement concerned cortical areas responsible for both motor and cognitive functions.
Topics: Child; Humans; White Matter; Magnetic Resonance Imaging; Diffusion Tensor Imaging; Autism Spectrum Disorder; Gray Matter; Brain
PubMed: 37994059
DOI: No ID Found -
Movement Disorders Clinical Practice 2017The majority of patients with Parkinson's disease (PD) have handwriting abnormalities. Micrographia (abnormally small letter size) is the most commonly reported and... (Review)
Review
BACKGROUND
The majority of patients with Parkinson's disease (PD) have handwriting abnormalities. Micrographia (abnormally small letter size) is the most commonly reported and easily detectable handwriting abnormality in patients with PD. However, micrographia is perhaps the tip of the iceberg representing the handwriting abnormalities in PD. Digitizing tablet technology, which has evolved over the last 2 decades, has made it possible to study the pressure and kinematic features of handwriting. This has resulted in a surge of studies investigating graphomotor impairment in patients with PD.
METHODS
The objectives of this study were to review the evolution of the kinematic analysis of handwriting in PD and to provide an overview of handwriting abnormalities observed in PD along with future directions for research in this field. Articles for review were searched from the PubMed and SCOPUS databases.
RESULTS
Digitizing tablet technologies have resulted in a shift of focus from the analysis of only letter size to the analysis of several kinematic features of handwriting. Studies based on the kinematic analysis of handwriting have revealed that patients with PD may have abnormalities in velocity, fluency, and acceleration in addition to micrographia. The recognition of abnormalities in several kinematic parameters of handwriting has given rise to the term . In addition, certain kinematic properties potentially may be helpful in distinguishing PD from other parkinsonian disorders.
CONCLUSION
The journey from micrographia to is indeed a paradigm shift. Further research is warranted to gain better insight into the graphomotor impairments in PD and their clinical implications.
PubMed: 30363367
DOI: 10.1002/mdc3.12552