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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 -
Open Forum Infectious Diseases Mar 2023We present the case of a 61-year-old woman with a history of orthotopic heart transplant who was hospitalized with new-onset headache. Magnetic resonance imaging (MRI)...
We present the case of a 61-year-old woman with a history of orthotopic heart transplant who was hospitalized with new-onset headache. Magnetic resonance imaging (MRI) of the brain revealed T2 hyperintense signal involving the left occipital lobe with leptomeningeal enhancement and mild vasogenic edema. Initial neurologic examination was normal; however, after 7 days she developed imbalance, visual disturbances, night sweats, bradyphrenia, alexia without agraphia, and right hemianopsia. Brain MRI showed enlargement of the left occipital mass and worsening edema. Stereotactic needle biopsy showed nondiagnostic necrosis. The patient continued to deteriorate despite dexamethasone. Cerebrospinal fluid (CSF) suggested infection, and cytomegalovirus CSF polymerase chain reaction (PCR) was positive. The patient received vancomycin, imipenem, and ganciclovir. After obtaining a positive serum beta-D-glucan (Fungitell), amphotericin was added. Despite best medical efforts, the patient died. Postmortem broad-range PCR sequencing of the brain tissue was positive for rare amoeba .
PubMed: 37008568
DOI: 10.1093/ofid/ofad094 -
Neurocase Apr 2018A 62-year-old male presented with progressive isolated writing and spelling difficulties. Neurological, neuropsychological, speech, and language evaluations identified...
A 62-year-old male presented with progressive isolated writing and spelling difficulties. Neurological, neuropsychological, speech, and language evaluations identified only minimal additional abnormalities. The presenting characteristics did not meet criteria for any particular variant of primary progressive aphasia; his clinical presentation is best described as primary progressive aphasia, with a predominant, almost pure agraphia. Brain MRI showed asymmetric, bilateral parenchymal volume loss, with left hippocampal atrophy. Fluorodeoxyglucose-F18 positron emission tomography showed hypometabolism in the lateral left frontal lobe, including Exner's area. Beta-amyloid and tau-positron emission tomography scans were negative, indicating the etiology was not Alzheimer's disease. The underlying neurodegenerative process is most likely related to TDP-43, although a 4-repeat tauopathy cannot be excluded. Following his clinical evolution, and ultimately identifying the underlying pathology from autopsy, will elucidate the etiology of this interesting clinical presentation.
Topics: Agraphia; Aphasia, Primary Progressive; Brain; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Positron-Emission Tomography
PubMed: 29569990
DOI: 10.1080/13554794.2018.1454963 -
Neurocase Jun 2014Studies of patients with brain lesions have demonstrated that language and praxis are mediated by dissociable networks. However, language has the capacity to influence...
Studies of patients with brain lesions have demonstrated that language and praxis are mediated by dissociable networks. However, language has the capacity to influence the selection of purposeful actions. The abilities to use language and to program purposeful movements are often mediated by networks that have anatomic proximity. With hemispheric injury, the diagnosis of apraxia is often confounded by the specific influence of language impairments on the ability to select and produce transitive gestures. We report a patient who illustrates this confound. This patient is a right-handed man who developed global aphasia and neglect after a right hemispheric stroke. His right hand remained deft, and when asked to produce specific transitive gestures (pantomimes), he often performed normally but did make some body part as object and perseverative errors. However, he did not demonstrate the temporal or spatial errors typical of ideomotor apraxia. He also had a perseverative agraphia. Our patient's left hemisphere praxis system appeared to be intact, and the error types demonstrated during production of transitive gestures cannot be attributed to a degradation of postural and movement (praxis) programs mediated by his left hemisphere. The praxis errors types are most consistent with a deficit in the ability to select the necessary praxis programs. Thus, our patient appeared to have dissociation between language and praxis programs that resulted in body part as object and perseverative errors.
Topics: Aphasia; Cerebral Infarction; Gestures; Handwriting; Humans; Male; Middle Aged
PubMed: 23557340
DOI: 10.1080/13554794.2013.770883 -
Neurologia 2020
Topics: Adult; Agraphia; Cerebrospinal Fluid; Communication; Headache; Humans; Leukocytosis; Male; Mobile Applications; Smartphone; Tendinopathy
PubMed: 29169804
DOI: 10.1016/j.nrl.2017.08.004 -
Case Reports in Neurology Jan 2013A 71-year-old right-handed man was admitted to our hospital with right hemiparesis and sensory impairment associated with mild aphasia. Although aphasia gradually...
A 71-year-old right-handed man was admitted to our hospital with right hemiparesis and sensory impairment associated with mild aphasia. Although aphasia gradually resolved within 2 weeks after stroke onset, his writing ability remained disturbed. A computed tomography (CT) scan at stroke onset revealed a hematoma in the left thalamus, but no cortical lesions were observed. Further, a single-photon emission CT (SPECT) scan showed decreased blood flow in the left thalamus, in the cortical region extending from the left superior temporal gyrus to the parietal lobe, and in the frontal lobe. It is possible that agraphia may have directly resulted from the thalamic lesion, but SPECT findings strongly suggested that a general decrease in left cortical function concomitant with a disruption of the thalamocortical and cortico-thalamocortical projection fibers produced these cognitive deficits.
PubMed: 23620716
DOI: 10.1159/000350713 -
Behavioural Neurology 2012Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian... (Review)
Review
Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian neuropsychology and is dominated by the syndrome approach most notably by the writings of Luria. Indeed, our understanding of acquired dysgraphia in Russian speakers is conceptualized according to the classical approach in Modern Russia. In this review, we describe the classical approach and compare it to the cognitive neuropsychological models of writing disorders that are developed to explain dysgraphia in English and in other Western European languages. We argue that the basic theoretical assumptions of the two approaches - cognitive and classical or syndrome approach - share similarities. It is therefore proposed that identification of acquired cases of dysgraphia in Russian could potentially benefit from taking the cognitive neuropsychological perspective. We also conclude that adopting elements of the syndrome approach would substantially enrich the understanding of acquired dysgraphia since these offer an insight into processes not described in the cognitive neuropsychological approach.
Topics: Agraphia; Cognition Disorders; Humans; Neuropsychological Tests; Russia; Writing
PubMed: 22713406
DOI: 10.3233/BEN-2012-119010 -
Neuropsychologia Jul 2012This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one...
This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one PPA patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words, exception words and nonwords, were recorded. Error types were classified based on phonetic plausibility. In the first analysis, scores were evaluated by clinical diagnosis. Errors in spelling exception words and phonetically plausible errors were seen in PPA-S. Conversely, PPA-G was associated with errors in nonword spelling and phonetically implausible errors. In the next analysis, spelling scores were correlated to other neuropsychological language test scores. Significant correlations were found between exception word spelling and measures of naming and single word comprehension. Nonword spelling correlated with tests of grammar and repetition. Global language measures did not correlate significantly with spelling scores, however. Cortical thickness analysis based on MRI showed that atrophy in several language regions of interest were correlated with spelling errors. Atrophy in the left supramarginal gyrus and inferior frontal gyrus (IFG) pars orbitalis correlated with errors in nonword spelling, while thinning in the left temporal pole and fusiform gyrus correlated with errors in exception word spelling. Additionally, phonetically implausible errors in regular word spelling correlated with thinning in the left IFG pars triangularis and pars opercularis. Together, these findings suggest two independent systems for spelling to dictation, one phonetic (phoneme to grapheme conversion), and one lexical (whole word retrieval).
Topics: Aged; Agraphia; Aphasia, Primary Progressive; Atrophy; Case-Control Studies; Cerebral Cortex; Humans; Language Tests; Magnetic Resonance Imaging; Middle Aged; Neuropsychological Tests; Organ Size; Phonetics; Semantics
PubMed: 22579708
DOI: 10.1016/j.neuropsychologia.2012.04.017 -
Aphasiology Feb 2005BACKGROUND: Spaced Retrieval (SR) is a treatment approach developed to facilitate recall of information by individuals with dementia. Essentially an errorless learning...
BACKGROUND: Spaced Retrieval (SR) is a treatment approach developed to facilitate recall of information by individuals with dementia. Essentially an errorless learning procedure that can be used to facilitate recall of a variety of information, SR gradually increases the interval between correct recall of target items. AIMS: Given the success of using SR in dementia, the purpose of this study was to explore its usefulness in improving naming by individuals with aphasia. The rate of acquisition and retention of items was compared between SR and a more traditional treatment technique-cueing hierarchy (CH). Also, each oral naming treatment was run concurrently with a single word writing treatment. METHODS #ENTITYSTARTX00026; PROCEDURES: Three participants who had moderate or severe naming impairments and agraphia were studied. Single-subject design was applied across oral and written naming and treated and untreated items. OUTCOMES #ENTITYSTARTX00026; RESULTS: The results indicate that for these participants, SR resulted in improved naming of specific items. The data further suggest that SR compared favourably to CH with regard to both acquisition and retention of items. The participants also benefited nicely from the writing treatment. CONCLUSIONS: These findings suggest SR may be an alternative for managing naming impairment resulting from aphasia. Furthermore, the study supports providing treatments aimed at two different modalities concurrently.
PubMed: 16823467
DOI: 10.1080/02687030444000660 -
Journal of Neurology, Neurosurgery, and... May 1983
Topics: Agraphia; Aphasia, Wernicke; Brain; Diagnostic Errors; Dyslexia, Acquired; Female; Humans; Male; Neuropsychological Tests
PubMed: 6101190
DOI: 10.1136/jnnp.46.5.462