Aphemia with hemiplegic migraine.
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Biomedical subjects
Publications and source records attributed to A G Reeves.
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Extraocular movements were investigated in a patient with bilateral vascular lesions of the medial longitudinal fasciculus. The patient showed voluntary and reflex horizontal gaze consistent with his lesion, but had absent reflex vertical gaze. Voluntary vertical gaze was present. Necropsy was performed, and the findings suggest that the medial longitudinal fasciculi in the pons conveys impulses for reflex vertical gaze, but are not required for voluntary vertical gaze.
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Abnormal responses to 13 questions from a typical mental status examination and 32 signs of neurological dysfunction were correlated with increasing degrees of cognitive impairment as measured by the Halstead-Reitan Neuropsychological Battery. Thirteen of these factors were found to be useful predictors of diffuse cerebral dysfunction when combined into a brief screening examination for application at the bedside.
13 of 17 cats which received unilateral olfactory tubercle lesions exhibited contralateral sensory inattention and ipsilateral circling and hyperresponsiveness. The possible neural substrates involved in these asymmetries are discussed, including ascending amine systems and ascending and descending connections with the orbital cortex.
A patient with alexia without agraphia, hemianopia, or color-naming defect was found at operation to have a meningioma arising from the tentorium cerebelli that compressed the inferior aspect of the left temporal-occipital junction. It is presumed to have involved only the left ventral visual association cortex and its inferior outflow tracts to the angular gyrus. The input from the right occipital area also was disconnected from the visual language verbal association area by involvement of the ventral outflow of the splenium of the corpus callosum. Preservation of color naming and matching suggests that these functions are dependent on the integrity of more dorsal occipital association systems.
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A patient with episodic hypothermia and agenesis of the corpus callosum had no direct evidence of hypothalamic-pituitary dysfunction. However, it is speculated on the basis of a recent clinicopathologic case study that selective hypothalamic involvement is the cause of the hypothermia. Electroencephalograms and treatment with antiseizure medication did not support an epileptic genesis for the episodic hypothermia. Double, simultaneous, tachistoscopic stimulation studies revealed an asymmetry of response that can be explained by either a functional disconnection of the cerebral hemispheres or bilateral independent and asymmetrical representation of speech mechanisms.
The nuchocephalic reflex, previously undescribed, was investigated in a controlled study of 146 subjects ranging in age from 11 hours to 94 years. In 110 subjects over 16 years of age, the presence of the reflex was correlated directly with evidence of diffuse cerebral dysfunction as measured by a shortened form of the Wechsler Adult Intelligence Scale. Thirty-six children were studied from the newborn period to the age of 16 years. The reflex was found to be uninhibited in infants and to become inhibited by the age of 4 years. Among the adult subjects, the nuchocephalic reflex was found to be sensitive indicator of the status of higher cortical function. The presence or absence of the reflex appears to have somewhat different predictive value at different points in the adult age spectrum.
We have observed that midsagittal reticular formation lesions in cats produce bilateral deficits in attention to and localization of various sensory modalities. To correlate these changes with previously reported changes following lesions in other areas of the brain, we propose the existence of two interdependent inhibitory pathways which originate in the frontal lobes.
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