Biomedical subjects
Publications and source records attributed to T H Ju.
A Taiwanese girl, aged 12 years, presented with early myogenic hypotonia, multiple joint contractures, mental subnormality and epilepsy. Computerized tomography scanning of the brain showed white matter hyperlucency. According to her clinical manifestations and radiological pictures, the patient could be the fourth oriental case who had the features of occidental-type cerebromuscular dystrophy.
Seven patients (all men, mean age 32 years, range 17-47) with stroke following methamphetamine inhalation were collected during the last 2 years. Like oral or intravenous abusers, our patients had more hemorrhagic (n = 5) than ischemic strokes (n = 2). Cases of intracerebral hemorrhage (ICH) were lobar (n = 3), caudate (n = 1) or putaminal (n = 1), whereas the infarctions were both in the middle cerebral artery region. Each stroke event occurred within 3 days after drug use. Three patients had hypertension on admission. Though young in age, most patients had multiple stroke risk factors. In 3 patients with ICH, we also found small, low attenuated lesions on the brain computed tomography, however, without clinical correlations. Except for arteriovenous malformation in 1 patient, all angiograms failed to show vasculopathy or vasospasm. Contrary to what one might surmise from previously published reports, methamphetamine inhalation is at least as likely to produce ICH as it is to produce brain infarction.
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A 51-year-old man has suffered from progressive dysarthria since 1989. He himself noted slight weakness and tightness of the tongue, so that he was unable to perform motor tasks in a normal fashion. He was diagnosed as having nasopharyngeal carcinoma and had irradiation 70 Gy in 32 divided doses in 1979. Neurological examination revealed left-sided tongue atrophy and myokymia sparing of facial muscles involvement. Electrical discharges of myokymia and neuromyotonia were observed in the tongue muscles, suggesting hypoglossal nerve lesion with hyperexcitability of the axon membrance. Computed tomogram of brain did not show any evidence of recurrence of tumor; indicating that irradiation was the pathologic basis. Our report revealed that myokymia and neuromyotonia of the tongue was an unusual complication of irradiation.
We report a case of bilateral cerebral ischemia with frequent painful tonic spasms involving face, both upper and sometimes both lower extremities. The spasms subsided after treatment with diazepam.
We conducted a prospective study to evaluate the underlying diseases and their frequencies in 50 consecutive patients older than 50 years of age admitted to our neurologic service because of walking difficulty. The diseases identified in our study were as follows: multiple cerebral infarcts, 24%; myelopathy, 22%; parkinsonism, 12%; cerebellar degeneration, 8%; other diseases, 24%; and unknown etiology, 10%. Potentially treatable causes of gait impairment were found in nearly one third of patients.