Biomedical subjects

Y Mon

Publications and source records attributed to Y Mon.

4 recordsLinked to original sources

PubMed2000

[Velopharyngeal palsy: a case report].

Here we present a case of velopharyngeal palsy. An 18-year-old man had hyperemia in his left conjunctivum. One or two weeks later he experienced nasal speech and difficulty in swallowing. General physical examination was normal. The only abnormal neurological finding was palato-pharyngeal paralysis on the right side. MRI of the head and neck had no abnormalities. Acute and convalescent sera showed no rise in viral antibody titer. CSF examination was normal except for the increased IgG% and IgG.albumin index. Treatment consisted of glycerol and steroid, and his symptom improved within two or three weeks. We think immunological mechanism is important because CSF examination showed increased IgG% and IgG.albumin index in our case. Acquired and isolated velopharyngeal palsy is uncommon. Only 26 cases have been reported so far. This is the first case in Japan. The disease has some characteristics. This occurs in childhood and adolescence. Onset is sudden, consisting in rhinolalia and dysphagia. On examination there is asymmetry of the pharynx and deviation of the uvula contralateral to the affected side. There is no other neurological abnormalities. Complete spontaneous recovery is usual. In some cases viral infection is the cause, but in most cases the cause is unknown. In contrast, the disease with both acquired velopharyngeal palsy and vocal cord palsy is relatively common. This occurs in the middle aged or elderly people. In addition to dysphagia and hoarse voice, this disease often accompanies neurological abnormalities such as other cranial nerve palsy and meningitis, fever, and pain in the pharyngeal region. In most cases viral infection is the cause.

Adolescent↗

PubMed1997

[An elderly patient with beriberi].

An 82-year-old man was admitted to the hospital in the summer of 1995 due to dyspnea, peripheral edema, and a tingling sensation and muscle weakness in all extremities. Physical examination showed heart failure and polyneuropathy. Laboratory data showed a low concentration of vitamin B1 (10 ng/ml normal 23.8-45.9 ng/ml) and a low level of erythrocyte transketolase activity (0.58 IU/gHb normal 0.75-1.30 IU/gHb). A chest X-ray film revealed cardiomegaly (cardiothoracic ratio 57.1%) and ultrasonic cardiography revealed increased motion of the left ventricle. A diagnosis of beriberi was made. The disease in this case may have been caused by hard work in the summer heat. The patient was treated with thiamine and his symptoms and signs resolved within a few weeks. A search of the literature revealed no previous report of beriberi in a patient of this age, but reports of beriberi in older patients in Japan are more common now than in previous years. Beriberi should be included in the differential diagnosis of polyneuropathy in elderly patients.

Age of Onset↗

PubMed1996

[Midbrain hemorrhage presenting with trochlear nerve palsy--a case report].

A case of midbrain hemorrhage with isolated trochlear nerve palsy was reported. A 70-year-old female noticed vertical diplopia of insidious onset. Ouclar motility was normal. But her diplopia increased with right head tilt and in the left downward gaze, and disappeared with left head tilt. She had no other neurological symptoms and signs. CT scan revealed high density spot in the left tectum of lower midbrain. This lesion decreased over months but small high density spot existed five months later, which means calcified lesion, probably vascular anomaly. This is the first stroke case of trochlear nerve palsy without other neurological symptoms and signs. The first reason this patient showed isolated trochlear nerve palsy is that hematoma was small. The second is that hematoma developed slowly.

Aged↗

PubMed1992

[A case of hemi-hyperhidrosis and non-paralytic pontine exotropia due to brainstem infarction].

A case of hemihyperhidrosis and non-paralytic pontine exotropia due to brainstem infarction is reported. A 55-year-old hypertensive man developed right hemiparesis with slight dysarthria and nausea upon awaking. The right side of his face and right upper limb and trunk to the level of the Th8-9 territory showed hyperhidrosis, which disappeared in a week. Ocular motor examination revealed that during forward gaze with the left eye fixing, the right eye deviated outward. The patient was able to adduct the right eye to midposition with the right eye fixing. Rightward gaze elicited full abduction and right-beating nystagmus of the right eye, but the left eye did not adduct. When he attempted to gaze leftward, both eyes made the full excursion, but saccades were slow in that direction. Convergence was intact. Vertical gaze was full, and he did not show Horner's sign. This ocular sign, non-paralytic pontine exotropia, disappeared three days later. T2-weighted spin echo magnetic resonance imaging disclosed a small lesion with high intensity in the inner side of the left middle pons. This hyperhidrosis was thought to be caused by destruction of inhibitory fibers thermoregulating sweating. These findings suggest that at the level of the middle pons inhibitory fibers descend along the inner side of facilitatory fibers thermoregulating sweating, which are speculated to descend the dorso-lateral part of the pontine tegmentum. These findings also suggest that lesions of non-paralytic pontine exotropia may be located in the paramedian pontine reticular formation rostral to the abducens nucleus with ipsilateral medial longitudinal fasciculus lesion, but further investigation is necessary.

Brain Stem↗