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Upper extremity sensory feedback therapy in chronic cerebrovascular accident patients with impaired expressive aphasia and auditory comprehension.

Electromyographic (EMG) sensory feedback therapy (SFT) was used in the neuromuscular retraining of the nonfunctional upper extremity in five chronic left cerebrovascular accident (CVA) patients with impaired expressive and auditory comprehension. Speech diagnoses included global, moderate-to-severe Broca, and Wernicke aphasias. These patients had experienced increased despondency associated with previous therapy failures and often had indicated that they wished to have their involved extremity amputated, so that it would no longer be in the way. In this study, specific behavioral training strategies to increase patient involvement were used, including: general relaxation, modified SFT instruction, and home exercises, which were supported by family and/or friends. After an average of 50 therapy sessions, all patients were successfully retrained to use their right upper extremity at the gross-assist level. This resulted in feelings of increased self-esteem to the extent that amputation was no longer requested. It is concluded that EMG SFT can be beneficial in the neuromuscular reeducation of paretic upper extremity muscles of CVA patients with expressive aphasia and (impaired) auditory comprehension.

Aphasia, Broca↗

Neuropsychological impairment following inorganic arsenic exposure.

A 50-year-old chemical engineer, routinely screened for occupational arsenic exposure, was admitted with a delirium for which no known etiology was found. Elevated levels of arsenic were found in the urine and hair. The patient received chelation treatment with British anti-Lewisite; substantial amounts of arsenic were excreted and the toxic encephalopathy improved gradually over the 8-month follow-up period. The patient was tested at 6 weeks, 4 months, and 8 months postdelirium with a battery of neuropsychological tasks. The pattern of results showed verbal learning and memory to be severely impaired while tests of general intellectual abilities and language remained unaffected. Follow-up examinations with no subsequent reexposure revealed improvements on specific cognitive tasks. It is unclear whether recovery of cortical functions occurred or if compensatory strategies were developed. It is proposed that a subacute exposure to arsenic may have contributed to the neuropsychological deficits.

Arsenic↗

[Clinical symptomatology of epileptic seizures of temporal origin].

Many discrepancies still exist in the description of clinical symptoms and signs attributable to a paroxysmal disorganization of temporal structures. They result from various methodological appraisals of clinical, electrophysiological and neuroradiological data concerning partial epilepsies. However a study of anatomo-electroclinical correlations in temporal seizures yield an easy pattern when the methods of elaboration, the criteria of validity and their meaning are strictly defined. An analysis of temporal seizures, recorded, filmed and described clinically in 300 patients having had a pre-surgical SEEG examination is the basis of a proposed classification of their main clinical features. The structures supposed to be ictally disorganized are, for each category, as follows: simple and complex visual and auditory hallucinations and illusions are due to a discharge beginning in the temporal-occipital or superior (posterior or anterior) temporal cortex. Memory troubles like dreamy-state are due to a simultaneous impairment of some neo-cortical areas and of Ammon's horn. Instinctive-affective troubles, like genital and sexual signs, or symptoms, emotional, mood, affective troubles seem to be linked to discharges in hippocampal and juxta-insular, internal perisylvian areas. Autonomous (cardiac, digestive, etc.) troubles are linked to a disorganization of basal limbic structures and especially of the perisylvian cortex. Motor and verbal automatisms have different meanings: only chewing is due to a discharge in the amygdalian area and in its hypothalamic efferents. Cognitive impairment is difficult to classify.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Children's performance on multidimensionally scored time-compressed sentential stimuli.

Normative data were obtained for 96 children with normal auditory and language abilities in grades 2, 4, and 6 when presented monaurally with time-compressed (TC) sentences and 1st- and 2nd-order sentential approximations at 32 db re SRT. Oral responses were taped and multidimensionally scored in order to sensitize the test. Consistent with previous reports of normative data at other age levels, performance became poorer for 0 to either 40 or 60% TC (there was a negligible difference between the latter), was better for normal sentences than for sentential approximations, and improved slightly in the higher grades.

Auditory Perceptual Disorders↗

Auditory perpetual dysfunction in patients with CCI, with implications for therapy.

Injury to the head, as from impact, can result in damaged function of the auditory receptive (peripheral) or perceptual (central) system, or both. The altered function may be clearly apparent, as in a loss of hearing, or may be exposed only through specially devised tests. At the Loewenstein Rehabilitation Hospital tests were designed or adapted to evaluate processing in the auditory periphery, the brain stem and the cortex. With speech as the the stimulus the tasks explore binaural interaction, cerebral hemisphere dominance and suppression, and cognitive efficiency in understanding degraded speech messages. Other stimuli, such as pure tones and musical patterns are employed to reveal dysfunction on various levels of the system. This report concentrates on tests which require the cerebral hemispheres to listen competitively. Results are given for earphone listening and for two new types of selective listening tasks in the sound field (loudspeaker) mode.

Adult↗

Psychological evaluation of the child with a suspected central auditory dysfunction.

I have attempted to summarize the role of the psychologist and psychological evaluation in assessing a child with a suspected central auditory dysfunction. The reasons why a child may be referred for a psychological evaluation along with some of the exhibiting behaviors were discussed. The role of the psychological evaluation was examined. The indications for psychological evaluation in central auditory dysfunction were presented and alternative types of education were discussed.

Achievement↗

Effects of mild hearing loss on auditory processing.

The impact on language learning of mild hearing loss due to otitis media with effusion has forced a new look at the dynamics of central auditory processing. A model of auditory deprivation that would produce the test results that define CAP deficits would be a mild conductive hearing loss. It is relevant to reexamine CAP theory in terms of such hearing loss.

Auditory Perceptual Disorders↗

Screening for perceptual skills dysfunction: an up-date.

The paper argues that the primary-care practitioner has an obligation to screen the visual and auditory perceptual skills of all his/her elementary school-aged patients. Two easy-to-administer tests are described, along with guidelines for interpreting and making decisions on the basis of test outcomes.

Auditory Perceptual Disorders↗

[Recognition of onomatopoeias and animal cries during focalized lesions of the cerebral cortex (author's transl)].

The recognition of animal cries and their onomatopoeias was compared during the course of right or left unilateral cortical lesions. A double dissociation is noted; in left-sided affections there is a more severe deficiency to onomatopoeia than to cries, whereas in right-sided lesions the quality of the performances is reversed. These results suggest that the right hemisphere is dominant in the auditive recognition of familiar sounds, and supply information as to the linguistic value of onomatopoeias.

Animals↗

Alcoholic coma and some associated conditions.

The diagnosis of alcoholic coma is made only when there is a high blood alcohol level and signs of bilateral cortical dysfunction, without focal neurologic signs, and when all other metabolic and structural causes of coma have been ruled out. The ethanol-induced hypoglycemic coma of youth appears to result from the failure of gluconeogenesis to release glucose into the bloodstream. If the hypoglycemia is not immediately corrected, permanent and possibly lethal brain damage will result.

Alcoholic Intoxication↗