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Abe T, Fukusako T. [Tuberculous Meningitis in Which Inflammation Cannot Be Adequately Suppressed by Standard Therapy: How to Think and Treat]. Brain Nerve 2022; 74:427-432. [PMID: 35589627 DOI: 10.11477/mf.1416202060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Tuberculous meningitis is the most severe form of tuberculosis and often causes critical illness with high mortality. Treatment should be initiated without waiting for a definitive diagnosis of tuberculous meningitis. Although we often experience treatment-resistant tuberculous meningitis, it is important to continue examination and treatment.
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Affiliation(s)
- Tetsuya Abe
- Department of Neurology, Yamaguchi Prefectural Grand Medical Center
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2
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Matsuo K, Koga M, Shiraishi M, Hasegawa M, Kanda T, Fukusako T. [A case of severe acute flaccid myelitis requiring continuous mechanical ventilation]. Rinsho Shinkeigaku 2019; 59:579-583. [PMID: 31474644 DOI: 10.5692/clinicalneurol.cn-001319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Many cases of acute flaccid paralysis occurred during an enterovirus D68 (EV-D68) outbreak in North America in the fall of 2014, and this epidemic has been newly defined as a distinct disease entity named acute flaccid myelitis (AFM). This disease entity is relatively popular among pediatricians, whereas it remains little-known among neurologists in Japan. We reported a 7-year-old girl with AFM, in whom severe limb weakness and respiratory failure developed five days after appearance of respiratory symptoms. Clinical features of our case were mimicked by those of acute axonal motor neuropathy at early stage of the disease, and this resulted in delayed diagnosis of AFM. DNA of EV-D68 was not detected. There are few reported cases of severe AFM, in which artificial ventilation is needed for a long time including both acute and recovery phases of the illness, and functional prognosis of AFM is discussed by literature.
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Affiliation(s)
- Kinya Matsuo
- Department of Neurology, Yamaguchi Prefectural Grand Medical Center.,Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
| | - Michiaki Koga
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
| | | | - Masanari Hasegawa
- Department of Pediatrics, Yamaguchi Prefectural Grand Medical Center
| | - Takashi Kanda
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
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Koga M, Kishi M, Fukusako T, Ikuta N, Kato M, Kanda T. Antecedent infections in Fisher syndrome: sources of variation in clinical characteristics. J Neurol 2019; 266:1655-1662. [PMID: 30955122 PMCID: PMC6586698 DOI: 10.1007/s00415-019-09308-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 11/28/2022]
Abstract
The clinical features of Guillain–Barré syndrome (GBS) are highly variable, according to the type of antecedent infection. Although a major GBS phenotype, Fisher syndrome (FS), has been shown to be preceded by infections similar to those preceding GBS, whether or not the clinical features in FS also vary according to antecedent infection remains unclarified. Frequent antecedent infections among this study of 70 FS patients included Haemophilus influenzae [n = 15 (21%)], Campylobacter jejuni [n = 10 (14%)], and cytomegalovirus (CMV) [n = 6 (8.6%)]. Compared with other FS patients, H. influenzae-seropositive FS patients more frequently had a history of prior upper respiratory tract infection; double vision as the initial symptom; and, except for oculomotor disturbance, more rarely showed cranial nerve involvement. C. jejuni-related FS occurred predominantly in younger male patients and characteristically presented with blurred vision. According to GBS disability scale, CMV-related FS tended to be more severe, although every patient received immunotherapy. Serum anti-GQ1b IgG antibodies were detected in most cases, regardless of antecedent infection type. At the nadir of illness, the most frequent diagnosis in H. influenzae-related cases was “pure FS” without limb weakness or central nervous system involvement (71%), in C. jejuni-related cases “incomplete FS” such as acute ophthalmoparesis with or without ataxia (60%), and in CMV-related cases (50%) advanced conditions such as GBS overlap and Bickerstaff brainstem encephalitis. These findings indicate that the type of preceding infection determined the neurological features of FS. CMV-related FS appeared to be similar to H. influenzae- and C. jejuni-related FS regarding anti-GQ1b antibody-mediated pathogenesis, as opposed to CMV-related GBS.
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Affiliation(s)
- Michiaki Koga
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Minami-kogushi 1-1-1, Ube, Yamaguchi, 755-8505, Japan.
| | - Masahiko Kishi
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Chiba, Japan.,Yachiyo Rehabilitation Hospital, Chiba, Japan
| | - Toshihiro Fukusako
- Department of Neurology, Yamaguchi Prefectural Grand Medical Center, Yamaguchi, Japan
| | - Naomi Ikuta
- Department of Neurology, Ube-Kosan Central Hospital, Yamaguchi, Japan
| | - Masayuki Kato
- Department of Neurology, Shimonoseki Medical Center, Yamaguchi, Japan
| | - Takashi Kanda
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Minami-kogushi 1-1-1, Ube, Yamaguchi, 755-8505, Japan
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Koga M, Kishi M, Fukusako T, Kanda T. Distal limb weakness phenotype of Guillain-Barré syndrome. J Neurol Sci 2018; 392:83-88. [DOI: 10.1016/j.jns.2018.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/08/2018] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
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Kumazawa R, Tomiyama H, Li Y, Imamichi Y, Funayama M, Yoshino H, Yokochi F, Fukusako T, Takehisa Y, Kashihara K, Kondo T, Elibol B, Bostantjopoulou S, Toda T, Takahashi H, Yoshii F, Mizuno Y, Hattori N. Mutation analysis of the PINK1 gene in 391 patients with Parkinson disease. ACTA ACUST UNITED AC 2008; 65:802-8. [PMID: 18541801 DOI: 10.1001/archneur.65.6.802] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To determine the frequency, distribution, and clinical features of Parkinson disease (PD) with PINK1 mutations. DESIGN Retrospective clinical and genetic review. SETTING University hospital. PATIENTS We performed extensive mutation analyses of PINK1 in 414 PD patients negative for parkin mutations (mean [SD] age at onset, 42.8 [14.3] years), including 391 unrelated patients (190 patients with sporadic PD and 201 probands of patients with familial PD) from 13 countries. RESULTS We found 10 patients with PD from 9 families with PINK1 mutations and identified 7 novel mutations (2 homozygous mutations [p.D297MfsX22 and p.W437R] and 5 single heterozygous mutations [p.A78V, p.P196QfsX25, p.M342V, p.W437R, and p.N542S]). No compound heterozygous mutations were found. The frequency of homozygous mutations was 4.26% (2 of 47) in families with autosomal recessive PD and 0.53% (1 of 190) in patients with sporadic PD. The frequency of heterozygous mutations was 1.89% (2 of 106) in families with potential autosomal dominant PD and 1.05% (2 of 190) in patients with sporadic PD. The mean (SD) age at onset in patients with single heterozygous mutations (53.6 [11.1] years; range, 39-69 years) was higher than that in patients with homozygous mutations (34.0 [20.3] years; range, 10-55 years). Myocardial iodine-123 metaiodobenzylguanidine uptake was low in patients with heterozygous mutations but not in those with homozygous mutations. CONCLUSIONS Our results suggest that homozygous PINK1 mutations tend to be diagnosed as the early-onset autosomal recessive form of PD. Single heterozygous mutations may contribute to the development of sporadic PD and also could be an additional genetic predisposition for developing familial PD. The reduced myocardial iodine-123 metaiodobenzylguanidine uptake observed in patients with single heterozygous PINK1 mutations is similar to that seen in patients with sporadic PD.
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Affiliation(s)
- Ryuya Kumazawa
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
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Fukusako T, Yamashita H, Omoto M, Matsuda K, Shinohara K, Fujimura Y. [Case of thrombotic thrombocytopenic purpura associated with clopidogrel]. Rinsho Shinkeigaku 2007; 47:635-638. [PMID: 18095495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We reported a Japanese first case of thrombotic thrombocytopenic purpura (TTP) induced by clopidogrel, a newly developed antithrombotic drug, marketed in May 2006 in Japan. This 80 years old woman developed cerebral infarction and suffered from Broca's aphasia and right hemiparesis. Clopidogrel was started on Day 6 after the onset. On Day 10, four days after the administration of clopidogrel, two egg-sized purpura with marked decrease in platelet count was found. The purpura extended over the entire body in next few days. Despite total seven times of plasma exchange, platelet count did not normalize. Twenty four days after the onset of TTP, the patient developed central catheter infection and died of sepsis. TTP will become a lethal side effect of clopidogrel, when diagnosis and treatment are late. Because it is assumed that the mechanism of clopidogrel induced TTP differs from that of ticlopidine, we should establish firm treatment urgently.
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Ikuta N, Fukusako T, Yuki N, Morimatsu M, Koga M. Acute oropharyngeal palsy associated with anti-GM1b IgG antibody. J Neurol 2003; 250:881-2. [PMID: 12883937 DOI: 10.1007/s00415-003-1114-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2003] [Accepted: 03/20/2003] [Indexed: 10/26/2022]
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Omoto M, Fukusako T, Ikuta N, Ogasawara J, Kawai M, Negoro K, Morimatsu M. [A case presenting with Raeder's syndrome-like symptoms due to vertebral artery aneurysm]. Rinsho Shinkeigaku 2001; 41:701-3. [PMID: 11993193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
A 50-year-old man complained of headache around his left orbit, left frontal pain and paresthesia associated with left incomplete Horner syndrome. MRI demonstrated a mass at the level of medulla oblongata. Left vertebral angiogram revealed an aneurysm of left vertebral artery. Following the removal of the aneurysm, these Raeder's syndrome-like symptoms improved. Therefore, they were probably caused by a compression of the spinal tract of the trigeminal nerve and the central sympathetic tract by the aneurysm. This is the first report of Reader's syndrome-like symptoms caused by vertebral artery aneurysm, thus indicating that MRI and cerebral angiogram are necessary for differential diagnosis of this syndrome.
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Affiliation(s)
- M Omoto
- Department of Neurology, Ube Industry Central Hospital
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Yamamoto R, Doyama M, Takai O, Fukusako T. Atomic relaxations and electrical resistivities due to vacancies in alkali metals. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0305-4608/3/6/010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Fukusako T, Negoro K, Morimatsu M. Acute myopathy after liver transplantation. Neurology 1998; 51:1775-6. [PMID: 9855558 DOI: 10.1212/wnl.51.6.1775-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Negoro K, Nishimura Y, Kato M, Fukusako T, Nogaki H, Morimatsu M. [Trigeminal neuralgia in multiple sclerosis]. No To Shinkei 1997; 49:1154. [PMID: 9453046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- K Negoro
- Department of Neurology, Reed Neurological Research Center, UCLA School of Medicine 90095, USA
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Kato M, Mochizuki T, Negaro K, Fukusako T, Nogaki H, Morimatsu M. [Magnetic resonance imaging of a case of central nervous system tuberculosis with tuberculous arachnoiditis and multiple tuberculomas]. Nihon Ronen Igakkai Zasshi 1997; 34:818-24. [PMID: 9455127 DOI: 10.3143/geriatrics.34.818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A 62-year-old woman developed headache, vomiting and fever. On admission to hospital, she showed an imparied level of consciousness, diplopia on left lateral gaze, bilateral hearing loss and left hemiparesis. Cranial contrast computed tomography (CT) revealed basal meningeal enhancement. Lumbar cerebrospinal fluid (CSF) showed an increase in cell count (80/mm3) and total protein (3000 mg/dl), and a decrease in glucose (65 mg/dl) in comparison with blood sugar (173 mg/dl). Polymerase chain reaction was positive for Mycobacterium tuberculosis in the CSF. She was diagnosed as having tuberculous meningitis and was treated with anti-tuberculous chemotherapy. Her level of consciousness recovered and other clinical signs improved gradually the first month after admission. However, in spite of the combination of anti-tuberculous chemotherapy and steroid therapy, her combination of anti-tuberculous chemotherapy and steroid therapy, her consciousness level worsened again in association with paraplegia at the sixth week after admission and magnetic resonance imaging (MRI) revealed multiple tuberculomas, spinal arachnoiditis and spinal cord infarction. On T2-weighted imaging some of the tuberculomas showed a central hyperintense area (a central bright core) with an isointense periphery, which was surrounded by a hyperintense area. The lesion appeared hypointense with an isointense rim on T1-weighted imaging, showing a ring enhancement on post-contrast T1W imaging. The spinal cord infarction was situated at the third thoracic cord, which corresponded to the borderline of spinal artery perfusion. This is a rare case of progression of spinal arachnoiditis and spinal cord infarction during anti-tuberculous chemotherapy, and who had tuberculoma with a central bright core on MRI.
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Affiliation(s)
- M Kato
- Department of Neurology, Yamaguchi University, School of Medicine
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13
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Fukusako T, Mochizuki T, Negoro K, Nogaki H, Morimatsu M. [A case of rapidly progressive T cell type malignant lymphoma which started with multiple cranial neuropathy]. Rinsho Shinkeigaku 1997; 37:845-7. [PMID: 9431002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 35-year-old man had suffered from recurrent right trigeminal nerve palsy and flaccid paraparesis for about five months. Cerebrospinal fluid (CSF) showed a marked increase of protein (400 mg/dl) and mononuclear cells (146/mm3), but there were no malignant cells. Antibiotic therapy remitted his inguinal and mediastinal lymph nodes swelling, and trigeminal nerve palsy had recovered spontaneously. Then he developed left trigeminal and facial nerve palsy, mononeuropathy multiplex, and cauda equina syndrome. Nerve conduction studies revealed delayed velocity and reduction of amplitude. Enhanced magnetic resonance imaging showed increased signal intensity in bilateral trigeminal nerves, left internal auditory meatus, and meninges of the basal cistern. Also, there were two mass lesions in cauda equina. They were operated by orthopedist, and were not malignant. After that, CSF cells of malignant lymphoma were elevated and revealed T cell type (large cell). Then the patient exacerbated in bulbar palsy and died. When there is lymph node swelling with multiple neurological deficits, despite remission of lesions and signs, biopsies should be positively pursued early in the patient's clinical course.
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Affiliation(s)
- T Fukusako
- Department of Neurology, Yamaguchi University School of Medicine
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Morimatsu M, Negoro K, Katoh M, Fukusako T. 1-30-17 A clinical study on corticobasal degeneration. J Neurol Sci 1997. [DOI: 10.1016/s0022-510x(97)85049-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saeki S, Hirata I, Fukusako T, Negoro K, Nogaki H, Morimatsu M. [A case of psittacosis with psychiatric symptoms, abnormal EEG, and abnormal SPECT]. No To Shinkei 1996; 48:1141-5. [PMID: 8990481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 40-year-old woman was admitted to our hospital with disorientation, delusional idea, and sensory disturbance of lower face after having a fever and cough for 5 days. A chest X-ray examination revealed an infiltration in the left lower lobe field. Psittacosis was diagnosed because the serum antibody titer against chlamydia psittaci was elevated. Electroencephalogram showed right temporal lobe spikes. SPECT showed decreased accumulation of 99mTc-HMPAO in the right frontal and temporal lobe. Computed tomography scan of the brain was normal. This patient was diagnosed as ornithsis Encephalitis.
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Affiliation(s)
- S Saeki
- Department of Neurology, Yamaguchi University School of Medicine, Japan
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Abstract
A 63-year-old woman was admitted to the hospital because of swelling of both forearms and muscle weakness in the limbs. Laboratory examination revealed abnormally high levels of serum creatine kinase, glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, and lactate dehydrogenase. Polymyositis was diagnosed, and prednisolone was administered. Her condition had been well controlled on prednisolone until several months before admission, when bilateral blepharoptosis and diplopia developed. An edrophonium test was positive: muscle weakness was transiently alleviated. High titers of anti-acetylcholine receptor antibodies were found. A chest CT scan showed a mass in the anterior part of the mediastinum. We diagnosed myasthenia gravis associated with thymoma. After an extended thymectomy, the patient's condition improved. When muscle weakness recurs after remission of polymyositis, myasthenia gravis should be considered.
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Affiliation(s)
- S Saeki
- Department of Neurology, Yamaguchi University School of Medicine
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Affiliation(s)
- H Nogaki
- Department of Neurology, Yamaguchi University School of Medicine, Japan
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Tsuda N, Negoro K, Fukusako T, Morimatsu M. [A case of myotonic dystrophy with morning headache following sleep apnea syndrome]. No To Shinkei 1995; 47:173-6. [PMID: 7669417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We reported a 39-year-old man with myotonic dystrophy. He suffered from morning headache. Respiratory function tests showed restrictive pattern and arterial gas analysis showed hypoxia and hypercapnia with respiratory acidosis (PaCO2 50.8 mmHg, PaO2 63.8mmHg, pH 7.317, SaO2 89.8%). Polysomnograph showed central apneas exclusively in light sleep (stage 1 and 2). O2 saturation fell at most to as low as 50% during the apneas. We conclude that sleep apnea should be consider in patients with myotonic dystrophy associated with morning headache.
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Affiliation(s)
- N Tsuda
- Department of Neurology, Yamaguchi University School of Medicine, Ube, Japan
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Fukusako T, Negoro K, Tsuda N, Kato M, Morimatsu M. [A case of secondary carnitine deficiency due to anorexia nervosa and severe liver damage]. Rinsho Shinkeigaku 1995; 35:34-7. [PMID: 7781212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We reported an 18-year-old woman with anorexia nervosa and liver damage who showed carnitine deficiency. Her unbalanced diet had little carnitine, and severely damaged liver could not synthesize carnitine. Since total parenteral nutrition (TPN) and tube-feed formulas contain little or no carnitine, the patient had progressive weakness and muscle atrophy. Muscle biopsy revealed variability of fiber diameter, type 1 fiber atrophy and copious amount of lipid granules. Carnitine deficiency must be diagnosed in the early stage by muscle biopsy or muscle carnitine levels, and treated with oral intake of L-carnitine.
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Affiliation(s)
- T Fukusako
- Department of Neurology, Yamaguchi University School of Medicine
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20
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Negoro K, Fukusako T, Tsuda N, Nogaki H, Morimatsu M. [Clinical analysis of benign transient shuddering-like involuntary movement in elderly people]. Rinsho Shinkeigaku 1994; 34:1153-6. [PMID: 7729098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We described 9 patients who developed acute onset benign transient shuddering-like involuntary movement in elderly people. There was no consciousness disturbance or sensorimotor dysfunction. There were finger tremor, dysarthria, or gait disturbance in some patients. Asterixis was observed in the upper extremities in 2 patients. Duration of an involuntary movement was less than 1 second, and the series of the involuntary movements continued for several days. This state appeared acutely and disappeared within 0.5 -4 days in the natural course without any sequelae. Oral administration of clonazepam was very effective to suppress this tremulousness. Seven of 9 patients developed recurrence. Although the cause of this syndrome remains unknown, we believe that this condition is clinically important for differential diagnosis of acute onset involuntary movements in elderly people.
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Affiliation(s)
- K Negoro
- Department of Neurology, Yamaguchi University School of Medicine
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21
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Negoro K, Fukusako T, Morimatsu M, Liao CM. Acute axonal polyneuropathy during interferon alpha-2A therapy for chronic hepatitis type C. Muscle Nerve 1994; 17:1351-2. [PMID: 7935561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Nogaki H, Kakinuma S, Fukusako T, Sasabe F, Negoro K, Morimatsu M, Fukuoka Y. [Statistical analysis of bone density in patients with Parkinson's disease]. Nihon Ronen Igakkai Zasshi 1993; 30:997-8. [PMID: 8295361 DOI: 10.3143/geriatrics.30.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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23
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Yamamoto K, Fukusako T, Nogaki H, Morimatsu M. [Multiple system atrophy with macro square wave jerks and pendular nystagmus]. Rinsho Shinkeigaku 1992; 32:1261-5. [PMID: 1301329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A 51-year-old woman was admitted to our hospital because of gait disturbance and dysuria. Neurological examination revealed limb and truncal ataxia, orthostatic hypotension, cogwheel rigidity in all limbs, generalized hyperreflexia without pathological reflex, and horizontal gaze nystagmus. She became progressively worse and bedridden at age 52. Then she developed abnormal eye movements. Electrooculogram revealed vertical, horizontal or oblique macro square wave jerks and pendular nystagmus. Macro square wave jerks appeared during fixation and disappeared with eye closure or in the dark room. Macro square wave jerks were characterized by a duration of about 200 msec and an amplitude of 10 to 15 degrees. Pendular nystagmus with a duration of several seconds and amplitude of 5 to 15 degrees appeared when she changed her fixation or the point of fixation disappeared. Macro square wave jerks and pendular nystagmus were mildly suppressed after the intramuscular injection of 100 mg of phenobarbital, the oral intake of sodium valproate of 600 mg/day or baclofen of 60 mg/day. They were almost completely depressed after the intravenous injection of 3 mg of diazepam or the oral intake of clonazepam of 1.5 mg/day. We suggested that both macro square wave jerks and pendular nystagmus in this patient might be caused by the dysfunction of GABAergic system in the saccadic eye movement system.
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Affiliation(s)
- K Yamamoto
- Department of Neurology, Yamaguchi University School of Medicine
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Sasabe F, Takase Y, Fukusako T, Yamamoto K, Morimatsu M. [Early-onset benign autosomal dominant limb-girdle myopathy with contractures (Bethlem myopathy) in a Japanese family]. Rinsho Shinkeigaku 1992; 32:138-42. [PMID: 1611771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report a family showing an early-onset benign autosomal dominant limb-girdle myopathy with contractures. The clinical features in our family included; 1) slowly progressive limb-girdle muscle weakness since childhood. 2) contractures of fingers, elbows and ankles, 3) mild motor impairment with preserved activities of daily living. The disease was inherited through an autosomal dominant trait. Muscle pathology revealed variation in fiber size, slightly increased central nuclei, mild endomysial fibrosis, type 1 fiber predominance and type 2 fiber atrophy. The above clinical features were similar to those seen in patients reported by Bethlem (1976) and Mohire (1988), and therefore we made a diagnosis of Bethlem myopathy on this familial patients which was extremely rare in Japan.
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Affiliation(s)
- F Sasabe
- Department of Neurology, Yamaguchi University School of Medicine
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Tsuda N, Yamamoto K, Fukusako T, Morimatsu M. [A case of unilateral lingual atrophy and ipsilateral muscular atrophy supplied by trigeminal nerve--in relation to progressive facial hemiatrophy]. Rinsho Shinkeigaku 1991; 31:1007-9. [PMID: 1769148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A 39-year-old man was admitted to our hospital because of atrophy of the right side of the tongue of 6 years' duration. Neurological examination showed atrophy and fasciculations in the right side of the tongue. Magnetic resonance imaging showed atrophy and high signal intensity areas on T1 and T2 weighted images in the right masseter, temporal, lateral and medial pterygoid muscles. Electromyography showed fibrillations and positive sharp waves at rest, high amplitude polyphasic motor unit potentials with weak contraction in the right tongue and masseter muscles. Examination of autonomic functions suggested postganglionic lesion of right facial sympathetic nerves. We believe that this case may be related to progressive facial hemiatrophy.
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Affiliation(s)
- N Tsuda
- Department of Neurology, Yamaguchi University School of Medicine
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27
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Kawai M, Yamamoto K, Takase Y, Fukusako T, Morimatsu M. [A case of progressive myoclonus epilepsy with the first and second branchial syndrome]. Rinsho Shinkeigaku 1991; 31:1021-4. [PMID: 1769151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A 22-year-old woman with progressive myoclonus epilepsy associated with the first and second branchial syndrome is described. Clinical features included generalized convulsive seizure, myoclonus, cerebellar ataxia and intellectual deterioration with micrognathia and malformation of auricles. She was initially suspected of mitochondrial encephalomyopathy, but the analysis of muscle biopsy and mitochondrial enzyme activities was negative. Her micrognathia and malformation of auricles were diagnosed as the first and second branchial syndrome. The case of progressive myoclonus epilepsy associated with this syndrome has never been reported, and the relationship between them remains unknown.
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Affiliation(s)
- M Kawai
- Department of Neurology, Yamaguchi University School of Medicine
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28
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Yamamoto K, Ikeda T, Yamamoto K, Takase Y, Fukusako T, Morimatsu M, Yamada M. Stress-Related Immune Activity in Tension-Type Headache: Analysis of Immune System-Associated Antigen Expressed on Peripheral Blood Lymphocytes. Cephalalgia 1991. [DOI: 10.1177/0333102491011s11193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In order to evaluate the effect of psychological stress on immune activity, we examined immune system-associated antigen expressed on peripheral blood lymphocytes in tension-type headache. We found differences between the highly stressed patient group and the minimally stressed. These results support the concept that psychological stress my significantly alter the immune activity in patients suffering from tension-type headache depending upon whether they are highly stressed or not.
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Affiliation(s)
| | | | - Kiyoshi Yamamoto
- Department of Neurology, Yamaguchi University School of Medicine, Ube, Japan
| | - Yoshitaka Takase
- Department of Neurology, Yamaguchi University School of Medicine, Ube, Japan
| | - Toshihiro Fukusako
- Department of Neurology, Yamaguchi University School of Medicine, Ube, Japan
| | - Mitsunori Morimatsu
- Department of Neurology, Yamaguchi University School of Medicine, Ube, Japan
| | - Michio Yamada
- Department of Neurology, Yamaguchi University School of Medicine, Ube, Japan
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29
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Yamamoto K, Sasabe F, Fukusako T, Takase Y, Morimatsu M. [Analysis of hemiparesis with homolateral ataxia by single photon emission CT]. Rinsho Shinkeigaku 1991; 31:314-7. [PMID: 1893673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Case 1. A 46-year-old man suddenly developed mild gait disturbance and left hemiparesis. On examination, gross strength was slightly reduced in the left extremities. The finger-to-nose and heel-to-knee tests disclosed moderate dyssynergia and dysmetria on the left side that could not be explained by the muscular weakness. Deep tendon reflexes were more brisk in the left extremities. There was no Babinski sign. Magnetic resonance imaging showed a region of high signal intensity in the right posterior limb of internal capsule with extension into lateral thalamus. The lesion involved the cortico-ponto-cerebellar pathway and partly the dentato-rubro-thalamo-cortical pathway. No lesions were seen in the brainstem. Single photon emission CT with 123I-IMP showed left cerebellar hypoperfusion termed crossed cerebellar diaschisis by Baron et al. Case 2. A 65-year-old female developed weakness of the left extremities and gait disturbance. On examination, there was a horizontal nystagmus on lateral gaze to each side. She showed dysarthria, mild left hemiparesis and slight left hypesthesia. The finger-nose and heel-knees tests revealed moderate dysmetria and dyssynergia on the left side. Deep tendon reflexes were hyperactive in the left extremities with left Babinski sign. CT showed a low density area in the right basis pontis at about middle level. Intravenous digital subtraction angiography revealed a slight stenosis of right vertebral artery, but no other abnormality. The lesion involved the cortico-ponto-cerebellar pathway. Single photon emission CT with 123I-IMP showed left cerebellar hypoperfusion. The right cerebellar blood flow was normal.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- K Yamamoto
- Department of Neurology, Yamaguchi University School of Medicine
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30
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Yamamoto K, Takase Y, Fukusako T, Nogaki H, Morimatsu M. [A case of senile onset rimmed vacuole myopathy with proximally dominant involvement]. Rinsho Shinkeigaku 1990; 30:1128-32. [PMID: 2279364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A 73-year-old woman with progressive proximal-dominant muscular atrophy and weakness was described. She had been well until 70-year-old, when she found difficulty in standing up from sitting position. At age 72 years, she could not raise her arms. Neurological examination showed muscular wasting and weakness in the proximal parts of extremities, shoulder and pelvic girdle. In the thigh, the flexors and adductors were severely affected. Muscular weakness was also observed in m. tibialis anterior. Serum CK and aldolase were normal. Electromyography showed low voltage short duration motor unit potentials with positive sharp waves and fibrillations. Rimmed vacuoles were observed in 4.8% of muscle fibers in biopsy sample obtained from right m. quadriceps femoris. No inflammatory cells, PAS-positive materials and inclusion bodies were observed in the sample. This case differs from distal myopathy with rimmed vacuoles, because the onset was very late and her muscular weakness and atrophy was proximal dominant. This case also differs from inclusion body myositis, because muscle biopsy revealed no inflammatory cells or inclusion body.
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Affiliation(s)
- K Yamamoto
- Department of Neurology, Yamaguchi University School of Medicine
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31
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Takase Y, Yamamoto K, Nogaki H, Fukusako T, Sasabe F, Morimatsu M. Rigid spine syndrome associated with cardiomyopathy: clinical and nosological considerations. Jpn J Med 1990; 29:555-9. [PMID: 2089184 DOI: 10.2169/internalmedicine1962.29.555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We report observations in a 32-year-old man with the following characteristics of rigid spine syndrome: humero-peroneal muscular atrophy and weakness; bradycardia, dilated cardiomegaly and complete cardiac conduction block; and severe fatty degeneration of the paravertebral and calf muscles. The latter showed a predominance of type 1 fibers, a deficiency of type 2A fibers, and an increase in type 2C fibers. The patient had no familial background of the disease. There was no contracture of the elbows. These findings, especially the severe cardiac involvement, suggest that the rigid spine syndrome can be difficult to distinguish from the Emery-Dreifuss form of muscular dystrophy.
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Affiliation(s)
- Y Takase
- Department of Neurology, Yamaguchi University School of Medicine, Ube, Japan
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32
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Yamamoto K, Sasabe F, Fukusako T, Takase Y, Morimatsu M. [A case of transient bilateral primary oculomotor nerve paresis associated with head injury]. Rinsho Shinkeigaku 1990; 30:790-2. [PMID: 2242637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 13-year-old boy, with no past medical history, was admitted after a car accident on October 29, 1989. On admission, he was alert. Physical examination revealed a bruise on the left frontal region, a fracture of right clavicula and right hemopneumothorax. He was treated with respirator due to dyspnea. On November 1, 1989, he was removed from respirator and expressed diplopia. Neurological examination showed bilateral ptosis, mild anisocoria, normal light reflex and horizontal gaze nystagmus in lateral gaze. Both eyes were deviated outward slightly in the primary position and showed inability to converge. The external ocular movements of both eyes were mildly limited in elevation and adduction. Ataxia was observed in bilateral upper extremities. Deep reflexes were normal and no pathological reflexes were observed. Brain CT scans showed no abnormality. On November 6, 1989, his ptosis and diplopia improved. On November 8, he was completely recovered. A magnetic resonance imaging on November 10 revealed no abnormality. We suggested that transient dysfunction of midbrain associated with head injury might cause transient bilateral primary oculomotor nerve paresis, nystagmus and ataxia.
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Affiliation(s)
- K Yamamoto
- Department of Neurology, Yamaguchi University School of Medicine
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33
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Yamamoto K, Takase Y, Nogaki H, Fukusako T, Morimatus M. [A case of Cogan's syndrome associated with multiple cranial neuropathy]. Rinsho Shinkeigaku 1990; 30:639-42. [PMID: 2225659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 52-year-old woman was admitted to our hospital because of disturbance of right visual acuity and double vision. At 38-year-old she became deaf bilaterally and experienced many vertigo attacks. She was diagnosed as Ménière disease. At 45-year-old vertigo attacks disappeared. At 47-year-old right peripheral facial nerve palsy developed transiently with interstitial keratitis and episcleritis of the both eyes. Oral adrenocorticosteroid therapy produced an improvement of interstitial keratitis and episcleritis. On admission, ophthalmological examination revealed bilateral interstitial keratitis and episcleritis, right retrobulbar optic neuritis and she was proven to have bilateral sensorineural deafness by otologist. Neurological examination revealed right abducens nerve paresis. Laboratory examinations revealed slightly increased erythrocyte sedimentation rate. CRP was positive. Serological tests for syphilis were negative. CSF showed mildly elevated protein level. Orbital CT scans revealed the swelling of right optic nerve. Cerebral MRI showed multiple high spotty areas in left thalamus, bilateral basal ganglia and deep white matter in T2 weighted images. After treatment with adrenocorticosteroid, right optic neuritis and abducens nerve paresis improved together with bilateral interstitial keratitis and episcleritis. Multiple cranial neuropathy may develop with Cogan's syndrome.
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Affiliation(s)
- K Yamamoto
- Department of Neurology, Yamaguchi University School of Medicine
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34
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Fukusako T, Yamamoto K, Takase Y, Nogaki H, Morimatsu M. [A case of reflex epilepsy with binasal visual field defects attack induced by family computer game]. Rinsho Shinkeigaku 1990; 30:540-3. [PMID: 2401114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A 12-year-old male case of reflex epilepsy with visual field defects attack induced by a family computer game was reported. This patient showed binasal visual field defects attack when he was playing a family computer game. Neurological findings and ophthalmological examinations were normal. EEG showed spike and slow wave complex distributed on right occipital region. These paroxysmal waves were activated by checkerboard pattern reversal stimuli. Stimulus intensity was closely related with these activations, but not stimulus ratio was. Examinations of brain CT and brain MRI were normal. This patient complained of discomfort without visual symptoms when he suffered checkerboard pattern stimuli. A family computer game needs mental concentration, recognition, decision, alert state of consciousness and complex finger movement. Integration of these factors may have induced visual field defects attack. It is interesting that a family computer game is the inducer of reflex epilepsy with visual symptoms. The number of reflex epilepsy is thought to increase because of prevalence of family computer games.
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Affiliation(s)
- T Fukusako
- Department of Neurology, Yamaguchi University School of Medicine
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35
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Yamamoto K, Takase Y, Fukusako T, Nogaki H, Morimatsu M. [Micrographia due to the lesions around basal ganglia and genu of internal capsule and dysarthria-clumsy hand syndrome]. Rinsho Shinkeigaku 1990; 30:113-4. [PMID: 2331817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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36
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Yamamoto K, Kawazawa S, Takase Y, Fukusako T, Morimatsu M. [Paroxysmal itching and magnetic resonance imaging of the spinal cord in multiple sclerosis]. Rinsho Shinkeigaku 1989; 29:1345-51. [PMID: 2625019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In three women with multiple sclerosis, paroxysmal itching occurred. We were able to detect the spinal segment lesions corresponding to the dermatome of paroxysmal itching by magnetic resonance imaging (MRI) in them. Case 1. A 38-year-old woman was admitted with chief complaints of tingling sensation in the left side of the body, left hemiparesis and paroxysmal itching in the neck and left upper extremity. Examination on admission revealed left hemiparesis, mildly exaggerated deep tendon reflexes in the left upper and lower extremities, positive Lhermitte's sign. Superficial sensation was decreased and dysesthetic below the left C3 segment. Vibration and joint sense were moderately decreased in the left upper limb. Painful tonic seizure-like attack occurred in the neck bilaterally. Paroxysmal itching occurred in the neck and left upper extremity corresponding to the cervical spinal segments bilateral C3, left C4 to C6. MRI revealed multiple high signal intensities in the white matter of the cerebral hemispheres, the medullo-cervical junction and the cervical segment C3 to C4 in T2-weighted spin-echo images. The C3 to C4 lesion was found in the left dorsal area of spinal cord in axial image. High signal areas of cervical cords on T2-weighted spin-echo images were reduced in response to adrenocorticosteroid therapy, and paroxysmal itching disappeared. Case 2. A 24-year-old woman complained chiefly of mild tetraparesis and left hand clumsiness. On admission, she had right central facial palsy, mild weakness of all limbs, painful tonic seizure of left upper limb, positive Lhermitte's sign and bilateral Babinski sign. Superficial sense was mildly decreased and dysesthetic in left upper extremity.(ABSTRACT TRUNCATED AT 250 WORDS)
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