Oral rehydration solution containing trisodium citrate for treating severe diarrhoea: controlled clinical trial.

Abstract

<b><i>Objective: </i></b> To characterize clinically acute insular strokes from four patients with a first ever acute stroke restricted to the insula on MRI. <b><i>Methods: </i></b> The authors studied the clinical presentation of four patients with a first ever acute stroke restricted to the insula on MRI. <b><i>Results: </i></b> The authors found five main groups of clinical presentations: 1) somatosensory deficits in three patients with posterior insular stroke (two with a transient pseudothalamic sensory syndrome, one with partial distribution); 2) gustatory disorder in a patient with left posterior insular infarct; 3) vestibular-like syndrome, with dizziness, gait instability, and tendency to fall, but no nystagmus, in three patients with posterior insular strokes; 4) cardiovascular disturbances, consisting of hypertensive episodes in a patient with a right posterior insular infarct; and 5) neuropsychological disorders, including aphasia (left posterior insula), dysarthria, and transient somatoparaphrenia (right posterior insula). <b><i>Conclusion: </i></b> Strokes restricted to the posterior insula may present with pseudothalamic sensory and vestibular-like syndromes as prominent clinical manifestations, but also dysarthria and aphasia (in left lesions), somatoparaphrenia (right lesions) and gustatory dysfunction and blood pressure with hypertensive episodes in right lesions; we did not find acute dysphagia reported in anterior, insular strokes.