Left-sided Signs Research Articles

NEUROSYCHOLOGICAL COMPONENT IN THE COMPREHENSIVE ASSESSMENT OF STUDENTS‘ HEALTH

It was revealed that the gradations of the health of the examined students, which were assessed by objective indicators, differ depending on the lateral organization of the visual system. It was found that young men with left-sided signs in the visual system were characterized by the best objective health indicators.

Heart Failure Is Common and Under-Recognized in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia.

Heart failure (HF) prevalence in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) varies depending on study cohort and is not well characterized. This study sought to determine prevalence and predictors of HF in ARVC/D. Clinical HF, defined as at least 1 HF sign or symptom, was retrospectively adjudicated for 289 patients meeting ARVC/D Task Force Criteria. HF was present in 142 patients (49%): 113 had isolated RV involvement and 29 had evidence of LV dysfunction. Average age of HF onset was 40±14 years. Most commonly reported symptoms were exertional dyspnea (78%) and fatigue (73%). Only 40% (n=57/142) had signs of volume overload. Left-sided HF signs were rare. Patients with clinical HF before ARVC/D diagnosis (n=31) were older (P=0.005) and met fewer Task Force Criteria (P=0.013) than those who developed HF after ARVC/D presentation. Female sex (odds ratio, 2.2; 95% confidence interval, 1.21-4.01; P=0.01) and lateral precordial T-wave inversions (odds ratio, 9.87; 95% confidence interval, 1.07-91.1; P=0.043) were associated with increased odds of HF. Additionally, patients with symptomatic LV dysfunction had higher odds of lateral precordial T-wave inversions (odds ratio, 18.4; 95% confidence interval, 2.92-116.18; P=0.002). Patients with HF were more likely to undergo heart transplantation (15/142 versus 1/147; P<0.001) or die during study follow-up period (7 versus 0; P=0.007). HF symptoms, especially exertional dyspnea, are common in ARVC/D; yet, classic left-sided signs are typically absent and less than half have evidence of volume overload. Given the unique predominately right-sided phenotype, a large portion of patients with HF may be under-recognized.

Abnormal pattern visual evoked response in carotid-cavernous fistula

Abnormal pattern visual evoked response in carotid-cavernous fistula

Cognitive and Affective Functioning in Parkinson's Disease Patients with Lateralized Motor Signs

Eleven patients with Parkinson's disease (PD) and predominantly right-sided motor signs, 12 patients with PD and predominantly left-sided signs, and 11 demographically matched healthy controls were compared on tests assessing a range of cognitive and affective functions. Assuming a novel approach, our test battery was composed of measures drawn from ones previously used in the hemiparkinson's disease and lateralized PD literature. The two patient groups were similar in illness duration, severity of motor signs, and degree of lateralized motor deficits. Statistical analyses did not reveal significant differences between patient groups, consistent with other studies that have failed to find differences in neuropsychological functioning between PD patients with right- and left-sided motor signs.

Secondary mania after ventral pontine infarction

Secondary mania is increasingly recognized clinically, and consists of acute exhibition of manic symptoms without past or family history of affective disorder. It has been reported with toxic and metabolic disturbances, primary and metastatic brain tumors, epilepsy, and cerebrovascular events. A multifactorial etiology has been suggested. We report two men, 52 and 56 years old, who developed grandiosity, sleeplessness, irritable mood, hyperactivity, and paranoid and religious delusions, with attempted violence in one case. Both had no premorbid psychiatric history and were healthy except for hypertension. One patient had a normal neurologic examination, and the other had mild left hemiparesis and hyperreflexia. EEGs, brainstem auditory-evoked responses, and median nerve somatosensory-evoked potentials were normal. Magnetic resonance studies demonstrated infarction of the ventral pons (on the right in the patient with left-sided signs and on the left in the patient with normal neurologic examination). The two patients responded to lithium carbonate and neuroleptics and have not had further psychiatric symptoms in 18 months of follow-up. These cases emphasize the relationship of late-onset mania with predisposing brain disease, and they suggest that brainstem disturbances can influence mood, sleep, libido, and thought.

Neuropsychological performance in lateralized parkinsonism.

Seven dextral patients with Parkinson's disease (PD) who had predominant right-sided motor signs were compared on neuropsychological tests with eight dextral patients with PD who had predominant left-sided signs. Objective criteria for group designation were developed from clinical ratings. The patient subgroups were matched on age, education, estimated premorbid IQ, severity of motor signs, and medication usage. Patients with signs lateralized to the right were more impaired on tests of dominant hemisphere function (serial digit learning, confrontation naming, and verbal associative fluency), but no differences were found on tests of nondominant hemisphere function (form sequence learning, line orientation, facial recognition), indicating some correlation of neuropsychological performance with lateralization of predominant motor signs. Findings demonstrate that the cognitive deficits (particularly visuospatial) previously reported in the literature are not seen consistently in all subjects with PD.

Relation of forward and backward digit repetition to neurological impairment in children with learning disabilities

The WISC digit span scaled scores of 297 children with learning disabilities fell below any of their overall I.Q. measures. More than 30 per cent of these Ss also had a greater than normal difference of 3 or more digits between their forward and backward spans. When 292 Ss for whom neurological data were available were categorized according to their signs (none, predominantly left, right, or bilateral), Ss with right-sided signs (presumed left hemisphere damage) were worse on digits forward, while Ss with left-sided signs (presumed right hemisphere damage) were worse on digits backward. Most Ss who could not repeat digits backward at all had bilateral impairment. Analysis of the data by age, suggests that the large gap between forward and backward digits, characteristic of the group with left-sided signs, tends to increase with age since their ability to repeat digits forward improves without concommitant improvement in their ability to repeat them backward. Conversely, the backward span of the group with right-sided signs tends to “catch up” and even equal their limited forward repetition. The data appear to support a left-hemisphere-dependent auditory verbal component of the digit span task reflected in digits forward and a right-hemisphere-dependent, visuo-spatial component reflected in digits backward. The distribution of verbal and performance WISC scores of these Ss, as well as their forward and backward digit spans, suggest that patterns of adult hemispheric asymmetry are similar in children with restricted early brain damage.