1/128. The coincidence of schizophrenia and Parkinsonism: some neurochemical implications.The hypothesis has recently been advanced that increased activity of central dopaminergic mechanisms underlies the symptomatology of the schizophrenias. The evidence that dopaminergic transmission in the corpus striatum is impaired in Parkinson's disease suggests that observations on the relationship between Parkinson's disease and schizophrenia may illuminate the patholophysiology of the latter disease. Four cases are reported in which an illness with schizophrenic features developed in the setting of longstanding Parkinson's disease; attention is drawn to earlier reports of schizophrenic illnesses occurring as postencephalitic sequelae in the presence of a parkinsonian syndrome. These observations appear to conflict with the view that increased dopamine release in the striatum is necessary for the expression of schizophrenic psychopathology, but do not exclude the possibility that increased transmission may occur at other dopaminergic sites in the brain, for example the nucleus accumbens, tuberculum olfactorium or cerebral cortex. Similarly the dopamine receptor blockade hypothesis of the therapeutic effects of neuroleptic drugs cannot be maintained with respect to an action in the striatum in view of the differences between the actions of thioridazine and chlorpromazine in this structure, but may be tenable for actions at extra-straital sites.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/128. Transient peduncular hallucinations secondary to brain stem compression by a cerebellar pilocytic astrocytoma.Almost all peduncular hallucinations have been described in patients with intrinsic lesions of the midbrain. An, as yet, unreported case of peduncular hallucinosis caused by posterior compression of the midbrain by a cerebellar pilocytic astrocytoma is described. The hallucinations and associated symptoms only ceased after removal of the tumour.- - - - - - - - - - ranking = 6keywords = brain (Clic here for more details about this article) |
3/128. When the left brain is not right the right brain may be left: report of personal experience of occipital hemianopia.OBJECTIVES: To make a personal report of a hemianopia due to an occipital infarct, sustained by a professor of neurology. methods: Verbatim observation of neurological phenomena recorded during the acute illness. RESULTS: Hemianopia, visual hallucinations, and non-occipital deficits without extraoccipital lesions on MRI, are described and discussed. CONCLUSIONS: Hemianopia, due to an occipital infarct, without alexia, is not a disability which precludes a normal professional career. Neurorehabilitation has not been necessary.- - - - - - - - - - ranking = 8keywords = brain (Clic here for more details about this article) |
4/128. Musical hallucinations in schizophrenia.There have been many reports of musical hallucinations in deafness, organic brain disease and epilepsy, but few reports of their occurrence in schizophrenia. Musical hallucinations tend to be regarded as specific manifestations of deafness and organic brain disease rather than of schizophrenia. However, since schizophrenic musical hallucinations are less distressing to schizophrenic patients than verbal hallucinations and psychiatrists have little interest in them, they may be missed. We treated schizophrenic patients who experienced musical hallucinations and traced the symptomatic changes. They exhibited semeiological changes similar to the changes in verbal hallucinations. Musical hallucinations are clearly a symptom of schizophrenia. By reporting these cases, we encourage concern about this symptom, which may be missed when psychiatrists interview patients.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
5/128. Peduncular hallucinosis: an unusual sequel to surgical intervention in the suprasellar region.Peduncular hallucinations are formed visual images often associated with sleep disturbance, and are caused by lesions in the midbrain, pons and diencephalon. In the present study, we report two patients who developed peduncular hallucinations following surgery in the suprasellar region. In one of these, the peduncular hallucinations were a sequel to endoscopic third ventriculostomy, while in the other, they were due to diencephalon and mid-brain compression by a postoperative clot following excision of a hypothalamic astrocytoma.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
6/128. taste and smell phantoms revealed by brain functional MRI (fMRI).PURPOSE: Our goal was to demonstrate the appearance of phantom tastes and smells (phantageusia and phantosmia, respectively) by use of functional MRI (fMRI) of the brain and to demonstrate the efficacy of drug treatment that inhibited both the subjective presence of these phantoms and the fMRI brain activation initiated by these phantoms. METHOD: Multislice FLASH MR or echo planar MR brain scans were obtained in two patients with phantageusia and phantosmia in response to memory of two tastants (salt and sweet); memory of two odors (banana and peppermint); actual smell of amyl acetate, menthone, and pyridine; and memory of phantom tastes and smells before and after treatment with thioridazine and haloperidol. Activation images were derived using correlation analysis, and ratios of brain area activated to total brain area were obtained. RESULTS: Prior to treatment, both patients experienced persistent birhinal and global oral obnoxious tastes and smells in the absence of any external stimulus. The fMRI response to memory of phantoms was activation in sensory-specific brain regions for taste and smell, respectively. fMRI activation was greater than for memory of any tastant or odorant or for actual smell of any odor. After treatment with thioridazine or haloperidol, which successfully inhibited each phantom in each patient, fMRI response to phantom memory was significantly inhibited and was significantly lower than for memory of any tastant or odorant or actual smell of any odorant. CONCLUSION: These results demonstrate that (a) phantom taste and smell can be revealed by fMRI brain activation, (b) brain activation in response to taste and smell phantoms is localized in sensory-specific brain regions for taste and smell, respectively, (c) brain activation in response to memory of each phantom initiated the greatest degree of activation we had previously measured, and (d) treatment with thioridazine or haloperidol inhibited both the presence of each phantom and its associated fMRI brain activation. This is the first study in which phantom tastes and smells have been demonstrated by an objective technique and treatment that inhibited the phantoms was characterized by objective inhibition of fMRI activation. These two patients represent a relatively common group that may be classified as having primary phantageusia and phantosmia distinct from those with phantoms or auras secondary to neurological, migrainous, psychiatric, or other causes.- - - - - - - - - - ranking = 15keywords = brain (Clic here for more details about this article) |
7/128. Peduncular hallucinosis : an unusual sequelae of medulloblastoma surgery.Peduncular hallucinations are formed visual images often associated with sleep disturbance and are caused by lesions in the midbrain, pons and diencephalon. In present case report, a four year child, who was operated for midline posterior fossa medulloblastoma developed peduncular hallucinations on 3rd post operative day. traction trauma or the compression of mid brain was thought to be the most possible cause of hallucinations.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
8/128. hallucinations, REM sleep, and Parkinson's disease: a medical hypothesis.BACKGROUND: patients with PD can have disabling visual hallucinations associated with dopaminergic therapy. sleep disorders, including vivid dreams and REM sleep with motor behaviors (RBD), are frequent in these patients. methods: The association of hallucinations and REM sleep both at night and during the day was examined in 10 consecutive nondemented patients with long-standing levodopa-responsive PD and hallucinations. Seven patients presented with paranoia and paranoid delusions. Overnight sleep recordings and standard multiple daytime sleep latency test were performed. The results were compared to those of 10 similar patients with PD not experiencing hallucinations. RESULTS: RBD was detected in all 10 patients with hallucinations and in six without. Although nighttime sleep conditions were similar in both groups, hallucinators tended to be sleepier during the day. delusions following nighttime REM period and daytime REM onsets were observed in three and eight of the hallucinators, and zero and two of the others. Daytime hallucinations, coincident with REM sleep intrusions during periods of wakefulness, were reported only by hallucinators. Postmortem examination of the brain of one patient showed numerous lewy bodies in neurons of the subcoeruleus nucleus, a region that is involved in REM sleep control. CONCLUSION: The visual hallucinations that coincide with daytime episodes of REM sleep in patients who also experience post-REM delusions at night may be dream imagery. Psychosis in patients with PD may therefore reflect a narcolepsy-like REM sleep disorder.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
9/128. A female with central anticholinergic syndrome responsive to neostigmine.Central anticholinergic syndrome is a rarely observed condition in children. The occurrence of this syndrome after ingestion of solanum pseudocapsicum is infrequent because findings tend to be milder and localized to the gastrointestinal system, without central nervous system involvement. Most patients do not present with diagnostic problems because their relatives can usually report any ingestion of poisonous agents; however, when drug poisoning or plant ingestion is uncertain, a differential diagnosis with encephalitis must be considered. physostigmine salicylate is the specific antidote because it crosses the blood-brain barrier because of its tertiary ammonium group. neostigmine methylsulfate has a quaternary ammonium group, which prevents its penetration through the blood-brain barrier; hence its primary influence is believed to be due to its action on the peripheral nervous system. We describe a female with central anticholinergic syndrome caused by ingestion of solanum pseudocapsicum. A slow intravenous infusion of neostigmine methylsulfate (0.03 mg/kg) immediately resolved the clinical picture. To our knowledge, this case is the first reported of central anticholinergic syndrome occurring after ingestion of solanum pseudocapsicum in a child and the first report of a complete and rapid remission after intravenous neostigmine methylsulfate administration.- - - - - - - - - - ranking = 3.1984953054962keywords = brain, central nervous system, nervous system (Clic here for more details about this article) |
10/128. Visual hallucinations induced by deep brain stimulation in Parkinson's disease.We report a patient with idiopathic Parkinson's disease who underwent bilateral deep brain stimulation (DBS) of the nucleus subthalamicus (STN) and developed visual hallucinations (VH) while taking no medications only when the DBS was turned on. The hallucinations resolved when the stimulator was turned off. The phenomenology and the prompt response to clozapine suggest that DBS-induced VH mimic pharmacologically-induced VH.- - - - - - - - - - ranking = 5keywords = brain (Clic here for more details about this article) |
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