Document Detail


Isolated right temporal lobe stroke patients present with Geschwind Gastaut syndrome, frontal network syndrome and delusional misidentification syndromes.
MedLine Citation:
PMID:  19641245     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Right temporal lobe lesion syndrome elicitation presents a clinical challenge. Aside from occasional covert quadrantanopias, heralding elementary neurological deficits are absent. AIM: Isolated right and left temporal lobe stroke patients were analyzed for the panoply of known temporal and frontal cognitive and neuropsychiatric syndromes. METHODS: Temporal lobe stroke patients were analyzed, derived from a dedicated cognitive stroke registry. Patients were screened by a validated bedside cognitive battery and a neuropsychological test battery, including the Bear Fedio Inventory for diagnosis of the Geschwind Gastaut (GG) syndrome, frontal network syndrome testing (FNS), emotional intelligence testing and delusional misidentification syndromes (DMIS). NIH stroke scores were documented and lesion location identified with the 3 dimensional digitized Cerefy coxial brain atlas. Exclusions were coma, encephalopathy and medication related effects. RESULTS: Of 2389 patients analyzed, in patients with isolated right temporal lobe (IRT) stroke (n = 5, infarcts n = 3, hemorrhage n = 2), the GG syndrome and FNS were present in all five. Other relatively frequent syndromes included DMIS in 4, visuospatial dysfunction in 2 and amusia in 2. No patient had a NIHSS greater than 1. The only elementary neurological sign was quadrantanopia in 3 patients. Lesion location was mid and lateral temporal lobe (n = 2), middle and mesial temporal lobe (n = 1) middle temporal lobe (n = 1) and lateral temporal lobe (n = 1). Comparison with isolated left temporal lobe (ILT) stroke revealed syndromes of aphasia (n = 4), alexia (n = 2), acalculia (n = 2), agnosia (n = 2), verbal amnesia (n = 1), none of which occurred in the IRT patients. The mean NIHSS scores of IRT (0.6) and ILT strokes (4.2) was different (t = 2.23, p = 0.04). The 2 x 8 Fisher Exact Test revealed significant differences for the clusters of syndromes occurring in the right and left isolated temporal lobe lesions (p = 0.00002). CONCLUSION: The GG syndrome, FNS and DMIS are prominent syndrome constellations in stroke patients involving the right temporal lobe and constitute the neurological deficit without heralding long tract signs. By extrapolation these syndromes may also be present in the general right hemisphere lesion population.
Authors:
Michael Hoffmann
Related Documents :
3824025 - Family violence and the klüver-bucy syndrome.
23860075 - Early abdomino-perineal pull-through vaginoplasty.
650245 - Neuropsychological syndrome in a patient with episodic howling and violent motor behavi...
19233315 - Misdiagnosis due to gastrointestinal symptoms in an adolescent with probable autonomic ...
7458515 - Noncardiac surgery in patients receiving propranolol. case reports and recommended appr...
6681885 - Myokymia in guillain-barré syndrome.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Behavioural neurology     Volume:  20     ISSN:  1875-8584     ISO Abbreviation:  Behav Neurol     Publication Date:  2008  
Date Detail:
Created Date:  2009-07-30     Completed Date:  2009-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8914585     Medline TA:  Behav Neurol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  83-9     Citation Subset:  IM    
Affiliation:
Division of Cognitive Neurology, Department of Neurology, University of South Florida and VA James A Haley Hospital, Tampa, FL 33612, USA. mhoffman@health.usf.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cognition Disorders / physiopathology
Drive
Female
Hemianopsia / physiopathology
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Middle Aged
Neuropsychological Tests
Personality Disorders / psychology*
Registries
Stroke / physiopathology*,  psychology*
Syndrome
Temporal Lobe / blood supply,  physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Psychophysiology and imaging of visual cortical functions in the blind: A review.
Next Document:  Agraphia in bulbar-onset amyotrophic lateral sclerosis: Not merely a consequence of dementia or apha...