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G Ambrosetto – 1st expert on this subject based on the ideXlab platform

  • unilateral opercular macrogyria and benign childhood epilepsy with centrotemporal rolandic spikes report of a case
    Epilepsia, 1992
    Co-Authors: G Ambrosetto


    Summary: An 18-year-old mentally normal epileptic boy had frequent left brachiofacial or unilateral motor seizures which started at age 4 years and ceased 10 years later. Seizures were exclusively sleep-related. No relapse followed antiepileptic drug (AED) discontinuation. Left arm slight paresis and left hand astereognosia occurred at age 10 years. Awake EEGs showed persistent right rolandic discharges increased by sleep. Somatosensory evoked potentials (SEPs) were giant with left median nerve stimulation. Computed tomography (CT) and magnetic resonance imaging (MRI) disclosed right opercular macrogyria. We suggest that the structural brain lesion was causally related to his “idiopathic” partial epilepsy. Similar case reports and pathologic studies will elucidate the morphologic substrate of the underlying functional disorder in idiopathic partial epilepsies.

Bungo Okuda – 2nd expert on this subject based on the ideXlab platform

  • useless hand syndrome with Astereognosis in multiple sclerosis
    Multiple sclerosis and related disorders, 2015
    Co-Authors: Kenji Kamogawa, Bungo Okuda


    Abstract We report on a patient with multiple sclerosis (MS) who developed bilateral useless hand syndrome (UHS) and Astereognosis. Clinical features of UHS in our patient are similar to limb-kinetic apraxia with Astereognosis. Cervical T1-weighted magnetic resonance imaging revealed a gadolinium-enhanced lesion at the level of C3–C4, mainly involving the posterior cord. This patient suggests that posterior cord lesions at high cervical levels cause UHS and Astereognosis in MS, involving the sensorimotor integration needed to execute complex finger movements.

  • A case of multiple sclerosis with bilateral useless hand syndrome as a main clinical feature
    Rinshō shinkeigaku Clinical neurology, 2005
    Co-Authors: Eri Hamada, Kensho Okamoto, Bungo Okuda


    : A 41-year-old, right-handed man was admitted to our hospital on September 12, 2002, due to progressive clumsiness in both hands. The patient had been diagnosed as having multiple sclerosis three years prior to admission. He noticed difficulty in manipulating objects three months before admission. Cervical T2-weighted MRI showed a high signal intensity at the level of C3-4 which was enhanced on T1-weighted image with gadolinium. On admission, neurological examinations revealed impairment of dexterity, deep sensory disturbance, and Astereognosis in both hands. The clumsiness of complex finger movements was predominant on the left side, and was exaggerated with the eyes closed in association with pseudoathetosis. After steroid therapy, his clumsy hands improved gradually. This type of clumsiness in multiple sclerosis had been described as useless hand syndrome by Oppenheim. In accordance with our case, useless hand syndrome has been reported to arise from high cervical (C2-4) lesions, mainly involving the posterior cord ipsilateral to the clumsy hand. Although the majority of reported cases with useless hand syndrome had other neurological complications, such as hemiparesis, tetraparesis, and truncal ataxia, our patient exhibited a pure form of useless hand syndrome. In addition, useless hand syndrome is usually unilateral, and bilateral useless hand syndrome is very rare. Clumsiness of fine finger movements with Astereognosis in our patient is similar to numb clumsy hands or limb-kinetic apraxia due to cervical spondylosis or postcentral gyrus lesion, respectively. This indicates an important role of the high cervical posterior cord in conveying a kinesthetic sense necessary to guide fine finger movements. It should be kept in mind that high cervical lesions in multiple sclerosis causes clumsy hands mimicking limb-kinetic apraxia.

Roger Fabian – 3rd expert on this subject based on the ideXlab platform

  • Functional Outcome of Patients with Parietal Lobe Stroke
    Neurorehabilitation and Neural Repair, 1997
    Co-Authors: Nages Nagaratnam, Colin Xavier, Roger Fabian


    Parietal lobe somatosensory damage may impair recovery and interfere with rehabili tation. Ten patients with CT evidence of parietal lobe stroke with discriminative sen sory dysfunction (tactile extinction and Astereognosis) and impaired motor control (tactile apraxia and optic ataxia) were studied. Functional status was graded by the Rankin Scale at 3 and 6 months after onset of stroke. Patients with this subtype of stroke showed statistically significant improvement at 3 and 6 months. Patients with left brain stroke had a better functional outcome. Age, gender, size of infarct, and lo cation of infarct were not useful as predictors of outcome. In one-half of the patients studied there was a 25 percent to 50 percent reduction in neurologic deficits at 6 months follow-up.