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Efrain Salgado - One of the best experts on this subject based on the ideXlab platform.

  • Recurrent Transcortical Motor Aphasia—Another CNS Infectious Syndrome Associated with Herpes Virus Infection
    Journal of vascular and interventional neurology, 2016
    Co-Authors: Raghav Govindarajan, Efrain Salgado
    Abstract:

    Herpes simplex encephalitis is an acute/subacute illness that causes both general and focal signs of cerebral dysfunction with fever, headache, and confusion as cardinal features. Recurrent herpes simplex meningitis, also known as Mollaret's meningitis, is another manifestation of central nervous system herpetic infection with recurrent episodes of fever, headache, and nuchal rigidity associated with cerebrospinal fluid (CSF) evidence of active herpes simplex infection. Bell's palsy is yet another manifestation of a herpes virus infection in at least some reported cases documented by CSF analysis. We report a case of a 70-year-old male who presented with acute Transcortical Motor Aphasia initiating a stroke work-up that was negative. Physical examination revealed genital vesicles, and the CSF was consistent with active herpes simplex infection.

  • recurrent Transcortical Motor Aphasia another cns infectious syndrome associated with herpes virus infection
    Journal of vascular and interventional neurology, 2016
    Co-Authors: Raghav Govindarajan, Efrain Salgado
    Abstract:

    Herpes simplex encephalitis is an acute/subacute illness that causes both general and focal signs of cerebral dysfunction with fever, headache, and confusion as cardinal features. Recurrent herpes simplex meningitis, also known as Mollaret's meningitis, is another manifestation of central nervous system herpetic infection with recurrent episodes of fever, headache, and nuchal rigidity associated with cerebrospinal fluid (CSF) evidence of active herpes simplex infection. Bell's palsy is yet another manifestation of a herpes virus infection in at least some reported cases documented by CSF analysis. We report a case of a 70-year-old male who presented with acute Transcortical Motor Aphasia initiating a stroke work-up that was negative. Physical examination revealed genital vesicles, and the CSF was consistent with active herpes simplex infection.

Anastasia M. Raymer - One of the best experts on this subject based on the ideXlab platform.

  • Transcortical Motor Aphasia
    Oxford Handbooks Online, 2015
    Co-Authors: Bruce Crosson, Anastasia Ford, Anastasia M. Raymer
    Abstract:

    The defining symptoms of Transcortical Motor Aphasia (TCMA) are nonfluent verbal output with relatively preserved repetition. Other symptoms, such as naming difficulties, agrammatic output, or even some parAphasias, may occur, but these are not cardinal symptoms defining TCMA and are not necessary for the diagnosis. The core anatomy involved in TCMA is a lesion of the medial frontal cortex, especially the left presupplementary Motor area (pre-SMA) and adjacent Brodmann’s area 32; a lesion of the left posterior inferior frontal cortex, especially pars opercularis and ventral lateral preMotor cortex; or a lesion of the pathways between these frontal structures. TCMA occasionally has been reported with a lesion of the left basal ganglia, the left thalamus, or the ascending dopaminergic pathways. From a cognitive standpoint, TCMA can be conceptualized as a disorder of intention, in other words, as a disorder of initiation and continuation of spoken language that is internally motivated. The medial frontal cortex provides the impetus to speak; this impetus to speak is conveyed to lateral frontal structures through frontal-subcortical pathways where it activates various language production mechanisms. The influence of the ascending dopaminergic pathways may occur either through their heavy connections with the pre- SMA region or through their influence on the basal ganglia. The influence of the basal ganglia and thalamus probably occurs through their connections with the medial frontal cortex. Assessments for TCMA should involve a thorough evaluation of conversational or narrative language output and repetition. New treatments are available that attemto engage right- hemisphere intention mechanisms with left- hand movements and may be effective in TCMA. Although dopamine agonists have also shown some positive effects in increasing verbal output in TCMA, trials have been small, and some caution must be exercised in interpreting these findings.

  • Treatment of adynamia in Aphasia.
    Frontiers in bioscience : a journal and virtual library, 2003
    Co-Authors: Anastasia M. Raymer
    Abstract:

    Transcortical Motor Aphasia (TCMA) is an acquired impairment of language expression that occurs following neurologic damage that affects left frontal cortex and spares perisylvian regions. In some individuals with TCMA, verbal expression is rendered nonfluent due to difficulty spontaneously initiating and elaborating upon verbal messages. Nonfluency arises from impaired activation of intended messages and inhibition of competing verbal expressions. This impairment of the intentional aspects of language expression can be termed 'adynamia.' Because adynamic forms of TCMA occur infrequently, few systematic treatment investigations have been reported for this condition. Behavioral treatments have been proposed to engage intact frontal regions to improve the ability to initiate spontaneous verbal expression. Some data suggest that nonsymbolic limb movements performed in the context of speaking activities, a form of what Luria termed gestural reorganization, may improve the adynamic verbal expression. (1) In addition, the influence of pharmacologic treatment with bromocriptine, a dopaminergic agonist, has been considered for its effects on verbal nonfluency in Aphasia. Individuals classified as TCMA are more likely to benefit than those with other forms of nonfluent Aphasia, suggesting an influence of bromocriptine on circuits necessary to activate spontaneous language. Additional studies are warranted that contrast behavioral and pharmacologic interventions to determine optimal conditions to improve verbal expression in adynamic forms of Aphasia.

  • Nonsymbolic movement training to improve sentence generation in Transcortical Motor Aphasia: A case study
    Aphasiology, 2002
    Co-Authors: Anastasia M. Raymer, Lauren Rowland, Melissa Haley, Bruce Crosson
    Abstract:

    Background: Nonfluent verbal production in individuals with Transcortical Motor Aphasia (TMA) relates primarily to impaired initiation of verbalisation. Luria (1973) proposed the notion of gestural reorganisation, limb movements used to provoke verbalisations, as a means to improve verbal initiation in Aphasia. In particular, movements performed with the left hand in left space may engage right frontal mechanisms to enhance verbal initiation (Crosson, Singletary, Richards, Koehler, & Rothi, 2000). However, little evidence is available as to the effects of this type of treatment for nonfluent verbal production in TMA. Aims: We administered a treatment in which we incorporated nonsymbolic limb movements during production of sentences and evaluated the effects on verbal fluency in our participant, MP, who had TMA. Methods & Procedures: We used a single-participant experimental treatment design across behaviours. During training, MP tapped with his left hand in left space as he practised production of sentenc...

  • Frontal-opercular Aphasia.
    Brain and language, 1999
    Co-Authors: R.w. Taubner, Anastasia M. Raymer, Kenneth M. Heilman
    Abstract:

    The standard nomenclature divides nonfluent aphasic syndromes with relatively spared comprehension into Broca's Aphasia and Transcortical Motor Aphasia. We report on a patient with a persistent nonfluent Aphasia from a discrete, primarily cortical, frontal-opercular lesion who had impaired syntax but intact repetition and, therefore, did not conform to the traditional classification. Based on this patient's behavior and a review of other cases, we have divided the nonfluent Aphasias with intact comprehension into five disorders. (1) Verbal akinesia-exhibiting diminished intention or drive to speak and associated with medial frontal lesions (supplementary Motor area and cingulate gyrus) or with lesions damaging the efferent projections from these areas. (2) Disorders of syntax-telegraphic and agrammatic utterances that may be associated with dominant pars opercularis lesions. (3) Phonemic disintegration-a failure to correctly produce phonemes, which may be associated with injury to the opercular primary Motor cortex or efferent projections from this area. (4) Defects of lexical access-patients who struggle to find words and are impaired at timed word-generation tasks. Defects of lexical access may be associated with lesions of the pars triangularis and adjacent prefrontal cortex. (5) Mixed defects. According to this model, the traditional patient with Broca's Aphasia would exhibit disorders of syntax, phonemic disintegration, and defects of lexical access, whereas the traditional patient with Transcortical Motor Aphasia would have verbal akinesia or defects of lexical access or both. Our patient had defects of lexical access and syntax, but only mild symptoms of phonemic disintegration, suggesting that his opercular primary Motor cortex was relatively intact. Our patient's ability to repeat normally while his propositional speech remained telegraphic suggests that different neural mechanisms subserve these functions.

Yaprak Alper - One of the best experts on this subject based on the ideXlab platform.

  • Strokes in the subinsular territory: Clinical, topographical, and etiological patterns
    Neurology, 2004
    Co-Authors: Emre Kumral, Tolga Özdemirkıran, Yaprak Alper
    Abstract:

    The authors studied 11 patients with subinsular stroke (subIS) located in a deep border zone between lenticulostriate arteries and small insular cortical penetrating branches of the middle cerebral artery. The typical clinical features of subIS were Motor deficits (11 patients), sensory disturbances (6 patients), Transcortical Motor Aphasia and hypophonia (2 patients), and transient dysphagia at stroke onset (5 patients). Large artery disease and cardioembolic mechanisms may give rise to subIS by hemodynamic mechanisms.

Jong Moon Kim - One of the best experts on this subject based on the ideXlab platform.

Raghav Govindarajan - One of the best experts on this subject based on the ideXlab platform.

  • Recurrent Transcortical Motor Aphasia—Another CNS Infectious Syndrome Associated with Herpes Virus Infection
    Journal of vascular and interventional neurology, 2016
    Co-Authors: Raghav Govindarajan, Efrain Salgado
    Abstract:

    Herpes simplex encephalitis is an acute/subacute illness that causes both general and focal signs of cerebral dysfunction with fever, headache, and confusion as cardinal features. Recurrent herpes simplex meningitis, also known as Mollaret's meningitis, is another manifestation of central nervous system herpetic infection with recurrent episodes of fever, headache, and nuchal rigidity associated with cerebrospinal fluid (CSF) evidence of active herpes simplex infection. Bell's palsy is yet another manifestation of a herpes virus infection in at least some reported cases documented by CSF analysis. We report a case of a 70-year-old male who presented with acute Transcortical Motor Aphasia initiating a stroke work-up that was negative. Physical examination revealed genital vesicles, and the CSF was consistent with active herpes simplex infection.

  • recurrent Transcortical Motor Aphasia another cns infectious syndrome associated with herpes virus infection
    Journal of vascular and interventional neurology, 2016
    Co-Authors: Raghav Govindarajan, Efrain Salgado
    Abstract:

    Herpes simplex encephalitis is an acute/subacute illness that causes both general and focal signs of cerebral dysfunction with fever, headache, and confusion as cardinal features. Recurrent herpes simplex meningitis, also known as Mollaret's meningitis, is another manifestation of central nervous system herpetic infection with recurrent episodes of fever, headache, and nuchal rigidity associated with cerebrospinal fluid (CSF) evidence of active herpes simplex infection. Bell's palsy is yet another manifestation of a herpes virus infection in at least some reported cases documented by CSF analysis. We report a case of a 70-year-old male who presented with acute Transcortical Motor Aphasia initiating a stroke work-up that was negative. Physical examination revealed genital vesicles, and the CSF was consistent with active herpes simplex infection.