Frontiers of neurology and neuroscience
-
There have been many descriptions of presumed 'hysterics' in fiction, many appearing in French literature, but also in a number of other languages. It is clear that contemporary medical ideas and insights about hysteria had a major influence on its depiction in novels. This is particularly true for naturalistic literature, which has been the subject of previous reviews. ⋯ In the novel, as well as in this chapter, the diagnosis of hysteria is discussed in the light of theories about hysteria of around 1900. For comparison, we present some examples of true 'hysterics' as they occur in fiction. Since it has become clear that severe nonpsychiatric diseases such as an ovarian teratoma can lead to bizarre phenotypes, the association of 'hysteria' with the womb has to be seen in another light.
-
Fyodor Mikhailovich Dostoevsky (1821-1881) suffered from epilepsy. Some type of psychopathology can be found in about 25% of the characters of his novels. Some of them have seizures. ⋯ Special attention is given to the so-called ecstatic aura. This element of focal epileptic seizures is so rare that in the past the description of it raised doubts on its existence as such and therefore the embellishment by Dostoevsky, describing his own experience and/or that of his epileptic characters Kirillov and Myshkin. The consequence of this analytic approach, however, should not be losing one's amazement of the genius polyphonic creativity of Dostoevsky to integrate so many profound aspects of the human and especially the Russian soul in the characters of his novels.
-
Front Neurol Neurosci · Jan 2013
ReviewCompensatory contribution of the contralateral pyramidal tract after stroke.
Stroke is a leading cause of long-term disability with early accelerated followed by gradual recovery during the first 6 months after the ictus. The most important mechanism concerning early recovery is thought to be brain plasticity provided by anatomical and functional reorganization of the central nervous system after injury. ⋯ Since motor tracts vary considerably among subjects, the ratio of contralateral corticospinal tract fibers and their interhemispheric control versus the amount and function of ipsilateral corticospinal tract fibers may affect the scale of motor recovery after stroke. Further studies are needed to clarify the mechanisms of motor recovery after stroke in humans.
-
Pontine infarcts are often part of a large ischemia involving the brainstem, although infarcts may be restricted to the pons. In both cases, infarcts in the pons are characterized by interesting clinical patterns resulting from a variety of cranial nerve dysfunctions, eye movement disorders and motor, sensory and cerebellar manifestations, either isolated or in combination. ⋯ Penetrating branch artery disease is the most common etiology. Ten percent of all intracerebral hemorrhages are located in the pons, and small hemorrhages in this brainstem structure may, in some instances, give rise to unusual clinical manifestations.
-
Delirium is one of the most serious and common complications that up to one third of older patients admitted to hospital develop. It is characterized by a disturbance of consciousness, decreased attention, and disorganized thinking that develops over a short period of time, and fluctuates during the course of the day. Delirium post-stroke prevalence ranges from 13 to 48% in general hospitals, and from 10.1 to 28% in Stroke Units. ⋯ Delirium without other signs of stroke has been reported more often after right-sided than after left-sided lesions. Age, cognitive decline, and multiple coexisting conditions are the most consistent and important risk factors for delirium post-stroke. Haloperidol is currently used as the drug of choice, if sedation is needed.