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false localising sign in neurology

Lekhjung Thapa, Raju Paudel, Pramod Chhetri, P V S Rana
A 27-year-old man presented with diplopia without features of raised intracranial pressure. He had left sixth cranial nerve (CN) palsy. Initial investigations in the form of blood tests, cerebrospinal fluid (CSF) opening pressure including CSF analysis and CT head were normal. He represented with paraparesis after 3 weeks. Examination revealed sixth CN palsy (eye twist) and new left-sided twelfth CN palsy (tongue twist), and hence Godtfredsen syndrome was diagnosed. MRI showed vertebral and clivus metastases...
2011: BMJ Case Reports
Abdul Majid Wani, Waleed Mohd Hussain, Mohamad Ibrahim Fatani, Ahmad Qadmani, Ghassan Adnan Al Maimani, Ahmad Turkistani, Khalid S Dairi, Ahmad Abumatar, Mazen G Bafaraj
Presentation of primary antiphospholipid syndrome (APS) is usually untrustworthy and unusual presentations are difficult to diagnose on the basis of clinical features alone. This is true especially in young and elderly patients. Cerebral venous thrombosis (CVT) is less frequent than arterial thrombosis in APS. CVT has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, benign intracranial hypertension and stroke...
2009: BMJ Case Reports
A J Larner
Neurological signs have been described as "false localising" if they reflect dysfunction distant or remote from the expected anatomical locus of pathology, hence challenging the traditional clinicoanatomical correlation paradigm on which neurological examination is based. False localising signs occur in two major contexts: as a consequence of raised intracranial pressure, and with spinal cord lesions. Cranial nerve palsies (especially sixth nerve palsy), hemiparesis, sensory features (such as truncal sensory levels), and muscle atrophy, may all occur as false localising signs...
April 2003: Journal of Neurology, Neurosurgery, and Psychiatry
A Rapanà, F Guida, C Conti, G Rizzo, G Trincia
According to Gardner's hypothesis (1962) later confirmed by Jannetta (1982, 1985), hemifacial spasm can usually be related to a "vascular conflict" which takes place inside the cerebellopontine angle (CPA). Occasionally, the causative lesion can be identified as a mass encasing the facial nerve at its root exit zone (REZ) from the brain stem. The hemifacial spasm has been rarely reported in presence of a contralateral CPA mass ("false localising sign"). Hemifacial spasm in patients with masses in anatomical regions other than the CPA has to be considered exceptional...
April 1999: Revue Neurologique
A Terminassian, F Bonnet, P Guerrini, F Ricolfi, F Delaunay, L Beydon, P Catoire
A case is reported of a patient with a traumatic aneurysm of the intracranial part of the carotid artery occurring after a traffic accident. The patient was admitted in coma (Glasgow score 5), and presented with a depressed fracture of the frontal and parietal bones, a fracture of the left petrous pyramid and of the left anterior clinoid process, as well as of the right tympanic bone and temporomandibular joint. The borders of the left carotid canal seemed unaltered. Despite the lack of localised neurological signs, cervical and transcranial Doppler ultrasonography was carried out...
1992: Annales Françaises D'anesthèsie et de Rèanimation
K Kitaoka, K Tashiro, M Sato, H Abe, M Tsuru
The clinical investigations especially on symptomatology of 30 cases of the tumors of the lateral ventricle are carried out. For the clinical analysis, in agreement with Koos and Laubichler, the tumors of the lateral ventricle are classified into 2 groups, as follows: 1. Intraventricular tumors group (11 cases). 2. Paraventricular tumors group (18 cases). The following points are emphasized in the clinical features excluding radiological findings. 1. Because of symptomatologically no difference between the intraventricular tumors group and paraventricular tumors group, paraventricular tumors are included into the tumors of the lateral ventricle...
August 1978: No Shinkei Geka. Neurological Surgery
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