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It seems that somatic anxiety and situations of stress may be determinants of speech-hearing disability.
Some studies indicated an increased prevalence of a family history of hearing impairment in these patients. The pattern of results is suggestive that King-Kopetzky patients may be related to conditions of autosomal dominant inheritance.
It was found that based on sensitized measures of auditory dysfunction and on psychological assessment, Subjects could be subdivided into seven subcategories:
1. middle ear dysfunction
2. mild cochlear pathology
3. central/medial olivocochlear efferent system (MOCS) auditory dysfunction
4. purely psychological problems
5. multiple auditory pathologies
6. combined auditory dysfunction and psychological problems
7. unknown
Different subgroups may represent different pathogenic and aetiological factors. Thus, subcategorization provides further understanding of the basis of King–Kopetzky syndrome, and hence may guide the rehabilitative management of these patients.This was suggested by Professor Dafydd Stephens and F Zhao at the Welsh Hearing Institute, Cardiff University.
Known causes include physical trauma, acoustic neuroma, measles, labyrinthitis, microtia, meningitis, Ménière's disease, Waardenburg syndrome, mumps (epidemic parotitis), and mastoiditis.
A 1998 study of schoolchildren found that per thousand, 6-12 had some form of unilateral hearing loss and 0-5 had moderate to profound unilateral hearing loss. It was estimated that in 1998 some 391,000 school-aged children in the United States had unilateral hearing loss.
Because MOMO is such a rare disorder, very few studies have been conducted into its causes. Current research suggests that it is linked to a de novo (new) autosomal dominant mutation.
MOMO syndrome is an extremely rare genetic disorder which belongs to the overgrowth syndromes and has been diagnosed in only six cases around the world, and occurs in 1 in 100 million births. The name is an acronym of the four primary aspects of the disorder: Macrosomia (excessive birth weight), Obesity, Macrocephaly (excessive head size) and Ocular abnormalities. It is unknown if it is a life-limiting condition. MOMO syndrome was first diagnosed in 1993 by Professor Célia Priszkulnik Koiffmann, a Brazilian researcher in the Genetic and Clinical Studies of neurodevelopmental disorders.
This syndrome's acronym is an intended pun. It refers to the traditionally tall and obese king of Carnivals, Momus—Rei Momo in Portuguese.
The onset of alcohol dementia can occur as early as age thirty, although it is far more common that the dementia will reveal itself anywhere from age fifty to age seventy. The onset and the severity of this type of dementia is directly correlated to the amount of alcohol that a person consumes over his or her lifetime.
Epidemiological studies show an association between long-term alcohol intoxication and dementia. Alcohol can damage the brain directly as a neurotoxin, or it can damage it indirectly by causing malnutrition, primarily a loss of thiamine (vitamin B1). Alcohol abuse is common in older persons, and alcohol-related dementia is under-diagnosed. A discredited French study claimed that moderate alcohol consumption (up to four glasses of wine per week) protected against dementia, whereas higher rates of consumption have conclusively been shown to increase the chances of getting it.
Cluttering (also called tachyphemia or tachyphrasia) is a speech and communication disorder characterized by a rapid rate of speech, erratic rhythm, and poor syntax or grammar, making speech difficult to understand.
Males and Females get Mongolian spots equally. A hospital-based, cross-sectional, prospective study was conducted in the Department of Dermatology, Venereology and Leprosy, BLDE University, Shri B. M. Patil Medical College Hospital and Research Center, Bijapur. One thousand neonates delivered in the Department of Obstetrics and Gynecology of the same institution was surveyed for the presence of skin lesions. The study was conducted in the period of November 2007 to May 2009. The study showed that 467 males were born with Mongolian spots and 380 females were born with Mongolian spots. The results showed there was no statistical significance in males and females born with Mongolian spots. Within the same study, different racial groups were recorded and documented. The study showed that among the Australian neonate, 25.5% were born with Mongolian spots. In the Iranian neonate, 71-81% were reported, in the Japanese neonate 81.5%, in the Turkish neonate 13.2%, in the caucasian neonate 62.8%, in the African American neonate 86.6%, and in the Indian neonate 72-89% were reported in having Mongolian spots. The populations with the most incidences of Mongolian spots were Iranian, Japanese, African American, and Indian.
Cluttering is a speech and communication disorder that has also been described as a fluency disorder.
It is defined as:"Cluttering is a fluency disorder characterized by a rate that is perceived to be abnormally rapid, irregular, or both for the speaker (although measured syllable rates may not exceed normal limits). These rate abnormalities further are manifest in one or more of the following symptoms: (a) an excessive number of disfluencies, the majority of which are not typical of people with stuttering; (b) the frequent placement of pauses and use of prosodic patterns that do not conform to syntactic and semantic constraints; and (c) inappropriate (usually excessive) degrees of coarticulation among sounds, especially in multisyllabic words".
There is no known definitive single mechanism that causes colpocephaly. However, researchers believe there are many possible causes of colpocephaly. It is a common symptom of other neurological disorders in newborns, can be caused as a result of shunt treatment of hydrocephalus, developmental disorders in premature infants, due to intrauterine disturbances during pregnancy, genetic disorders, underdevelopment or lack of white matter in the cerebrum, and exposure of the mother and the developing fetus to medications, infections, radiation, or toxic substances. Also, it is usually more common in premature infants than in full-term infants, especially in babies born with hypoxia or lung immaturity.
Some of the central nervous system disorders which are associated with colpocephaly are as follows:
- polymicrogyria
- Periventricular leukomalacia (PVL)
- intraventricular hemorrhage
- Hydrocephalus
- schizencephaly
- microgyria
- microcephaly
- Pierre-Robin syndrome
- Neurofibromatosis
Often colpocephaly occurs as a result of hydrocephalus. Hydrocephalus is the accumulation of cerebrospinal fluid (CSF) in the ventricles or in the subarachnoid space over the brain. The increased pressure due to this condition dilates occipital horns causing colpocephaly.
The most generally accepted theory is that of neuronal migration disorders occurring during the second to fifth months of fetal life. Neuronal migration disorders are caused by abnormal migration, proliferation, and organization of neurons during early brain development. During the seventh week of gestation, neurons start proliferating in the germinal matrix which is located in the subependymal layer of the walls of the lateral ventricles. During the eighth week of gestation, the neurons then start migrating from the germinal zone to cortex along specialized radial glial fibers. Next, neurons organize themselves into layers and form synaptic contacts with other neurons present in the cortex. Under normal conditions, the neurons forming a germinal layer around ventricles migrate to the surface of the brain and form the cerebral cortex and basal ganglia. If this process is abnormal or disturbed it could result in the enlargement of the occipital horns of the lateral ventricles. Common prenatal disturbances that have been shown to disturb the neuronal migration process include the following:
- continuation of oral contraceptives
- exposure to alcohol
- intrauterine malnutrition
- intrauterine infections such as toxoplasmosis
- maternal drug ingestion during early pregnancy such as corticosteroids, salbutamol, and theophylline
Researchers also believe that these factors can cause destruction of neural elements that have previously been normally formed.
It is suggested that the underdevelopment or lack of white matter in the developing fetus could be a cause of colpocephaly. The partial or complete absence of white matter, also known as agenesis of the corpus callosum results in anatomic malformations that can lead to colpocephaly. This starts to occur around the middle of the second month to the fifth month of pregnancy. The lateral ventricles are formed as large cavities of the telencephalic vesicle. The size of the ventricles are decreased in normal development after the formation of the Foramen of Magendie, which decompresses the ventricular cavities. Myelination of the ventricular walls and association fibers of the corpus callosum and the calcarine fissure helps shape the occipital horns. In cases where this developmental process is interrupted, occipital horns are disproportionately enlarged.
Colpocephaly has been associated with chromosomal abnormalities such as trisomy 8 mosaic and trisomy 9 mosaic. A few reports of genetically transmitted colpocephaly are also found in literature. Some of these are of two siblings, monozygotic twins, and non-identical twins. The authors suggest a genetic origin with an autosomal or X-linked recessive inheritance rather than resulting from early prenatal disturbances.
Treatment usually involves resting the affected foot, taking pain relievers and trying to avoid putting pressure on the foot. In acute cases, the patient is often fitted with a cast that stops below the knee. The cast is usually worn for 6 to 8 weeks. After the cast is taken off, some patients are prescribed arch support for about 6 months. Also, moderate exercise is often beneficial, and physical therapy may help as well.
Prognosis for children with this disease is very good. It may persist for some time, but most cases are resolved within two years of the initial diagnosis. Although in most cases no permanent damage is done, some will have lasting damage to the foot. Also, later in life, Kohler's disease can spread to the hips.
Mongolian spots, or Dermal melanocytosis, result from failure of complete melanocyte migration into the epidermis before birth with ensuing dermal nesting and melanin production. If there are many spots, or a spot covers a large area, it may be a sign of an underlying disorder, such as a metabolism problem called GM1 gangliosidosis Type 1. Recent data suggest that Mongolian spots may be associated with inborn errors of metabolism. Inborn errors of metabolism arise from single gene defect, most often involving an enzyme function, which leads to disruption of a specific metabolic pathway giving rise to abnormalities in the synthesis or catabolism or proteins, fats or carbohydrates. The most common condition associated with Mongolian spots is Hurler's disease followed by GM1 gangliosidosis Type 1. The clinical manifestations in Mongolian spots in inborn errors of metabolism are spots deeper in color and have a generalized distribution involving dorsal and ventral trunk in addition to sacral region and extremities. They are persistent and in some cases an indistinct feathery border has been described. Another possible cause is through genetic inheritance. Mongolian spots have been diagnosed on several occasions through family history, Mongolian spots were linked with an autosomal dominant inheritance. The majority of the neonatal cutaneous lesions are physiological and transient requiring no therapy. It is necessary to differentiate between benign and clinically significant skin lesions in newborn. Therefore, it is important to be aware of the innocent transient skin lesions in newborn and differentiate these from other serious conditions, which will help avoid unnecessary therapy to the neonates. Parents can be assured of good prognosis of these skin manifestations.
Deaf-mute is a term which was used historically to identify a person who was either deaf using a sign language or both deaf and could not speak. The term continues to be used to refer to deaf people who cannot speak an oral language or have some degree of speaking ability, but choose not to speak because of the negative or unwanted attention atypical voices sometimes attract. Such people communicate using sign language. Some consider it to be a derogatory term if used outside its historical context; the preferred term today is simply "deaf".
WNT4 (found on the short arm (p) of chromosome 1) has been clearly implicated in the atypical version of this disorder. A genetic mutation causes a leucine to proline residue substitution at amino acid position 12. This occurrence reduces the intranuclear levels of β catenin. In addition, it removes the inhibition of steroidogenic enzymes like 3β-hydroxysteriod dehydrogenase and 17α-hydroxylase. Patients therefore have androgen excess. Furthermore, without WNT4, the Müllerian duct is either deformed or absent. Female reproductive organs, such as the cervix, fallopian tubes, ovaries, and much of the vagina, are hence affected.
An association with a deletion mutation in the long arm (q) of chromosome 17 (17q12) has been reported. The gene LHX1 is located in this region and may be the cause of a number of these cases.
Acute intermittent porphyria (AIP) is a genetic metabolic disorder affecting the production of heme, the oxygen-binding prosthetic group of hemoglobin. It is characterized by a deficiency of the enzyme porphobilinogen deaminase. Its inheritance is more commonly autosomal dominant; however, autosomal recessive forms of this disorder have occurred. Its incidence is estimated to be between 5 and 10 in 100,000.
Tension myositis syndrome (TMS), also known as tension myoneural syndrome or mindbody syndrome is a name given by John E. Sarno to a condition he describes as characterized by musculoskeletal and nerve symptoms, most notably back pain. Sarno, a Professor of Clinical Rehabilitation Medicine at New York University School of Medicine and Attending Physician at The Rusk Institute of Rehabilitation Medicine at New York University Medical Center, has described TMS in four books, and has stated that the condition may be involved in other pain disorders as well. The treatment protocol for TMS includes education, writing about emotional issues, resumption of a normal lifestyle and, for some patients, support meetings and/or psychotherapy. In 2007, David Schechter (a medical doctor and former student and research assistant of Sarno's) published a peer-reviewed study of TMS treatment showing a 54% success rate for chronic back pain. In terms of statistical significance and success rate, the study outperformed similar studies of other psychological interventions for chronic back pain.
The TMS diagnosis and treatment protocol are not accepted by the mainstream medical community. However, TMS and Sarno's treatment methods have received national attention, including a segment on ABC's "20/20"; an episode of "Larry King Live"; an interview with "Medscape"; and articles in "Newsweek", "The Seattle Times", and "The New York Times". Prominent medical doctors who support TMS treatment include Andrew Weil and Mehmet Oz. Notable patients treated for tension myositis syndrome include Senator Tom Harkin, John Stossel, Howard Stern, and Anne Bancroft.
Alcohol-related dementia (ARD) is a form of dementia caused by long-term, excessive consumption of alcoholic beverages, resulting in neurological damage and impaired cognitive function.
Colpocephaly is a cephalic disorder involving the disproportionate enlargement of the occipital horns of the lateral ventricles and is usually diagnosed early after birth due to seizures. It is a nonspecific finding and is associated with multiple neurological syndromes, including agenesis of the corpus callosum, Chiari malformation, lissencephaly, and microcephaly. Although the exact cause of colpocephaly is not known yet, it is commonly believed to occur as a result of neuronal migration disorders during early brain development, intrauterine disturbances, perinatal injuries, and other central nervous system disorders. Individuals with colpocephaly have various degrees of motor disabilities, visual defects, spasticity, and moderate to severe intellectual disability.
No specific treatment for colpocephaly exists, but patients may undergo certain treatments to improve their motor function or intellectual disability.
CHS is exhibited typically as a congenital disorder, but in rare circumstances, can also result from severe brain or spinal trauma or injury (such as after an automobile accident, stroke, asphyxiation, brain tumor, encephalitis, poisoning, as a complication of neurosurgery) or due to particular neurodegenerative conditions such as Parkinsons and Multiple Sclerosis. Long and Allen (1984) were the first to report the abnormal brainstem auditory evoked responses in an alcoholic woman who recovered from Ondine's curse. These investigators hypothesized that their patient's brainstem was poisoned — not destroyed — by her chronic alcoholism.
Medical investigation of patients with this syndrome has led to a deeper understanding of how the body and brain regulate breathing on a molecular level. PHOX2B, a transcription factor involved in the development of neurons, can be associated with this condition. This homeobox gene is important for the normal development of the autonomic nervous system.
The disease used to be classified as a "neurocristopathy", or disease of the neural crest because part of the autonomic nervous system (such as sympathetic ganglia) derives from the neural crest. However, this denomination is no longer favored because essential neurons of the autonomic nervous system, including those that underlie the defining symptom of the disease (respiratory arrests), are derived from the neural tube (the medulla), not from the neural crest, although such mixed embryological origins are also true for most other neurocristopathies.
Back pain is frequently mentioned as a TMS symptom, but Sarno defines TMS symptoms much more broadly than that:
- "Symptom type:" TMS symptoms include pain, stiffness, weakness, tingling, numbness, muscle contractures, cramps and other negative sensations, according to Sarno.
- "Symptom location:" In addition to the back, Sarno states that TMS symptoms can occur in the neck, knee, arms, wrists, and other parts of the body. Schechter states that the symptoms have a tendency to move to other parts of the body. He considers symptom movement an important indicator that the pain is from TMS.
Central hypoventilation syndrome (CHS) is a respiratory disorder that results in respiratory arrest during sleep. CHS can either be congenital (CCHS) or acquired (ACHS) later in life. It is fatal if untreated. It is also known as Ondine's curse.
ACHS can develop as a result of severe injury or trauma to the brain or brainstem. Congenital cases are very rare and involve a failure of autonomic control of breathing. In 2006, there were only about 200 known cases worldwide. As of 2008, only 1000 total cases were known. The diagnosis may be delayed because of variations in the severity of the manifestations or lack of awareness in the medical community, particularly in milder cases. However, as there have been cases where asymptomatic family members also were found to have CCHS, it may be that these figures only reflect those found to require mechanical ventilation. In all cases, episodes of apnea occur in sleep, but in a few patients, at the most severe end of the spectrum, apnea also occurs while awake.
Although rare, cases of long-term untreated CCHS have been reported and are termed late onset CCHS (LO-CCHS). Cases that go undiagnosed until later life and middle age, although the symptoms are usually obvious in retrospect. There have, however, even been cases of LO-CCHS where family members found to have it have been asymptomatic. Again, lack of awareness in the medical community may cause such a delay. CCHS susceptibility is not known to be affected by gender.
The prevalence remains sparsely investigated. To date, two population-based nationwide studies have been conducted both estimating a prevalence about 1 in 5000 live female births. According to some reports, Queen Amalia of Greece may have had the syndrome, but a 2011 review of the historical evidence concludes that it is not possible to determine the inability of her and her husband to have a child. Her inability to provide an heir contributed to the overthrow of her husband, King Otto.
Historically, eating grain products, particularly rye, contaminated with the fungus "Claviceps purpurea" was the cause of ergotism.
The toxic ergoline derivatives are found in ergot-based drugs (such as methylergometrine, ergotamine or, previously, ergotoxine). The deleterious side-effects occur either under high dose or when moderate doses interact with potentiators such as erythromycin.
The alkaloids can pass through lactation from mother to child, causing ergotism in infants.
The type of treatment needed for dogs diagnosed with CM/SM depends on the severity of the condition and the age of the dog. Young dogs with clinical signs should be considered for surgical removal to minimize the progression of the disease as the dog ages. Older dogs with little or no clinical signs may be treated medically, rather than surgically. However, severe cases of CM/SM may require surgery regardless of age. The goal of surgery is syrynx decompression through restoration of normal cerebrospinal fluid circulation.
The surgical treatment of CM in dogs is described as "foramen magnum decompression FMD". Despite an approximately 80% success rate with this surgical technique, there is a 25% to 50% relapse, primarily due to excessive scar tissue formation at the decompression site. A cranioplasty may be performed instead, in which a plate, constructed using titanium mesh and bone cement, is fixed to the back of the skull following a standard FMD procedure. The procedure had been effective in humans. The postoperative relapse rate associated with the titanium cranioplasty procedure is less than 7%.