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. 1993 Jul;56(7):816–819. doi: 10.1136/jnnp.56.7.816

Hemineglect and seizures in Binswanger's disease: clinical-pathological report.

S A Mayer 1, T K Tatemichi 1, L S Hair 1, J E Goldman 1, A Camac 1, J P Mohr 1
PMCID: PMC1015066  PMID: 8331360

Abstract

The range of clinical effects from ischaemic damage to white matter in Binswanger's disease has not been fully characterised. Although focal deficits and seizures occur frequently, superficial infarcts often coexist, making the cause of these symptoms unclear. The case of a 69 year old woman is described who presented with acute left sided weakness and hemispatial neglect, followed a year later by electrographically documented seizures originating from the right hemisphere. Interim examinations showed bilateral pyramidal signs and mild intellectual decline. Serial CT and MRI studies showed bilateral diffuse ischaemic lesions of the cerebral white matter and old left sided lacunar infarcts but no evidence of acute infarction. Post-mortem examination showed gliosis and demyelination of the deep white matter which spared the subcortical arcuate fibres; this is consistent with Binswanger's disease. The neocortex was normal. This case and previous reports indicate that focal symptoms typically referable to the grey matter, including hemineglect and seizures, may occur as a manifestation of subcortical ischaemic injury to white matter in Binswanger's disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aronson S. M., Perl D. P. Clinical neuropathological conference. A 58-year-old concrete worker was amitted to the hospital because of slowly progressive dementia. Dis Nerv Syst. 1974 Jun;35(6):286–291. [PubMed] [Google Scholar]
  2. Babikian V., Ropper A. H. Binswanger's disease: a review. Stroke. 1987 Jan-Feb;18(1):2–12. doi: 10.1161/01.str.18.1.2. [DOI] [PubMed] [Google Scholar]
  3. Biemond A. On Binswanger's subcortical arteriosclerotic encephalopathy and the possibility of its clinical recognition. Psychiatr Neurol Neurochir. 1970 Nov-Dec;73(6):413–417. [PubMed] [Google Scholar]
  4. Caplan L. R., Schoene W. C. Clinical features of subcortical arteriosclerotic encephalopathy (Binswanger disease). Neurology. 1978 Dec;28(12):1206–1215. doi: 10.1212/wnl.28.12.1206. [DOI] [PubMed] [Google Scholar]
  5. Cherif A. A., Labrecque R., Pellissier J. F., Poncet M., Boudouresques J. Encéphalopathie sous-corticale de Binswanger. Etude d'un cas comportant une atteinte hémisphérique gauche nettement prédominante. Rev Neurol (Paris) 1979 Nov;135(10):665–678. [PubMed] [Google Scholar]
  6. Dubas F., Gray F., Roullet E., Escourolle R. Leucoencéphalopathies artériopathiques. (17 cas anatomo-cliniques). Rev Neurol (Paris) 1985;141(2):93–108. [PubMed] [Google Scholar]
  7. Dupuis M., Brucher J. M., Gonsette R. E. Observation anatomo-clinique d'une encéphalopathie sous-corticale artérioscléreuse ("maladie de Binswanger") avec hypodensité de la substance blanche au scanner cérébral. Acta Neurol Belg. 1984 May-Jul;84(3):131–140. [PubMed] [Google Scholar]
  8. Englund E., Brun A., Alling C. White matter changes in dementia of Alzheimer's type. Biochemical and neuropathological correlates. Brain. 1988 Dec;111(Pt 6):1425–1439. doi: 10.1093/brain/111.6.1425. [DOI] [PubMed] [Google Scholar]
  9. Fisher C. M. Binswanger's encephalopathy: a review. J Neurol. 1989 Feb;236(2):65–79. doi: 10.1007/BF00314400. [DOI] [PubMed] [Google Scholar]
  10. Garcia-Albea E., Cabello A., Franch O. Subcortical arteriosclerotic encephalopathy (Binswanger's disease): a report of five patients. Acta Neurol Scand. 1987 May;75(5):295–303. doi: 10.1111/j.1600-0404.1987.tb05450.x. [DOI] [PubMed] [Google Scholar]
  11. Healton E. B., Navarro C., Bressman S., Brust J. C. Subcortical neglect. Neurology. 1982 Jul;32(7):776–778. doi: 10.1212/wnl.32.7.776. [DOI] [PubMed] [Google Scholar]
  12. Herholz K., Heindel W., Rackl A., Neubauer I., Steinbrich W., Pietrzyk U., Erasmi-Körber H., Heiss W. D. Regional cerebral blood flow in patients with leuko-araiosis and atherosclerotic carotid artery disease. Arch Neurol. 1990 Apr;47(4):392–396. doi: 10.1001/archneur.1990.00530040034016. [DOI] [PubMed] [Google Scholar]
  13. Kinnunen E., Wikström J. Prevalence and prognosis of epilepsy in patients with multiple sclerosis. Epilepsia. 1986 Nov-Dec;27(6):729–733. doi: 10.1111/j.1528-1157.1986.tb03602.x. [DOI] [PubMed] [Google Scholar]
  14. Krupp L. B., Lipton R. B., Swerdlow M. L., Leeds N. E., Llena J. Progressive multifocal leukoencephalopathy: clinical and radiographic features. Ann Neurol. 1985 Apr;17(4):344–349. doi: 10.1002/ana.410170407. [DOI] [PubMed] [Google Scholar]
  15. Lassen N. A. Incomplete cerebral infarction--focal incomplete ischemic tissue necrosis not leading to emollision. Stroke. 1982 Jul-Aug;13(4):522–523. doi: 10.1161/01.str.13.4.522. [DOI] [PubMed] [Google Scholar]
  16. Rosenberg G. A., Kornfeld M., Stovring J., Bicknell J. M. Subcortical arteriosclerotic encephalopathy (Binswanger): computerized tomography. Neurology. 1979 Aug;29(8):1102–1106. doi: 10.1212/wnl.29.8.1102. [DOI] [PubMed] [Google Scholar]
  17. Stein S., Volpe B. T. Classical "parietal" neglect syndrome after subcortical right frontal lobe infarction. Neurology. 1983 Jun;33(6):797–799. doi: 10.1212/wnl.33.6.797. [DOI] [PubMed] [Google Scholar]
  18. White J. C. Periodic EEG activity in subcortical arteriosclerotic encephalopathy (Binswanger's type). Arch Neurol. 1979 Aug;36(8):485–489. doi: 10.1001/archneur.1979.00500440055010. [DOI] [PubMed] [Google Scholar]
  19. Yao H., Sadoshima S., Kuwabara Y., Ichiya Y., Fujishima M. Cerebral blood flow and oxygen metabolism in patients with vascular dementia of the Binswanger type. Stroke. 1990 Dec;21(12):1694–1699. doi: 10.1161/01.str.21.12.1694. [DOI] [PubMed] [Google Scholar]

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