Cerebral Hemisphere Syndromes - Oxford Medicine

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Cerebral Hemisphere Syndromes 

Cerebral Hemisphere Syndromes

Robert B. Darnell

and Jerome B. Posner

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Paraneoplastic syndromes can affect any portion of the brain, including the cerebral hemispheres (considered here), the brainstem, and the cerebellum (see Chapter 5). Gray matter, white matter, and vasculature may all be affected. Table 4–1 lists some of the syndromes affecting the cerebral hemispheres. Any one of the syndromes listed in Table 4–1 can occur in either an isolated form, affecting only a single area or single cell type in the nervous system, or as part of a more widespread disorder called by Henson and colleagues encephalomyelitis with carcinoma.1 However, even when the clinical findings are restricted to dysfunction of the brain, autopsy studies usually reveal more widespread abnormalities, particularly inflammation.1 The classification given in Table 4–1 is by no means clinically discrete. For example, sleep disorders may occur with either hypothalamic or brainstem dysfunction, or both. Parkinsonian-like syndromes may arise from the basal ganglia or the substantia nigra of the midbrain. Nevertheless, this classification allows a structure for thinking about paraneoplastic neurologic symptoms. With the exception of limbic encephalitis, these disorders are quite rare.

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