By K. Jack. Delta College.

Hypergraphia may be seen as part of the interictal psychosis which sometimes develops in patients with complex partial seizures from a temporal lobe (especially nondominant hemisphere) focus order 50 mg clomid fast delivery, or with other nondominant temporal lobe lesions (vascular order clomid 50 mg with visa, neoplastic buy clomid 100mg without prescription, demyelinative clomid 25 mg line, neurodegenerative), or psychiatric disorders (schizophrenia). Hypergraphia is a feature of Geschwind’s syndrome, along with hyperreligiosity and hyposexuality. Advances in Neurology 1991; 55: 411-421 Van Vugt P, Paquier P, Kees L, Cras P. Increased writing activity in neurological conditions: a review and clinical study. Journal of Neurology, Neurosurgery and Psychiatry 1996; 61: 510-514 Cross References Automatic writing behavior; Hyperreligiosity; Hyposexuality Hyperhidrosis Hyperhidrosis is excessive (unphysiological) sweating. Localized hyperhidrosis caused by food (gustatory sweat- ing) may result from aberrant connections between nerve fibers sup- plying sweat glands and salivary glands. Other causes of hyperhidrosis include mercury poisoning, phaeochromocytoma, and tetanus. Transient hyperhidrosis contralateral to a large cerebral infarct in the absence of autonomic dysfunction has also been described. Regional syndromes of hyperhidrosis (hands, feet, axillae) are also described. Symptoms may be helped (but not abol- ished) by low dose anticholinergic drugs, clonidine or propantheline. For focal syndromes, botulinum toxin injections or sympathectomy may be helpful. BMJ 2000; 320: 1221- 1222 - 159 - H Hyperkinesia Labar DR, Mohr JP, Nichols FT, Tatemichi TK. Neurology 1988; 38: 1679-1682 Naumann M, Flachenecker P, Brocker EB, Toyka KV, Reiners K. Lancet 1997; 349: 252 Cross References Anhidrosis; Diaphoresis; Holmes-adie pupil, Holmes-adie syndrome Hyperkinesia Hyperkinesia indicates an involuntary movement disorder character- ized by excessive amplitude of movement, such as ballism, or chorea, or the speech disorders occurring with them. Cross References Ballism, ballismus; Chorea, choreoathetosis; Dysarthria Hypermetamorphosis Hypermetamorphosis is an overattention to external stimuli. Patients with hypermetamorphosis may explore compulsively and touch every- thing in their environment. This is one element of the environmental dependency syndrome and may be associated with other forms of uti- lization behavior, imitation behavior (echolalia, echopraxia) and frontal release signs, such as the grasp reflex. It occurs with severe frontal lobe damage and may be observed following recovery from her- pes simplex encephalitis and in frontal lobe dementias including Pick’s disease. Bitemporal lobectomy may also result in hypermetamorpho- sis, as a feature of the Klüver-Bucy syndrome. Cross References Attention; Echolalia; Echopraxia; Frontal release signs; Grasp reflex; imitation behavior; Klüver-bucy syndrome; Utilization behavior Hypermetria - see DYSMETRIA Hypermnesia - see EIDETIC MEMORY; SYNESTHESIA Hyperorality Hyperorality is a neurobehavioral abnormality consisting of drinking more than usual, eating excessively, eating anything in sight, and put- ting objects inappropriately into the mouth. It is one element of the Klüver-Bucy syndrome, along with hypersexuality. Cross References Klüver-bucy syndrome Hyperpathia Hyperpathia is an unpleasant sensation, often a burning pain, associ- ated with elevated threshold for cutaneous sensory stimuli, such as light touch or hot and cold stimuli, especially repetitive stimuli. Clinical features of hyperpathia may - 160 - Hyperreflexia H include summation (pain perception increases with repeated stimula- tion) and aftersensations (pain continues after stimulation has ceased). The term thus overlaps to some extent with hyperalgesia (although the initial stimulus need not be painful itself) and dysesthesia. There is an accompanying diminution of sensibility due to raising of the sen- sory threshold (cf. Hyperpathia is a feature of thalamic lesions, and hence tends to involve the whole of one side of the body following a unilateral lesion, such as a cerebral hemorrhage or thrombosis. Generalized hyperpathia may also be seen in variant Creutzfeldt-Jakob disease, in which poste- rior thalamic (pulvinar) lesions are said to be a characteristic neurora- diological finding. Cross References Allodynia; Dysesthesia; Hyperalgesia Hyperphagia Hyperphagia is increased or excessive eating. Binge eating, particularly of sweet things, is one of the neurobehavioral disturbances seen in cer- tain of the frontotemporal dementias.

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Sally Ann Jones first got a manual wheelchair but confronted an unanticipated problem cheap clomid 25mg without a prescription. I lived in a household with three impatient males who always said 25mg clomid fast delivery, ‘Oh mother cheap clomid 25mg on line, we can do this cheap clomid 25mg online. Regular wheelchairs make me enormously uncomfortable be- cause there’s somebody back there pushing. With an electric chair, I wouldn’t be using Wheeled Mobility / 213 the muscles to push the chair. Hugh Gregory Gallagher was concerned about his image but confronted the physical real- ities of postpolio, losing muscle power and endurance. Incrementally, yet absolutely, I have become less independent, more invalid. In my mind’s eye, I am one of those lean, mean athletic wheelies who compete in the marathon and get their pictures on the back of Wheaties boxes. And besides, electric wheel- chairs are so big, like Sherman tanks, nothing at all like my light- weight chair, which goes so fast and turns on a dime. He feels that people react slightly differently to him in his manual versus four-wheeled power wheelchair. I think the manual is perceived as personal equipment—like crutches, or perhaps a blindman’s cane. The electric, on the other hand is seen as a thing—a vehicle something like a golf cart.... In motion, the electric chair moves from A to B so effectively, so effi- ciently, that it imparts to its occupant a dignity that is somehow missing in a hand-propelled chair. The wheelchair makes you seem like your legs’re broke or you just can’t walk. Eva said she would never use it: “As much pain as I’d be in, I’d be embar- rassed because it’s me. That way I don’t have to depend on my daughter to leave work and come over and do it for me. I just felt very elderly all of a sudden, but then we started having fun with it. The three-year-old stands on the front; the five-year- old gets in the back. Other than problems with transportation and the curb cuts—things that have to do with the system and the city—I love my Wheeled Mobility / 215 chair. But the urban environment still presents barriers, both physical and interpersonal. Sometimes people find their equipment doesn’t work for them, and they abandon it—the wheelchair just gathers dust. Views on the Street Much of society remains uneasy with persons who roll rather than walk. The anthropologist Robert Murphy, who had a spinal tumor, found that something changed when he started using a wheelchair: Not long after I took up life in the wheelchair, I began to notice other curious shifts and nuances in my social world. After a dentist patted me on the head in 1980, I never returned to his office.... I am now a white man who is worse off than they are, and my subtle loss of public standing brings me closer to their own status. We share a common position on the pe- riphery of society—we are fellow Outsiders. During my first couple of years in the wheelchair, I noticed that men and women responded to me differently. My peer group of middle-aged, middle-class males seemed most menaced by my dis- ability, probably because they identify most closely with me. On the other hand, I found that my relations with most women of all ages have become more relaxed and open.

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