Abstract Details

Title Chronotaraxis: An Underestimated Right Hemisphere Syndrome

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P13 - Poster Session 13 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-005

Objective Loss of sense of time (chronotaraxis) has rarely been reported. A better understanding of its frequencies was investigated with a stroke registry

Background

Behavioral neurological syndromes are numerous and correlated with significant impairment and management challenges. Chronotaraxis has implicated the right parietal lobe.

Design/Methods A cognitive stroke registry derived patient cohort (n=2389), patients with isolated stroke devoid of dementia aphasia, abulia, encephalopathy, significant inattention and aphasia were excluded. A validated bedside cognitive test battery was administered, including an array of right hemisphere (RH) syndromes; anosognosia, neglect syndromes, visuospatial dysfunction, aprosodias and a miscellaneous group. The latter included a category of loss of sense of time, either volunteered or by collateral history. Specific questions included i) inability to judge the passage of time (example length of interview), ii) altered temporal relation of habitual activities (brushing teeth, showering), iii) whether time appears to pass more quickly and iv) illusory acceleration of moving objects (quick motion or Zeitraffer phenomenon).

Results

After exclusions, 690 (33%) patients with RH lesions, syndrome frequency instances, included frontal network syndromes (n=192; 27%), neglect syndromes (n=144; 20%), anosognosias (n=98; 17%), visuospatial dysfunction (n=49; 7%) and aprosodias (n=36; 5%). The miscellaneous group (n=123;18%) included apraxia (n=53; 7%), delusional misidentification syndromes (n=21: 3%), involuntary emotional expression disorder (IEED) (n=11; 2%), geographical disorientation (n=8:1%), increased sense of humor (7: 1%), prosopagnosia (6: 1%), palinopsia (5: 1%), amusia (4:1%), Gastaut Geschwind syndrome (3; 0.5%), astereognosis, (n=2; 0.3%), and chronotaraxis (n=3: 0.4%). Apart from mild episodic dysmemory, neglect syndromes and constructional apraxia the cognitive testing was otherwise normal in these 3 patients.

Conclusions

RH stroke patients may present with 5 common syndromes and less frequent syndromes including chronotaraxis.

Neurological monitoring merits documentation of these, some may not be volunteered and hence underestimated

Chronotaraxis, may pose significant behavioral, safety and care giver challenges

Authors/Disclosures
Michael Hoffmann, MD, FCP, FAHA, F�鶹��ýӳ�� PRESENTER	No disclosure on file

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