A Case of Hemiplegia Vegetativa Alterna, Paroxysmal Sympathetic Hyperactivity and Ogilvie’s Syndrome: The Role of Central Sympathetic Pathways in Their Pathophysiology
Bibliographic record
Abstract
We describe a patient with aneurysmal subarachnoid hemorrhage who developed hemiplegia vegetativa alterna (HVA), a rare brainstem syndrome characterized by contralateral hemiplegia, hemisensory loss, hemihyperhidrosis and ipsilateral Horner’s syndrome. The patient also experienced paroxysmal sympathetic hyperactivity (PSH) and colonic pseudo-obstruction, known as Ogilvie’s syndrome. A magnetic resonance imaging (MRI) scan revealed a focal lesion at the anterolateral mesencephalon. It is believed that lesions of this region can interrupt central sympathetic pathways and account for this unique combination of syndromes. This first documented case provides an opportunity to review the relevant neuroanatomy and contributes to cumulative clinical evidence verifying the excitatory-inhibitory ratio (EIR) disconnection theory for PSH. J Neurol Res. 2015;5(3):221-224 doi: http://dx.doi.org/10.14740/jnr284w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".