ANNOUNCING: New word in lexicon of Neurology; please read!

[GopherBrain]

One of my co-residents coined a new word recently. It is DYSAMBULIA, defined as a general term for gait disorder NOS. As in "Medicine consulted us for a 80 y/o male with a 3 month history of progressive dysambulia." Or "His dysambulia turned out to be caused by a small cerebellar stroke." There wasn't previously a single word that adequately captured this idea.

Anyhow, my mission is to spread the word (no pun intended). Start dropping this into notes and case presentations... I want to be able to find this in Steadmans in a few years, so get to work!

Clarification: In case it wasn't obvious, the root word we are working from is ambulate.

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[neurologist]

One of my co-residents coined a new word recently. It is DYSAMBULIA, defined as a general term for gait disorder NOS. As in "Medicine consulted us for a 80 y/o male with a 3 month history of progressive dysambulia." Or "His dysambulia turned out to be caused by a small cerebellar stroke." There wasn't previously a single word that adequately captured this idea.

Anyhow, my mission is to spread the word (no pun intended). Start dropping this into notes and case presentations... I want to be able to find this in Steadmans in a few years, so get to work!

Clarification: In case it wasn't obvious, the root word we are working from is ambulate.

I will for sure use this ASAP!

Keep in mind that in frontal lobe syndromes, dysAMbulia may be caused by dysbulia!

 

[Cephalorectus]

Being totally nitpicky: is it really correct to use Greek prefix "dys" and suffix "ia" with "ambul," a Latin root?

Probably why the word didn't exist "ante-post" !

 

[neurologist]

Being totally nitpicky: is it really correct to use Greek prefix "dys" and suffix "ia" with "ambul," a Latin root?

Probably why the word didn't exist "ante-post" !

Mixing Greek and Latin?!?!?

That's DIS-GUSTING!!!!!!!

Happens all the time.

 

[Cephalorectus]

I don't really understand why I'm being flamed for my observation. I just find etymology interesting. Of course, we speakers of 'perfect American' drop Greek, Latin, Germanic, French words into our common diction everyday... In terms of fancy medical terminology, I'm fairly sure this bastardization pheonomena doesn't occur in the space of one word. But, hey, what do I know? I'm only an amateur at this stuff... (and I have my head up my butt).

If "dysambulia" rocks your world, go ahead and use it ad nauseum. I think it's a little pretentious. I don't think I'll use it based on the opinion that I think we have enough confusion in the medical world between fancy jargon and lay-speak.

If we're going to throw all the rules out the window, what's wrong with "don't walk no good" ?

 

[neurologist]

I don't really understand why I'm being flamed for my observation. I just find etymology interesting. Of course, we speakers of 'perfect American' drop Greek, Latin, Germanic, French words into our common diction everyday... In terms of fancy medical terminology, I'm fairly sure this bastardization pheonomena doesn't occur in the space of one word. But, hey, what do I know? I'm only an amateur at this stuff... (and I have my head up my butt).

If "dysambulia" rocks your world, go ahead and use it ad nauseum. I think it's a little pretentious. I don't think I'll use it based on the opinion that I think we have enough confusion in the medical world between fancy jargon and lay-speak.

If we're going to throw all the rules out the window, what's wrong with "don't walk no good" ?

Get your cephalus out of your rectus and look again at my post.

I purposely highlighted DIS-GUSTING because it is, in fact, a commonly used example of melding Greek ("dys" or in this case the anglicised "dis") with a Latin root (i.e., "gust-"). Such bastardizations are not all that uncommon.

Is "dysambulia" pretentious? Sure it is. That's what makes it so damn funny. Will it gain common use? Well, how often have you actually written down that a patient has "dysdiadochokinesia"? I think I used that once as an R2 trying to impress some attending.

Language evolves, dude. I think your defensive response merely calls to attention your lack of anything resembling a sense of humor, or, dare I say it, "dyslevity."

 

[Cephalorectus]

I can't believe I'm getting drawn into this tit-for-tat argument. (At least it's more engaging than the drivel Onco posts. I can't wait to see what he has to say about this thread.) But, I suppose I've been DIS-SED.

On an academic point, the Latin "dis" is not the same as the Greek "dys" so your assertion that the word "disgusting" represents mixed roots is, how you say, hmm, completely wrong. I win this pissing match. Yay me. S-M-R-T!

Sorry for being such a sour puss, but I can't believe this (i.e. making up new words) is how you get your jollies. But, hey, I'm an admitted word geek, and I get my jollies by pointing out such asinine behavior. Language does evolve... but hopefully for the better, not for pretentious obfuscation.

You doosh.

 

[GopherBrain]

It's good to see a spirited discussion on this very important issue.

Neurologist has the right idea. "Dysambulia" is a nod to the jargon-filled specialty that we all know and love... I mean, it sometimes seems as though every possible finding has a multi-syllable word that to describe it. Why isn't there a term to describe one of the problems we see most? It is fun to casually drop it into conversation with other neurologists and see the reaction. Some just let it slide (it conforms to the pattern so well that perhaps they think it is an established word that they haven't heard before) and others (typically the kind of people that would think nothing of dropping dysdiadochokinesia into a conversation) look at you like you are loony. My plan is just to wear them down with repeated use.

I definitely stick to plain english with my patients (and consulting services). This is more of a neurology "in joke" for now. Today neurologists, tomorrow the world!

 

[Nerdoscience]

Why?

Anyway, I would have to agree that "dis" means to undo or not, while "dys" means painful, difficult, or wrong/bad. They are totally different. Mixed roots do happen in commonly used medical words, though. Take "quadriparesis," for example. "Quadri" is Latin, and "paresis" is Greek. Some now prefer "tetraparesis," which is totally Greek. Also, many Greek roots come to us through Latin.

Here's another issue that I find interesting, which has nothing to do with ataxic gait. How do you pronouce "apoptosis"? Many a dictionary list both "a (as in apple) -puh - TOE- sis" and "a-pop-TOE-sis" or "A (as in aim)-pop-TOE-sis. I have heard many people argue that because the word is composed of "apo-" and "-ptosis," that it should only be pronounce the first way.

This argument makes no sense at all. If that were true, then we would fly hee-lih-ko-TAIRs, would call loss of memory A-NEE-zha, people who don't know if there is a God A-NOS-tics, bulging forward of the eyeball pro-TO-sis, the large muscle of the calf the gas-tro-NEE-mee-us, and someone with one eye a SY-clahs.

There are words where we don't pronounce a "p" after a vowel, but these tend to be newer words that have a lot of roots. For instance, "parapsychology," "biopsychosocial," and maybe "iliopsoas." These are greatly outnumbered by the other category of words, though.

Another issue: Latin plurals that people get messed up.

-a -ae Vertebra vertebrae
-ceps -cipites (biceps bicipites)
-nx -nges (phalanx phalanges, syrinx syringes, meninx meninges)
-is -es (penis penes -- NOT PENI!!!!)

How about the genitive case in Latin?
Tensor fasciae latae (tightener OF the fascia lata)

What about -pus -podes
Octopus octopodes?
Definitely not octopi

But again, why? Who really cares? Does it matter?

 

[neurodoc]

Why?

Anyway, I would have to agree that "dis" means to undo or not, while "dys" means painful, difficult, or wrong/bad. They are totally different. Mixed roots do happen in commonly used medical words, though. Take "quadriparesis," for example. "Quadri" is Latin, and "paresis" is Greek. Some now prefer "tetraparesis," which is totally Greek. Also, many Greek roots come to us through Latin.

[...etc.]

Nerdo, you be de man! It's nice to see a post by someone who obviously knows something about etymology, and what you say about "dis" v. "dys" and Latin and Greek is absolutely correct. The mixed etymologies have found their way into chimeric English words, and that's just they way it is. We may have to accept this "illogocal" chimerism, but it shouldn't prevent us from expressing our irritation.

Despite my objections to the term, which are similar to your objections, I like the bastard term, "dysambulia." As a bastard, it is no worse than "quadraparesis." Actualy, I prefer "tetraparesis" to "quadraparesis," and I use "tetraparesis" to the occasional consternation of my colleagues.

Off topic, my pet peeve is the term, "dystopia," that I've seen used by writers to mean something like the opposite of "utopia." "Dystopia" presumably means "a bad place." This term was obviously created by writers who confused "utopia" ["no place"] with "eutopia" ["a good place"]. This represents ignorance of language, in my opinion, the same kind of ignorance that leads people to think of "bicep" as the singular form of "biceps."

Nick

 

[Nerdoscience]

Off topic, my pet peeve is the term, "dystopia," that I've seen used by writers to mean something like the opposite of "utopia." "Dystopia" presumably means "a bad place." This term was obviously created by writers who confused "utopia" ["no place"] with "eutopia" ["a good place"].

Nick

Right on. Technically, though, the etymology of "utopia" has never been confirmed 100%, and since St. Thomas More is long dead, I guess we will have to trust the scholars.

I thought of another -is -es word -- naris nares. One nostril is a naris, not a nare.

Did I mention my favorite medical terms?

Ptosed -- meaning fallen, such as a droopy eyelid.
I'd like some ptosed with jam and butter.

Levator labii superioris alaeque nasi
levator = lifter
labii = of the lip
superioris = upper
alae = of the wing
-que = and
nasi = of the nose
lifter of the upper lip and of the wing of the nose

 

[Cephalorectus]

Well, hey, people who know what they're talking about! I stand corrected as far as the chimeras go. Nice pick-up on "quadriparesis" . So is there a difference between that and "quadriplegia" ? (I don't have access to the OED anymore, and I'm asking 100% earnestly.)

Another pet peeve: listing the abbreviation AD ("ano Domini") after the year--as in 2007 AD. We are marking the 2007th year of Christ's reign (if you are inclined to believe so.) So technically, it's AD 2007.

Does any of this matter? Probably not, but I do think it's interesting... I sort of cringe when writing "Qdaily," but it's a patient safety issue--and I think that takes priority.

 

[Nerdoscience]

Well, hey, people who know what they're talking about! I stand corrected as far as the chimeras go. Nice pick-up on "quadriparesis" . So is there a difference between that and "quadriplegia" ? (I don't have access to the OED anymore, and I'm asking 100% earnestly.)

Another pet peeve: listing the abbreviation AD ("ano Domini") after the year--as in 2007 AD. We are marking the 2007th year of Christ's reign (if you are inclined to believe so.) So technically, it's AD 2007.

Does any of this matter? Probably not, but I do think it's interesting... I sort of cringe when writing "Qdaily," but it's a patient safety issue--and I think that takes priority.

Paresis is weakness. Plegia is paralysis. Some use plegia in spinal cord injury to mean any weakness or abnormality affecting 2 or 4 limbs (para vs quad). However, when using hemi- before them, they are more strict in meaning total paralysis vs. just weakness.

And what's wrong with just daily or qday?

 

[Nerdoscience]

Has anyone noticed that more threads get derailed into disputes or very odd conversations than stay on track?

It's like they are dysambulic.

 

[Wheezy]

I can't beleive I'm RiTing this. I'm not too fussy about mixing latin & greek, I'm just happi wen I spil them Korektly.

by the way I like a (as in apple)-pop-tosis, but it's not a big deal to me. But what about cephalic, encephalitis & cephalosporins. I prefer the harder (like K) use rather than the softer (like S) use of C. Am I correct?

Pet peeve (I'm gonna get shot for this). I hate the american pronouciation of duodenum. y'know like (Dooo-waaa-de-num). I prefer the English/Irish (Duo as in two, -deee-num).

Don't get me wrong, I like the american accent. I had one for a long time, but now have an odd Irish & Chicago mix! I sometimes wonder if the duodenum issue has to do with where the stress in the word is . y'know americans stress the first syllable rEEEsources, where as the Brits stress the second resoooooooources.. let's throw in some latin spice resourceeeees.

It applies to Capillaries and tones of other words.

 

[Nerdoscience]

The precedent is to pronounce c's after e and i as an s sound. If you look back at the Greek words, they are spelled with a kappa (K). In Vulgar Latin, the c is pronounced as a k sound, but in Church Latin, is is pronounced as a k before a, o, and u, but as a ch sound before i or e.

So, you're not really right, but you do have history on your side, kinda.

 

[neurodoc]

Has anyone noticed that more threads get derailed into disputes or very odd conversations than stay on track?

It's like they are dysambulic.

To get back on track, "dysambulism" and its various derivatives (dysambulic, dysambulistic, etc., are OK by me. But this thread has provided a nice opportunity to discuss medical terminology in general.

It used to be that physicians were well-educated in language as part of their "general" education. At least it was expected that someone with an MD would not be illiterate. There was a time when a passing familiarity with Latin (+/- Greek) was required of medical students. That time is long gone.

From what I have seen, that time is more than just gone. Too many physicians can't even write a good English paragraph, and their progress notes show that. Psychiatrists, who you would think would have to be experts in oral and writen English communication, are often very poor at that. is may have something to do with the fact that many Psychiatrists are IMG's whose first language is not English.

 

[neurodoc]

More peeves regarding Neuro terminology...

The "a"-prefix refers to a complete loss of something. This is a Greek thing, referred to as "the alpha privative." The Latin equivalent would be the "non-" prefix. "Aphasia," for example, should be reserved to a complete loss of language function of a specific type (e.g. fluent or non-fluent "aphasia").

Partial language impairments should be referred to as "dysphasia." Dysambulation, therefore, would be a partially impaired ability to ambulate. A complete loss of that ability should be called "anambulation," or if you want to keep it all Latin, "nonambulation."

Consider the term, "dysarthria," and compare it to "anarthria."

"Apraxia" should be reserved to describe a total loss of skilled motor function. "Dyspraxia" should be used to describe partial deficits in skilled motor function.

And I could easily cite many other examples of misused terminology.

I'm sure that I'll be flamed for posting this stuff, but the fact is that precision in the use of language is important. So flame on all of you nattering nabobs of negativistic nonsense (to paraphrase a political figure of the 1970's).

 

[neurodoc]

Here's a story about pompous alpha-hotels I've encountered in college and med school. I had a P-Chem Prof at UCB who insisted on correcting my American pronunciation of "centimeter." He insisted that we pronounce it "sauntimeter." I told him that, if he wanted my "two saunts" worth of opinion, it wasn't worth arguing...

 

[danielmd06]

Too many physicians can't even write a good English paragraph, and their progress notes show that.

Agreed.

Grammar, literature, and diction are lost among most physicians. It comes from recruiting students strong in math and science, but weak in the liberal arts. Very few medical school applicants are completely well-rounded. Don't even get me started on music, art, mythology, or history. C'est la vie.

On a brighter note, I like this term "dysambulic." Very cute.

 

[Wheezy]

Here's a story about pompous alpha-hotels I've encountered in college and med school. I had a P-Chem Prof at UCB who insisted on correcting my American pronunciation of "centimeter." He insisted that we pronounce it "sauntimeter." I told him that, if he wanted my "two saunts" worth of opinion, it wasn't worth arguing...

nicely done, "sauntimeter" rubs me the wrong way too. I love different accents & pronouciations (even if they are slightly incorrect), they add a bit of flavour to speech.

But I think when it comes to written medical terminology we should be precise.

Here's another one; this actually comes up in our neuroscience conference regularly. The discussion starts when a patient presents with paroxysmal staring episodes and the poor resident uses the term "absence episodes" to discribe the "staring episodes" eventhough they haven't been diagnosed with absence seizures.

should we just call them "staring episodes" until the diagnosis is confirmed/refuted or should we just relax?

 

[neurodoc]

:Here's another one; this actually comes up in our neuroscience conference regularly. The discussion starts when a patient presents with paroxysmal staring episodes and the poor resident uses the term "absence episodes" to discribe the "staring episodes" eventhough they haven't been diagnosed with absence seizures.

should we just call them "staring episodes" until the diagnosis is confirmed/refuted or should we just relax?

I'm with you on calling them "staring episodes." Describe what you see, and what others could see if they were looking along with you. Calling it an "absence episode" demands a conclusion that can be confirmed only by suimultaneous EEG monitoring...

I've had the experience of observing many patients with presumed epiletic behavior while these patients were hooked up to an EEG monitor (both surface and implanted cortical electrodes). I used to think I was able to tell the difference between epileptic and non-epileptic behaviors. Believe me, it is not easy at all.

 

[Bill59]

... and speaking of...

The verb is seize. The noun is seizure.