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Tropical Medicine & International... Jun 2023To determine the prevalence of signs and symptoms of HTLV-1 and 2 infection in paediatric patients. (Review)
Review
OBJECTIVE
To determine the prevalence of signs and symptoms of HTLV-1 and 2 infection in paediatric patients.
METHODS
We included cohort, case-control and descriptive observational studies that reported the prevalence of signs and symptoms of HTLV-1 and 2 infections in paediatric patients. Searches were performed in MEDLINE® (Ovid), EMBASE and LILACS from inception to the present, and we saturated information with other sources of published and unpublished literature. We decided not to perform meta-analysis according to heterogeneity.
RESULTS
A total of eight studies met the inclusion criteria for qualitative analysis. No studies of HTLV-2 were found. Females predominated and there was vertical transmission in nearly 100% of cases. Infective dermatitis was a common manifestation of HTLV in paediatric patients. In addition, persistent hyperreflexia, clonus and the Babinski sign were early neurological alterations observed in patients carrying the virus.
CONCLUSION
HTLV screening is recommended in patients presenting infective dermatitis, persistent hyperreflexia, walking disturbances and in those who come from endemic zones.
Topics: Child; Female; Humans; Dermatitis; HTLV-I Infections; Human T-lymphotropic virus 1; Paraparesis, Tropical Spastic; Reflex, Abnormal; Observational Studies as Topic
PubMed: 37101377
DOI: 10.1111/tmi.13879 -
The New England Journal of Medicine Aug 2022
Topics: Humans; Optic Nerve; Pupil; Pupil Disorders; Reflex, Abnormal
PubMed: 36001714
DOI: 10.1056/NEJMicm2120226 -
European Journal of Paediatric... Sep 2022We previously found that atypical responses to the knee jerk reflex, i.e., tonic responses (TRs), clonus and contralateral responses in very high-risk (VHR) infants were...
INTRODUCTION
We previously found that atypical responses to the knee jerk reflex, i.e., tonic responses (TRs), clonus and contralateral responses in very high-risk (VHR) infants were associated with cerebral palsy (CP) at 21 months. The current study aimed for a better understanding of pathophysiology of atypical knee jerk responses by evaluating whether infant atypical knee jerk responses are associated with CP and atypical knee jerk responses at school-age.
METHODS
31 VHR-children, who had also been assessed longitudinally during infancy, and 24 typically developing children, were assessed at 7-10 years (school-age). We continuously recorded surface EMG of thigh muscles during knee jerk responses longitudinally during infancy and once at school-age. Neurological condition was assessed with age-appropriate neurological examinations. It included the diagnosis of CP at 21 months corrected age and school-age. CP's type and severity (Gross Motor Function Classification System (GMFCS)) were reported.
RESULTS
Persistent TRs in infancy were associated with CP at school-age. TR prevalence decreased from infancy to childhood. At school-age it was no longer associated with CP. Clonus prevalence in VHR-children did not change with increasing age; it was significantly higher in children without than those with CP. Reflex irradiation was common in all school-age children, and its prevalence in contralateral muscles in VHR-children decreased between infancy and childhood.
CONCLUSIONS
In infancy, TRs indicated an increased risk of CP, but at school-age TRs were not associated with CP. In general, spinal hyperexcitability, expressed as reflex irradiation and TRs, decreased between infancy and school-age.
Topics: Cerebral Palsy; Child; Electromyography; Humans; Infant; Longitudinal Studies; Muscle, Skeletal; Reflex, Abnormal
PubMed: 35872514
DOI: 10.1016/j.ejpn.2022.07.003 -
Kinematic and kinetic analysis of the inter- and intra-applicator assessment of the Babinski reflex.Neurophysiologie Clinique = Clinical... Nov 2014The first aim was to quantify variability in the mechanical technique used by neurologists to elicit the Babinski reflex. The second aim of the study was to assess if... (Comparative Study)
Comparative Study
AIMS OF THE STUDY
The first aim was to quantify variability in the mechanical technique used by neurologists to elicit the Babinski reflex. The second aim of the study was to assess if the mechanical technique is an important determinant of the subsequent reflex response.
MATERIALS AND METHODS
In this study, twelve neurologists elicited the Babinski reflex five times on the same foot of the same participant using a special reflex hammer which recorded the force and duration of the stroke. Hallux movement, tibialis anterior maximum EMG amplitude and pain felt by the participant for each stroke were recorded.
RESULTS
A large inter- and intra-applicator variability was shown amongst the neurologists. The change in hallux angle was significantly correlated with the duration of the stroke (R(2)=0.18, P<0.01), maximum (R(2)=0.14, P=0.01) and average (R(2)=0.17, P<0.01) force used to elicit the reflex. No correlations were shown between the hammer forces and duration and the maximum amplitude of the tibialis anterior. Significant correlations were shown between the pain score and the maximum (R(2)=0.15, P<0.01) and average (R(2)=0.17, P=0.001) force used to elicit the Babinski reflex.
CONCLUSION
These results indicate that there was substantial variation when performing the Babinski reflex test within and between neurologists which could lead to differences in the resultant reflex and therefore may affect subsequent diagnoses.
Topics: Biomechanical Phenomena; Electromyography; Humans; Kinetics; Neurologic Examination; Neurology; Observer Variation; Reflex, Abnormal; Reflex, Babinski; Reproducibility of Results; Statistics, Nonparametric; Stress, Mechanical
PubMed: 25438979
DOI: 10.1016/j.neucli.2014.07.002 -
Clinical Pediatrics Jan 2020
Topics: Blepharoptosis; Child, Preschool; Diagnosis, Differential; Diagnostic Techniques, Ophthalmological; Heart Defects, Congenital; Humans; Infant; Jaw Abnormalities; Male; Nervous System Diseases; Reflex, Abnormal
PubMed: 31583889
DOI: 10.1177/0009922819879465 -
Pediatric Neurology May 2020
Topics: Adolescent; Central Nervous System Vascular Malformations; Cervical Cord; Hiccup; Humans; Magnetic Resonance Imaging; Male; Medulla Oblongata; Reflex, Abnormal
PubMed: 32139168
DOI: 10.1016/j.pediatrneurol.2019.12.012 -
Journal of Voice : Official Journal of... Sep 2018The vagus nerve has sensory and motor function in the larynx, as well as parasympathetic function in the thorax and abdomen. Stimulation of the superior laryngeal nerve... (Review)
Review
INTRODUCTION
The vagus nerve has sensory and motor function in the larynx, as well as parasympathetic function in the thorax and abdomen. Stimulation of the superior laryngeal nerve can cause reflexive bradycardia.
CASE
We describe a case of a 45-year-old man with pre-syncopal symptoms while exercising, and bradycardia found during cardiology workup. Radiography and flexible laryngoscopy showed evidence of a right-sided, vascular laryngeal mass. Exercise testing before and after superior laryngeal nerve block showed reversal of the symptoms with the block. Subsequent resection of the lymphovascular malformation with CO laser eliminated the patient's symptoms.
DISCUSSION
This is the first case reported of the laryngocardiac reflex producing symptomatic bradycardia as a result of exercise-induced engorgement of a supraglottic lymphovascular malformation, which was then cured by surgical excision. We discuss this case and the literature regarding lymphovascular malformations in the airway and the neural pathways of the laryngocardiac reflex.
Topics: Bradycardia; Exercise; Heart; Heart Rate; Humans; Laryngeal Nerves; Laryngoscopy; Larynx; Laser Therapy; Lasers, Gas; Magnetic Resonance Imaging; Male; Middle Aged; Reflex, Abnormal; Syncope; Tomography, X-Ray Computed; Treatment Outcome; Vagus Nerve; Vascular Malformations
PubMed: 29079124
DOI: 10.1016/j.jvoice.2017.07.022 -
Journal of Clinical Neuroscience :... May 2016Diabetes may affect the typical physical findings associated with cervical spondylotic myelopathy, as coexisting diabetic neuropathy may dampen expected hyperreflexia...
Diabetes may affect the typical physical findings associated with cervical spondylotic myelopathy, as coexisting diabetic neuropathy may dampen expected hyperreflexia and also produce non-dermatomal extremity numbness. Most large studies of surgically treated diabetic patients with cervical spondylotic myelopathy have focused upon infection rates rather than exploring any differences in the presenting physical signs. We conducted a retrospective study of the pattern of presenting neurological signs and symptoms and of the clinical outcomes in 438 patients surgically treated for cervical spondylotic myelopathy, 79 of whom had diabetes. Compared with non-diabetic patients, those with diabetes were slightly older and had lower preoperative modified Japanese Orthopaedic Association (mJOA) scores. Those with diabetes also had a significantly higher incidence of hyporeflexia and a higher incidence of a positive Babinski sign, but there was no difference in the appearance of the Hoffman sign. The magnitude of mJOA improvement after surgery was comparable. We conclude that diabetes may alter the typical signs and symptoms of cervical spondylotic myelopathy and suggest that knowledge of the differences may aid in securing a prompt and accurate diagnosis.
Topics: Adult; Aged; Cervical Vertebrae; Diabetes Complications; Diabetes Mellitus; Female; Humans; Male; Middle Aged; Reflex, Abnormal; Retrospective Studies; Spinal Cord Diseases; Spondylosis; Treatment Outcome
PubMed: 26747704
DOI: 10.1016/j.jocn.2015.07.025 -
Otology & Neurotology : Official... Mar 2021To describe the site of lesion responsible for the severe, bilateral, symmetrical, selective loss of vestibular function in Cerebellar Ataxia with Neuronopathy and...
OBJECTIVE
To describe the site of lesion responsible for the severe, bilateral, symmetrical, selective loss of vestibular function in Cerebellar Ataxia with Neuronopathy and Vestibular Areflexia Syndrome (CANVAS), an adult-onset recessively-inherited ataxia, characterized by progressive imbalance due to a combination of cerebellar, somatosensory, and selective vestibular impairment with normal hearing.
METHODS
Histologic examination of five temporal bones and the brainstems from four CANVAS patients and the brainstem only from one more, each diagnosed and followed from diagnosis to death by one of the clinician authors.
RESULTS
All five temporal bones showed severe loss of vestibular ganglion cells (cell counts 3-16% of normal), and atrophy of the vestibular nerves, whereas vestibular receptor hair cells and the vestibular nuclei were preserved. In contrast, auditory receptor hair cells, the auditory ganglia (cell counts 51-100% of normal), and the auditory nerves were relatively preserved. In addition, the cranial sensory ganglia (geniculate and trigeminal), present in two temporal bones, also showed severe degeneration.
CONCLUSIONS
In CANVAS there is a severe cranial sensory ganglionopathy neuronopathy (ganglionopathy) involving the vestibular, facial, and trigeminal ganglia but sparing the auditory ganglia. These observations, when coupled with the known spinal dorsal root ganglionopathy in CANVAS, indicate a shared pathogenesis of its somatosensory and cranial nerve manifestations. This is the first published account of both the otopathology and neuropathology of CANVAS, a disease that involves the central as well as the peripheral nervous system.
Topics: Adult; Bilateral Vestibulopathy; Cerebellar Ataxia; Humans; Reflex, Abnormal; Reflex, Vestibulo-Ocular; Vestibular Diseases
PubMed: 33492056
DOI: 10.1097/MAO.0000000000002985 -
Journal of Neurophysiology Mar 2018Many studies highlight the remarkable plasticity demonstrated by spinal circuits following an incomplete spinal cord injury (SCI). Such plasticity can contribute to... (Review)
Review
Many studies highlight the remarkable plasticity demonstrated by spinal circuits following an incomplete spinal cord injury (SCI). Such plasticity can contribute to improvements in volitional motor recovery, such as walking function, although similar mechanisms underlying this recovery may also contribute to the manifestation of exaggerated responses to afferent input, or spastic behaviors. Rehabilitation interventions directed toward augmenting spinal excitability have shown some initial success in improving locomotor function. However, the potential effects of these strategies on involuntary motor behaviors may be of concern. In this article, we provide a brief review of the mechanisms underlying recovery of volitional function and exaggerated reflexes, and the potential overlap between these changes. We then highlight findings from studies that explore changes in spinal excitability during volitional movement in controlled conditions, as well as altered kinematic and behavioral performance during functional tasks. The initial focus will be directed toward recovery of reflex and volitional behaviors following incomplete SCI, followed by recent work elucidating neurophysiological mechanisms underlying patterns of static and dynamic muscle activation following chronic incomplete SCI during primarily single-joint movements. We will then transition to studies of locomotor function and the role of altered spinal integration following incomplete SCI, including enhanced excitability of specific spinal circuits with physical and pharmacological interventions that can modulate locomotor output. The effects of previous and newly developed strategies will need to focus on changes in both volitional function and involuntary spastic reflexes for the successful translation of effective therapies to the clinical setting.
Topics: Animals; Brain-Derived Neurotrophic Factor; Humans; Locomotion; Neuronal Plasticity; Physical Therapy Modalities; Psychomotor Performance; Recovery of Function; Reflex, Abnormal; Selective Serotonin Reuptake Inhibitors; Spinal Cord; Spinal Cord Injuries; Volition
PubMed: 29093168
DOI: 10.1152/jn.00051.2017