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Spinal Cord May 2019
Topics: Clinical Trials as Topic; Humans; Internationality; Paralysis; Spinal Cord Injuries
PubMed: 30962517
DOI: 10.1038/s41393-019-0277-1 -
Laryngo- Rhino- Otologie Jun 2018There are numerous reasons for facial palsy, which range from idiopathic palsy (Bell's palsy) to destruction of the facial nerve by a malignant salivary gland tumor. If...
There are numerous reasons for facial palsy, which range from idiopathic palsy (Bell's palsy) to destruction of the facial nerve by a malignant salivary gland tumor. If the chance of spontaneous recovery is low or there is no drug therapy available, surgery is a therapeutical option. Recently, larger studies were published by specialized centers which enable a more individualized therapeutical concept to achieve tone, symmetry and movement of the paralyzed face based on a detailed preoperative assessment. An important therapy target is the improvement of patient´s quality of life. In the present article, we systematically review the important diagnostic steps and, directly derived from this, the indications for surgical options for reanimation of the mimic function. Furthermore, we provide an overview about a variety of postoperative adjuvant measures as well as on new objective assessment tools to evaluate the therapy results.
Topics: Facial Paralysis; Humans; Quality of Life
PubMed: 29890531
DOI: 10.1055/a-0588-6622 -
Handbook of Clinical Neurology 2016Functional (psychogenic) limb weakness describes genuinely experienced limb power or paralysis in the absence of neurologic disease. The hallmark of functional limb... (Review)
Review
Functional (psychogenic) limb weakness describes genuinely experienced limb power or paralysis in the absence of neurologic disease. The hallmark of functional limb weakness is the presence of internal inconsistency revealing a pattern of symptoms governed by abnormally focused attention. In this chapter we review the history and epidemiology of this clinical presentation as well as its subjective experience highlighting the detailed descriptions of authors at the end of the 19th and early 20th century. We discuss the relevance that physiological triggers such as injury and migraine and psychophysiological events such as panic and dissociation have to understanding of mechanism and treatment. We review many different positive diagnostic features, their basis in neurophysiological testing and present data on sensitivity and specificity. Diagnostic bedside tests with the most evidence are Hoover's sign, the hip abductor sign, drift without pronation, dragging gait, give way weakness and co-contraction.
Topics: Conversion Disorder; History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Medieval; Humans; Muscle Weakness; Nervous System Diseases; Paralysis
PubMed: 27719840
DOI: 10.1016/B978-0-12-801772-2.00018-7 -
Handbook of Clinical Neurology 2022Phrenic nerve injury results in paralysis of the diaphragm muscle, the primary generator of an inspiratory effort, as well as a stabilizing muscle involved in postural... (Review)
Review
Phrenic nerve injury results in paralysis of the diaphragm muscle, the primary generator of an inspiratory effort, as well as a stabilizing muscle involved in postural control and spinal alignment. Unilateral deficits often result in exertional dyspnea, orthopnea, and sleep-disordered breathing, whereas oxygen or ventilator dependency can occur with bilateral paralysis. Common etiologies of phrenic injuries include cervical trauma, iatrogenic injury in the neck or chest, and neuralgic amyotrophy. Many patients have no identifiable etiology and are considered to have idiopathic paralysis. Diagnostic evaluation requires radiographic and pulmonary function testing, as well as electrodiagnostic assessment to quantitate the nerve deficit and determine the extent of denervation atrophy. Treatment for symptomatic diaphragm paralysis has traditionally been limited. Medical therapies and nocturnal positive airway pressure may provide some benefit. Surgical repair of the nerve injury to restore functional diaphragmatic activity, termed phrenic nerve reconstruction, is a safe and effective alternative to static repositioning of the diaphragm (diaphragm plication), in properly selected patients. Phrenic nerve reconstruction has increasingly become a standard surgical treatment for diaphragm paralysis due to phrenic nerve injury. A multidisciplinary approach at specialty referral centers combining diagnostic evaluation, surgical treatment, and rehabilitation is required to achieve optimal long-term outcomes.
Topics: Diaphragm; Humans; Neurosurgical Procedures; Paralysis; Phrenic Nerve; Plastic Surgery Procedures; Respiratory Paralysis
PubMed: 36031309
DOI: 10.1016/B978-0-323-91532-8.00003-3 -
Science (New York, N.Y.) Aug 2023Treating cardiovascular paralysis with epidural electrical neuromodulation.
Treating cardiovascular paralysis with epidural electrical neuromodulation.
Topics: Humans; Paralysis; Cardiovascular Diseases; Spinal Cord Injuries; Baroreflex; Animals; Rats; Hypotension; Electric Stimulation Therapy; Epidural Space
PubMed: 37535742
DOI: 10.1126/science.adj1973 -
Journal of Neuro-ophthalmology : the... Jun 2016We describe a 50-year-old man who developed eight-and-a-half syndrome associated with an ipsilateral trigeminal nerve palsy because of a post-transplant...
We describe a 50-year-old man who developed eight-and-a-half syndrome associated with an ipsilateral trigeminal nerve palsy because of a post-transplant lymphoproliferative disorder. This case widens the spectrum of eight-and-a-half syndrome to include a thirteen-and-a-half syndrome.
Topics: Diagnosis, Differential; Facial Paralysis; Humans; Lymphoproliferative Disorders; Magnetic Resonance Imaging; Male; Middle Aged; Ophthalmoplegia; Syndrome; Trigeminal Nerve Diseases
PubMed: 26928599
DOI: 10.1097/WNO.0000000000000341 -
Medecine Sciences : M/S Oct 2017Since centuries, scientists, clinicians and philosophers have been debating about the interactions between the body and the mind. Researches and advances in... (Review)
Review
Since centuries, scientists, clinicians and philosophers have been debating about the interactions between the body and the mind. Researches and advances in neurophysiology over the last decades have challenged many principles and theories, mainly based on empirical observations, generally well accepted in clinical practice. These new findings, achieved through functional "magnetic resonance imaging", awake brain surgery and allow new techniques and opportunities in physical rehabilitation. More than ever the body and the brain must be considered and treated as a functional entity, the distinction between body and soul developed by Platon should no longer be applied. The development of new technologies, in particular the virtual reality, lends itself perfectly to this global approach. The aim of this article is to present how a purely cognitive training can have beneficial effects on the body and the motor performances in clinics.
Topics: Amputation, Surgical; Amputees; Brain; Cognition; Exercise; Functional Laterality; Humans; Paralysis; Physical Education and Training; Physical Stimulation; Psychophysiology
PubMed: 28994385
DOI: 10.1051/medsci/20173310021 -
Endokrynologia Polska 2022Thyrotoxic myopathy is hyperthyroidism accompanied by muscle lesions. It is recognized as the general term for a group of symptoms with several main manifestations of... (Review)
Review
Thyrotoxic myopathy is hyperthyroidism accompanied by muscle lesions. It is recognized as the general term for a group of symptoms with several main manifestations of several hyperthyroidism patients in the course (e.g. muscle weakness, muscle paralysis, or pain). From the clinical perspective, it may only be manifested as muscle-related symptoms. The symptoms of high metabolic syndrome (e.g. thyrotoxicosis) are absent, obscured, or relatively delayed, so it can be easily misdiagnosed. Accordingly, patients experiencing the first symptom of myopathy should concentrate on the possibility of thyrotoxic myopathy. Given the clinical characteristics, thyrotoxic myopathy can be devided into chronic thyrotoxic myopathy, thyrotoxicosis with periodic paralysis, acute thyrotoxic myopathy, hyperthyroidism with myasthenia gravis, as well as infiltrating exophthalmos with ophthalmoplegia. In this paper, we review thyrotoxic myopathy research status, diagnoses, and treatments.
Topics: Humans; Hyperthyroidism; Muscle Weakness; Muscular Diseases; Paralysis; Thyrotoxicosis
PubMed: 35119093
DOI: 10.5603/EP.a2022.0004 -
Biomolecules Oct 2023Amyotrophic lateral sclerosis (ALS) is a fatal condition characterized by the selective loss of motor neurons in the motor cortex, brainstem, and spinal cord. Muscle... (Review)
Review
Amyotrophic lateral sclerosis (ALS) is a fatal condition characterized by the selective loss of motor neurons in the motor cortex, brainstem, and spinal cord. Muscle involvement, muscle atrophy, and subsequent paralysis are among the main features of this disease, which is defined as a neuromuscular disorder. ALS is a persistently progressive disease, and as motor neurons continue to degenerate, individuals with ALS experience a gradual decline in their ability to perform daily activities. Ultimately, muscle function loss may result in paralysis, presenting significant challenges in mobility, communication, and self-care. While the majority of ALS research has traditionally focused on pathogenic pathways in the central nervous system, there has been a great interest in muscle research. These studies were carried out on patients and animal models in order to better understand the molecular mechanisms involved and to develop therapies aimed at improving muscle function. This review summarizes the features of ALS and discusses the role of muscle, as well as examines recent studies in the development of treatments.
Topics: Animals; Humans; Amyotrophic Lateral Sclerosis; Motor Neurons; Muscle, Skeletal; Muscular Atrophy; Paralysis
PubMed: 38002264
DOI: 10.3390/biom13111582 -
BMJ Case Reports Apr 2022A woman in her 70s was admitted to hospital with worsening shortness of breath and no prior respiratory history of note. This patient's shortness of breath was...
A woman in her 70s was admitted to hospital with worsening shortness of breath and no prior respiratory history of note. This patient's shortness of breath was posture-dependent; symptoms were markedly worse and oxygen saturations were lower on sitting upright than in recumbency. Her shortness of breath had started several weeks prior to admission and had slowly worsened. Chest X-ray revealed a raised right hemidiaphragm. Further investigation revealed a patent foramen ovale, which was managed with percutaneous closure. This is one of several cases that demonstrate right-to-left shunting through a septal defect secondary to right hemidiaphragmatic paralysis. However, previous reports have not provided a clear guide for management of these cases. We suggest where patients are admitted with new onset breathlessness and platypnoea-orthodeoxia, a septal defect should be suspected. In this report, we have suggested a flowchart for the investigation and management of platypnoea-orthodeoxia syndrome.
Topics: Dyspnea; Female; Foramen Ovale, Patent; Heart Septal Defects; Humans; Hypoxia; Paralysis
PubMed: 35383098
DOI: 10.1136/bcr-2021-248502