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The Annals of Otology, Rhinology, and... Sep 2022Evidence demonstrates neurotropism is a common feature of coronaviruses. In our laryngology clinics we have noted an increase in cases of "idiopathic" vocal fold...
OBJECTIVE
Evidence demonstrates neurotropism is a common feature of coronaviruses. In our laryngology clinics we have noted an increase in cases of "idiopathic" vocal fold paralysis and paresis in patients with no history of intubation who are recovering from the novel SARS-Cov-2 coronavirus (COVID-19). This finding is concerning for a post-viral vagal neuropathy (PVVN) as a result of infection with COVID-19. Our objective is to raise the possibility that vocal fold paresis may be an additional neuropathic sequela of infection with COVID-19.
METHODS
Retrospective review of patients who tested positive for COVID-19, had no history of intubation as a result of their infection, and subsequently presented with vocal fold paresis between May 2020 and January 2021. Charts were reviewed for demographic information, confirmation of COVID-19 infection, presenting symptoms, laryngoscopy and stroboscopy exam findings, and laryngeal electromyography (LEMG) results.
RESULTS
Sixteen patients presented with new-onset dysphonia during and after recovering from a COVID-19 infection and were found to have unilateral or bilateral vocal fold paresis or paralysis. LEMG was performed in 25% of patients and confirmed the diagnosis of neuropathy in these cases.
CONCLUSIONS
We believe that COVID-19 can cause a PVVN resulting in abnormal vocal fold mobility. This diagnosis should be included in the constellation of morbidities that can result from COVID-19 as the otolaryngologist can identify this entity through careful history and examination.
Topics: COVID-19; Electromyography; Humans; Paresis; SARS-CoV-2; Vocal Cord Paralysis; Vocal Cords
PubMed: 34643462
DOI: 10.1177/00034894211047829 -
BMJ (Clinical Research Ed.) May 2015
Review
Topics: Cerebral Hemorrhage; Female; Functional Neuroimaging; Humans; Magnetic Resonance Angiography; Middle Aged; Multiple Sclerosis, Relapsing-Remitting; Paresis; Radiosurgery; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 25994363
DOI: 10.1136/bmj.h2484 -
The American Journal of Emergency... Feb 2017
Topics: Aged; Catheterization, Central Venous; Embolism, Air; Humans; Male; Paresis; Sclerotherapy; Tomography, X-Ray Computed; Treatment Outcome; Varicose Veins
PubMed: 27590210
DOI: 10.1016/j.ajem.2016.07.055 -
Revue Neurologique Feb 2015Neurorestoration of motor command in spastic paresis requires a double action of stimulation and guidance of central nervous system plasticity. Beyond drug therapies,... (Review)
Review
Neurorestoration of motor command in spastic paresis requires a double action of stimulation and guidance of central nervous system plasticity. Beyond drug therapies, electrical stimulation and cell therapies, which may stimulate plasticity without precisely guiding it, two interventions seem capable of driving plasticity with a double stimulation and guidance component: the lesion itself (lesion-induced plasticity) and durable behavior modifications (behavior-induced plasticity). Modern literature makes it clear that the intensity of the neuronal and physical training is a primary condition to foster behavior-induced plasticity. When it comes to working on movement, intensity can be achieved by the combination of two key components, one is the difficulty of the trained movement, the other is the number of repetitions or the daily duration of the practice. A number of recent studies shed light on promising recovery prospects, particularly using the emergence of new technologies such as robot-assisted therapy and concepts such as guided self-rehabilitation contracts.
Topics: Humans; Movement Disorders; Muscle Spasticity; Neurological Rehabilitation; Neuronal Plasticity; Paresis; Recovery of Function; Time Factors
PubMed: 25572141
DOI: 10.1016/j.neurol.2014.09.011 -
Neurological Sciences : Official... Jul 2017The description of the motor deficit of patients with spinal cord injury (SCI) varies significantly, leading to confusion within the neurological terminology. This paper... (Review)
Review
The description of the motor deficit of patients with spinal cord injury (SCI) varies significantly, leading to confusion within the neurological terminology. This paper proposes a concise and easy to use terminology to describe the motor deficit of patients with SCI. A broad review of the origin of the nomenclature used to describe the motor deficit of patients with SCI was performed and discussed. The prefix: "hemi" should be used to describe paralysis of one half of the body; "mono" for one limb; "para" for lower limbs, di" for two symmetrical segments and/or parts in both sides of the body; "tri" for three limbs, or two limbs and one side of the face; and "tetra" for four limbs. The suffix: "plegia" should be used for total paralysis of a limb or part of the body, and "paresis" for partial paralysis. The term "brachial" refers to the upper limbs; and "podal" to the lower limbs. According to the spinal cord origin of the main key muscles for the limbs, patients with complete injury affecting spinal cord segments C1-5 usually presents with "tetraplegia"; C6-T1 presents with "paraplegia and brachial diparesis"; T2-L2 with "paraplegia"; and L3-S1 with "paraparesis".
Topics: Humans; Paraparesis; Paraplegia; Paresis; Quadriplegia; Spinal Cord; Spinal Cord Injuries; Upper Extremity
PubMed: 28357583
DOI: 10.1007/s10072-017-2931-8 -
Journal of the Neurological Sciences Feb 2016
Topics: Electrodiagnosis; Female; Guillain-Barre Syndrome; Humans; Middle Aged; Neural Conduction; Paresis
PubMed: 26810530
DOI: 10.1016/j.jns.2015.12.030 -
Neurorehabilitation and Neural Repair Feb 2017Robot technology for poststroke rehabilitation is developing rapidly. A number of new randomized controlled trials (RCTs) have investigated the effects of robot-assisted... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Robot technology for poststroke rehabilitation is developing rapidly. A number of new randomized controlled trials (RCTs) have investigated the effects of robot-assisted therapy for the paretic upper limb (RT-UL).
OBJECTIVE
To systematically review the effects of poststroke RT-UL on measures of motor control of the paretic arm, muscle strength and tone, upper limb capacity, and basic activities of daily living (ADL) in comparison with nonrobotic treatment.
METHODS
Relevant RCTs were identified in electronic searches. Meta-analyses were performed for measures of motor control (eg, Fugl-Meyer Assessment of the arm; FMA arm), muscle strength and tone, upper limb capacity, and basic ADL. Subgroup analyses were applied for the number of joints involved, robot type, timing poststroke, and treatment contrast.
RESULTS
Forty-four RCTs (N = 1362) were included. No serious adverse events were reported. Meta-analyses of 38 trials (N = 1206) showed significant but small improvements in motor control (~2 points FMA arm) and muscle strength of the paretic arm and a negative effect on muscle tone. No effects were found for upper limb capacity and basic ADL. Shoulder/elbow robotics showed small but significant effects on motor control and muscle strength, while elbow/wrist robotics had small but significant effects on motor control.
CONCLUSIONS
RT-UL allows patients to increase the number of repetitions and hence intensity of practice poststroke, and appears to be a safe therapy. Effects on motor control are small and specific to the joints targeted by RT-UL, whereas no generalization is found to improvements in upper limb capacity. The impact of RT-UL started in the first weeks poststroke remains unclear. These limited findings could mainly be related to poor understanding of robot-induced motor learning as well as inadequate designing of RT-UL trials, by not applying an appropriate selection of stroke patients with a potential to recovery at baseline as well as the lack of fixed timing of baseline assessments and using an insufficient treatment contrast early poststroke.
Topics: Activities of Daily Living; Humans; Paresis; Randomized Controlled Trials as Topic; Robotics; Stroke; Stroke Rehabilitation; Upper Extremity
PubMed: 27597165
DOI: 10.1177/1545968316666957 -
PloS One 2021Recent studies have suggested that people's intent and ability to act also can influence their perception of their bodies' peripersonal space. Vice versa one could...
Recent studies have suggested that people's intent and ability to act also can influence their perception of their bodies' peripersonal space. Vice versa one could assume that the inability to reach toward and grasp an object might have an impact on the subject's perception of reaching distance. Here we tested this prediction by investigating body size and action capability perception of neurological patients suffering from arm paresis after stroke, comparing 32 right-brain-damaged patients (13 with left-sided arm paresis without additional spatial neglect, 10 with left-sided arm paresis and additional spatial neglect, 9 patients had neither arm paresis nor neglect) and 27 healthy controls. Nineteen of the group of right hemisphere stroke patients could be re-examined about five months after initial injury. Arm length was estimated in three different methodological approaches: explicit visual, explicit tactile/proprioceptive, and implicit reaching. Results fulfilled the working hypothesis. Patients with an arm paresis indeed perceived their bodies differently. We found a transient overestimation of the length of the contralesional, paretic arm after stroke. Body size and action capability perception for the extremities thus indeed seem to be tightly linked in humans.
Topics: Aged; Arm; Body Size; Case-Control Studies; Female; Humans; Male; Middle Aged; Paresis; Proprioception; Size Perception; Stroke
PubMed: 34086777
DOI: 10.1371/journal.pone.0252596 -
Developmental Medicine and Child... Aug 2015Acute hemiparesis in children is a common clinical syndrome presenting to a variety of care settings. The recognition and the differential diagnosis is challenging,... (Review)
Review
Acute hemiparesis in children is a common clinical syndrome presenting to a variety of care settings. The recognition and the differential diagnosis is challenging, particularly in young children. Arterial ischaemic stroke (AIS) is the primary diagnosis to be considered as this requires emergency investigations and management; however, there are several conditions collectively described as 'stroke mimics' that need consideration. Accurate diagnosis is essential for appropriate management. Clinical data combined with neuroimaging are important for accurate diagnosis and management. This review and the accompanying illustrative case vignettes suggest a practical approach to differential diagnosis and management of children presenting with acute hemiparesis.
Topics: Child; Humans; Paresis
PubMed: 25832616
DOI: 10.1111/dmcn.12750 -
The Israel Medical Association Journal... Dec 2015
Topics: Carotid Artery Injuries; Humans; Ischemia; Leg; Male; Middle Aged; Occupational Diseases; Paresis
PubMed: 26897987
DOI: No ID Found