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Science (New York, N.Y.) Apr 2023Neuroprosthetic technologies can control blood pressure and restore walking.
Neuroprosthetic technologies can control blood pressure and restore walking.
Topics: Humans; Paralysis; Walking; Blood Pressure; Neural Prostheses; Spinal Cord Injuries
PubMed: 37023195
DOI: 10.1126/science.adg7669 -
Physiology (Bethesda, Md.) Sep 2017Paralysis due to spinal cord injury can severely limit motor function and independence. This review summarizes different approaches to electrical stimulation of the... (Review)
Review
Paralysis due to spinal cord injury can severely limit motor function and independence. This review summarizes different approaches to electrical stimulation of the spinal cord designed to restore motor function, with a brief discussion of their origins and the current understanding of their mechanisms of action. Spinal stimulation leads to impressive improvements in motor function along with some benefits to autonomic functions such as bladder control. Nonetheless, the precise mechanisms underlying these improvements and the optimal spinal stimulation approaches for restoration of motor function are largely unknown. Finally, spinal stimulation may augment other therapies that address the molecular and cellular environment of the injured spinal cord. The fact that several stimulation approaches are now leading to substantial and durable improvements in function following spinal cord injury provides a new perspectives on the previously "incurable" condition of paralysis.
Topics: Animals; Electric Stimulation; Humans; Motor Neurons; Paralysis; Recovery of Function; Spinal Cord; Spinal Cord Injuries
PubMed: 28814499
DOI: 10.1152/physiol.00010.2017 -
Ethiopian Journal of Health Sciences Jul 2021Polio is a disabling and potentially deadly disease caused by a wild poliovirus and vaccine-derived poliovirus. The purpose of this review is to discuss the current... (Review)
Review
BACKGROUND
Polio is a disabling and potentially deadly disease caused by a wild poliovirus and vaccine-derived poliovirus. The purpose of this review is to discuss the current situation of polio in Ethiopia.
METHOD
Relevant scientific articles on Polio were searched from different data bases and websites.
RESULTS
The first wild poliovirus in Ethiopia was detected in 1999, followed by detection of few cases in 2000 and 2001. No wild poliovirus was detected in Ethiopia for the next 3 years (2001-2003). However, the disease resurged again in the country between 2004 and 2008 due to challenge to provide sufficient oral poliovirus vaccine coverage, migration and cross border economic activities and lack of good acute flaccid paralysis surveillance. After almost 5 years with no wild polio virus, Ethiopia again affected by polio outbreak importation in 2013. However, due to multiple supplementary immunization activities campaigns of improved quality and enhanced surveillance, the outbreak was eventually successfully interrupted within 6 months of confirmation. The most recent emergence of polio in Ethiopia has seen in this year (2020) six years after the country documented zero polio cases since 2014. The cause of the resurgence of the disease is circulating vaccine derived polio virus-2. Currently, Ethiopia has been conducting outbreak response by declaring Mop-up campaigns since September 2020.
CONCLUSIONS
Therefore, it can be recommended that: - 1. The country has to completely shift from oral polio virus vaccine to inactivated polio vaccine so that the risk of vaccine derived polio will be diminished; 2. Ethiopia has to strengthen the mop up campaign that it has started in September 2020 following the reemergence of the disease in the country; 3. Ethiopia has to strengthen surveillance for acute flaccid paralysis in order to rapidly detect any new virus importation and to facilitate a rapid response.
Topics: Ethiopia; Humans; Paralysis; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral
PubMed: 34703190
DOI: 10.4314/ejhs.v31i4.25 -
Journal (Canadian Dental Association) Aug 2022Bell's palsy is the most common mononeuropathy that causes acute unilateral facial paralysis or paresis. The condition peaks within 72 h and may be associated with...
Bell's palsy is the most common mononeuropathy that causes acute unilateral facial paralysis or paresis. The condition peaks within 72 h and may be associated with numerous signs and symptoms, including post-auricular pain, drooping of the eyelid, loss of taste sensation and decreased lacrimation. Although the etiology of the condition is unknown, inflammation, viral infection, ischemia and anatomy of the facial nerve have all been implicated in the pathophysiology of the disease. Diagnosis and determination of etiology are significant in the early management of this condition. Most incidents resolve spontaneously; however, treatment reduces cases of incomplete recovery and entails the use of corticosteroids, with a possible role for antivirals if a viral etiology is suspected. For patients with incomplete recovery, long-term complications have esthetic, physiological and psychological implications, which greatly affect their quality of life. The purpose of this article is to summarize the current literature on etiology, diagnosis and management of Bell's palsy.
Topics: Humans; Bell Palsy; Facial Paralysis; Quality of Life; Antiviral Agents; Adrenal Cortex Hormones
PubMed: 36322635
DOI: No ID Found -
Journal of the Neurological Sciences May 2020
Topics: Genetic Predisposition to Disease; Humans; Hypokalemic Periodic Paralysis; Paralyses, Familial Periodic; Paralysis; Thyrotoxicosis
PubMed: 32229026
DOI: 10.1016/j.jns.2020.116794 -
Current Opinion in Otolaryngology &... Aug 2014To present the recent advances in the treatment of facial paralysis, emphasizing the emerging technologies. This review will summarize the current state of the art in... (Review)
Review
PURPOSE OF REVIEW
To present the recent advances in the treatment of facial paralysis, emphasizing the emerging technologies. This review will summarize the current state of the art in the management of facial paralysis and discuss the advances in nerve regeneration, facial reanimation, and use of novel biomaterials. This review includes surgical innovations in reinnervation and reanimation as well as progress with bioelectrical interfaces.
RECENT FINDINGS
The last decade has witnessed major advances in the understanding of nerve injury and approaches for management. Key innovations include strategies to accelerate nerve regeneration, provide tissue-engineered constructs that may replace nonfunctional nerves, approaches to influence axonal guidance, limiting of donor-site morbidity, and optimization of functional outcomes. Approaches to muscle transfer continue to evolve, and new technologies allow for electrical nerve stimulation and use of artificial tissues.
SUMMARY
The fields of biomedical engineering and facial reanimation increasingly intersect, with innovative surgical approaches complementing a growing array of tissue engineering tools. The goal of treatment remains the predictable restoration of natural facial movement, with acceptable morbidity and long-term stability. Advances in bioelectrical interfaces and nanotechnology hold promise for widening the window for successful treatment intervention and for restoring both lost neural inputs and muscle function.
Topics: Electric Stimulation Therapy; Facial Expression; Facial Paralysis; Humans; Nerve Regeneration; Nerve Transfer; Neuronal Plasticity; Tissue Engineering; Tissue Scaffolds
PubMed: 24979369
DOI: 10.1097/MOO.0000000000000062 -
Bone Dec 2021Metabolic bone is highly innervated by both sensory and sympathetic nerves. In addition to skeletal development, neural regulation participates in local bone remodeling,...
Metabolic bone is highly innervated by both sensory and sympathetic nerves. In addition to skeletal development, neural regulation participates in local bone remodeling, which is important for successful osseointegration of titanium implants. Neurectomy is a model used to investigate the lack of neural function on bone homeostasis, but the relative impacts of direct denervation to bone or denervation-induced muscle paralysis are less well defined. To investigate this difference, we used two nerve intervention models, sciatic and femoral neurectomy (SFN) v. botox-induced muscle paralysis (BTX) and assessed the resulting femoral bone phenotype and Ti implant osseointegration. Male Sprague Dawley rats (19) were randomly divided into three groups: implant control (n = 5), SFN (n = 7), and BTX (n = 7). Ti implants (microrough/hydrophilic [modSLA], Institut Straumann AG) were placed in the distal metaphysis of each femur on day 24 post-SFN or BTX. Bone and muscle were examined on day 28 after implant insertion. Both nerve intervention models impaired osseointegration. MicroCT and histology indicated that both models had reduced trabecular bone formation. Only BTX reduced cortical bone formation and increased cortical bone porosity. BTX resulted in more bone loss characterized by the least trabecular and cortical bone, as well as osseointegration. Osteoblasts isolated from the tibia exhibited a model-specific phenotype when they were grown on Ti substrates in vitro. Neurectomy caused more severe muscle atrophy than botox injection. These results indicate that neural regulation directly modulates bone formation and osseointegration. Muscle paralysis modulated the effects of loss of neural inputs into bone, supporting the hypothesis that mechanical loading of bone is a factor in achieving successful osseointegration. The different effects of botox and neurectomy on bone phenotype indicated that the sensory and sympathetic nerves had a role in the osseointegration process.
Topics: Animals; Botulinum Toxins, Type A; Denervation; Male; Muscles; Osseointegration; Paralysis; Phenotype; Rats; Rats, Sprague-Dawley; Titanium
PubMed: 34390886
DOI: 10.1016/j.bone.2021.116145 -
BioMed Research International 2016. Treatment for bilateral vocal fold paralysis (BVFP) has evolved from external irreversible procedures to endolaryngeal laser surgery with greater focus on anatomic and... (Review)
Review
. Treatment for bilateral vocal fold paralysis (BVFP) has evolved from external irreversible procedures to endolaryngeal laser surgery with greater focus on anatomic and functional preservation. Since the introduction of endolaryngeal laser arytenoidectomy, certain modifications have been described, such as partial resection procedures and mucosa sparing techniques as opposed to total arytenoidectomy. . The primary outcome measure in studies on BVFP treatment using total or partial arytenoidectomy is avoidance of tracheotomy or decannulation and reported success ranges between 90 and 100% in this regard. Phonation is invariably affected and arytenoidectomy worsens both aerodynamic and acoustic vocal properties. Recent reports indicate that partial and total arytenoidectomies have similar outcome in respect to phonation and swallowing. We use CO laser assisted partial arytenoidectomy with a posteromedially based mucosal flap for primary cases and reserve total arytenoidectomy for revision. Lateral suturing of preserved mucosa provides tension on the vocal fold leading to better voice and leaves no raw surgical field to unpredictable scarring or granulation. . Arytenoidectomy as a permanent static procedure remains a traditional yet sound choice in the treatment of BVFP. Laser dissection provides a precise dissection in a narrow surgical field and the possibility to perform partial arytenoidectomy.
Topics: Deglutition; Female; Humans; Laser Therapy; Male; Phonation; Recovery of Function; Vocal Cord Paralysis
PubMed: 27830141
DOI: 10.1155/2016/3601612 -
Nature Nov 2016Spinal cord injury disrupts the communication between the brain and the spinal circuits that orchestrate movement. To bypass the lesion, brain-computer interfaces have...
Spinal cord injury disrupts the communication between the brain and the spinal circuits that orchestrate movement. To bypass the lesion, brain-computer interfaces have directly linked cortical activity to electrical stimulation of muscles, and have thus restored grasping abilities after hand paralysis. Theoretically, this strategy could also restore control over leg muscle activity for walking. However, replicating the complex sequence of individual muscle activation patterns underlying natural and adaptive locomotor movements poses formidable conceptual and technological challenges. Recently, it was shown in rats that epidural electrical stimulation of the lumbar spinal cord can reproduce the natural activation of synergistic muscle groups producing locomotion. Here we interface leg motor cortex activity with epidural electrical stimulation protocols to establish a brain-spine interface that alleviated gait deficits after a spinal cord injury in non-human primates. Rhesus monkeys (Macaca mulatta) were implanted with an intracortical microelectrode array in the leg area of the motor cortex and with a spinal cord stimulation system composed of a spatially selective epidural implant and a pulse generator with real-time triggering capabilities. We designed and implemented wireless control systems that linked online neural decoding of extension and flexion motor states with stimulation protocols promoting these movements. These systems allowed the monkeys to behave freely without any restrictions or constraining tethered electronics. After validation of the brain-spine interface in intact (uninjured) monkeys, we performed a unilateral corticospinal tract lesion at the thoracic level. As early as six days post-injury and without prior training of the monkeys, the brain-spine interface restored weight-bearing locomotion of the paralysed leg on a treadmill and overground. The implantable components integrated in the brain-spine interface have all been approved for investigational applications in similar human research, suggesting a practical translational pathway for proof-of-concept studies in people with spinal cord injury.
Topics: Animals; Brain-Computer Interfaces; Disease Models, Animal; Electric Stimulation; Electric Stimulation Therapy; Gait; Gait Disorders, Neurologic; Leg; Locomotion; Lumbosacral Region; Macaca mulatta; Male; Microelectrodes; Motor Cortex; Neural Prostheses; Paralysis; Reproducibility of Results; Spinal Cord; Spinal Cord Injuries; Wireless Technology
PubMed: 27830790
DOI: 10.1038/nature20118 -
Ear, Nose, & Throat Journal Mar 2022Arytenoid dislocation and subluxations commonly are reduced surgically using Holinger and straight Miller-3 laryngoscopes. We present a case of arytenoid cartilage...
Arytenoid dislocation and subluxations commonly are reduced surgically using Holinger and straight Miller-3 laryngoscopes. We present a case of arytenoid cartilage subluxation returned to good position using a 28-Jackson dilator. A 66-year-old man was diagnosed previously with right vocal fold paresis and left vocal fold paralysis following a motor vehicle accident that required a 14-day intubation and tracheotomy maintained for 3 weeks. Evaluation by strobovideolaryngoscopy 3 months following the accident showed severe left vocal fold hypomotility and arytenoid height disparity; laryngeal electromyography showed only mild-to-moderate decreased recruitment in laryngeal muscles. No abnormalities were appreciated on neck computed tomography. Upon palpation of both arytenoid cartilages in the operating room, the left joint was found to be subluxed anteriorly and immobile. A 28-Jackson dilator was used to mobilize and reduce the left arytenoid cartilage, and steroid was injected into the cricothyroid joint. Increased mobility was obtained in the operating room and the patient reported significant improvement in his voice. Six months later, we saw improvement in arytenoid height disparity and left vocal fold movement, better glottic closure, and voice handicap index was improved. A 28-Jackson dilator can be used to manipulate the cricoarytenoid joint without trauma to the vocal process.
Topics: Aged; Arytenoid Cartilage; Humans; Laryngeal Muscles; Laryngoscopes; Male; Vocal Cord Paralysis; Vocal Cords
PubMed: 32804570
DOI: 10.1177/0145561320946901