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Geriatrics & Gerontology International Oct 2023
Topics: Humans; Aged; Independent Living; Muscle Weakness; Hand Strength; Paresis
PubMed: 37696672
DOI: 10.1111/ggi.14655 -
Chest Jul 1994
Topics: Critical Care; Humans; Neuromuscular Blocking Agents; Neuromuscular Diseases; Paresis; Ventilator Weaning
PubMed: 8020252
DOI: 10.1016/s0012-3692(16)38947-4 -
Seminars in Neurology Feb 2011The office evaluation of weakness can be a daunting task. Many different disorders affecting many different parts of the nervous system can manifest with "weakness," and... (Review)
Review
The office evaluation of weakness can be a daunting task. Many different disorders affecting many different parts of the nervous system can manifest with "weakness," and several nonneurologic conditions may present with complaints of weakness. It is the job of the neurologist to determine whether a patient has neurologic weakness or suffers simply from fatigue. The physician then must properly localize the pathophysiologic site of weakness. The author focuses on neuromuscular causes of weakness affecting muscle, the neuromuscular junction, peripheral nerve, or the anterior horn cell. General historical and examination clues to localization will be discussed. A localization-based evaluation will be outlined, with more specific recommendations regarding the evaluation of a few specific disorders offered. Localization-specific laboratory, electrodiagnostic, imaging, and pathologic investigations will be presented.
Topics: Asthenia; Electromyography; Humans; Muscle Weakness; Office Visits
PubMed: 21321838
DOI: 10.1055/s-0031-1271307 -
Internal Medicine (Tokyo, Japan) Mar 2021We herein report a 39-year-old woman who had aggravated body pain, waddling gait, and fatigability for the past 2 years. A neurological examination showed hyperreflexia...
We herein report a 39-year-old woman who had aggravated body pain, waddling gait, and fatigability for the past 2 years. A neurological examination showed hyperreflexia and proximal muscle weakness. The serum calcium level was normal (10.1 mg/dL). However, serum alkaline phosphatase (3,855 IU/I) and parathyroid hormone (1,008 pg/mL) levels were remarkably high. Cervical ultrasonography revealed parathyroid goiter. The patient was diagnosed with hyperparathyroidism. Her muscle weakness and pain improved within three months after parathyroidectomy. Our findings suggest that clinicians should consider hyperparathyroidism as a differential diagnosis in patients with proximal muscle weakness, even if the serum calcium level is normal.
Topics: Adult; Calcium; Female; Humans; Hyperparathyroidism, Primary; Muscle Weakness; Pain; Parathyroid Hormone; Parathyroidectomy
PubMed: 33250466
DOI: 10.2169/internalmedicine.6131-20 -
The Journal of the Association of... Jan 2020
Topics: Connective Tissue; Connective Tissue Diseases; Humans; Muscle Weakness; Muscle, Skeletal; Paresis
PubMed: 31979719
DOI: No ID Found -
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 -
Studies in Health Technology and... Jun 2020Identifying adverse events in clinical documents is demanded in retrospective clinical research and prospective monitoring of treatment safety and cost-effectiveness. We...
Identifying adverse events in clinical documents is demanded in retrospective clinical research and prospective monitoring of treatment safety and cost-effectiveness. We proposed and evaluated a few methods of semi-automated muscle weakness detection in preoperative clinical notes for a larger project on predicting paresis by images. The combination of semi-expert and machine learning methods demonstrated maximized sensitivity = 0.860 and specificity = 0.919, and largest AUC = 0.943 with a 95% CI [0.874; 0.991], outperforming each method used individually. Our approaches are expected to be effective for autoshaping a well- verified training dataset for supervised machine learning.
Topics: Electronic Health Records; Humans; Muscle Weakness; Natural Language Processing; Paresis; Prospective Studies; Retrospective Studies
PubMed: 32570367
DOI: 10.3233/SHTI200143 -
Joint Bone Spine May 2020
Topics: Female; Hip; Hip Joint; Humans; Male; Muscle Weakness; Osteoarthritis, Hip
PubMed: 31568839
DOI: 10.1016/j.jbspin.2019.09.013 -
PloS One 2023To assess the incidence and determinants of ICU-acquired muscle weakness (ICUAW) in adult patients with enteral nutrition (EN) during the first 7 days in the ICU and...
OBJECTIVE
To assess the incidence and determinants of ICU-acquired muscle weakness (ICUAW) in adult patients with enteral nutrition (EN) during the first 7 days in the ICU and mechanical ventilation for at least 48 hours.
METHODS
A prospective, nationwide, multicentre cohort study in a national ICU network of 80 ICUs. ICU patients receiving invasive mechanical ventilation for at least 48 hours and EN the first 7 days of their ICU stay were included. The primary outcome was incidence of ICUAW. The secondary outcome was analysed, during days 3-7 of ICU stay, the relationship between demographic and clinical data to contribute to the onset of ICUAW, identify whether energy and protein intake can contribute independently to the onset of ICUAW and degree of compliance guidelines for EN.
RESULTS
319 patients were studied from 69 ICUs in our country. The incidence of ICUAW was 153/222 (68.9%; 95% CI [62.5%-74.7%]). Patients without ICUAW showed higher levels of active mobility (p = 0.018). The logistic regression analysis showed no effect on energy or protein intake on the onset of ICUAW. Overfeeding was observed on a significant proportion of patient-days, while more overfeeding (as per US guidelines) was found among patients with obesity than those without (42.9% vs 12.5%; p<0.001). Protein intake was deficient (as per US/European guidelines) during ICU days 3-7.
CONCLUSIONS
The incidence of ICUAW was high in this patient cohort. Early mobility was associated with a lower incidence of ICUAW. Significant overfeeding and deficient protein intake were observed. However, energy and protein intake alone were insufficient to explain ICUAW onset.
RELEVANCE TO CLINICAL PRACTICE
Low mobility, high incidence of ICUAW and low protein intake suggest the need to train, update and involve ICU professionals in nutritional care and the need for early mobilization of ICU patients.
Topics: Humans; Adult; Cohort Studies; Enteral Nutrition; Prospective Studies; Critical Illness; Intensive Care Units; Muscle Weakness; Paresis; Respiration, Artificial
PubMed: 37285356
DOI: 10.1371/journal.pone.0286598 -
Neurocritical Care Dec 2015Acute non-traumatic weakness may be life threatening if it involves the respiratory muscles or is associated with autonomic dysfunction. Most patients presenting with... (Review)
Review
Acute non-traumatic weakness may be life threatening if it involves the respiratory muscles or is associated with autonomic dysfunction. Most patients presenting with acute muscle weakness have a worsening neurological disorder that requires a rapid, systematic evaluation, and detailed neurological exam to localize the disorder. Urgent laboratory tests and neuroimaging are needed in many patients to make the diagnosis. Because acute weakness is a common presenting sign of neurological emergencies, it was chosen as an Emergency Neurological Life Support protocol. Causes of acute non-traumatic weakness are discussed by both presenting clinical signs and anatomical location. For each diagnosis, key features of the history, examination, investigations, and treatment are outlined in the included tables.
Topics: Acute Disease; Emergency Treatment; Humans; Life Support Care; Muscle Weakness; Nervous System Diseases
PubMed: 26438455
DOI: 10.1007/s12028-015-0160-7