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British Medical Journal Aug 1949
Topics: Extremities; Humans; Musculoskeletal Diseases; Paralyses, Familial Periodic; Paralysis
PubMed: 18138458
DOI: 10.1136/bmj.2.4625.470 -
Journal of Neurology, Neurosurgery, and... Nov 1998The occurrence of a lingual paralysis after unilateral upper motor neuron lesions is an infrequent clinical phenomenon, and the underlying pathophysiological mechanisms... (Comparative Study)
Comparative Study
OBJECTIVES
The occurrence of a lingual paralysis after unilateral upper motor neuron lesions is an infrequent clinical phenomenon, and the underlying pathophysiological mechanisms are poorly understood. We studied the cortical motor representations of ipsilateral and contralateral lingual muscles in healthy controls and in a selected group of stroke patients, to clarify the variable occurrence of a lingual paralysis after recent monohemispheric ischaemia.
METHODS
A special bipolar surface electrode was used to record the ipsilateral and contralateral compound muscle action potentials (CMAPs) from the lingual muscles after transcranial magnetic stimulation (TMS) of the human motor cortex and peripheral electrical stimulation (PES) of the hypoglossal nerve medial to the angle of the jaw. Four patients with a lingual paralysis (group 1) and four patients with symmetric lingual movements (group 2) after monohemispheric first ever stroke were studied and compared with 40 healthy controls.
RESULTS
In controls, TMS of either hemisphere invariably produces CAMPs in the ipsilateral and contralateral lingual muscles, elicited through crossed and uncrossed central motor pathways, respectively. In the 40 healthy controls, TMS of either hemisphere elicited CMAPs of significantly greater amplitudes and shorter onset latencies from the contralateral muscles compared with the ipsilateral responses (p<0.0001). In the patient groups, TMS of the affected hemisphere failed to evoke any CMAP from either lingual side; TMS of the unsevered hemisphere always produced normal ipsilateral and contralateral responses, irrespective of whether the ipsilateral muscles were paralysed or not.
CONCLUSIONS
Bilateral crossed and uncrossed corticonuclear projections are invariably existent in humans. After unilateral interruption of these pathways, some people do exhibit a lingual paralysis whereas others do not. The development of a central lingual paralysis is most likely dependent on the ability of the unsevered hemisphere to utilise the pre-existent uncrossed motor projections. The variable availability of these pathways among individual subjects is in good agreement with the inconstant occurrence of a lingual paralysis after restricted monohemispheric lesions.
Topics: Adult; Aged; Brain; Brain Ischemia; Electric Stimulation; Evoked Potentials, Motor; Female; Functional Laterality; Humans; Magnetics; Male; Middle Aged; Muscle, Skeletal; Paralysis; Tongue
PubMed: 9810951
DOI: 10.1136/jnnp.65.5.755 -
Neurology Sep 1981
Topics: Child, Preschool; Diagnosis, Differential; Female; Humans; Hyperkalemia; Infant; Paralyses, Familial Periodic; Paralysis
PubMed: 7196540
DOI: 10.1212/wnl.31.9.1157 -
Nigerian Journal of Medicine : Journal... 2009When the goal of eradication of poliomyelitis was set in 1988, the need for active surveillance for acute flaccid paralysis (AFP) became necessary. This has led to the...
BACKGROUND
When the goal of eradication of poliomyelitis was set in 1988, the need for active surveillance for acute flaccid paralysis (AFP) became necessary. This has led to the realisation that although the number of polio endemic countries decreased from 125 in 1988 to 6 in 2004, Nigeria is still one of the high transmission areas for the wild virus. The objective of this paper was to review the need for acute flaccid paralysis surveillance by presenting two cases.
METHOD
The case records of two children treated at the University of Port Harcourt Teaching Hospital in 2006 with acute onset of flaccid paralysis were retrieved for presentation.
RESULT
Two girls aged 6 years and 13 years presented with sudden onset of flaccid paralysis for which the clinical diagnoses included poliomyelitis. Their stool specimens taken within 2 weeks of onset of symptoms showed no poliovirus. They initially deteriorated clinically but recovered with little or no residual paralysis.
CONCLUSION
The need to rule out causes other than polio in all acutely paralysed children is hereby highlighted. All polio eradication strategies should continue to be effectively implemented if we must attain the goal of polio eradication.
Topics: Acute Disease; Adolescent; Child; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Muscle Hypotonia; Paralysis; Poliomyelitis; Treatment Outcome
PubMed: 19485162
DOI: No ID Found -
Brain : a Journal of Neurology May 2014Previously, we reported that one individual who had a motor complete, but sensory incomplete spinal cord injury regained voluntary movement after 7 months of epidural...
Previously, we reported that one individual who had a motor complete, but sensory incomplete spinal cord injury regained voluntary movement after 7 months of epidural stimulation and stand training. We presumed that the residual sensory pathways were critical in this recovery. However, we now report in three more individuals voluntary movement occurred with epidural stimulation immediately after implant even in two who were diagnosed with a motor and sensory complete lesion. We demonstrate that neuromodulating the spinal circuitry with epidural stimulation, enables completely paralysed individuals to process conceptual, auditory and visual input to regain relatively fine voluntary control of paralysed muscles. We show that neuromodulation of the sub-threshold motor state of excitability of the lumbosacral spinal networks was the key to recovery of intentional movement in four of four individuals diagnosed as having complete paralysis of the legs. We have uncovered a fundamentally new intervention strategy that can dramatically affect recovery of voluntary movement in individuals with complete paralysis even years after injury.
Topics: Adult; Chronic Disease; Electric Stimulation Therapy; Electromyography; Evoked Potentials, Motor; Exercise Test; Humans; Locomotion; Male; Movement; Muscle, Skeletal; Paralysis; Physical Therapy Modalities; Spinal Cord; Treatment Outcome; Young Adult
PubMed: 24713270
DOI: 10.1093/brain/awu038 -
Drugs Jun 1995Guillain-Barré syndrome (GBS) is the commonest cause of acute neuromuscular paralysis in the developed world today. Patients present most commonly with a rapidly... (Review)
Review
Guillain-Barré syndrome (GBS) is the commonest cause of acute neuromuscular paralysis in the developed world today. Patients present most commonly with a rapidly ascending paralysis together with sensory symptoms and variable autonomic involvement. The diagnosis is clinical, but lumbar puncture and nerve conduction studies are helpful in excluding other conditions. The improvement in prognosis in recent years is largely due to advances in respiratory intensive care management. Careful monitoring of cardiorespiratory function and in particular regular measurements of the vital capacity will help to predict which patients will require elective ventilation to prevent impending neuromuscular respiratory failure. The paralysed patient is susceptible to all the complications of immobility, in particular venous thromboembolism and hypostatic pneumonia, and good nursing care and physiotherapy are therefore mandatory. Autonomic involvement may predispose to cardiac arrhythmias and labile blood pressure. The prolonged nature of the illness predisposes to psychiatric complications, particularly depression, and this should be treated appropriately. Specific treatment is aimed at reducing the period of maximum disability. Both plasma exchange (PE) and intravenous immune globulin (IVIg) have been shown to be effective in randomised controlled trials. A multicentre trial is currently under way to determine whether PE or IVIg or PE followed by IVIg is the most effective treatment for this condition. Steroids alone have not been shown to be of value, although a trial is under way comparing the combination of IVIg and methylprednisolone with IVIg alone. The prognosis of GBS is generally good, with about 80% of patients making a full recovery, although about 5% die of complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Diagnosis, Differential; Female; Humans; Male; Paralysis; Polyradiculoneuropathy; Prognosis; Treatment Outcome
PubMed: 7641605
DOI: 10.2165/00003495-199549060-00005 -
Anaesthesia Feb 1982A case is described of a baby born with a combination of a paralysed hemidiaphragm and congenital hypothyroidism which led to the need for artificial ventilation....
A case is described of a baby born with a combination of a paralysed hemidiaphragm and congenital hypothyroidism which led to the need for artificial ventilation. Difficulties were encountered in discontinuing the ventilatory support. The problems involved in timing extubation of infants are discussed together with consideration of the diagnosis and treatment of neonatal hypothyroidism.
Topics: Congenital Hypothyroidism; Female; Humans; Hypothyroidism; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Positive-Pressure Respiration; Respiratory Paralysis
PubMed: 7044179
DOI: 10.1111/j.1365-2044.1982.tb01060.x -
Journal of Clinical Nursing Dec 2015The aim of this study was to describe the meaning of being temporary paralysed from spinal anaesthesia when undergoing total knee replacement.
AIMS AND OBJECTIVES
The aim of this study was to describe the meaning of being temporary paralysed from spinal anaesthesia when undergoing total knee replacement.
BACKGROUND
Total knee arthroplasty is a common procedure, and regional anaesthesia is used as a method for anaesthetising the patient. The experience is highly individual in substance and duration, and it can extend far beyond care settings as intraoperative care and the postanaesthesia care unit that have been investigated so far.
DESIGN
A qualitative phenomenological hermeneutic design was chosen to gain a deeper understanding of the experience of spinal anaesthesia, as a part of having a total knee replacement.
METHODS
Twelve patients were interviewed in March 2014 after undergoing an elective total knee arthroplasty under spinal anaesthesia. The interviews were analysed with a Ricoeur-inspired interpretation method.
RESULTS
Three themes were derived from the interviews: 'anaesthesia--an unavoidable necessity', 'an unrecognisable and incomprehensible body' and 'the body returns--joy and agony'.
CONCLUSION
The results reveal that trust in the health care personnel and knowledge of the course of events play a key role in the experience. The trust can be breached by unforeseen events, or if the patient's experiences were not taken into account. The ability of the health care personnel to be in contact, share relevant knowledge with- and compensate for the patient is crucial in the prevention of negative experiences.
RELEVANCE TO CLINICAL PRACTICE
The results of this study contribute to insights and deeper knowledge that can enhance staff's ability to provide care for patients undergoing total knee arthroplasty in spinal anaesthesia. The results provide perspectives that argue for care in accordance to individual needs.
Topics: Aged; Anesthesia, Spinal; Arthroplasty, Replacement, Knee; Female; Humans; Male; Middle Aged; Paralysis; Qualitative Research; Trust
PubMed: 26463761
DOI: 10.1111/jocn.13007 -
Annals of Internal Medicine Sep 1962
Topics: Humans; Paralyses, Familial Periodic; Paralysis; Paralysis, Hyperkalemic Periodic; Potassium
PubMed: 13862370
DOI: 10.7326/0003-4819-57-3-455 -
Journal of Hand Surgery (Edinburgh,... Feb 1986A case of selective paralysis of shoulder muscles with its reconstructive procedure, is presented. The deltoid, infra- and supraspinatus paralysed, leaving one of the...
A case of selective paralysis of shoulder muscles with its reconstructive procedure, is presented. The deltoid, infra- and supraspinatus paralysed, leaving one of the steering group of muscles around the shoulder--the subscapularis--intact, made the transfer of the trapezius to deltoid feasible, utilizing a modification of Saha's technique. An excellent result with full range of motion of the paralysed shoulder has been achieved.
Topics: Adult; Humans; Male; Muscular Atrophy; Neoplasm Recurrence, Local; Neurilemmoma; Paralysis; Postoperative Complications; Shoulder; Tendon Transfer
PubMed: 3958555
DOI: 10.1016/0266-7681(86)90020-3