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Otolaryngologic Clinics of North America Aug 2019This article discusses vocal fold paresis as a separate and distinct condition from vocal fold paralysis. The signs and symptoms of paresis may be different and less... (Review)
Review
This article discusses vocal fold paresis as a separate and distinct condition from vocal fold paralysis. The signs and symptoms of paresis may be different and less obvious than those for paralysis, so this condition is often misdiagnosed or underdiagnosed. Elements necessary to heighten clinical suspicion are included to assist in educating practitioners on these subtle findings. Once paresis is suspected, associated respiratory or sensory abnormalities also should be sought, because these may change the treatment plan when recognized. Utility of laryngeal electromyography is discussed along with potential treatment options for both the motor and often-present sensory symptoms.
Topics: Diagnosis, Differential; Electromyography; Humans; Paresis; Prognosis; Stroboscopy; Vocal Cord Paralysis; Vocal Cords
PubMed: 31088695
DOI: 10.1016/j.otc.2019.03.008 -
Current Opinion in Critical Care Feb 2004To review the medical literature on neuromuscular abnormalities acquired in the intensive care unit (ICU), particularly after mechanical ventilation, focusing on the... (Review)
Review
PURPOSE OF REVIEW
To review the medical literature on neuromuscular abnormalities acquired in the intensive care unit (ICU), particularly after mechanical ventilation, focusing on the most recent advances in this field.
RECENT FINDING
Using a simple bedside muscle strength score, significant clinical weakness is detected in one fourth of patients awakening in ICU after more than 1 week of mechanical ventilation. Weakness is associated with a longer time on mechanical ventilation, although the exact relationship between limb and respiratory neuromuscular involvement remains unclear. Muscle involvement is often combined with axonal involvement and can predominate or occur in isolation in some patients. Although prolonged severe weakness is unusual, milder abnormalities may persist for several months after discharge. In addition to severity and duration of initial organ failures, both neuromuscular inactivity and use of corticosteroids make an independent contribution of the neuromuscular abnormalities. Conversely, strict glycemic control may prevent neuromuscular abnormalities, although this needs to be confirmed in general ICU patients.
SUMMARY
Avoiding complete neuromuscular inactivity, using corticosteroids with greater discernment, and closely monitoring blood glucose levels might be worthwhile avenues for research in prevention of neuromuscular abnormalities acquired in the most severely ill ICU patients. Investigations of the severity of the respiratory neuromuscular involvement are also warranted.
Topics: Adrenal Cortex Hormones; Blood Glucose; Humans; Intensive Care Units; Monitoring, Physiologic; Paresis; Risk Factors; Ventilators, Mechanical
PubMed: 15166849
DOI: 10.1097/00075198-200402000-00008 -
Veterinary Journal (London, England :... Nov 2014The aetiology, pathogenesis, diagnosis and treatment of bovine spastic paresis of the gastrocnemius muscle (BSP-G) have been investigated for several decades, but much... (Review)
Review
The aetiology, pathogenesis, diagnosis and treatment of bovine spastic paresis of the gastrocnemius muscle (BSP-G) have been investigated for several decades, but much remains to be elucidated. In some breeds, the proportion of atypical presentations of BSP involving the quadriceps muscle (BSP-Q) and/or several other muscles (mixed presentation, BSP-M) appears to be increasing. Differentiation between BSP-G, -Q and -M is challenging and existing surgical treatments are usually ineffective in cattle affected by one of the atypical forms of the disease. This paper reviews the current knowledge on BSP and addresses several areas where understanding of the disease is incomplete.
Topics: Animals; Cattle; Cattle Diseases; Muscle Spasticity; Paresis
PubMed: 25201252
DOI: 10.1016/j.tvjl.2014.07.015 -
Veterinary Journal (London, England :... Oct 2016Bovine spastic paresis (BSP) is a sporadic, progressive neuromuscular disease that is thought to affect all breeds of cattle. The disease manifests as a unilateral or... (Review)
Review
Bovine spastic paresis (BSP) is a sporadic, progressive neuromuscular disease that is thought to affect all breeds of cattle. The disease manifests as a unilateral or bilateral hyperextension of the hind limb due to increased muscle tone or permanent spasm of mainly the gastrocnemius and/or the quadriceps muscle. Clinical signs only appear in rising, standing and moving animals, which is an important diagnostic feature. Although several medical treatments have been described, surgical procedures such as neurectomy or tenectomy are generally indicated. Even though complete recovery can be achieved, BSP-affected animals should not be used for breeding, since BSP is commonly considered a hereditary disease. The condition therefore negatively affects animal welfare, economics and breeding. When first described in 1922, BSP was already assumed to be heritable, and this assumption has been perpetuated by subsequent authors who have only discussed its possible modes of inheritance, which included monogenetic and polygenetic modes and gene-environment interactions. Besides some clinical aspects and the consideration of the tarsal joint angle as a BSP-correlated trait, this review mainly focuses on the assumed genetic aspects of BSP. Evaluation of the published literature demonstrates that to date, irrevocable proof for the assumed heritability of BSP is still missing. The assumption of heredity is further contradicted by known allele frequencies and incidences of proven hereditary diseases in cattle, such as arachnomelia or bovine spinal muscular atrophy. Consequently, future research is needed to determine the cause of spastic paresis. Procedures that will help test the null-hypothesis ('BSP is not hereditary') and possible modes of inheritance are discussed in this review.
Topics: Animals; Cattle; Cattle Diseases; Genetic Background; Hindlimb; Muscle Spasticity; Muscle, Skeletal; Paresis
PubMed: 27687928
DOI: 10.1016/j.tvjl.2016.07.001 -
BMJ Case Reports Mar 2017A man aged 77 years sustained a left-hemisphere stroke with right hemiparesis. After spending 10 days in the hospital, he was referred to an area rehabilitation...
A man aged 77 years sustained a left-hemisphere stroke with right hemiparesis. After spending 10 days in the hospital, he was referred to an area rehabilitation centre. There he carried out daily physical, occupational and speech therapy, with an emphasis on task-oriented treatment. The patient's upper-extremity motor performance was evaluated at admission to the rehabilitation centre and before leaving the hospital by 3 different measurement tools: the upper-extremity motor part of the Fugl-Meyer assessment scale, electromyography in hand-reach and grasp and object manipulation and handwriting tasks. Significant improvement in hand function was observed in proximal as well as in distal skills. Significant improvement in handwriting skills and decreased impairment level of the upper extremity had considerable effects on the quality of life of the patient. The case report emphasises the importance of intensive task-oriented training during the first 3 months after stroke to support the natural recovery of the lesioned area.
Topics: Aged; Arm; Exercise Therapy; Hand; Hand Strength; Humans; Male; Paresis; Recovery of Function; Stroke; Stroke Rehabilitation
PubMed: 28314812
DOI: 10.1136/bcr-2017-219250 -
Agri : Agri (Algoloji) Dernegi'nin... Jul 2023Herpes zoster (HZ) is a segmental vesicular eruption, pain, and sensorial symptoms. Segmental motor weakness can rarely be seen as a complication of HZ. Here, we present...
Herpes zoster (HZ) is a segmental vesicular eruption, pain, and sensorial symptoms. Segmental motor weakness can rarely be seen as a complication of HZ. Here, we present two cases of motor paresis associated with HZ, case 1 was L2 and L3 segmental motor paresis with femoral neuropathy and case 2 was L5 and S1 segmental motor paresis with sensorial ganglion involvement. In both cases after electrotherapy, exercise program, and medication for pain, there were no motor weakness and pain. Zoster motor paresis is a rare complication that responds to treatment and physicians should be careful about its presence in clinical follow-up.
Topics: Humans; Paresis; Herpes Zoster; Pain; Lower Extremity; Upper Extremity
PubMed: 37493485
DOI: 10.14744/agri.2021.70846 -
PM & R : the Journal of Injury,... Sep 2013Herpes zoster is a distinct clinical syndrome that may present with a segmental zoster paresis. Although thoracic dermatomes are the most commonly affected, paresis of... (Review)
Review
Herpes zoster is a distinct clinical syndrome that may present with a segmental zoster paresis. Although thoracic dermatomes are the most commonly affected, paresis of the abdominal muscles has been less frequently reported. To review the existing published evidence regarding this unusual clinical entity, a literature search of PubMed and Google was performed. In total, 35 articles that described 36 individual cases were identified. The information from all the cases was tabulated for the analysis. The mean age was 67.5 years. The ratio of men to women was approximately 4:1. The left and right side were approximately equally affected. The most affected associated dermatome was T11. In 88.9% of the patients, the typical herpetic rash preceded the abdominal weakness. The mean latent period from rash to onset of abdominal muscle weakness was 3.5 weeks. Electrodiagnostic studies confirmed the diagnosis in 95% of the tested patients. Complete recovery with conservative measures occurred in 79.3% of the patients who were followed-up for recovery, with a mean time for recovery of 4.9 months. Visceral neuropathy co-occurred in 19.4% of the patients. Because of its self-limited nature and good prognosis, recognition of this complication is important to prevent unnecessary diagnostic studies and procedures. Electrodiagnostic studies can be effectively used to confirm the diagnosis. Because visceral neuropathy commonly co-occurs with segmental zoster abdominal paresis, it should be actively investigated and treated.
Topics: Abdominal Muscles; Diagnosis, Differential; Electromyography; Herpes Zoster; Humans; Paresis
PubMed: 24054853
DOI: 10.1016/j.pmrj.2013.05.013 -
Journal of Neurology, Neurosurgery, and... Apr 2005
Topics: Aged; Female; Humans; Internal Capsule; Paresis; Tomography, X-Ray Computed; Tongue
PubMed: 15774456
DOI: 10.1136/jnnp.2004.047472 -
Neurological Sciences : Official... Mar 2023
Topics: Humans; Vocal Cord Paralysis; Ischemic Stroke; Electromyography; Paresis; Vocal Cords
PubMed: 36307746
DOI: 10.1007/s10072-022-06469-y -
Clinical and Experimental Dermatology Aug 2019
Topics: Acyclovir; Administration, Intravenous; Aged; Antiviral Agents; Bromodeoxyuridine; Female; Herpes Zoster; Humans; Paresis; Physical Therapy Modalities
PubMed: 30552696
DOI: 10.1111/ced.13846