-
Minerva Surgery Dec 2022Recurrent laryngeal nerve (RLN) paresis is a rare but serious complication in thyroid surgery. Intermittent intraoperative nerve monitoring (IONM) was thought to prevent...
BACKGROUND
Recurrent laryngeal nerve (RLN) paresis is a rare but serious complication in thyroid surgery. Intermittent intraoperative nerve monitoring (IONM) was thought to prevent paresis of the RLN, but until today data are not conclusive. Our objective was to confirm the hypothesis that IONM can reduce paresis of RLN compared to nerve visualization alone. Therefore, we examined one of the largest cohorts ever evaluated of a tertiary referral center for endocrine surgery undergoing thyroid surgery for benign thyroid disease.
METHODS
Overall, 2097 patients who underwent thyroid surgery for benign thyroid disease in 2016 and 2017 were evaluated. RLN was identified by IONM or visualization only. Preoperative and postoperative laryngoscopic examination was used to evaluate RLN paresis. Patients' characteristics and perioperative data were extracted retrospectively.
RESULTS
Overall, 1963 patients (2720 nerves at risk [NAR]) were included in this study: 378 surgeries with IONM (560 NAR) and 1585 without IONM (2160 NAR). Transient and permanent RLN pareses were found in 13 (3.4%; NAR=2.3%) and one (0.3%; NAR=0.2%) nerve treated with IONM vs. 37 (2.3%; NAR=1.7%) and five (0.3%; NAR=0.2%) nerves without IONM (P=0.507; NAR P=0.654), respectively.
CONCLUSIONS
Using intermittent IONM, our retrospective study could not demonstrate a significant decrease of RLN pareses in patients undergoing thyroid surgery for benign thyroid disease. This is probably explained by the very low overall number of RLN pareses in our department. Nevertheless, because of patients' safety to avoid any bilateral RLN pareses, we recommend IONM in bilateral resections.
Topics: Humans; Recurrent Laryngeal Nerve; Recurrent Laryngeal Nerve Injuries; Thyroidectomy; Retrospective Studies; Monitoring, Intraoperative; Thyroid Diseases; Paresis
PubMed: 35230041
DOI: 10.23736/S2724-5691.22.09421-7 -
Acta Psychiatrica Scandinavica 1965
Topics: Civilization; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Hyperthermia, Induced; Neurosyphilis; Paresis
PubMed: 5323420
DOI: 10.1111/j.1600-0447.1965.tb04986.x -
Journal of Rehabilitation Medicine Mar 2005To assess the reliability of 6 gait performance tests in individuals with chronic mild to moderate post-stroke hemiparesis.
OBJECTIVE
To assess the reliability of 6 gait performance tests in individuals with chronic mild to moderate post-stroke hemiparesis.
DESIGN
An intra-rater (between occasions) test-retest reliability study.
SUBJECTS
Fifty men and women (mean age 58+/-6.4 years) 6-46 months post-stroke.
METHODS
The Timed "Up & Go" test, the Comfortable and the Fast Gait Speed tests, the Stair Climbing ascend and descend tests and the 6-Minute Walk test were assessed 7 days apart. Reliability was evaluated with the intraclass correlation coefficient (ICC(2,1)), the Bland & Altman analysis, the standard error of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%).
RESULTS
Test-retest agreements were high (ICC(2,1) 0.94-0.99) with no discernible systematic differences between the tests. The standard error of measurement (SEM%), representing the smallest change that indicates a real (clinical) improvement for a group of individuals, was small (< 9%). The smallest real difference (SRD%), representing the smallest change that indicates a real (clinical) improvement for a single individual, was also small (13-23%).
CONCLUSION
These commonly used gait performance tests are highly reliable and can be recommended to evaluate improvements in various aspects of gait performance in individuals with chronic mild to moderate hemiparesis after stroke.
Topics: Activities of Daily Living; Aged; Female; Gait; Humans; Male; Middle Aged; Outcome and Process Assessment, Health Care; Paresis; Recovery of Function; Reproducibility of Results; Stroke; Stroke Rehabilitation; Walking
PubMed: 15788341
DOI: 10.1080/16501970410017215 -
Journal of the European Academy of... Apr 2024
Topics: Humans; Leg; Herpes Zoster; Herpesvirus 3, Human; Paresis; Nervous System Diseases
PubMed: 37907272
DOI: 10.1111/jdv.19601 -
Neurologia Oct 2020
Topics: Arthritis, Rheumatoid; Humans; Lower Extremity; Muscle Weakness; Neuroimaging; Paresis
PubMed: 31288941
DOI: 10.1016/j.nrl.2019.05.001 -
Electromyography and Clinical... Jun 2003Herpes zoster (HZ) is essentially a viral disease of the posterior root ganglia and sensory nerve fibers, which presents clinically with vesicular eruption of the skin,...
Herpes zoster (HZ) is essentially a viral disease of the posterior root ganglia and sensory nerve fibers, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, motor involvement can be seen as well. If classic cutaneous lesions are present, HZ-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be suspicious, especially if the weakness occurs before the cutaneous lesions have appeared, or weeks after they have subsided. We present a patient with HZ-related motor paresis due to radiculopathy in the cervical segments whose motor symptoms and signs appear as major clinical features.
Topics: Aged; Aged, 80 and over; Herpes Zoster; Humans; Male; Paresis
PubMed: 12836588
DOI: No ID Found -
BMJ Case Reports Oct 2013Hypoglycaemic haemiparesis (HH) is an uncommon but important presentation to the emergency department, and it often mimics stroke and is therefore frequently...
Hypoglycaemic haemiparesis (HH) is an uncommon but important presentation to the emergency department, and it often mimics stroke and is therefore frequently misdiagnosed by clinicians. The mechanism of haemiparesis is not fully understood. This case outlines a diabetic elderly woman, who had been having frequent hypoglycaemic episodes and presented to paramedics with hypoglycaemia associated with a right-sided haemiparesis. She was immediately transferred to the local stroke centre after presenting to the emergency department. CT and MRI did not fit in with her presenting neurology. Her weakness resolved, after normoglycaemia was achieved with dextrose infusion; however, she was reported to be more sleepy and drowsy than usual. After extensive and costly investigations during her prolonged inpatient stay, her unifying diagnosis was an HH which triggered of a hypoactive delirium.
Topics: Aged; Brain; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Emergency Service, Hospital; Female; Humans; Hypoglycemia; Neuroimaging; Paresis; Stroke
PubMed: 24130203
DOI: 10.1136/bcr-2013-008893 -
The Veterinary Record Jun 2018Bovine spastic syndrome (BSS) was described for the first time in 1941. The disease occurs in various-maybe even all-cattle breeds and is a chronic-progressive... (Review)
Review
Bovine spastic syndrome (BSS) was described for the first time in 1941. The disease occurs in various-maybe even all-cattle breeds and is a chronic-progressive neuromuscular disorder that commonly affects cattle of at least three years of age. Typical clinical signs of the disease are clonic-tonic cramps of the hindlimbs that occur in attacks. Since BSS does not recover, affected animals can only be treated symptomatically by improving welfare conditions and management factors, or with physical therapy or drugs. Although still not irrevocably proven, BSS is assumed to be a hereditary disease. Therefore, affected animals should be excluded from breeding, which negatively affects economics and breeding. Besides epidemiology, clinical signs, aetiopathogenesis, diagnosis and treatment, this review discusses genetic aspects and differences to the similar disease bovine spastic paresis. Furthermore, this review also picks up the discussion on possible parallels between human multiple sclerosis and BSS as a further interesting aspect, which might be of great interest for future research.
Topics: Animals; Cattle; Cattle Diseases; Humans; Multiple Sclerosis; Muscle Spasticity; Paresis; Syndrome
PubMed: 29678888
DOI: 10.1136/vr.104814 -
Infectious Disease Clinics of North... Sep 2008In middle and eastern European countries, tick-borne encephalitis (TBE) is one of the most important human infections of the central nervous system. TBE virus (TBEV) is... (Review)
Review
In middle and eastern European countries, tick-borne encephalitis (TBE) is one of the most important human infections of the central nervous system. TBE virus (TBEV) is mainly transmitted by tick bites and rarely by unpasteurized milk. In European countries, TBE presents as meningitis in about 50% of patients, as meningoencephalitis in 40%, and as meningoencephalomyelitis in 10%. The severity of TBE increases with age; in children and adolescents, meningitis is the predominant form of the disease. The long-term prognosis is unfavorable in about 40% to 50% of patients who sustain sequelae for months to years, mainly in terms of pareses, ataxia, and other gait disturbances. No specific treatment for TBE is known. It can be successfully prevented by active immunization.
Topics: Animals; Arachnid Vectors; Encephalitis Viruses, Tick-Borne; Encephalitis, Tick-Borne; Encephalomyelitis; Europe; Humans; Immunization; Meningitis, Viral; Meningoencephalitis; Paresis; Risk Factors; Ticks
PubMed: 18755391
DOI: 10.1016/j.idc.2008.03.013 -
Journal of Pediatric Rehabilitation... 2017
Topics: Child; Humans; Neuronal Plasticity; Paresis; Physical Therapy Modalities; Treatment Outcome
PubMed: 28339413
DOI: 10.3233/PRM-170413