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Journal of Anesthesia Apr 2022Segmental zoster paresis (SZP) of the limbs is characterized by a focal, asymmetric neurogenic weakness that may occur in an extremity affected by herpes zoster (HZ). In...
Segmental zoster paresis (SZP) of the limbs is characterized by a focal, asymmetric neurogenic weakness that may occur in an extremity affected by herpes zoster (HZ). In this case report, we describe the case of a patient with SZP who presented with these problems and responded well to temporary spinal cord stimulation (SCS) and systematic rehabilitation. A 62-year-old female patient was referred for right upper limb pain, weakness, and insomnia due to pain. After completing the 14-day trial stimulation, the pain numerical rating scale of the patient in the right upper extremity decreased from 8/10 to 2/10. The Athens insomnia scale score decreased from 15/24 to 10/24. Furthermore, the grip strength of the right hands increased from 6.7 to 16.8 kg at discharge. We induced temporal SCS and rehabilitation of the right upper limb SZP and successfully reduced the pain. An in-depth understanding of the neurological complications secondary to HZ should be emphasized, with temporal SCS and rehabilitation expected to play a crucial role in the motor recovery of patients with SZP.
Topics: Arm; Female; Herpes Zoster; Humans; Middle Aged; Paresis; Spinal Cord Stimulation; Upper Extremity
PubMed: 35274160
DOI: 10.1007/s00540-022-03056-5 -
Critical Care Medicine Dec 2009
Topics: Hospital Mortality; Humans; Intensive Care Units; Paresis; Severity of Illness Index
PubMed: 19923940
DOI: 10.1097/CCM.0b013e3181b01700 -
International Journal of Obstetric... May 2015
Topics: Adult; Anesthesia, Obstetrical; Anesthesia, Spinal; Cesarean Section; Conversion Disorder; Female; Humans; Lower Extremity; Paresis; Postpartum Period; Pregnancy; Psychotherapy; Young Adult
PubMed: 25797239
DOI: 10.1016/j.ijoa.2015.02.005 -
The Medical Journal of Australia Aug 2022
Topics: Emergency Medical Services; Hospitals; Humans; Paresis; Stroke
PubMed: 35820662
DOI: 10.5694/mja2.51654 -
International Ophthalmology Oct 2022To describe etiology, clinical characteristics, radiological features and management of isolated inferior oblique pareses.
PURPOSE
To describe etiology, clinical characteristics, radiological features and management of isolated inferior oblique pareses.
METHODS
A diagnosis of inferior oblique paresis was made after a thorough strabismus examination and neuroimaging. The patients were managed surgically with adjustable strabismus surgery, or conservatively. Surgical success was defined as average horizontal deviation within ≤ 10 prism diopters [PD] post-operatively and for vertical deviation, it was ≤ 5 PD, at last follow-up.
RESULTS
Seven cases were congenital, 6 cases were bilateral, with esotropia in 6 cases; 'A' pattern in 7 cases and hypotropia in 3 cases. The mean preoperative horizontal deviation was 52.5 PD, and the mean postoperative horizontal deviation was 2.37 PD (p = 0.028). The pre-operative vertical deviation was 18 PD and post-operative vertical deviation was 5 PD. MRI showed reduced IO muscle size; average area being 11.27 mm in the affected eyes, with normal sized inferior recti (average: 24.63 mm) and medial recti muscles (average: 30.08 mm). Surgical success was seen in all six cases. Average follow-up was 265 days. The Parks' three step test was not valid, except for one acquired unilateral case.
CONCLUSION
Isolated pareses of inferior oblique muscle exhibit defective elevation in adduction of the affected eye, 'A' pattern and fundus intorsion, and is confirmed by neuroimaging. These can be successfully managed surgically to correct the deviation.
Topics: Fundus Oculi; Humans; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Orbital Diseases; Paresis; Retrospective Studies; Strabismus; Treatment Outcome; Vision, Binocular
PubMed: 35583684
DOI: 10.1007/s10792-022-02316-3 -
Journal of the History of the... Jun 2002Caelius Aurelianus provides in his work Tardarum sive chronicarum passionum, based on Soranos' famous, but lost, work about acute and chronical illnesses, a remarkably...
Caelius Aurelianus provides in his work Tardarum sive chronicarum passionum, based on Soranos' famous, but lost, work about acute and chronical illnesses, a remarkably detailed description of the physio-therapy of paresis, which covers the complete therapeutic spectrum of the groundwork of a combined therapy. His view that rehabilitative treatment should be started from the second day of illness sounds almost revolutionary. Also, modern early rehabilitation makes a specific use of combined therapy in a way that is analogous to that described by Caelius Aurelianus. Even today, the view is taken that fast mobilisation of the patient is the top priority of therapy. The three-stage mobilisation therapy involving exercises in rolling-in-bed as well as practice in trying-to-sit-up is quite similar to what is common practice today.
Topics: Early Ambulation; History, Ancient; Humans; Hydrotherapy; Paresis; Rehabilitation
PubMed: 12122803
DOI: 10.1076/jhin.11.2.105.15192 -
Internal Medicine (Tokyo, Japan) 2013
Topics: Aged, 80 and over; Herpes Zoster; Humans; Male; Paresis; Shoulder
PubMed: 24334599
DOI: 10.2169/internalmedicine.52.1231 -
Respiratory Care Sep 2006Neuromuscular abnormalities culminating in skeletal-muscle weakness occur very commonly in critically ill patients. Intensive-care-unit (ICU) acquired neuromuscular... (Review)
Review
Neuromuscular abnormalities culminating in skeletal-muscle weakness occur very commonly in critically ill patients. Intensive-care-unit (ICU) acquired neuromuscular abnormalities are typically divided into 2 discrete classes: polyneuropathy and myopathy. However, it is likely that these 2 entities commonly coexist, with myopathy being the most common cause of weakness. Major risk factors for ICU-acquired neuromuscular abnormalities include sepsis, corticosteroid administration, and hyperglycemia, with other associated factors including neuromuscular blockade and increasing severity of illness. The pathogenesis of these disorders is not well defined, but probably involves inflammatory injury of nerve and/or muscle that is potentiated by functional denervation and corticosteroids. ICU-acquired neuromuscular abnormalities are associated with multiple adverse outcomes, including higher mortality, prolonged duration of mechanical ventilation, and increased length of stay. The only intervention proven to reduce the incidence of ICU-acquired neuromuscular abnormalities is intensive insulin therapy. Additional research is necessary to better delineate the causes and pathogenesis of these disorders and to identify potential preventive and therapeutic strategies. In addition, consensus guidelines for its classification and diagnosis are needed.
Topics: Humans; Incidence; Intensive Care Units; Muscle Weakness; Paresis; Risk Factors
PubMed: 16934167
DOI: No ID Found -
Revista de Neurologia Jun 2024Action observation (AO) and motor imagery (MI) are considered functionally equivalent forms of motor representation related to movement execution (ME). Because of their... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Action observation (AO) and motor imagery (MI) are considered functionally equivalent forms of motor representation related to movement execution (ME). Because of their characteristics, AO and MI have been proposed as techniques to facilitate the recovery of post-stroke hemiparesis in the upper extremities.
PATIENTS AND METHODS
An experimental, longitudinal, prospective, single-blinded design was undertaken. Eleven patients participated, and were randomly assigned to each study group. Both groups received 10 to 12 sessions of physical therapy. Five patients were assigned to the control treatment group, and six patients to the experimental treatment group (AO + MI). All were assessed before and after treatment for function, strength (newtons) and mobility (percentage) in the affected limb, as well as alpha desynchronisation (8-13 Hz) in the supplementary motor area, the premotor cortex and primary motor cortex while performing AO + MI tasks and action observation plus motor execution (AO + ME).
RESULTS
The experimental group presented improvement in function and strength. A negative correlation was found between desynchronisation in the supplementary motor area and function, as well as a post-treatment increase in desynchronisation in the premotor cortex of the injured hemisphere in the experimental group only.
CONCLUSIONS
An AO + MI-based intervention positively impacts recovery of the paretic upper extremity by stimulating the supplementary motor area, a cortex involved in movement preparation and learning. AO + MI therapy can be used as adjunctive treatment in patients with upper extremity paresis following chronic stroke.
Topics: Humans; Paresis; Male; Female; Single-Blind Method; Middle Aged; Prospective Studies; Stroke Rehabilitation; Aged; Stroke; Recovery of Function; Chronic Disease; Imagery, Psychotherapy; Upper Extremity; Imagination; Longitudinal Studies
PubMed: 38813788
DOI: 10.33588/rn.7811.2024017 -
Journal of Neonatal-perinatal Medicine 2023In this case report, we describe two repeated transcutaneous electromyography of the diaphragm (dEMG) measurements in an infant with suspected paresis of the right...
In this case report, we describe two repeated transcutaneous electromyography of the diaphragm (dEMG) measurements in an infant with suspected paresis of the right hemidiaphragm after cardiac surgery. The first measurement, performed at the time of diagnosis, showed a lower electrical activity of the right side of the diaphragm in comparison with the left side. The second measurement, performed after a period of expectative management, showed that electrical activity of the affected side had increased and was similar to the activity of the left diaphragm. This finding was accompanied by an improvement in the clinical condition. In conclusion, repeated measurement of diaphragmatic activity using transcutaneous dEMG enables the observation and quantification of spontaneous recovery over time. This information may assist the clinician in identifying patients not responding to expectative management and in determining the optimal timing of diaphragmatic surgery.
Topics: Infant, Newborn; Infant; Humans; Infant, Premature; Electromyography; Prospective Studies; Paresis; Diaphragm
PubMed: 38143382
DOI: 10.3233/NPM-230110