-
Neurology Jun 2004Although familiar to every neurologist, postictal paresis (PP) has only rarely been analyzed systematically.
BACKGROUND
Although familiar to every neurologist, postictal paresis (PP) has only rarely been analyzed systematically.
OBJECTIVE
To describe the frequency and duration of PP in patients undergoing video-EEG monitoring, the semiology characteristics of seizures preceding PP, and the pattern of associated symptoms and signs.
METHODS
The records of 513 consecutive patients who underwent prolonged video-EEG monitoring during presurgical epilepsy evaluation were reviewed for postictal motor deficit. Three hundred twenty-eight patients fulfilled the inclusion criteria. The videotapes of patients with PP were subsequently analyzed with a careful analysis of ictal motor phenomena at the side of the PP.
RESULTS
PP was found in 44 patients (13.4%). PP was always unilateral and always contralateral to the seizure focus and had a median duration of 173.5 seconds (range 11 seconds to 22 minutes). Of all seizures with PP, 77.8% were accompanied by evident and 9.7% by very slight ictal motor phenomena ipsilateral to the side of PP, whereas 9.7% of the seizures showed no motor signs (two seizures [2.8%] could not be evaluated for motor phenomena). The most common ictal lateralizing sign was unilateral clonic activity in 55.6% of all seizures. Concomitant dystonic posturing was found in 47.9% and ictal limb immobility in 24.6% of the seizures. PP was of longer duration if ictal clonic activity was present and after tonic-clonic seizures.
CONCLUSIONS
PP is relatively frequent (13.4%), is easy to detect, and has a high lateralizing value. The high incidences of dystonic posturing and of ictal limb immobility in our patients with PP may indicate that an active inhibitory process is involved in its pathogenesis.
Topics: Adolescent; Adult; Electroencephalography; Epilepsies, Partial; Female; Humans; Incidence; Male; Middle Aged; Paresis; Video Recording
PubMed: 15210875
DOI: 10.1212/wnl.62.12.2160 -
The Journal of International Medical... Jun 2013Segmental zoster paresis is a rare complication of herpes zoster, characterized by focal motor weakness that does not always present simultaneously with skin lesions....
Segmental zoster paresis is a rare complication of herpes zoster, characterized by focal motor weakness that does not always present simultaneously with skin lesions. Zoster paresis can be easily confused with other neuromuscular or spinal diseases. This case report describes the case of a 72-year-old woman with herpes zoster and cervical spinal stenosis at the same spinal level, where it was difficult to distinguish segmental zoster paresis from cervical radiculopathy combined with motor neuropathy. Although segmental zoster paresis in the upper extremity is rare, it should be included in the differential diagnosis of segmental pain and weakness in the extremities, especially in older or immunocompromised patients. Correct diagnosis is required, to avoid unnecessary surgery and allow timely antiviral treatment.
Topics: Aged; Diagnosis, Differential; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Muscular Atrophy, Spinal; Paresis; Radiculopathy; Spinal Stenosis; Spine
PubMed: 23628922
DOI: 10.1177/0300060513478084 -
Developmental Medicine and Child... Aug 2015Acute hemiparesis in children is a common clinical syndrome presenting to a variety of care settings. The recognition and the differential diagnosis is challenging,... (Review)
Review
Acute hemiparesis in children is a common clinical syndrome presenting to a variety of care settings. The recognition and the differential diagnosis is challenging, particularly in young children. Arterial ischaemic stroke (AIS) is the primary diagnosis to be considered as this requires emergency investigations and management; however, there are several conditions collectively described as 'stroke mimics' that need consideration. Accurate diagnosis is essential for appropriate management. Clinical data combined with neuroimaging are important for accurate diagnosis and management. This review and the accompanying illustrative case vignettes suggest a practical approach to differential diagnosis and management of children presenting with acute hemiparesis.
Topics: Child; Humans; Paresis
PubMed: 25832616
DOI: 10.1111/dmcn.12750 -
B-ENT 2015Ipsilateral hypoglossal nerve (XII) paresis has never been reported as the first and only complication of malignant otitis external (MOE).
BACKGROUND
Ipsilateral hypoglossal nerve (XII) paresis has never been reported as the first and only complication of malignant otitis external (MOE).
CASE REPORT
A 73-year-old diabetic male with persistent left temporomandibular joint ache and ear fullness was admitted with the diagnosis of MOE. He received intravenous ciprofloxacin for 14 days and then continued with oral administration (per os). After two months, he returned with otalgia, swallowing difficulty, and ipsilateral XII paresis. He was re-admitted, received intravenous ciprofloxacin for 6 weeks, and continued with per os ciprofloxacin for 6 months. A Ga67-scan 6 months after the first admission revealed no active infection. Two years after his last admission, the patient still has XII paresis. There is no other cranial nerve involvement and inflammatory markers continue to be normal.
CONCLUSION
Doctors should consider MOE in the differential diagnosis when there is XII paresis, especially in diabetic and immunocompromised patients.
Topics: Aged; Diagnosis, Differential; Humans; Hypoglossal Nerve; Hypoglossal Nerve Diseases; Male; Otitis Externa; Paresis; Tomography, X-Ray Computed
PubMed: 26601558
DOI: No ID Found -
Acta Dermato-venereologica 2006
Topics: Aged; Betamethasone; Diagnosis, Differential; Electromyography; Glucocorticoids; Hernia, Abdominal; Herpes Zoster; Humans; Male; Paresis
PubMed: 16586000
DOI: 10.1080/00015550510042886 -
Journal of Stroke and Cerebrovascular... Oct 2021Exercise therapy and neuromuscular electrical stimulation (NMES) during the initial 14 days after stroke may benefit recovery of gait. We aimed to determine whether... (Randomized Controlled Trial)
Randomized Controlled Trial
Neuromuscular Electric Stimulation in Addition to Exercise Therapy in Patients with Lower Extremity Paresis Due to Acute Ischemic Stroke. A proof-of-concept randomised controlled trial.
INTRODUCTION
Exercise therapy and neuromuscular electrical stimulation (NMES) during the initial 14 days after stroke may benefit recovery of gait. We aimed to determine whether poststroke NMES of vastus medial and tibial muscles during exercise therapy is more effective than exercise therapy alone.
MATERIALS AND METHODS
In this proof-of-concept randomised trial patients with first-ever acute ischemic stroke and a leg paresis (40-85 years of age) were randomised (1:1) to 10 min of daily NMES + exercise therapy or exercise therapy alone. Primary outcome was the between-group difference in change in 6 min Walk Test (6MWT) at 90 days post stroke estimated with a mixed regression model. Secondary outcomes included 10 m Walk Test, Fugl-Meyer Motor Assessment, Guralnik Timed Standing Balance, Sit to Stand, Timed Up and Go, EQ-5D-5L, Montreal Cognitive Assessment and Becks Depression Inventory.
RESULTS
50 stroke survivors (25 in each group) with a mean age of 67 years (range 43-83) were included. An insignificant between-group difference in change of 28.3 m (95%CI -16.0 to 72.6, p = 0.23, adjusted for baseline) in 6MWT at 90-days follow-up was found, in favour of the NMES group. All secondary outcomes showed no statistically significant between-group difference. The conclusion was that adding NMES to exercise therapy had no effect on poststroke walking distance measured by the 6 MWT or any of the secondary outcomes.
CONCLUSIONS
In this proof-of-concept RCT, we demonstrated that NMES in addition to exercise therapy during the first 14 days after onset of ischemic stroke did not improve walking distance or any of the secondary outcomes. Future studies with a longer trial period, stratifying patients into subgroups with comparable patterns of expected spontaneous recovery - if possible within 48 h post stroke, and greater sample size, than in this study are suggestions of how rehabilitation research could go on exploring the potential for NMES as an amplifier in stroke recovery.
Topics: Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Denmark; Electric Stimulation Therapy; Exercise Therapy; Female; Functional Status; Humans; Ischemic Stroke; Lower Extremity; Male; Middle Aged; Paresis; Proof of Concept Study; Quadriceps Muscle; Recovery of Function; Stroke Rehabilitation; Time Factors; Treatment Outcome; Walking
PubMed: 34418670
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106050 -
Annual International Conference of the... 2012Contralaterally controlled functional electrical stimulation (CCFES) is an innovative method of delivering neuromuscular electrical stimulation for rehabilitation of... (Review)
Review
Contralaterally controlled functional electrical stimulation (CCFES) is an innovative method of delivering neuromuscular electrical stimulation for rehabilitation of paretic limbs after stroke. It is being studied to evaluate its efficacy in improving recovery of arm and hand function and ankle dorsiflexion in chronic and subacute stroke patients. The initial studies provide preliminary evidence supporting the efficacy of CCFES.
Topics: Female; Humans; Male; Paresis; Stroke; Stroke Rehabilitation; Transcutaneous Electric Nerve Stimulation
PubMed: 23365893
DOI: 10.1109/EMBC.2012.6345932 -
Journal of Neuroimaging : Official... Oct 1995Trauma is a frequent cause for abducens (sixth) nerve paresis in a child, usually attributed to injury along the nerve's course. An unusual focal lesion of the sixth...
Trauma is a frequent cause for abducens (sixth) nerve paresis in a child, usually attributed to injury along the nerve's course. An unusual focal lesion of the sixth nerve nucleus is described.
Topics: Abducens Nerve Injury; Brain; Child; Cranial Nerve Diseases; Craniocerebral Trauma; Humans; Magnetic Resonance Imaging; Male; Paresis
PubMed: 7579755
DOI: 10.1111/jon199554246 -
Hernia : the Journal of Hernias and... Oct 2009Abdominal wall nerve injury as a result of trocar placement for laparoscopic surgery is rare. We intend to discuss causes of abdominal wall paresis as well as relevant...
PURPOSE
Abdominal wall nerve injury as a result of trocar placement for laparoscopic surgery is rare. We intend to discuss causes of abdominal wall paresis as well as relevant anatomy.
METHODS
A review of the nerve supply of the abdominal wall is illustrated with a rare case of a patient presenting with paresis of the internal oblique muscle due to a trocar lesion of the right iliohypogastric nerve after laparoscopic appendectomy.
RESULTS
Trocar placement in the upper lateral abdomen can damage the subcostal nerve (Th12), caudal intercostal nerves (Th7-11) and ventral rami of the thoracic nerves (Th7-12). Trocar placement in the lower abdomen can damage the ilioinguinal (L1 or L2) and iliohypogastric nerves (Th12-L1). Pareses of abdominal muscles due to trocar placement are rare due to overlap in innervation and relatively small sizes of trocar incisions.
CONCLUSION
Knowledge of the anatomy of the abdominal wall is mandatory in order to avoid the injury of important structures during trocar placement.
Topics: Abdominal Wall; Adult; Appendectomy; Appendicitis; Humans; Laparoscopy; Male; Paresis
PubMed: 19212701
DOI: 10.1007/s10029-009-0473-6 -
Rheumatology International Nov 2009
Topics: Contracture; Conversion Disorder; Female; Humans; Knee Joint; Orthopedic Procedures; Paresis; Physical Therapy Modalities; Treatment Outcome; Unnecessary Procedures; Young Adult
PubMed: 19526363
DOI: 10.1007/s00296-009-0998-0