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Ideggyogyaszati Szemle Jul 2022The incidence of brachial plexus palsy (BPP) has decreased recently, but the indivi-d-ual's quality of life is endangered. To provide better chan-ces to BPP neonates and... (Review)
Review
BACKGROUND AND PURPOSE
The incidence of brachial plexus palsy (BPP) has decreased recently, but the indivi-d-ual's quality of life is endangered. To provide better chan-ces to BPP neonates and infants, the Department of Developmental Neurology worked out, introduced, and applied a complex early therapy, including nerve point stimulation.
METHODS
After diagnosing the severity of BPP, early intensive and complex therapy should be started. Appro-x-imately after a week or ten days following birth, the slightest form (neurapraxia) normalizes without any intervention, and signs of recovery can be detected around this period. The therapy includes the unipolar nerve point electro-stimulation and the regular application of those elemen-tary sensorimotor patterns, which activate both extremities simultaneously.
RESULTS
With the guideline worked out and applied in the Department of Developmental Neurology, full recovery can be achieved in 50% of the patients, and even in the most severe cases (nerve root lesion), functional upper limb usage can be detected with typically developing body-scheme.
CONCLUSION
Immediately starting complex treatment based on early diagnosis alters the outcome of BPP, providing recovery in the majority of cases and enhancing the everyday arm function of those who only partially benefit from the early treatment.
Topics: Brachial Plexus; Brachial Plexus Neuropathies; Early Diagnosis; Humans; Infant; Infant, Newborn; Neonatal Brachial Plexus Palsy; Paralysis; Quality of Life
PubMed: 35916611
DOI: 10.18071/isz.75.0247 -
Acta Medica Portuguesa Dec 2011Peripheral facial paralysis (PFP) is a consequence of the peripheral neuronal lesion of the facial nerve (FN). It can be either primary (Bell`s Palsy) or secondary. The... (Review)
Review
Peripheral facial paralysis (PFP) is a consequence of the peripheral neuronal lesion of the facial nerve (FN). It can be either primary (Bell`s Palsy) or secondary. The classical clinical presentation typically involves both stages of the hemiface. However, there may be other symptoms (ex. xerophthalmia, hyperacusis, phonation and deglutition changes) that one should recall. Clinical evaluation includes rigorous muscle tonus and sensibility search in the FN territory. Some useful instruments allow better objectivity in the patients' evaluation (House-Brackmann System, Facial Grading System, Functional Evaluation). There are clear referral criteria to Physical Medicine and Rehabilitation. Treatment of Bell`s Palsy may include pharmacotherapy, neuromuscular training (NMT), physical methods and surgery. In the NMT field the several treatment techniques are systematized. Therapeutic strategies should be problem-oriented and adjusted to the patient's symptoms and signs. Physical methods are reviewed. In about 15-20 % of patients permanent sequelae subside after 3 months of evolution. PFP is commonly a multidisciplinary condition. Therefore, it is important to review strategies that Physical Medicine and Rehabilitation may offer.
Topics: Facial Paralysis; Humans; Physical Therapy Modalities
PubMed: 22863499
DOI: No ID Found -
Ugeskrift For Laeger Apr 2021Todd's paralysis is a clinical entity consisting of acute focal neurological deficits following an epileptic seizure. It occurs after 6-13% of seizures, and the symptoms... (Review)
Review
Todd's paralysis is a clinical entity consisting of acute focal neurological deficits following an epileptic seizure. It occurs after 6-13% of seizures, and the symptoms may last from minutes to 36 hours. Stroke with seizure at symptom onset is difficult to differentiate clinically from Todd's paralysis. The use of advanced imaging such as cerebral CT and MRI with angiography is recommended. This is a review of the current knowledge on pathogenesis, clinical presentation and differential diagnoses, and we propose an investigation plan for patients presenting with symptoms of Todd's paralysis.
Topics: Epilepsy; Humans; Magnetic Resonance Imaging; Paralysis; Seizures; Stroke
PubMed: 33913429
DOI: No ID Found -
BMJ Case Reports Apr 2022A woman in her 70s was admitted to hospital with worsening shortness of breath and no prior respiratory history of note. This patient's shortness of breath was...
A woman in her 70s was admitted to hospital with worsening shortness of breath and no prior respiratory history of note. This patient's shortness of breath was posture-dependent; symptoms were markedly worse and oxygen saturations were lower on sitting upright than in recumbency. Her shortness of breath had started several weeks prior to admission and had slowly worsened. Chest X-ray revealed a raised right hemidiaphragm. Further investigation revealed a patent foramen ovale, which was managed with percutaneous closure. This is one of several cases that demonstrate right-to-left shunting through a septal defect secondary to right hemidiaphragmatic paralysis. However, previous reports have not provided a clear guide for management of these cases. We suggest where patients are admitted with new onset breathlessness and platypnoea-orthodeoxia, a septal defect should be suspected. In this report, we have suggested a flowchart for the investigation and management of platypnoea-orthodeoxia syndrome.
Topics: Dyspnea; Female; Foramen Ovale, Patent; Heart Septal Defects; Humans; Hypoxia; Paralysis
PubMed: 35383098
DOI: 10.1136/bcr-2021-248502 -
Medical Science Monitor : International... Mar 2020Todd's paralysis, a neurological abnormality characterized by temporary limb weakness or hemiplegia, typically occurs following a seizure, without enduring consequences.... (Review)
Review
Todd's paralysis, a neurological abnormality characterized by temporary limb weakness or hemiplegia, typically occurs following a seizure, without enduring consequences. Since limb weakness or hemiplegia can also be a common symptom of an acute ischemic stroke, it is often difficult to diagnose Todd's paralysis in individuals experiencing an acute ischemic stroke if they do not have a pre-existing history of epilepsy. Given that there is a limited understanding of Todd's paralysis, this review discusses the history, prevalence, clinical manifestations, duration, etiology, and diagnosis of Todd's paralysis. A few factors that may help clinicians distinguish Todd's paralysis from other clinical indications are as follows: (1) Todd's paralysis is commonly observed after partial seizures or generalized tonic-clonic seizures. (2) The incidence of Todd's paralysis is greater if the epilepsy is associated with old age or stroke history. (3) The duration of Todd's paralysis can range from minutes to days, depending on the type of seizure or whether the patient has experienced cortical structural damage. (4) The etiology of Todd's paralysis is associated with cerebral perfusion abnormality after seizures. Further research is needed to explore factors that distinguish Todd's paralysis from other indications that may lead to limb weakness in order to improve the diagnosis of Todd's paralysis.
Topics: Epilepsy; Humans; Paralysis; Seizures; Stroke
PubMed: 32134903
DOI: 10.12659/MSM.920751 -
European Neurology 2007
Topics: Brain; Humans; Paralysis
PubMed: 17218773
DOI: 10.1159/000098476 -
The American Journal of Emergency... Aug 2022Unilateral paralysis is an alarming symptom with broad differential diagnoses, including stroke, Todd's paralysis, myelopathy, and peripheral neuropathy. Hypokalemic... (Review)
Review
Unilateral paralysis is an alarming symptom with broad differential diagnoses, including stroke, Todd's paralysis, myelopathy, and peripheral neuropathy. Hypokalemic paralysis (HP), a neuromuscular disorder associated with muscle dysfunction, is caused by hypokalemia and manifests as symmetric proximal extremity muscle weakness. Unilateral paralysis has rarely been reported in the literature. Once hypokalemia is corrected, HP is usually reversible. Delayed diagnosis and treatment may result in fatal consequences. Here, we report an atypical case of unilateral weakness along with a review of the literature on unilateral HP.
Topics: Humans; Hypokalemia; Hypokalemic Periodic Paralysis; Muscle Weakness; Paralysis; Stroke
PubMed: 35527097
DOI: 10.1016/j.ajem.2022.04.042 -
Journal of Internal Medicine Jul 2017The human nervous system is a vast network carrying not only sensory and movement information, but also information to and from our organs, intimately linking it to our... (Review)
Review
The human nervous system is a vast network carrying not only sensory and movement information, but also information to and from our organs, intimately linking it to our overall health. Scientists and engineers have been working for decades to tap into this network and 'crack the neural code' by decoding neural signals and learning how to 'speak' the language of the nervous system. Progress has been made in developing neural decoding methods to decipher brain activity and bioelectronic technologies to treat rheumatoid arthritis, paralysis, epilepsy and for diagnosing brain-related diseases such as Parkinson's and Alzheimer's disease. In a recent first-in-human study involving paralysis, a paralysed male study participant regained movement in his hand, years after his injury, through the use of a bioelectronic neural bypass. This work combined neural decoding and neurostimulation methods to translate and re-route signals around damaged neural pathways within the central nervous system. By extending these methods to decipher neural messages in the peripheral nervous system, status information from our bodily functions and specific organs could be gained. This, one day, could allow real-time diagnostics to be performed to give us a deeper insight into a patient's condition, or potentially even predict disease or allow early diagnosis. The future of bioelectronic medicine is extremely bright and is wide open as new diagnostic and treatment options are developed for patients around the world.
Topics: Biosensing Techniques; Biotechnology; Brain; Electric Stimulation Therapy; Electronics, Medical; Forecasting; Humans; Neurons; Paralysis; Synaptic Transmission
PubMed: 28419590
DOI: 10.1111/joim.12610 -
Medecine Sciences : M/S Oct 2017Since centuries, scientists, clinicians and philosophers have been debating about the interactions between the body and the mind. Researches and advances in... (Review)
Review
Since centuries, scientists, clinicians and philosophers have been debating about the interactions between the body and the mind. Researches and advances in neurophysiology over the last decades have challenged many principles and theories, mainly based on empirical observations, generally well accepted in clinical practice. These new findings, achieved through functional "magnetic resonance imaging", awake brain surgery and allow new techniques and opportunities in physical rehabilitation. More than ever the body and the brain must be considered and treated as a functional entity, the distinction between body and soul developed by Platon should no longer be applied. The development of new technologies, in particular the virtual reality, lends itself perfectly to this global approach. The aim of this article is to present how a purely cognitive training can have beneficial effects on the body and the motor performances in clinics.
Topics: Amputation, Surgical; Amputees; Brain; Cognition; Exercise; Functional Laterality; Humans; Paralysis; Physical Education and Training; Physical Stimulation; Psychophysiology
PubMed: 28994385
DOI: 10.1051/medsci/20173310021 -
Endokrynologia Polska 2022Thyrotoxic myopathy is hyperthyroidism accompanied by muscle lesions. It is recognized as the general term for a group of symptoms with several main manifestations of... (Review)
Review
Thyrotoxic myopathy is hyperthyroidism accompanied by muscle lesions. It is recognized as the general term for a group of symptoms with several main manifestations of several hyperthyroidism patients in the course (e.g. muscle weakness, muscle paralysis, or pain). From the clinical perspective, it may only be manifested as muscle-related symptoms. The symptoms of high metabolic syndrome (e.g. thyrotoxicosis) are absent, obscured, or relatively delayed, so it can be easily misdiagnosed. Accordingly, patients experiencing the first symptom of myopathy should concentrate on the possibility of thyrotoxic myopathy. Given the clinical characteristics, thyrotoxic myopathy can be devided into chronic thyrotoxic myopathy, thyrotoxicosis with periodic paralysis, acute thyrotoxic myopathy, hyperthyroidism with myasthenia gravis, as well as infiltrating exophthalmos with ophthalmoplegia. In this paper, we review thyrotoxic myopathy research status, diagnoses, and treatments.
Topics: Humans; Hyperthyroidism; Muscle Weakness; Muscular Diseases; Paralysis; Thyrotoxicosis
PubMed: 35119093
DOI: 10.5603/EP.a2022.0004