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Neurology India 2014Paralytic rabies closely simulates Guillain-Barre syndrome or ascending myelitis often causing clinical dilemma. Two such patients were managed in our hospital whose... (Review)
Review
Paralytic rabies closely simulates Guillain-Barre syndrome or ascending myelitis often causing clinical dilemma. Two such patients were managed in our hospital whose magnetic resonance imaging (MRI) revealed characteristic findings revealing T2 hyper intensity in central spinal cord and in posterior brainstem and hypothalamus. These MRI findings are helpful in the diagnosis of rabies in appropriate setting. We also review the literature on MRI changes in paralytic rabies.
Topics: Adolescent; Fatal Outcome; Humans; Magnetic Resonance Imaging; Male; Paralysis; Rabies
PubMed: 25591681
DOI: 10.4103/0028-3886.149394 -
Gerontology 2014Recent scientific achievements bring the concept of neural prosthetics for reinstating lost motor function closer to medical application. Current research involves... (Review)
Review
Recent scientific achievements bring the concept of neural prosthetics for reinstating lost motor function closer to medical application. Current research involves severely paralyzed people under the age of 65, but implications for seniors with stroke or trauma-induced impairments are clearly on the horizon. Demographic changes will lead to a shortage of personnel to care for an increasing population of senior citizens, threatening maintenance of an acceptable level of care and urging ways for people to live longer at their home independent from personal assistance. This is particularly challenging when people suffer from disabilities such as partial paralysis after stroke or trauma, where daily personal assistance is required. For some of these people, neural prosthetics can reinstate some lost motor function and/or lost communication, thereby increasing independence and possibly quality of life. In this viewpoint article, we present the state of the art in decoding brain activity in the service of brain-computer interfacing. Although some noninvasive applications produce good results, we focus on brain implants that benefit from better quality brain signals. Fully implantable neural prostheses for home use are not available yet, but clinical trials are being prepared. More sophisticated systems are expected to follow in the years to come, with capabilities of interest for less severe paralysis. Eventually the combination of smart robotics and brain implants is expected to enable people to interact well enough with their environment to live an independent life in spite of motor disabilities.
Topics: Aged; Brain; Brain-Computer Interfaces; Disabled Persons; Humans; Mobility Limitation; Neural Prostheses; Paralysis; Robotics; Stroke; Stroke Rehabilitation
PubMed: 24642607
DOI: 10.1159/000357565 -
Bone Dec 2013When the skeleton is catabolically challenged, there is great variability in the timing and extent of bone resorption observed at cancellous and cortical bone sites. It...
When the skeleton is catabolically challenged, there is great variability in the timing and extent of bone resorption observed at cancellous and cortical bone sites. It remains unclear whether this resorptive heterogeneity, which is often evident within a single bone, arises from increased permissiveness of specific sites to bone resorption or localized resorptive events of varied robustness. To explore this question, we used the mouse model of calf paralysis induced bone loss, which results in metaphyseal and diaphyseal bone resorption of different timing and magnitude. Given this phenotypic pattern of resorption, we hypothesized that bone loss in the proximal tibia metaphysis and diaphysis occurs through resorption events that are spatially and temporally distinct. To test this hypothesis, we undertook three complimentary in vivo/μCT imaging studies. Specifically, we defined spatiotemporal variations in endocortical bone resorption during the 3weeks following calf paralysis, applied a novel image registration approach to determine the location where bone resorption initiates within the proximal tibia metaphysis, and explored the role of varied basal osteoclast activity on the magnitude of bone loss initiation in the metaphysis using μCT based bone resorption parameters. A differential response of metaphyseal and diaphyseal bone resorption was observed throughout each study. Acute endocortical bone loss following muscle paralysis occurred almost exclusively within the metaphyseal compartment (96.5% of total endocortical bone loss within 6days). Using our trabecular image registration approach, we further resolved the initiation of metaphyseal bone loss to a focused region of significant basal osteoclast function (0.03mm(3)) adjacent to the growth plate. This correlative observation of paralysis induced bone loss mediated by basal growth plate cell dynamics was supported by the acute metaphyseal osteoclastic response of 5-week vs. 13-month-old mice. Specifically, μCT based bone resorption rates normalized to initial trabecular surface (BRRBS) were 3.7-fold greater in young vs. aged mice (2.27±0.27μm(3)/μm(2)/day vs. 0.60±0.44μm(3)/μm(2)/day). In contrast to the focused bone loss initiation in the metaphysis, diaphyseal bone loss initiated homogeneously throughout the long axis of the tibia predominantly in the second week following paralysis (81.3% of diaphyseal endocortical expansion between days 6 and 13). The timing and homogenous nature are consistent with de novo osteoclastogenesis mediating the diaphyseal resorption. Taken together, our data suggests that tibial metaphyseal and diaphyseal bone loss induced by transient calf paralysis are spatially and temporally discrete events. In a broader context, these findings are an essential first step toward clarifying the timing and origins of multiple resorptive events that would require targeting to fully inhibit bone loss following neuromuscular trauma.
Topics: Animals; Bone Resorption; Diaphyses; Mice; Muscle, Skeletal; Paralysis; Tibia; Time Factors; X-Ray Microtomography
PubMed: 24063948
DOI: 10.1016/j.bone.2013.09.009 -
Psychologie & Neuropsychiatrie Du... Mar 2009The sense of personal identity is an element of the Jasperian definition of self-conscience. Each of us is convinced of being a unique and stable individual, different... (Review)
Review
The sense of personal identity is an element of the Jasperian definition of self-conscience. Each of us is convinced of being a unique and stable individual, different from other individuals. These properties - stability ad coherence - belong to an image of ourselves that was proposed to us by the Other's look during the mirror phase. Brain focal lesions may threaten this certitude in two ways: 1) brain lesions result in deficiency, disability or handicap, which are experienced as a narcissistic injury. The patient questions himself about the image he offers to the Other's look, and, as a result, his sense of personal identity is unsettled; 2) a variety of focal brain lesions or dysfunctions may alter the activity of areas which are necessary for maintaining a stable image of the patients' body or self. This may lead patients to experience depersonalisation, autoscopy, somatoparaphrenic "delusions" or disturbed agency. The sense of personal identity may be disturbed during brief paroxystic or psychologically traumatic phenomena. However, this is not observed in chronic sequelae of brain lesions (e.g. right hemisphere syndrome or amnesic syndrome), even though the patients may present a broken up image of themselves.
Topics: Amnesia; Body Image; Brain Diseases; Brain Injuries; Consciousness; Depersonalization; Ego; Humans; Narcissism; Paralysis
PubMed: 19251569
DOI: 10.1684/pnv.2009.0156 -
Experimental Physiology Dec 2008Intramuscular injections of the paralytic botulinum neurotoxin A (Btx) and physical exercise are used in the treatment of chronic spasticity in children with cerebral...
Intramuscular injections of the paralytic botulinum neurotoxin A (Btx) and physical exercise are used in the treatment of chronic spasticity in children with cerebral palsy. We tested whether Btx-induced paralysis and/or exercise training would have differential effects on the expression of mechanosensing and signalling genes implicated in the adaptive remodelling of skeletal muscle. Juvenile (29-day-old) male rats were injected with Btx or saline (NoBtx) into the right gastrocnemius and housed in standard cages (NoEx) or with running wheels (Ex), for 3 weeks (n = 6 per group). The mRNA expression of nine sarcomere-associated genes in the medial gastrocnemius was then determined by quantitative reverse transcriptase-polymerase chain reaction. The Btx-injected muscles weighed 50% less than NoBtx muscles, but Ex had no effect on the wet mass of Btx or NoBtx muscles. Atrogenic MuRF1, sarcomeric Titin and myogenic MyoD were upregulated (2-fold) with the elimination of contractile activity in Btx muscle. Expression of CARP, Ankrd2 and MLP was increased with mechanical stimuli associated with Btx (5- to 10-fold) or Ex (2- to 4-fold). Expression of CARP and Ankrd2 increased synergistically in Btx-Ex muscle (> or = 20-fold), indicating that these genes may be sensitive to passive stretch of the sarcomeric I-band region of titin to which their proteins bind. Tcap, Myopalladin and Atrogin1 were not, or were no longer responsive to the altered mechanical stimuli after 3 weeks of Btx or Ex. The expression of Ankrd2, CARP and MLP may thus be enhanced by passive stretch within the Btx-paralysed and/or exercising gastrocnemius and contribute to adaptations, other than muscle mass, in juvenile rats.
Topics: Adaptation, Physiological; Animals; Body Weight; Botulinum Toxins, Type A; Disease Models, Animal; Gene Expression Regulation; Injections, Intramuscular; Male; Mechanotransduction, Cellular; Muscle Proteins; Muscle, Skeletal; Organ Size; Paralysis; Physical Exertion; RNA, Messenger; Rats; Rats, Sprague-Dawley; Reverse Transcriptase Polymerase Chain Reaction; Sarcomeres; Time Factors
PubMed: 18603602
DOI: 10.1113/expphysiol.2008.043174 -
Medicine Jul 2020Stroke is emerging as a significant health issue that threatens human health worldwide and as a common sequela of stroke spastic paralysis after stroke (SPAS) has...
BACKGROUND
Stroke is emerging as a significant health issue that threatens human health worldwide and as a common sequela of stroke spastic paralysis after stroke (SPAS) has received wide attention. Currently, several systematic reviews have suggested that the commonly used acupuncture therapy (electroacupuncture, fire acupuncture, warm acupuncture, and filiform needle acupuncture) has achieved significant efficacy in the treatment of SPAS. In this study, network meta-analysis will be used to analyze the results of different clinical trials and evaluate the differences in the efficacy of different acupuncture treatments for SPAS.
METHODS
Only randomized controlled trials will be included and all patients were diagnosed as spastic paralysis after stroke. A computer-based retrieval will be conducted at CNKI, WanFang databases, VIP, Sinoed, Pubmed, Embase, Web of Science, and the Cochrane library. The search period limit is from the time the date of database establishment to April 17, 2020. To avoid omissions, we will manually retrieve relevant references and conference papers. The risk of bias in the final included studies will be evaluated based on the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by Revman5.3, WinBUGS 1.4.3, and Stata14.2.
RESULTS
This study quantified the effectiveness of each intervention for different outcome indicators. The primary outcomes include the Fugl-Meyer Assessment score, the modified Ashworth scale for the assessment of spasticity, and Barthel Index. The secondary outcomes include clinical effectiveness and adverse reactions.
CONCLUSION
It will provide evidence-based medical evidence for clinicians to choose more effective acupuncture therapy for SPAS.
Topics: Acupuncture Therapy; Humans; Meta-Analysis as Topic; Muscle Spasticity; Paralysis; Stroke; Systematic Reviews as Topic
PubMed: 32629711
DOI: 10.1097/MD.0000000000020974 -
Anesthesiology Jun 2013
Topics: Female; Humans; Male; Monitoring, Intraoperative; Neuromuscular Blockade; Neuromuscular Monitoring; Paralysis
PubMed: 23695097
DOI: 10.1097/ALN.0b013e31828fdf77 -
Strabismus Dec 2021While most cases of superior oblique (SO) hypofunction represent contractile weakness due to denervation, sometimes the lesion is exclusively in the tendon. This study...
While most cases of superior oblique (SO) hypofunction represent contractile weakness due to denervation, sometimes the lesion is exclusively in the tendon. This study sought to distinguish the pattern of incomitant strabismus caused by deficiency of SO oculorotary force caused by tendon abnormalities versus that of neurogenic palsy. Clinical and magnetic resonance imaging (MRI) findings of 7 cases of unilateral SO tendon interruption or extirpation were compared with 11 cases of age matched unilateral SO palsy having intact tendons. We compared angles of misalignment with high-resolution MRI in central gaze and deorsumversion. Muscle bellies in neurogenic palsy were markedly atrophic with maximal cross sections averaging 6.5 ± 2.7 mm, in contrast with 13.5 ± 3.0 mm contralesionally ( < .0001). In contrast, SO muscle bellies ipsilateral to tendon interruption had maximum cross sections averaging 15.1 ± 3.0 mm occurring more posterior than on the contralesional side whose maximum averaged 12.1 ± 2.4 mm. While cross sections of SO bellies ipsilateral to tendon interruption exhibited normal contractile increase in infraduction ( < .0005), there was nevertheless strabismus with incomitance similar to that in SO atrophy. Binocular alignment was statistically similar ( > .5) in the two groups for all diagnostic positions, including head tilt, except in deorsumversion, where cases with SO tendon abnormalities averaged 20.5 ± 6.9Δ ipsilateral hypertropia, significantly more than 8.5 ± 6.6Δ in neurogenic SO atrophy ( = .001). The average difference in hypertropia Hypertropia averaged 9D greater in deorsumversion than central gaze in tendon abnormalities, but 4.1Δ less in SO atrophy (P< .019). In contralesional version, average overelevation in adduction was 1.7 (scale of 0-4) in tendon abnormalities, and 2.6 in SO atrophy ( = .23), while average underdepression in adduction was -2.3 in cases of tendon abnormalities and -1.6 in SO atrophy ( = .82). Repair of the SO tendon in three cases was effective, while alternative procedures were performed when repair was infeasible. While both denervation and tendon interruption impair SO oculorotary function, interruption causes greater hypertropia in infraversion. Surgical tightening of interrupted SO tendons may have particularly gratifying effects. Posterior SO thickening and large hypertropia in infraversion suggest SO tendon interruption that may guide a surgical strategy of tendon repair.
Topics: Atrophy; Humans; Oculomotor Muscles; Paralysis; Strabismus; Tendons; Trochlear Nerve Diseases
PubMed: 34787034
DOI: 10.1080/09273972.2021.1987931 -
Immunology Oct 1968The quantitative dose requirements for induction of paralysis by BSA in mice has been the subject of further study. Parallel studies have been made with lysozyme,...
The quantitative dose requirements for induction of paralysis by BSA in mice has been the subject of further study. Parallel studies have been made with lysozyme, ovalbumin, diphtheria toxoid and ribonuclease, in which similar paralysing and immunizing procedures were used, and similar direct binding tests applied to measurement of the response. In normal adults all the antigens tested induced high-zone paralysis and concomitant immunization, but BSA alone induced low-zone paralysis. With irradiation, with courses of injection commencing at birth, and with paralysis-maintaining treatment, all the antigens tested induced paralysis in a zone quantitatively similar to the low zone detectable in normal adults with BSA. Neither irradiation, treatment with cortisol, nor thymectomy affected the rate of induction of paralysis in the low zone. On the other hand the minimum dose required for immunization varied markedly from one antigen to another. The ability of BSA to induce low-zone paralysis in normal adults can, therefore, be attributed to the failure of low doses of this antigen to immunize. The consistency of paralysis threshold, in contrast to the variability for immunization, is interpreted as evidence of an additional step of complexity involved in immunization that is not required for paralysis.
Topics: Animals; Animals, Newborn; Diphtheria Toxoid; Hydrocortisone; Immune Tolerance; Immunization; Mice; Muramidase; Ovalbumin; Paralysis; Proteins; Ribonucleases; Serum Albumin, Bovine; Serum Albumin, Radio-Iodinated; Thymectomy
PubMed: 5696262
DOI: No ID Found -
The Pan African Medical Journal 2022South Sudan has made quite impressive progress in interrupting wild poliovirus and maintaining a polio-free status since the last case was reported in 2009. South Sudan...
INTRODUCTION
South Sudan has made quite impressive progress in interrupting wild poliovirus and maintaining a polio-free status since the last case was reported in 2009. South Sudan introduced different complementary strategies to enhance acute flaccid paralysis (AFP) surveillance. Hence, the objective of this study is to evaluate the sensitivity of the surveillance system using the WHO recommended surveillance standard and highlight the progress and challenges over the years.
METHODS
we conducted a retrospective, descriptive, quantitative study design and used the available secondary AFP surveillance database.
RESULTS
the overall non-polio AFP rate was 6.2/100,000 children under 15 years old in the study period. The stool adequacy was maintained well above the certification level of surveillance. The two main surveillance performance indicators were met at the national level throughout the study period. In contrast, only five out of ten states persistently attained and maintained the two main surveillance performance indicators throughout the study period, while in 2019 all states achieved except for Jonglei state. During the analysis period, no wild poliovirus was isolated except two circulating Vaccine Derived Poliovirus Type 2 (cVDPV2) cases in 2014 and one Immunodeficiency Vaccine Derived Poliovirus Type 2 (iVDPV2) case in 2015. However, on average, three cases were classified as polio compatible with each year of the study.
CONCLUSION
South Sudan met the two key surveillance performance indicators and had a sensitive AFP surveillance system during the period studied. We recommend intensifying surveillance activities in the former conflict-affected states and counties to maintain polio-free status.
Topics: Adolescent; Child; Humans; Central Nervous System Viral Diseases; Myelitis; Neuromuscular Diseases; Paralysis; Poliomyelitis; Poliovirus; Population Surveillance; Retrospective Studies; South Sudan
PubMed: 36158926
DOI: 10.11604/pamj.supp.2022.42.1.33965