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Journal of Traditional Chinese Medicine... Oct 2014To determine the characteristics and advantages of acupoint-to-acupoint penetrative needling (AAPN) treatment for post-stroke spastic paralysis (PSSP) to improve the... (Review)
Review
OBJECTIVE
To determine the characteristics and advantages of acupoint-to-acupoint penetrative needling (AAPN) treatment for post-stroke spastic paralysis (PSSP) to improve the clinical outcomes of this disease in the future.
METHODS
Randomized, controlled trials of PSSP patients receiving AAPN treatment were searched from MEDLINE, EMBASE, and China National Knowledge Infrastructure Database between January 2006 and June 2013. Key words included: clinic or clinical, acupuncture, needling, acupoint-to-acupoint, penetrative or penetration or penetrating, stroke or apoplexy or cerebral infarction or cerebral hemorrhage, spastic paralysis or spasticity or palsy, and hypermyotonia. Language was limited to English and Chinese. Case series reports, review articles, and, animal studies were excluded.
RESULTS
AAPN showed better clinical results on PSSP than other acupuncture treatments, especially when combined with adjunct therapies such as electroacupuncture, bloodletting, and rehabilitation. The greatest benefit was achieved with rehabilitation combined with penetration from Yang-channel acupoints to Yin-channel acupoints in the upper limbs, and from Yin-channel acupoints to Yang-channel acupoints in the lower limbs with a reinforcing maneuver.
CONCLUSION
AAPN is an effective treatment for PSSP, and it can accelerate and enhance functional repair of PSSP patients.
Topics: Acupuncture Points; Acupuncture Therapy; Clinical Trials as Topic; Humans; Muscle Spasticity; Paralysis; Stroke
PubMed: 25417414
DOI: 10.1016/s0254-6272(15)30071-6 -
Brazilian Journal of Otorhinolaryngology 2022Revision framework surgeries might be required for unilateral vocal fold paralyses. However, outcomes and indications of revision surgeries have not been adequately...
INTRODUCTION
Revision framework surgeries might be required for unilateral vocal fold paralyses. However, outcomes and indications of revision surgeries have not been adequately documented. For a better understanding of indications for the procedure and to help in achieving better vocal outcomes, we performed a retrospective chart review of patients who underwent revision framework surgeries for unilateral vocal fold paralysis.
OBJECTIVES
This study aimed to present clinical features of patients who underwent revision framework surgeries for the treatment of unilateral vocal fold paralysis.
METHODS
Of the 149 framework surgeries performed between October 2004 and October 2019, 21 revision framework surgeries were performed in 19 patients. Self-assessments by patients using the voice handicap index-10 questionnaire, and objective aerodynamic and acoustic assessments performed pre- and post-operatively were analyzed using the Wilcoxon's signed-rank test for paired comparisons.
RESULTS
Undercorrection was indicated as reasons for revision surgeries in all cases. The revision techniques included type I thyroplasty, type IV thyroplasty, and arytenoid adduction, and revision surgeries were completed without any severe complication in all cases. Pre- and post-operative voice handicap index-10 scores were obtained in 12 cases, and other parameters were evaluated in 18 cases. Significant improvements were observed in voice handicap index-10 scores, maximum phonation time, mean flow rate, Current/Direct Current ratio, and pitch perturbation quotient.
CONCLUSION
Undercorrection was observed in all patients who underwent revision framework surgeries for unilateral vocal fold paralysis, and the initial assessment and planning are thought to be important in order to avoid revision surgeries. Revision surgeries were performed safely in all cases, and significantly improved vocal outcomes were observed, even after multiple procedures. Revision surgery should be considered for patients with unsatisfactory vocal functions after primary framework surgeries for unilateral vocal fold paralysis.
Topics: Humans; Laryngoplasty; Reoperation; Retrospective Studies; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords; Voice Quality
PubMed: 33419650
DOI: 10.1016/j.bjorl.2020.11.016 -
Anesthesiology Apr 2010
Review
Topics: Anesthesia; Anesthesia Recovery Period; Brain Damage, Chronic; Humans; Monitoring, Intraoperative; Nerve Block; Neuromuscular Nondepolarizing Agents; Paralysis; Postoperative Complications; Respiratory Tract Diseases
PubMed: 20234315
DOI: 10.1097/ALN.0b013e3181cded07 -
The British Journal of Ophthalmology Nov 1956
Topics: Oculomotor Muscles; Ophthalmoplegia, Chronic Progressive External; Paralysis
PubMed: 13374242
DOI: 10.1136/bjo.40.11.686 -
Annals of Neurology Sep 2016This review highlights clinical features of the increasing cases of acute flaccid paralysis associated with anterior myelitis noted in the United States from 2012 to... (Review)
Review
This review highlights clinical features of the increasing cases of acute flaccid paralysis associated with anterior myelitis noted in the United States from 2012 to 2015. Acute flaccid myelitis refers to acute flaccid limb weakness with spinal cord gray matter lesions on imaging or evidence of spinal cord motor neuron injury on electrodiagnostic testing. Although some individuals demonstrated improvement in motor weakness and functional deficits, most have residual weakness a year or more after onset. Epidemiological evidence and biological plausibility support an association between enterovirus D68 and the recent increase in acute flaccid myelitis cases in the United States. Ann Neurol 2016;80:326-338.
Topics: Child; Enterovirus D, Human; Enterovirus Infections; Humans; Motor Neurons; Myelitis; Paralysis; United States
PubMed: 27422805
DOI: 10.1002/ana.24730 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Mar 2022To review the definition and possible etiologies for C palsy. (Review)
Review
OBJECTIVE
To review the definition and possible etiologies for C palsy.
METHODS
The literature on C palsy at home and abroad in recent years was extensively reviewed, and the possible etiologies were analyzed based on clinical practice experience.
RESULTS
There are two main theories (nerve root tether and spinal cord injury) accounting for the occurrence of C palsy, but both have certain limitations. The former can not explain the occurrence of C palsy after anterior cervical spine surgery, and the latter can not explain that the clinical symptoms of C palsy is often the motor dysfunction of the upper limb muscles. Based on the previous reports, combining our clinical experience and research, we propose that the occurrence of C palsy is mainly due to the instrumental injury of anterior horn of cervical spinal cord during anterior cervical decompression. In addition, the C palsy following surgery via posterior approach may be related to the nerve root tether caused by the spinal cord drift after decompression.
CONCLUSION
In view of the main cause of C palsy after cervical decompression, it is recommended to reduce the compression of the spinal cord by surgical instruments to reduce the risk of this complication.
Topics: Cervical Vertebrae; Decompression, Surgical; Humans; Neck; Paralysis
PubMed: 35293181
DOI: 10.7507/1002-1892.202111072 -
The Journal of Physiology May 2021Brain-computer interfaces (BCIs) aim to help paralysed patients to interact with their environment by controlling external devices using brain activity, thereby...
Brain-computer interfaces (BCIs) aim to help paralysed patients to interact with their environment by controlling external devices using brain activity, thereby bypassing the dysfunctional motor system. Some neuronal disorders, such as amyotrophic lateral sclerosis (ALS), severely impair the communication capacity of patients. Several invasive and non-invasive brain-computer interfaces (BCIs), most notably using electroencephalography (EEG), have been developed to provide a means of communication to paralysed patients. However, except for a few reports, all available BCI literature for the paralysed (mostly ALS patients) describes patients with intact eye movement control, i.e. patients in a locked-in state (LIS) but not a completely locked-in state (CLIS). In this article we will discuss: (1) the fundamental neuropsychological learning factors and neurophysiological factors determining BCI performance in clinical applications; (2) the difference between LIS and CLIS; (3) recent development in BCIs for communication with patients in the completely locked-in state; (4) the effect of BCI-based communication on emotional well-being and quality of life; and (5) the outlook and the methodology needed to provide a means of communication for patients who have none. Thus, we present an overview of available studies and recent results and try to anticipate future developments which may open new doors for BCI communication with the completely paralysed.
Topics: Amyotrophic Lateral Sclerosis; Brain; Brain-Computer Interfaces; Computers; Electroencephalography; Humans; Paralysis; Quality of Life
PubMed: 32045022
DOI: 10.1113/JP278775 -
Medical Engineering & Physics Jan 2003One of the major obstacles in restoration of functional FES supported standing in paraplegia is the lack of knowledge of a suitable control strategy. The main issue is... (Review)
Review
One of the major obstacles in restoration of functional FES supported standing in paraplegia is the lack of knowledge of a suitable control strategy. The main issue is how to integrate the purposeful actions of the non-paralysed upper body when interacting with the environment while standing, and the actions of the artificial FES control system supporting the paralyzed lower extremities. In this paper we provide a review of our approach to solving this question, which focuses on three inter-related areas: investigations of the basic mechanisms of functional postural responses in neurologically intact subjects; re-training of the residual sensory-motor activities of the upper body in paralyzed individuals; and development of closed-loop FES control systems for support of the paralyzed joints.
Topics: Algorithms; Electric Stimulation Therapy; Feedback; Humans; Leg; Models, Biological; Movement; Paralysis; Peripheral Nerves; Posture; Psychomotor Performance; Reference Values; Rotation
PubMed: 12485786
DOI: 10.1016/s1350-4533(02)00115-7 -
Journal of Bone and Mineral Research :... Nov 2014Intramuscular administration of Botulinum toxin (BTx) has been associated with impaired osteogenesis in diverse conditions of bone formation (eg, development, growth,...
Intramuscular administration of Botulinum toxin (BTx) has been associated with impaired osteogenesis in diverse conditions of bone formation (eg, development, growth, and healing), yet the mechanisms of neuromuscular-bone crosstalk underlying these deficits have yet to be identified. Motivated by the emerging utility of zebrafish (Danio rerio) as a rapid, genetically tractable, and optically transparent model for human pathologies (as well as the potential to interrogate neuromuscular-mediated bone disorders in a simple model that bridges in vitro and more complex in vivo model systems), in this study, we developed a model of BTx-induced muscle paralysis in adult zebrafish, and we examined its effects on intramembranous ossification during tail fin regeneration. BTx administration induced rapid muscle paralysis in adult zebrafish in a manner that was dose-dependent, transient, and focal, mirroring the paralytic phenotype observed in animal and human studies. During fin regeneration, BTx impaired continued bone ray outgrowth, morphology, and patterning, indicating defects in early osteogenesis. Further, BTx significantly decreased mineralizing activity and crystalline mineral accumulation, suggesting delayed late-stage osteoblast differentiation and/or altered secondary bone apposition. Bone ray transection proximal to the amputation site focally inhibited bone outgrowth in the affected ray, implicating intra- and/or inter-ray nerves in this process. Taken together, these studies demonstrate the potential to interrogate pathological features of BTx-induced osteoanabolic dysfunction in the regenerating zebrafish fin, define the technological toolbox for detecting bone growth and mineralization deficits in this process, and suggest that pathways mediating neuromuscular regulation of osteogenesis may be conserved beyond established mammalian models of bone anabolic disorders.
Topics: Adult; Animals; Bone Regeneration; Botulinum Toxins; Calcification, Physiologic; Cell Differentiation; Disease Models, Animal; Humans; Osteoblasts; Osteogenesis; Paralysis; Zebrafish
PubMed: 24806738
DOI: 10.1002/jbmr.2274 -
Journal of Feline Medicine and Surgery May 2009Although gait disturbance is one of the most common neurological presentations in feline medicine, the clinical approach to the paralyzed cat can be challenging. After... (Review)
Review
PRACTICAL RELEVANCE
Although gait disturbance is one of the most common neurological presentations in feline medicine, the clinical approach to the paralyzed cat can be challenging. After excluding orthopedic and cardiovascular diseases that may mimic a neurological condition, the clinician has to address a long list of different diseases that may affect the spinal cord and produce paresis.
CLINICAL CHALLENGES
In many cases a definitive cause of spinal weakness in cats is difficult to prove. Even when treatable diseases are identified, the prognosis is very much dependent on the severity of the clinical signs and their chronicity. This review sets out to describe the specific approach, diagnosis and management of cats with spinal cord disease and to outline the most common diseases responsible.
PATIENT GROUP
Patients of either gender and all ages and breeds can be affected by spinal cord disease.
EVIDENCE BASE
Many diseases affecting the spinal cord of cats, which include fibrocartilaginous embolic myelopathy, intervertebral disc disease, exogenous spinal cord trauma, spinal cord lymphosarcoma and feline infectious peritonitis, are well described in the literature. Many of these descriptions, however, have been based on case reports or series. While there have been several retrospective studies that describe the characteristics and incidence of these diseases in cats, there are no long term treatment trials or outcome studies to assist with prognostic determinations.
Topics: Animals; Cat Diseases; Cats; Diagnosis, Differential; Diagnostic Techniques, Neurological; Lymphoma, Non-Hodgkin; Neurologic Examination; Paralysis; Spinal Cord Diseases
PubMed: 19389636
DOI: 10.1016/j.jfms.2009.03.004