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Query: UMLS:C0004093 (asthenia)
 2,650 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of head position on conjugate horizontal gaze was studied in healthy adults, in patients with multiple sclerosis without eye movement signs, and in patients with downbeat nystagmus indicative of low brain stem lesions. Displacements of gaze from primary position to 30 degrees left and right were recorded using the electro-oculogram, with the head in the primary position, and turned voluntarily to the left and right (in yaw). The quality of eye movements was noted and peak velocities of saccades were measured. The head turning test trebled the incidence of abnormal eye movements found in the multiple sclerosis patients and increased it by tenfold in the patients with downbeat nystagmus. Disorders of eye movement were also found in approximately 20--30% of healthy subjects tested. Weakness of abduction was the most common eye movement defect and appeared to be posterior internuclear ophthalmoplegia. A hypothesis is made which unifies the theoretical explanations of anterior and posterior internuclear ophthalmoplegia. The most likely cause of the disorders of eye movement observed is vertebrobasilar ischaemia induced by stretching and compression of the vertebral arteries during eccentric head posture.
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PMID:Eccentric head positions reveal disorders of conjugate eye movement. 59 79

Weakness has been reported by patients as one side effect of baclofen. We evaluated torque production as a measure of contractile strength in 30 subjects with clinically definite multiple sclerosis. Participants, with minimal to moderate spasticity, were titrated onto baclofen by 5mg increments every other day for seven days and maintained at 20mg for one week. Using a KinCom isokinetic unit set at 60 degrees per second, subjects performed maximal concentric quadriceps contractions; three consecutive trials were recorded. Results indicated no significant difference in maximum torque production between sessions. Although torque values remained unchanged, the angle at which peak torque production occurred moved closer to normal values. Subjective reports of weakness do not appear related to physiologic properties of contraction, but may be a subjective interpretation that less stiffness is weakness because of less resistance to muscle contraction.
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PMID:Baclofen effect on quadriceps strength in multiple sclerosis. 154 26

A 66-year-old French homosexual man and a 42-year-old Brazilian man with no known risk factors for HIV infection developed headaches, asthenia, and neurologic episodes of abrupt onset. CT showed multiple hypodense, nonenhancing lesions. Serology for HIV was positive. They died respectively 2 months and 1 month after onset of the illnesses. Autopsy in both cases showed multiple, well-demarcated, demyelinating foci in the white matter of the cerebral hemispheres, brainstem, and cerebellum with histologic features characteristic of recent plaques of multiple sclerosis. There were no multinucleated giant cells or microglial nodules. Immunostaining for HIV was negative. Although a random coincidence of MS and HIV infection cannot be ruled out, the close temporal relationship between the 2 disorders suggests a possible etiologic association.
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PMID:Fulminating multiple sclerosis-like leukoencephalopathy revealing human immunodeficiency virus infection. 206 57

A case of multiple sclerosis (MS) in a 39 year old Japanese female with high antibody titer to human T-lymphotropic virus type I (HTLV-I) in serum and cerebrospinal fluid (CSF) was reported. At the age of 15, gait and urinary disturbances accompanied by sensory impairment in the lower abdomen and lower extremities developed suddenly. The motor disturbance slowly progressed to tetraparesis over a period of 15 years with several remissions. At the age of 28 the patient suffered from an acute loss of visual acuity, unilateral initially, and became blind by the age of 34. On admission to our department in September, 1987, the patient was alert and had spastic paraparesis, the impairment of all sensory modalities below the level of Th 10 and urinary disturbance. Weakness of facial muscles, nystagmus, deviation of the tongue and dysarthria were also noted. By the PA method, the antibody titer to HTLV-I was measured x512 in the serum and x64 in the CSF. Western blotting analysis of the CSF disclosed the bands to p19, p24 and p28 of HTLV-I gag proteins. The CSF contained a few ATL-like atypical cells and showed mild lymphocytosis, but the total protein was not increased. The computed tomography revealed diffuse low density areas in the cerebral white matter. The magnetic resonance imaging disclosed high intensity signal areas in the cerebral white matter and in the dorsolateral portion of the medulla oblongata on the T2 weighted image. The link of HTLV-I infection to the pathogenesis of human demyelinating diseases was discussed.
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PMID:[A case of multiple sclerosis with high CSF antibody titer to HTLV-I]. 275 51

Cross-sectional data from 1,793 cases of definite or probable multiple sclerosis (MS) identified in an extensive population survey in King and Pierce (K-P) Counties, Washington and Los Angeles (LA) County, California, were analyzed. Compared to the U.S. population as a whole, patients were more likely to be divorced and to have more years of schooling. The prevalence of MS was higher for females, and for northern-born, regardless of sex. Reconstructed age-, sex-specific incidence rate estimates for natives of the two areas showed a much higher peak annual incidence occurring in an older age group in K-P than in LA. Earliest symptoms in both areas were numbness in the legs, double vision, and loss of vision in one or both eyes. Weakness in arms, speech difficulties, and urinary incontinence tended to be late symptoms. The overall assessment of disability levels showed more than half of the patients to be fully ambulatory at the time of the first interview, with a somewhat higher proportion of each sex severely disabled in California. The ages of onset tended to be younger in LA than in K-P. The earlier onset of disease and the higher proportion of patients with high disability in Los Angeles County suggest that the course of disease is more malignant in this low-prevalence area.
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PMID:Two populations with multiple sclerosis. Clinical and demographic characteristics. 616 3

Six-week-old outbred mice were infected intracerebrally with a low dose of the MS strain of herpes simplex virus type 2. About 1% of neurologically abnormal survivors developed paralysis or severe leg weakness during the first three weeks of infection. Weakness persisted with little subsequent improvement. Five to 8 months later, 4 such mice were killed, and each spinal cord was examined in Epon sections in a series of transverse sections along their lengths. All cords had 2 or more major white matter lesions which were typically greatly elongated in the rostrocaudal dimension, as seen in multiple sequential sections. While a lesion's appearance frequently suggested some degree of tract association, its size, contour and position frequently varied from level to level in a manner which is not characteristic of tract degeneration. Further, axons were preserved in these lesions, and had been remyelinated. This was accomplished by a combination of oligodendrocytes and Schwann cells. The only evidence of Wallerian degeneration in these spinal cords was a modest reduction in the cross-sectional area of a white matter column associated with the most severe lesions. These pathological findings are consistent with previous ones in this model. Rostrocaudal elongation of spinal cord lesions may be seen in other animal models of virus-induced demyelination; this and other features reported here have been described in multiple sclerosis.
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PMID:Topography of remyelinated chronic spinal cord lesions in herpes simplex virus type 2 infections of mice. 665 86

Since their initial description in 1957, the interferons (IFNs) have been increasingly used to treat a wide array of diseases. Acute adverse effects, i.e. 'flu-like' syndromes, hypo- or hypertension, tachycardia, headache, myalgias and gastrointestinal disorders, occur within the first hour or day after starting treatment. They are seldom treatment-limiting and are easily manageable. Sub-acute and chronic effects develop after several days, usually within 2 and 4 weeks of therapy. The most typical is neurological toxicity, including fatigue/asthenia, and behavioural and cognitive changes. Such symptoms may seriously impair quality of life and result in treatment discontinuation. Seizures have seldom been described. Other infrequent central nervous system adverse effects include vertigo, cramp and oculomotor nerve paralysis. Distal paraesthesias and peripheral neuropathy have been reported. IFN-associated autoimmunity is quite rare but a matter of concern. Biological or clinical manifestations usually require several months to become apparent. Autoantibodies have been shown to develop in most patients but have been inconsistently associated with clinical symptoms of systemic lupus erythematosus, rheumatoid-like arthritis and thyroiditis. Both hypo- and hyperthyroidism have been described but are usually reversible. Other infrequent autoimmune reactions include diabetes, pemphigus and worsening of multiple sclerosis. Although several patients present with a pre-existing autoimmune disorder, no predisposing factor has been clearly established. While hypotension and tachycardia are the most frequent acute cardiovascular complications, a few additional cases of cardiac arrhythmias and myocardial ischaemia have been reported after a short course or several weeks of treatment. These latter complications do not appear to be dose-dependent or age-related. Isolated cases of congestive heart failure have also been described. Mild proteinuria has been observed in 15 to 25% of patients, but acute renal toxicity is uncommon. A transient rise in serum aminotransferase levels is frequently noted during the first stage of therapy, especially in patients receiving the highest dosages. Direct hepatotoxicity is extremely rare. Autoimmune hepatitis, which is ill-diagnosed as chronic viral hepatitis, and de novo induction of autoimmune hepatitis, account for the majority of liver diseases. Haematotoxicity is relatively common but mild to moderate, and develops gradually during the first weeks of treatment. Neutropenia is the most common haematological toxicity, but is usually not dose-limiting and resolves rapidly upon drug discontinuation. Myelosuppression, autoimmune and immune allergic haemolytic anaemias and thrombocytopenias have seldom been described. Cutaneous adverse effects comprised nonspecific erythema and hair loss and, less frequently, vasculitis, local ulcerations at the site of injection and exacerbation of psoriasis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical toxicity of the interferons. 751 63

The authors report a clinical case of a 48-year-old female patient admitted to the Neurological Division following acute symptoms characterised by generalised asthenia, motory disorders (incoordination, equilibrium or gait deficit) accompanied by diplopia. Instrumental (medullary and encephalic NMR) and laboratory tests revealed a malformation of the atlo-occpital hinge with basilar impression and areas of corticosubcortical demyelinisation signifying multiple sclerosis. The liquor test was also positive for the presence of oligoclonal bands of IgG with a Link index of 0.97 (lower v.n. at 0.7). The association between these two pathologies is rare, whereas the need for a differential diagnosis between them often arises. Therefore, two pathologies which are mutually exclusive in many cases were present in an associated form in this case.
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PMID:[A clinical case of demyelinating disease with basilar impression]. 780 85

Fatigue is a frequent complaint in multiple sclerosis (MS) patients. Its pathogenesis is unknown and the question of whether or not there is a specific type of fatigue in MS is controversial. The aim of this work was to determine the link between fatigue in MS and physical and psychological involvement. We studied 50 patients diagnosed of MS category la by Poser's criteria. They were examined using the Kurtzke and Hamilton scales for depression and anxiety. We also applied an original scale for assessing the spontaneity, clinical characteristics, severity and frequency of fatigue. Asthenia, a tendency to feel tired and a worsening of other symptoms were identified as clinical traits. Using statistical tests for non parametric distribution of data (Spearman's R and Kruskal-Wallis's H coefficients), we found a positive correlation between the characteristics of and severity of fatigue and functional system involvement, anxiety and depression. Thirty-one (62%) patients suffered fatigue, 22 of them spontaneously. Fatigue was the main symptom in 3. and was proportional to pyramidal involvement (r = 0.41; p < 0.01) and intelligence quotient (r = 0.30; p < 0.03). Depression and anxiety were not related to fatigue (p > 0.05). Patients in the progressive phase of disease had higher fatigue scores than did patients who were stable or in remission. Disease duration was not proportional to fatigue. Our results point to a high rate of fatigue in MS patients. The severity of fatigue is proportional to pyramidal involvement and mental decline and is linked to phases of disease progression.
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PMID:[Fatigue and functional system involvement in multiple sclerosis]. 876 76

An analysis was performed of features of incipient manifestations of multiple sclerosis in 648 patients with a primary diagnosis having been made at the Ukrainian Centre for Study of Demyelinating Diseases over 1992-1996. Incipient manifestations of disseminated sclerosis revealed themselves predominantly as sensory, motor, visual, and coordination impairment against the background of pain sensations, paresthesias and pronounced asthenia of the nervous system. Knowledge of disseminated sclerosis debut is important for the diagnosis of the condition to be made and treatments to be administered in a timely fashion.
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PMID:[The clinical characteristics of the early manifestations of disseminated sclerosis]. 967 Jun 58


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