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Query: UMLS:C0004134 (ataxia)
 15,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rehabilitation is under-represented in the neurological literature on disabling diseases. A Medline search was conducted to retrieve the articles published between January 1991 and June 1994 under the main headings of Stroke, Parkinson's disease, Multiple sclerosis, Brain injury, Ataxia and Dementia. These were then combined with the sub-heading Rehabilitation. The former search yielded 27724 articles, the latter 1272 (4.6%). In 1992, the Journal of Citation Reports (JCR) assigned to Journals publishing rehabilitation papers an average Impact Factor (IF) of 0.7-2.8 (median 1.8): that is, 31-90% (depending on the various main headings, median 68%) of the average IF given to Journals publishing non-rehabilitation papers. In the present study, the weight of the literature was defined as the product of the number of articles multiplied by the IF of the corresponding Journal (IF = 0 for non-JCR Journals). Across the various neurologic conditions, the weight of the Rehab literature was 0.1-7% (median 2%) of the weight of the non-Rehab literature. The results suggest that neurology is still reluctant to face the disability challenge.
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PMID:Rehabilitation: the Cinderella of neurological research? A bibliometric study. 885 19

Cerebellar ataxia is one of the most disabling symptoms of multiple sclerosis (MS) and also one of the least responsive to pharmacotherapy. However, cerebellar symptoms often improve dramatically in MS patients by brief, extracerebral applications of picotesla flux electromagnetic fields (EMFs). This report concerns two MS patients with chronic disabling ataxia who experienced rapid improvement in gait and balance after receiving a series of treatments with EMFs. To assess whether improvement in cerebellar gait is accompanied by changes in body image perception, a parietal lobe function, both patients were administered the Human Figure Drawing Test before and after a series of brief treatments with EMFs. Prior to application of EMFs these patients' free drawings of a person showed a figure with a wide-based stance characteristic of cerebellar ataxia. After receiving a series of EMFs treatments both patients demonstrated a change in body image perception with the drawings of the human figure showing a normal stance. These findings demonstrate that in MS improvement in cerebellar symptoms by pulsed applications of picotesla EMFs is associated with changes in the body image.
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PMID:Effect of weak electromagnetic fields on body image perception in patients with multiple sclerosis. 882 62

We report on ten patients with clinically definite multiple sclerosis (MS) and acute weakness during dorsiflexion of the foot and toes. Assuming an attack, two patients were treated with corticosteroids, but without any effect. Since there were very few clinical hints (hyposensitivity in the area of distribution of n. peronaeus superficialis in one, positive Hoffmann-Tinel signs in two cases) only detailed neurophysiological examinations finally resulted in locating circumscribed lesions of the peroneal nerves (mainly localized at the head of the fibula), which consequently ended up in peripheral paresis of the dorsiflexion muscles. In six cases the peroneal lesion was caused by direct pressure on the nerve (hard crossing of the legs in five patients, pressing the caput fibulae against the wheelchair in one), and in the other three cases by stretching of the nerve due to genu recurvatum. Seven patients forced this posture with the intention of compensating for ataxia of the trunk and/or gait. After a period of avoiding these mechanisms, we saw five patients for follow-up examinations with evident improvements in the clinical and neurophysiological aspects.
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PMID:[Acute foot drop paralysis in multiple sclerosis. Peroneal nerve compression as differential diagnosis of acute onset]. 885 Dec 99

A 28-year-old man presented with a bilateral visual loss of acute onset, and was diagnosed as having optic neuropathy by an ophthalmologist. It disappeared spontaneously within 2 months. A visual loss at the left side relapsed ten months later, followed by a dysarthria, horizontal defective saccade, ataxia, and mild weakness of four extremities, which also subsided within one month only by multi-vitamin therapy. These signs recurred episodically with characteristic clinical features of dysarthria, horizontal ophthalmoplegia, defective saccade, ataxia, and weakness, during the next year. Clinical features mimicked those of various neurological disorders, especially multiple sclerosis, Wernicke encephalopathy, brainstem encephalitis, Fisher syndrome, disorders of amino acid metabolism and episodic ataxia. Tablets of bromvalerylurea were incidentally found at the bedside and bromides were detected in his sera. Drugs containing bromides are now easily available without prescription, so we should keep the intoxications of those drugs in mind in facing undiagnosed patients with various episodic neurological symptoms.
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PMID:[A case of chronic bromvalerylurea intoxication with episodic neurological manifestations such as optic neuropathy ophthalmoplegia and ataxia]. 893 4

About 350,000 persons in the United States have multiple sclerosis, and primary care physicians are often called on to provide symptomatic therapy for these patients. We review our current pharmacologic approach to the management of multiple sclerosis exacerbations and the symptoms of spasticity, fatigue, bladder and bowel involvement, neurobehavioral complaints, pain syndromes, dystonic spasms, and tremor and ataxia.
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PMID:Current pharmacologic treatment of multiple sclerosis symptoms. 899 13

It is estimated that 10-20% of patients with multiple sclerosis (MS) have a chronic progressive (CP) course characterized by an insidious of neurological deficits followed by steady progression of disability in the absence of symptomatic remission. No therapeutic modality has shown specific efficacy in the treatment of patients with CP MS and there are no data to indicate that any pharmacologic or other modality alters the clinical course of CP MS. Treatment with picotesla electromagnetic fields (EMFs) is a highly effective modality for the symptomatic management of MS including the chronic progressive form. In addition, this treatment also appears to alter the natural course of the disease in CP patients. A 36 year-old man experienced, at the age of 31, insidious weakness in the legs and several months later developed difficulties with balance with ataxia of gait. His gait abnormality progressed slowly over the following years and at the age of 35 he was severely disabled with spastic paraparesis and ataxia using a rolling walker for ambulation and a scooter for longer distances. In particular, his disability had progressed rapidly over the six months preceding the initiation of treatment with EMFs. He as classified have CP MS and his prognosis was considered extremely unfavorable due to the degree of cerebellar and pyramidal tract involvement and the rapid course of deterioration. In July 1995 the patient began experimental treatment with EMFs. While receiving three treatment sessions a week over 12 months he experienced improvement in cerebellar functions such as gait, balance and tremor as well as bowel and bladder functions, mood, sleep and cognitive function and resolution of diplopia, blurring of vision, dysarthria, paresthesias in the hands, and fatigue. Most remarkably, there was no further progression of the disease during the course of magnetic therapy. This case illustrated that treatment with EMFs, in addition to producing symptomatic improvement, also reverses the clinical course of CP MS.
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PMID:Treatment with electromagnetic field alters the clinical course of chronic progressive multiple sclerosis--a case report. 900 66

Ataxic syndromes of the upper limbs are observed in various situations but are usually a result of lesions involving the efferent pathways of the cerebellum, the superior cerebellar peduncles and midbrain. The commonest causes are multiple sclerosis, brain injury and focal neoplastic or vascular lesions. Cerebellar tremor, which usually comprises a postural and intentional component, is the commonest clinical form. In this review, we assess the value of the various surgical techniques in the treatment of this particular form of ataxia of the upper limbs.
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PMID:Is electrostimulation preferable to surgery for upper limb ataxia? 900 3

A 44 year old woman presented with frequent paroxysms of unilateral tinnitus and ataxia which were abolished by treatment with carbamazepine. Hearing was normal and initially there were no other symptoms or signs between paroxysms. Brain stem evoked responses from the affected left ear were absent and MRI showed a large tumour in the left cerebellopontine angle. This was completely removed and histologically proved to be a meningioma. There were striking similarities to trigeminal neuralgia and other paroxysmal brain stem symptoms which occasionally occur in multiple sclerosis and diseases of the cerebellopontine angle. Possible mechanisms are discussed.
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PMID:Paroxysmal tinnitus due to a meningioma in the cerebellopontine angle. 912 Apr 61

A 37-year-old woman with a 5-year history of multiple sclerosis is reported. She began having recurrent syncope even in the sitting position; other neurological features included hiccup, faciooro-lingual flushing and clumsiness of the hands. She had alternating Horner's syndrome, mild hypoalgesia of the right face, exaggerated deep tendon reflexes of the upper extremities, decreased deep sensation and ataxia of the upper extremities, and incomplete transverse myelopathy with a T4 sensory level. Head-up tilt testing confirmed orthostatic hypotension with relative preservation of the heart rate increase. Magnetic resonance imaging indicated abnormal intensities in the paramedian tegmentum and base of the medulla, which may have been additionally responsible for orthostatic hypotension. Steroid pulse therapy and L-threo-3,4-dihydroxyphenylserine caused regression of brainstem signs and reduced syncopal attacks.
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PMID:Orthostatic hypotension in a case with multiple sclerosis. 923 62

In 10 patients (five females) suffering from multiple sclerosis with mild degree of disability, (EDSS ranging from 0 to 2) and in 10 age and sex matched control subjects we investigated lung function, respiratory muscles strength and cardiorespiratory response to incremental exercise in order to assess the metabolic cost of exercise. In the absence of any impairment of lung volumes and flows and in- and expiratory maximal mouth pressures, at peak of exercise oxygen consumption (VO2max = 1886 +/- 145 ml/min) and workload (Wmax = 137 +/- 9.8 watts) were slightly diminished in patients, as compared with controls (VO2max = 2246 +/- 196 ml/min and Wmax = 164 +/- 14.7 watts). These findings were associated with an increased heart rate (HR) and reduced oxygen pulse (VO2/HR) at the same workloads. During the whole exercise, however, the slope of the linear relationship between VO2 and work exhibited by the patients, amounting to 9.9 +/- 0.6 ml/min/watt, was similar to that of the controls (10.9 +/- 0.42 ml/min/watt). Incidentally, both at rest and during exercise, the patients showed a significantly greater minute ventilation (VE) due to a faster respiratory rate, associated with an augmented dead space (P < 0.05). We conclude that an increase of metabolic cost of exercise does not occur in multiple sclerosis patients with mild disability, suggesting a lack or a low degree of spasticity and/or ataxia elicited by the effort. Thus, their exertional capacity appears to be limited mainly by a poor training. The tachypnea observed in these patients at rest and during exercise was unexpected and the reason for adopting such a pattern of breathing is unclear.
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PMID:Energy cost of exercise in multiple sclerosis patients with low degree of disability. 934 81


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