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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

846 children with cerebral palsy were examined and 642 were selected for a statistical study by correspondence analysis. The aim was to identify without any prior assumptions, the relationships between the aetiological factors and the clinical findings. The study was completed by conventional statistical analysis of 584 of the cases. Small birth weight and a history of abnormal pregnancies was associated with a cerebral palsy affecting both legs, and often with a squint. Resuscitation was associated with athetosis and abnormalities of posture and behaviour. If the resuscitation lasted for more than 15 minutes or there were certain problems during delivery, severe abnormalities of both arms and major speech difficulties were observed. Resuscitation for less than 15 minutes or for an unknown time or intractable vomiting during pregnancy was associated with quadraplegia. Hemiplegia was related to post natal events but the aetiology was not always known. Foeto-maternal incompatibility was associated with athetosis, deafness, severe speech problems and ophthalmoplegias.
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PMID:[Statistical study of the relationships between the etiology and clinical picture of cerebral palsy]. 10 77

As a routine clinical tool the locomotion laboratory has been a long time evolving. This paper reviews the development, successes and failures of locomotion assessment systems. A detailed picture of the state of knowledge of normal gait is presented along with some suggested directions regarding needed technological development as well as some criticism of the lack of biomechanical modelling. As examples of clinical applications, four major gait pathologies are reviewed: amputees, hemiplegia, cerebral palsy and joint replacement. The state of knowledge of each of these patient populations is presented along with a critique of the assessment methods and conclusions. It is hoped that this paper will provoke discussion regarding the real purpose of a clinical locomotion laboratory, and put some perspective on the cost in terms of equipment, space, newly trained or retrained personnnel and computer systems.
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PMID:The locomotion laboratory as a clinical assessment system. 13 92

In patient with damaged upper motor neurones we show the therapeutic effect of electrical stimulation (called FES) of peripheral mixed nerves on the restoration of motor activity and movements. The results of neurophysiological, kinesiological and clinical observations are presented. We discuss the possible mechanisms, especially the spinal ones, which are fundamental for such a rhythmic activity as gait. We discuss them also from the point of view of activation of proprioceptive feedback mechanisms and of achieved sensory reinforcement influencing the spinal reflex mechanisms as well as the preserved supraspinal integrated activity which contributes to the long-term FES effect. The stimulation modes, the control of stimuli in relation to the needs of individual patients (hemiplegia in adults, paraparesis, cerebral palsy in children and multiple sclerosis) as well as the motor deficit are discussed. We conclude that the electronic system used for this purpose represents a functionally active orthotic aid with therapeutic effects.
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PMID:Functional electrical stimulation in control of motor output and movements. 22 5

Little has been written about the effects of sports activities on neurological diseases such as cerebral palsy, hemiplegia, brain trauma and paraplegia, and the available reports are mainly related to cardiopulmonary parameters. Compared to the securing of physiological data, it is more difficult to operationally define, or quantify questions concerning the motivation and social background--in a broader sense, sociological background--of the patient. Both data, however, are indispensable to rehabilitation. The experiences gained with a group of children with spina bifida attending a school for the physically handicapped, are used to describe the sequela of the central nervous system defect with which the physical education instructor has to cope, and stresses how important mutual information amongst the team members is for successful rehabilitation. The criteria for sports activities with spina bifida children are: (a) to promote their independence, (b) to give them socialisation stimuli, (c) to enhance their physical performance. It is hoped with this programme that a further personality maturation and stabilisation be achieved.
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PMID:[Sports in neurological rehabilitation (author's transl)]. 32 12

Between 1976 and 1978, we examined 110 Japanese children with cerebral palsy using a CT 1000 and a CT 1010 (EMI). In 92% of all patients, there were abnormal findings. Cortical atrophy was seen in 51%, ventricular dilatation in 86%, localized low density areas in 22%, brain anomalies in 10% and asymmetry of cerebral hemisphere in 31%. In spastic hemiplegia, the characteristic CT revealed asymmetrical ventricular dilatation without cortical atrophy and localized low density areas in the cerebral hemisphere contralateral to the palsy. In spastic tetraplegia, CT revealed moderate to marked diffuse cerebral atrophy or brain anomalies. In athetosis, CT revealed normal or slight cerebral atrophy. In 60 cases where a CT 1010 was used, we calculated the volume index of CSF space by computer, Eclipse S/200, and analyzed the relationship between the clinical features of cerebral palsy and the volume index of CSF space.
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PMID:Computed tomography of cerebral palsy: evaluation of brain damage by volume index of CSF space. 55 48

Ten children with cerebral palsy are presented on whom stereotaxic operations on the central nervous system were performed with the aim of ameliorating athetosis and spasticity. Tere were seven alert and co-operative children with spastic hemiplegia or diplegia, of whom six received benefit from thalamotomy or dentatotomy. The seventh, a child with diplegia, had improvement of his left lower limb, but the right became worse. One child with spastic diplegia, in whom a thoracic meningocoele had been closed at birth, was not improved by bilateral dentatotomy. Two severely quadriplegic children each had bilateral dentatotomy; one was a child with dystonic and spastic quadriplegia. In both cases the resulting reduction in tone and extensor spasm rendered the nursing of these patients much easier. The place of stereotaxic surgery in the central nervous system in the management of children with cerebral palsy is discussed. We suggest that in selected cases the stereotaxic operation should be performed early in order to gain the greatest benefit. Stereotaxic surgery should be regarded as an integral part of the management which involves close co-operation of paediatrician, physiotherapist, neurosurgeon and orthopaedic surgeon.
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PMID:Stereotaxic neurosurgery in the management of cerebral palsy. 110 96

From an unselected series of 560 Swedish cases of cerebral palsy, born 1954-1970, various data of etiologic and pathogenetic interest were analyzed in detail. Untraceable and prenatal factors were found to dominate within the group of spastic hemiplegia. Placental dysfunction in small-for-date babies and severe asphyxia were thought to be the two main pathogenetic factors among the patients with spastic tetraplegia. In spite of a significant decrease in the number of low birth weight children within the group of spastic diplegia, this syndrome was still very characteristic for the child born immature. Ataxic diplegic forms were found to have greater pathogenic similarities to spastic diplegia than to simple ataxia. In two-thirds of the children the latter syndrome was characterized by normal pregnancy, delivery and birth weight and an untraceable (genetic?) factor. Dyskinetic syndromes were mostly encountered after perinatal asphyxia.
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PMID:The changing panorama of cerebral palsy in Sweden 1954-1970. II. Analysis of the various syndromes. 113 Jan 75

A prospective longitudinal study involving 233 children with cerebral palsy was carried out to select signs useful for early prognostication of ambulation. All patients were followed from the time they were 12 months old and their progress was observed until they reached the age of 3 to 11 years. The population consisted of 61 children having congenital hemiplegia, 37 having diplegia, 85 having spastic quadriparesis and 28 having the spastic-athetoid clinical type of cerebral palsy. In addition, there were 14 children with athetoid, 6 with ataxic and 2 with hypotonic cerebral palsy. Of the total population, 78.7% achieved some degree of functional walking. Findings indicated that the probability of ambulation was related to the clinical type of cerebral palsy. In some the ultimate functional outcome was rather uniform, as in those with congenital hemiplegic and ataxic types where the prognosis was consistently favorable or in those with hypotonic cerebral palsy in whom the outlook was poor. In spastic diplegic, quadriparetic, spastic-athetoid and athetoid types, on the other hand, expectations varied considerably. For this group of patients, sitting by two years was found to be a predictive sign of high reliability since all children who sat by this age eventually walked. For the group of patients not sitting by two years which included more than half of the eventual ambulators, suppression of obligatory primitive reflex activity between 18 and 24 months provided a sensitive indicator to distinguish the children who ultimately walked from those who would not be expected to do so. These data offer a possibility for predicting future ambulatory status by two years of age in those clinical types of cerebral palsy where difficulties of early accurate prognostication are most likely to be encountered. Observations also suggested that the presence of mental retardation adversely affects ambulation.
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PMID:Cerebral palsy: predictive value of selected clinical signs for early prognostication of motor function. 126 90

Classification of cerebral palsy according to the topographical distribution of clinical phenomena permits determination of a prognosis of the natural history of CP and the probability of hip problems to some extent. In 55 patients with CP, 101 muscle release operations were performed between 1971 and 1988. Preoperatively, the diagnosis was established by the neuropediatrician, function was evaluated according to the Rancho-los-amigos system, and the X-rays of the hip were assessed according to Reimers. For the postoperative evaluation patients were grouped according to neurologic diagnosis: hemiplegia (4), diplegia (19), total body involvement (31). Patients with hemiplegia had no functional or radiological changes as a result of the operation. In diplegia functional deterioration was seen in 4 cases (21%); in 3 cases (16%) this meant loss of the ability to walk. The migration percentage was improved from 48% to 39% on average. In 19 cerebral palsy patients with total body involvement surgery was considered to be indicated on the basis of a suspected dislocation of the hip. No functional changes occurred as a result of surgery. Hip dislocation was successfully prevented in 90% of the cases. The migration percentage was improved from 73% to 33%. In another 12 patients with total body involvement, adductor and iliopsoas release was performed to allow better hygiene and care and for pain relief. These goals were achieved; neither the Rancho-Los-Amigos function classification system nor X-rays were used to evaluate the results.
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PMID:[The hip in infantile cerebral palsy, natural developmental course and treatment concepts]. 140 25

In 38 patients with spastic cerebral palsy, treatment was carried out for talipes equinovarus. There were 12 children with spastic hemiplegia, while 24 had diplegia or tetraplegia. Surgery was done with the goal of achieving plantigrade and muscle-balanced feet. In 24 feet of 19 children tibialis anterior transfer was performed, while tibialis posterior transfer was done in 20 feet of 19 patients. Without exception, additional surgery was performed on the triceps surae (30 x ATLs and 16 Vulpius operations); medial arthrolysis was also necessary in 6 cases. The clinical results were assessed by the senior author in the weekly neuro-orthopedic clinic an average of 3.2 years after surgery. An additional questionnaire was sent to all patients' families asking for their subjective assessment of the surgery performed. Figures were collected for 30 patients with 38 treated feet. The results were evaluated according to Kling's criteria. We saw good and very good results in 75% of the patients (4 feet very good, 23 feet good), while 25% of the patients (9 feet in 7 patients) showed poor results with over-corrections and calcaneo-valgus foot as the main problem. The best results were seen in spastic hemiplegia and the poorest in patients with severe tetraplegia and total body involvement.
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PMID:[Treatment of spastic club foot]. 140 27


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