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

The traditional medical history and physical examination format is disease rather than disability oriented. It has been shown to be incomplete for the total evaluation of rehabilitation patients. Direct applications of Weed's Problem-Oriented Medical Record have proven to be formidable and cumbersome due to the complexity and diversity of rehabilitation. Therefore, we have developed the Rehabilitation Evaluation System (RES) to document functional rehabilitation management and progress during inpatient hospitalization and outpatient follow-up. The system identifies 18 key rehabilitation areas, each with an individual and objective four-point scale. Utilization of this system in our department has been invaluable in formulating goals and continually evaluating the on-going rehabilitation process. We used the RES with equal facility on 46 rehabilitation inpatients including stroke, amputation, spinal cord injury, multiple sclerosis, orthopedic-trauma, rheumatoid arthritis and poliomyelitis. The mechanics of the RES are presented in detail with a specific patient-example of hemiplegia. Its complimentary use with the Problem-Oriented Medical Record is discussed. Practical advantages are seen in patient care, medical student and resident education, record keeping and research.
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PMID:A rehabilitation evaluation system which complements the problem-oriented medical record. 108 Jun 59

An 18-month-old infant developed hemiseizure-hemiplegia syndrome following a booster dose of vaccine against diphtheria, pertussis, tetanus, and poliomyelitis. Clinical, CT scan, and electroencephalographic findings during the two-and-a-half-year follow-up are described. The timing of events and data from the literature suggest that hemiseizure-hemiplegia syndrome is related to post-immunization hyperthermia rather than to direct neurologic toxicity of the vaccine.
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PMID:[Post-vaccinal hemi-convulsion hemiplegia syndrome]. 175 Jul 49

The reduction of working ability, because of disease, was considered in 1,053 subjects. 21 groups of maladies were found; the neurological disease and mental retardation (MR) caused various degrees of working inability in 416 subjects, i.e. in the 39.51% of the examined population; orthopaedic changes affected the 15.57% of the patients; psychic disorders determined some inability in 8.93% of the persons. The subjects unable to work receive, by Law, an economic help. This study was limited to neurological patients and to subjects mentally retarded. The working ability was reduced by 5 types of disturbances: neuromotor pathology, mental retardation, mental deterioration and dementia, epilepsy, other neurological diseases. The neuromotor pathology affected 163 subjects; the types of symptomatology: hemiplegia; it was found in 71 patients; 62 times it was the result of cerebrovascular disease; in 4 patients it was caused by a hypoxic-ischaemic pre-perinatal encephalopathy. 43 patients affected by cerebrovascular disease lost their personal autonomy, i.e. they could no longer do the activities of daily living (ADL); 7 patients lost their working ability; 12 subjects kept some ability to work. The hemiplegias which struck after 50 years of age were caused by cerebrovascular disease; paraplegia: 28 paraplegic patients have been seen; the aetiology was: poliomyelitis in 8 subjects; MS in 5 patients; ALS in 2 patients; in 13 patients the aetiology was unknown. 6 patients resulted unable to work; 8 persons kept some working ability; 14 patients lost the ability to do the ADL; tetraplegia, or double/bilateral hemiplegia, was found in 20 patients; the aetiology: poliomyelitis in 4 patients; pre-perinatal hypoxic ischaemic encephalopathy in 4 patients; 3 patients of MS; lesion of the cervical spinal cord because of breech delivery in 2 patients; the aetiology was not known in 7 persons. The ability to do the ADL was lost in 17 patients; 3 subjects kept some working ability. Double or bilateral hemiplegia (Little disease) was the model of neuromotor deficit subsequent natal encephalopathy (Infantile Cerebral Palsy, PCI); brachial plexus paralysis was only found from obstetrical (i.e. natal) origin; poliomyelitis and PKU resulted prevented as of 10 years. Mental Retardation (MR) was considered a borderline pathology between neurology and psychiatry; it included 162 subjects: in patients with severe MR a pre-perinatal hypoxic-ischaemic encephalopathy was found in 40.4% of the cases; in patients affected by moderate or light MR the same encephalopathy was found in the 11.3% of the subjects.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Neurologic diseases, mental retardation and reduction in work capacity]. 293 89

The major indication for the Grice extra-articular subtalar arthrodesis is valgus deformity occurring after poliomyelitis. Unsatisfactory long-term results in valgus deformities secondary to other neuromuscular conditions, myelodysplasia and flexible flat feet would indicate that subtalar arthrodesis is not appropriate in these conditions. The Grice procedure had limited success in patients with cerebral palsy, but only in those mildly afflicted with hemiplegia. With the eclipse of poliomyelitis by other neuromuscular conditions, the extra-articular would appear to have limited indications in modern orthopedic practice. Technical complications surely predispose to poor results and considerable attention must be placed on proper graft position and immediate revision in the event of slippage. Overcorrection into adductovarus and particularly ankle valgus from ankle instability is an important cause of unsatisfactory results. The Grice procedure may provide temporary benefits in certain valgus feet. A significant number of patients subsequently required triple arthrodesis and, although it might be argued that some did obtain temporary benefit at a younger age with the Grice procedure, this operation cannot be construed as an alternative to triple arthrodesis. Furthermore, exactly what significance and symptomatic developments can be attributed to the radiologic degenerative changes to subtalar arthrodesis remains to be delineated by longer follow-up studies.
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PMID:The Grice procedure: indications and evaluation of long-term results. 744 15

This report is based on a study of a small sample of five patients who were initially right-handed and became left-handed due to loss of function in the right arm after extracerebral causes such as polio or injury. Carotid amytal tests in these patients showed that all of them still had the speech centre in the left hemisphere. As expected, lateralised neuropsychological brain function tests showed no significant differences between right and left brain. In infantile right hemiplegia due to atrophic left brain lesions, the speech centre had shifted to right side in 10 out of 15 patients. Neuropsychological tests showed sparing and protection of dominant left brain functions.
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PMID:Lateralisation of speech centre in left-handedness due to cerebral and extracerebral lesions. 849 6

Phosphorus magnetic resonance spectroscopy (MRS) was used to study muscle phosphates metabolism in several brain disorders. Those with primary mitochondrial encephalomyopathies showed the typical pattern of impaired oxidative metabolism at rest and during recovery after exercise. In migraine, Parkinson's disease and alternating hemiplegia muscle MRS observations lend support to a possible mitochondrial dysfunction. Similar observations in multiple sclerosis are probably the result of secondary deconditioning. In post polio syndrome and in some of the hereditary ataxias, elevated intracellular inorganic phosphates may be the result of another, yet unknown, metabolic impairment. Thus, muscle phosphate metabolism may be altered in various central nervous system (CNS) disorders by different metabolic impairments. All these possibilities should be taken into account when evaluating MRS results in brain diseases.
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PMID:Muscle high-energy phosphates in central nervous system disorders. The phosphorus MRS experience. 949 67

Advanced heart failure (HF) is sometimes complicated with brain impairment because of a microthrombosis caused by decreased left ventricular contraction or reduced brain circulation. Some patients may recover after left ventricular assist device (LVAD) implantation. However, little is known about the perioperative therapeutic strategy in patients suffering from such complications, particularly from a cardiac rehabilitation viewpoint. We report on a 58-year-old male patient with a previous history of poliomyelitis and a light paralysis in the left upper extremity, who suffered left hemiplegia with no evidence of stroke after hemodynamic deterioration. The combination therapy of perioperative cardiac rehabilitation and LVAD therapy improved his left hemiplegia as well as activities of daily living, and the patient was discharged on foot on postoperative day 72 after briefing the family on LVAD home management. Early initiation of cardiac rehabilitation before LVAD implantation may be a key for the smooth discharge and resocialization of patients suffering from brain impairment complicated with advanced HF.
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PMID:Reversible Motor Paralysis and Early Cardiac Rehabilitation in Patients With Advanced Heart Failure Receiving Left Ventricular Assist Device Therapy. 2782 42

Osteological changes consistent with neurogenic paralysis were observed in one male and one female skeleton recovered from two Croatian medieval sites - Virje and Zadar. Both skeletons display limb asymmetry typical of neurogenic paralysis that occurs during the childhood. The male skeleton displays atrophy and shortening of the right arm and the right femur, while the female skeleton exhibits identical changes on the right arm and both legs. Additionally, both skeletons exhibit scoliotic changes of the spine, and the female skeleton also displays bilateral hip dysplasia. Differential diagnosis included disorders such as cerebral palsy, poliomyelitis, cerebrovascular accident, and Rasmussen's encephalitis. These are the first cases of neurogenic paralysis (cerebral palsy and/or paralytic poliomyelitis) identified in Croatian archeological series. The Virje skeleton is only the third case of hemiplegia identified from archeological contexts (first with spinal scoliosis), while the Zadar skeleton represents the first case of triplegia reported in the paleopathological literature.
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PMID:Two cases of neurogenic paralysis in medieval skeletal samples from Croatia. 2953 87

Since ancient times, the aim of orthopedic surgery has been to correct limb and joint deformities, including those resulting from central nervous system lesions. Recent developments in the treatment of spasticity have led to changes in concepts and management strategies. The increase in life expectancy has increased the functional needs of patients. Orthopedic surgery, along with treatments for spasticity, improves the functional capacity of patients with neuro-orthopaedic disorders, improving their autonomy. In this paper, we describe key moments in the history of orthopedic surgery regarding the treatment of patients with central nervous system lesions, from poliomyelitis to stroke-related hemiplegia, from the limbs to the spine, and from contractures to heterotopic ossification. A synthesis of the current surgical techniques is then provided, and the importance of multidisciplinary evaluation and management is highlighted, along with indications for medical, rehabilitation and surgical treatments and their combinations. We explain why it is essential to consider patients' expectations and to set achievable goals, particularly before surgery, which is by nature irreversible. More recently, specialized surgical teams have begun to favor the use of soft-tissue techniques over bony and joint procedures, except for spinal disorders. We highlight that orthopedic surgery is no longer the end-point of treatment. For example, lengthening a contractured muscle improves the balance around a joint, improving mobility and stability but may be only part of the problem. Further medical treatment and rehabilitation, or additional surgery, are often necessary to continue to improve the function of the limb. Despite the recognized effectiveness of orthopedic surgery for neuro-orthopedic disorders, few studies have formally evaluated them. Hence, there is a need for research to provide evidence to support orthopedic surgery for treating neuro-orthopedic disorders.
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PMID:Orthopaedic surgery for patients with central nervous system lesions: Concepts and techniques. 3029 Feb 82