Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The goal of these experiments was to evaluate the effects of some drugs affecting noradrenergic (NE) synaptic transmission, commonly prescribed following stroke or traumatic brain injury, on functional recovery. Measurement of recovery from a transient hemiplegia produced by a traumatic unilateral focal contusion in sensorimotor cortex (SMCX) of rats was used to assess the effects of chronic haloperidol (HAL) treatment begun early (1 day) or late (18 days to recovered animals) after injury. Additionally, using the same model, the effects of a single administration of drugs with selective action at NE receptors were also evaluated early or late (30 days) after injury. These drugs were: phenoxybenzamine (PBZ), an alpha 1-NE antagonist; prazosin (PRAZ), an alpha 1-NE antagonist; yohimbine (YOH), an alpha 2-NE antagonist; propranolol (PROP), a beta 1- and 2-NE receptor antagonist; methoxymine (METHOX), an alpha 1-NE agonist; and clonidine (CLON), an alpha 2-NE agonist. The data indicate that drugs with antagonistic effects at alpha 1 NE receptors, including HAL and PRAZ but not PROP, administered early after SMCX contusion retard locomotor recovery. Beneficial effects of enhancing NE transmission by METHOX or YOH were not observed. In animals recovered from beam walk (BW) deficits, a single administration of PBZ or PRAZ (alpha 1 NE antagonists) or CLON (alpha 2 NE agonist) transiently reinstated hemiplegic symptoms. The nonspecific beta NE receptor antagonist PROP had no effect in recovered animals. A single dose of HAL had no effect in recovered animals, but a BW deficit transiently developed in some animals following chronic treatment. The data are discussed with reference to drug contraindications noted in clinical studies of recovery from poststroke aphasia and cognition in demented patients with degenerative brain disease.
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PMID:Norepinephrine and brain damage: alpha noradrenergic pharmacology alters functional recovery after cortical trauma. 216 17

Strokes in children occur in conjunction with cardiac disease, hematological disorders, trauma, intracranial infections and migraine. Recently several inborn errors of metabolism have been recognized as possible causes of stroke-like symptoms. We describe a female heterozygote of ornithine transcarbamylase deficiency, who presented with convulsions and right sided hemiplegia. MR-imaging of the brain demonstrated an acute ischemic lesion in the left hemisphere. In addition to other known metabolic causes of stroke like attacks urea cycle defects should be considered in the differential diagnosis of acute hemiplegia in childhood.
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PMID:Acute hemiparesis as the presenting sign in a heterozygote for ornithine transcarbamylase deficiency. 223 17

The F response can provide a measure of motoneurone excitability (MNE) and so it may be used to investigate upper motoneurone disorders. This report studies the F-wave configuration in patients with stroke to evaluate the changes of the central excitability of the motoneurones at different times after an acute cerebral insult. Various parameters of the F response, including amplitude (absolute and F%/M), duration, and persistence have been determined in 26 patients with unilateral hemiplegia and in 32 healthy subjects of both sexes in the same age range. The investigation was carried out applying a series of 20 supramaximal stimuli at 0.5 Hz on tibial and ulnar nerves bilaterally. In all patients a detailed clinical examination and a CT scan were performed. Our results indicate that an initial stage of reduced spinal motoneuron excitability evidenced by a decreased F amplitude and persistence was present in the early phases after a stroke, followed within 90 days by an enhanced MNE. Moreover, F-wave amplitude shows a positive correlation with weakness and increased tone.
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PMID:Analysis of F response in upper motoneurone lesions. 228 50

Elbow movement during voluntary positioning of the hand (with the arm supported against gravity) is described in a longitudinal study of five patients recovering from hemiplegia due to stroke. Over a twelve month period, four of the patients improved their speed of movement, three exhibiting slightly better recovery of elbow extension, one of flexion. In some instances co-contraction of the elbow agonist and antagonist (measured just before the onset of movement) decreased with time after stroke. The effects of contrasting movements at the shoulder on elbow movement were also studied. Estimates of recovery were generally similar whether patients kept the shoulder still or made movements that were synergic or counter-synergic to those of the elbow.
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PMID:Recovery of elbow function in voluntary positioning of the hand following hemiplegia due to stroke. 231 99

An anecdotal series of nine patients (three men and six women with an average age of 57 years) presented with progressive neurologic deterioration while on medical therapy for large right hemispheric cerebral infarction. Clinical signs of uncal herniation (anisocoria or fixed and dilated pupils, and/or left hemiplegia with right decerebrate posturing) were present in seven of these nine patients. Computerized tomography of the head confirmed mass effect from cerebral edema. It was the clinical judgment of the treating neurologists and neurosurgeons that each of these nine patients would perish unless surgical decompression of the infarcted brain was performed. Accordingly, each was treated with right hemicraniectomy and dural augmentation. Six patients demonstrated neurologic improvement on the first postoperative day. One patient, with a postoperative diagnosis of lung cancer, died 1 month after surgery. The remaining eight patients are currently living with their families with a follow-up period ranging from 5 to 25 months. Patient outcome as evaluated by the Barthel Index indicates that three individuals are functioning with minimal assistance and that the remaining six patients are functionally dependent. After rehabilitative therapy, four patients returned for elective cranioplasty. These results suggest that hemicraniectomy can be an effective lifesaving procedure for malignant cerebral edema after large hemispheric infarction.
Stroke 1990 Jun
PMID:Treatment of right hemispheric cerebral infarction by hemicraniectomy. 234 90

Medial medullary infarction is characterized by ipsilateral hypoglossal nerve palsy, contralateral hemiparesis sparing the face, and contralateral disturbance of deep sensation. Although it is possible to make a clinical diagnosis in typical patients, diagnosis is difficult if hypoglossal nerve palsy is absent. We describe a patient with medial medullary infarction without hypoglossal nerve palsy. The patient suffered from left hemiplegia and homolateral disturbance of deep sensation. Magnetic resonance imaging revealed the site of the lesion to be in the medial portion of the upper medulla oblongata. The result of somatosensory evoked potential testing was compatible with disturbance of the medullary medial lemniscus. In a review of the literature, we examined the relation between clinical features and lesion location in 16 patients with medial medullary infarction and compared these to the present patient. Motor paresis was present in every patient, while disturbance of deep sensation was recorded in nine of 13 patients and hypoglossal nerve palsy in six of 14 patients. In atypical patients with medial medullary infarction (such as the present patient), magnetic resonance imaging is necessary to detect the lesion and to make a clinical diagnosis.
Stroke 1990 Jun
PMID:Magnetic resonance imaging of medial medullary infarction. 234 1

The usual signs and symptoms of hypoglycemia include tachycardia and profound diaphoresis. These will progress to include an altered mental status that can advance in severe cases to coma, seizures, and death. Occasionally, hypoglycemia may present with focal neurologic signs that can include hemiparesis or hemiplegia with preservation of mental status. In patients with the latter signs, the possibility of a cerebrovascular accident or other intracranial abnormality must be considered. The authors describe an elderly patient with hypoglycemic hemiplegia secondary to insulin administration. Their report includes observations on clinical presentation, the various mechanisms involved, and guidelines for the management of this syndrome.
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PMID:Hypoglycemic hemiplegia. 235 82

Line bisection testing was performed on 82 elderly subjects within 14 days of a non-lacunar stroke. The 40 subjects with impaired line bisection were of similar age and pre-stroke dependency as the 42 subjects with normal line bisection but had a more severe current stroke deficit as evidenced by a higher incidence of new hemiplegia, homonomous hemianopia, visual extinction and constructional impairment, and greater power loss. Subjects with impaired line bisection had poorer functional outcome than those with normal line bisection as measured by Barthel activities of daily living scores, walking speed and discharge residence. When subjects with impaired line bisection were divided into two groups according to line bisection error, the severely impaired had worse functional outcome than the mildly impaired. After accounting for motor loss and the ability to draw a house by using logistic regression, line bisection did not contribute significantly to predicting functional outcome.
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PMID:Spatial neglect in acute stroke: the line bisection test. 236 23

One of the causes for shoulder pain associated with hemiplegia is thought to be vigorous range of motion to the involved upper extremity. The objective of this study was to analyze the occurrence of pain in patients treated with one of the three exercise programs commonly used in the rehabilitation of hemiplegia: 1) range of motion by the therapist, 2) skate board and 3) overhead pulley. Of the 48 hemiplegic patients evaluated, 28 were assigned to one of the three exercise groups. Comparing the number of patients who developed pain in each group, there was a significant difference, with 8% of the patients in the range of motion by the therapist group, 12% of the patients in the skate board group and 62% of the patients in the overhead pulley group developing pain (chi 2 = 8.44) (P = 0.014). The three groups did not differ in the side of involvement (P = 0.57), extent of hemiplegia (P = 0.25) or presence of subluxation (P = 0.84). Use of overhead pulley has the highest risk of developing shoulder pain and should be avoided during rehabilitation of stroke patients.
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PMID:Shoulder pain in hemiplegia. The role of exercise. 238 82

A case study is presented of a 64-year-old, right-handed, congenitally deaf man who suffered a single, unilateral, left CVA resulting in a right hemiplegia and moderate aphasia. The relationship between his verbal (reading and writing), manual, and pantomimic performances is examined in two ways. First, a comparison of the three modes of communication shows whether or not these systems can be dissociated by pathology. Second, the extent to which one mode recovers more fully than the others indicates whether the three modes function independently. Results of testing conducted at six weeks and at 18 months postonset revealed that this individual's manual, verbal, and pantomimic communication skills were all similarly impaired as a result of his CVA. Furthermore, at 18 months no single mode had recovered more rapidly or to a greater extent than any other. These results support the notion that aphasia in the deaf and hearing population is similar, and is consistent with the view that aphasia is the result of a central symbolic/cognitive process which manifests itself in parallel dysfunctions of verbal, manual, and pantomimic communication.
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PMID:Communication skills in an aphasic deaf adult. 246 80


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