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

A 42-year-old man developed necrosis of the brainstem 10 months following fast neutron irradiation of a recurrent adenocystic carcinoma of the right submandibular salivary gland. The neoplasm had been diagnosed 15 years earlier. Neck dissection and several local excisions failed to control local extension, so that 7000 rad 4.8 MeV x-rays were administered. The right mandible and part of the tongue and palate were resected for recurrence and chemotherapy and transfer factor were given. Because of cranial neuropathy and erosion of the skull base, fast neutron radiation (2.080 rads) was administered five and one-half years after the x-ray therapy, but to a nonoverlapping field. Ten months later, rapidly progressive symptoms and signs of multiple cranial nerve palsies on the right side and left hemihypesthesia and hemiplegia appeared. Clinical manifestations of brainstem necrosis lasted 4 months. Postmortem examination demonstrated radionecrosis of pons and upper medulla, predominantly on the right side. This case illustrates the efficacy of neutron radiation in eradicating local carcinoma and also the serious complications of this therapeutic modality.
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PMID:Delayed radiation necrosis of brainstem related to fast neutron beam irradiation: case report and literature review. 22 99

A study has been made of the pathological changes in the recurrent laryngeal nerves from horses with clinical and sub-clinical idiopathic laryngeal hemiplegia. Qualitative and quantitative studies showed in clinical cases there was a progressive distal loss of large myelinated fibres in the left recurrent nerve. Regenerating clusters and onion bulbs were frequently seen in affected nerves both at proximal and distal levels. Degenerating axons were characterized by collections of organelles, and denervated bands of Bungner were common. Similar but less severe changes were seen in the left recurrent nerve of sub-clinical cases, and in both the clinical and sub-clinical cases the distal right recurrent nerve was also affected. Teased fibre studies showed evidence of chronic demyelination and remyelination. The aetiology of this chronic neuropathy remains uncertain but the possibility of nerve compression is discussed.
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PMID:A light and electron microscopic study of the neuropathy of equine idiopathic laryngeal hemiplegia. 74 76

Fifty-nine biopsies of human muscle, 53 of them abnormal, 6 normal, were studied for the histochemical localization of acetylcholinesterase (AChE) using frozen sections and light microscopy. In addition to AChE which was found at the myoneural and myotendon junction, specific staining was found around the periphery of many fibers from normal and abnormal muscles. Moreover, AChE activity was found to be high in the sarcoplasm of more than 10% of the fibers from 28 biopsies of abnormal muscle including cases of hemiplegia, spinal cord injury, denervation and neuropathy, infantile spinal muscle atrophy, Duchenne, limb-girdle and facioscapulohumeral dystrophies, Schwartz-Jampel syndrome and a myasthenic syndrome. Of the muscles from experimental animals examined, only the Rhesus monkey exhibited AChE around the periphery of the fibers, and only the dystrophic chicken and not the dystrophic mouse or hamster, showed extensive sarcoplasmic AChE. Histograms of muscle fiber diameters indicated that AChE in the sarcoplasm was associated with fibers of all sizes, depending on the nature of the disorder examined. Fibers containing AChE were smaller than unstained fibers in dystrophic chicken muscle. The results suggest that in the human, sarcoplasmic AChE is reversibly repressed during muscle maturation and that its mode of regulation by motor neurons is similar to that found in the chicken.
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PMID:Incidence of acetylcholinesterase in the sarcoplasm of human and chicken muscles. 80 46

Five patients are presented, all of whom had middle cerebral artery syndrome with hemiplegia on the contralateral side. All five had electromyographic evidence consistent with neuropathy involving the upper trunk of the brachial plexus on the side affected by the stroke. All patients were exposed to intensive rehabilitation team effort involving range of motion, strengthening exercises, positioning, splinting, coordination exercises and exercises designed to increase ability at arm placement. Three patients regained EMG evidence of innervation of the shoulder girdle muscles after more than eight months, during which time a rehabilitative effort was made. The other two patients have not yet regained control over the muscles of the shoulder girdle by EMG or clinical criteria. The EMG evidence of brachial plexus injury in those patients who eventually showed reinnervation took 8 to 12 months to resolve. The rehabilitation of the patients with stroke involving the upper extremity may have been set back significantly as a result of the neuropathy. It is suggested that patients with stroke and brachial plexus injury probably will have a more arduous and prolonged course in rehabilitation of the upper extremity as a result.
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PMID:Stroke and brachial plexus injury: a difficult problem. 90 58

The age of onset of equine recurrent laryngeal neuropathy has not been ascertained, although the clinical condition of left laryngeal hemiplegia ("roaring") has been recognized for centuries. The purpose of this study was to evaluate the laryngeal muscles of draft horse foals for the presence of fiber-type grouping, indicating denervation and reinnervation, and to determine if histological evidence of recurrent laryngeal neuropathy was present. Abductor and adductor laryngeal muscles from the left and right sides were collected immediately after euthanasia from male draft horse foals, six less than 2 weeks and four 6 months of age, and stained for myosin ATPase. A morphometric test was used to objectively evaluate several areas from each muscle for fiber-type grouping. Extensive fiber-type grouping which was characteristic of recurrent laryngeal neuropathy was found in one of the young foals and all of the older foals. Four of the young foals had some areas of fiber-type grouping suggestive of mild, early changes associated with recurrent laryngeal neuropathy. One of the young foals had no fiber-type grouping present in any of the laryngeal muscles evaluated. These findings suggest an early age of onset of recurrent laryngeal neuropathy.
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PMID:Determination of the early age of onset of equine recurrent laryngeal neuropathy. 1. Muscle pathology. 138 68

We reported 9 cases of primary Sjogren syndrome (SS) who were complicated with nervous system involvement. All were women. Age between 24 to 58 years old. Their clinical symptoms of the nervous system varied widely, 7 of them manifested with the involvement of central nervous system, the main features were in case 1 bouts of seizures, case 2 multi-level damage of the brain and spinal cord which was similar to multiple sclerosis, case 3 recurrent hemiplegia caused by cerebral thrombosis then fatal vascular hemorrhage, case 4 sudden hemiplegia, case 5 persistent psychological disturbance, case 6 cranial neuropathy of V and VII, case 9 multi-focal symptoms of ataxia, myelopathy and transient blindness. 5 of the 9, case 3, 6-9 all appeared with the symptoms of peripheral neuropathy, case 7 also complicated with carpal tunnel syndrome. 4 of the 9 cases also complicated with renal tubular acidosis and/or chronic active hepatitis and/or fibrosing alveolitis and/or thrombocytopenic purpura and/or myositis. No differences of the positivity of autoantibodies was observed between those with or without nervous system involvement.
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PMID:[The manifestations of the nervous system in primary Sjogren syndrome]. 158 41

This study was designed to define a simple, unequivocal test for the evaluation of laryngeal function and the diagnosis of idiopathic laryngeal hemiplegia (ILH). ILH is a disorder that results from left recurrent laryngeal neuropathy and in which there is no movement of the left arytenoid cartilage and vocal fold. Laryngeal function was evaluated in seven horses using four techniques designed to stimulate laryngeal movements:-nasal occlusion, exercise, swallowing and administration of a respiratory stimulant. In addition, the effects of sedation and twitching on the endoscopic examination were also examined. The cross-sectional area of the rima glottidis was measured in each horse at rest and after each technique was performed. There was no statistically significant difference in the increase in area seen after nasal occlusion or exercise. Doxapram hydrochloride increased the cross-sectional area of the rima glottidis, whereas xylazine caused a decrease. Neither of these pharmacological agents exaggerated or decreased the amount of asynchronous movement or tremoring of the arytenoid cartilages. Manual occlusion of the external nares during endoscopy is a simple, yet effective method of stimulating arytenoid function and hence diagnosing ILH.
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PMID:A comparison of techniques to enhance the evaluation of equine laryngeal function. 204 4

The terminal branches of the recurrent laryngeal nerve (RLN) of three normal ponies and six horses with sub-clinical laryngeal disease were examined qualitatively and quantitatively in an attempt to explain the preferential denervation of the laryngeal adductor muscles in the neuropathy of idiopathic laryngeal hemiplegia (ILH). The myelinated fibre spectra of all the motor nerve fibres in the left and right abductor and adductor branches of the RLN in three normal ponies were measured. The density of myelinated fibres was also calculated. There was no significant difference between the larger group of myelinated fibres in the adductor or abductor branches. In the six horses with laryngeal hemiparesis, however, there was a marked preferential loss of the medium/large size myelinated fibres in the left adductor branch, although nerve fibre densities were not significantly different. While no simple morphometrical feature was found to explain the selective muscle denervation, the greater loss of large diameter myelinated fibres in the adductor branches confirms the earlier observation of adductor muscle susceptibility in the neuropathy of ILH.
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PMID:Preferential denervation of the adductor muscles of the equine larynx. II: Nerve pathology. 204 12

We report 31 cases of herpes zoster (HZ) with neurological complications: 14 with cranial nerve deficits, 1 with cranial nerve deficit associated with segmental motor disorder, 3 with segmental motor deficits, 2 with meningoencephalitis, 2 with meningoencephalitis associated with cranial neuropathy or myelitis, 2 with meningitis, 2 with hemiplegia contralateral to the ophthalmic HZ. 1 with hemiplegia and motor deficit and finally 1 with hemiplegia and a cranial neuropathy. Smoking was the putative risk factor in 53% of our patients together with diabetes, which has already been mentioned in the literature. We frequently observed more than one complication in succession (19.3%) that could not easily be related to the cutaneous distribution. Acyclovir had no demonstrable positive effects on neurological complication in our patients.
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PMID:Neurological complications of herpes zoster. 208 79

The thoracic outlet syndrome is known to cause brachial neuropathy. Pressure on the subclavian artery causing post-stenotic dilatation with intraluminal thrombosis is not a common complication. This may lead to antegrade embolisation and ischemic changes in the upper limb. In right sided thoracic outlet syndrome the thrombus may extend retrogradely. From this an embolus may detach to the right hemisphere of the brain resulting in left sided hemiplegia. This is a rare but serious complication from a neglected, relatively benign, curable condition. This report describes two cases of a right sided thoracic outlet syndrome due to cervical rib compression with retrograde embolisation.
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PMID:Embolic brain infarction: a rare complication of thoracic outlet syndrome. A report of two cases. 337 92


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