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)

A 58-year-old woman was admitted to our hospital with complaints of general fatigue, thirst and lumbago. A diagnosis of Cushing's syndrome was made on the basis of elevated serum levels of cortisol and adrenocorticotropic hormone (ACTH). Although Cushing's disease was most suspected, no evident image of pituitary adenoma could be found on brain CT scan and MRI. Therefore, treatment with oral Trilostane was started. Three months after admission, left hemiplegia was noticed and cerebral abscess in the right frontal lobe was demonstrated by brain CT scan. In spite of surgical removal of the abscess by total resection, she had a relapse in the same site and also developed a new lesion in the left lateral lobe. Surgical drainage was performed and Nocardia asteroides was isolated from the drained pus. An intensive chemotherapy with aminobenzylpenicillin (ABPC) and latamoxef (LMOX) in combination resulted in marked decrease in size of the lesion in the brain and subsequent improvement of left hemiplegia was achieved. Since approximately one month before when a diagnosis of cerebral abscess was made, there had been demonstrated a coin lesion in the right middle field on chest X-ray films. This lesion in the right lung disappeared concomitantly with the improvement of the lesions in the brain. This fact strongly suggests that the lesion in both brain and lung were of the same nature. Nocardia is known to make a primary lesion in the lung after being inhaled and then through hematogenous dissemination to make distant lesions in various sites, especially in the brain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of Cushing's syndrome associated with Nocardia cerebral abscess]. 206 9

Isometric contractions of single motor units in the first dorsal interosseous muscle were recorded with an intramuscular microstimulation technique in patients with short- or long-term hemiplegia and compared with controls. In the hemiplegic patients motor units could be classified as in controls, utilizing twitch contraction time and fatigue sensitivity, as FF (fast fatigable), FR (fast fatigue resistant) and S (slow fatigable). The mean twitch contraction time of fast-twitch but not slow-twitch units was slightly prolonged in patients with spastic hemiplegia and motor units, especially type S, tended to generate larger twitch tensions. A fourth type of motor unit, characterized by slow-twitch contraction times and increased fatigability (SF units), was recorded in long-term hemiplegia. The data demonstrate that during long-term spastic hemiplegia in man some motor units develop increased fatigability and prolonged-twitch contraction times, reflecting the dynamic properties of muscle.
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PMID:Physiological alterations of motor units in hemiplegia. 709 10

The aim of this study was to investigate whether significant differences in peak torque (PT), mean power frequency of EMG (fmean) and perceived fatigue exist between the dominant and non-dominant knee extensors throughout repeated contractions. The present study forms part of a research project aimed at developing tests for the determination of the degree of motor control in patients with sequelae after CNS injury. A total of 22 clinically healthy subjects (14 males and eight females) took part in the investigation. The subjects performed endurance tests of the lower limbs, consisting of 100 repeated knee extensions using a Cybex dynamometer at 1.57 rad s-1. The patterns of PT, fmean and perception of fatigue throughout the endurance test were investigated. The endurance curves of PT and fmean showed, in common with other studies, an initial steep decrease followed by a stable phase. No significant differences existed between dominant and non-dominant knee extensors with regard to PT, fmean or perception of fatigue. The results indicate that it may be possible to use the contralateral knee extensors as an indicator of motor recovery in hemiplegia in patients with a high degree of recovery.
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PMID:Knee extensor performance of dominant and non-dominant limb throughout repeated isokinetic contractions, with special reference to peak torque and mean frequency of the EMG. 762 49

The systolic (SP) and diastolic (DP) blood pressure and heart rate (HR) responses during a fatiguing isometric contraction of either the handgrip or quadriceps muscles was measured in 139 paraplegic patients divided into five groups (having injuries at T4, T12 and L1-L3 and suffering complete paraplegia and having injuries at T4 but showing incomplete hemiplegia or paraplegia) and 25 controls. While all handgrip exercise was maintained by voluntary effort, only the controls were able to make a voluntary contraction of their quadriceps muscles; the paraplegics had isometric contractions of their quadriceps muscles elicited by functional electrical stimulation (FES). The endurance of the handgrip exercise was not significantly different among the controls and any one of the five experimental groups (control group endurance = 151 s, average paraplegic group endurance = 141 s) while it was higher in the leg muscles (P < 0.05 controls 133 s, paraplegics 111 s). All subjects showed a linear increase in SP and DP throughout the duration of the handgrip exercise, pressure increasing from rest to fatigue by 55-56 mmHg. The controls, subjects with a complete and incomplete spinal cord injuries at T4 showed similar SP and DP increases during leg exercise, both the SP and DP response was eliminated in the T12 and L1-L3 injury groups. The HR increased during fatiguing isometric handgrip contractions from an average resting value of 82 to a maximum of 121 beats x min(-1) in both the controls and paraplegic subjects. However, while the HR increased to a slightly higher level of 127 beats x min(-1) at the end of the contraction of the leg muscles in the controls, the increase in HR during FES exercise was modest, increasing by an average of only 6 beats x min(-1) in the paraplegic group.
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PMID:Blood pressure and heart rate response to isometric exercise: the effect of spinal cord injury in humans. 1171 79

This pilot study investigated the feasibility of using functional magnetic resonance imaging (fMRI) as a physiological marker of brain plasticity before and after an intensive body-weight-supported treadmill training (BWSTT) program in children with cerebral palsy (CP). Six ambulatory children (four males, two females; mean age 10y 6mo, age range 6-14y) with spastic CP (four hemiplegia, two asymmetric diplegia, all Gross Motor Function Classification System Level I) received BWSTT twice daily for 2 weeks. All children tolerated therapy; only one therapy session was aborted due to fatigue. With training, over ground mean walking speed increased from 1.47 to 1.66m/s (p=0.035). There was no change in distance walked for 6 minutes (pre-: 451m; post-: 458m;p 0.851). In three children, reliable fMRIs were taken of cortical activation pre- and post-intervention. Post-intervention increases in cortical activation during ankle dorsiflexion were observed in all three children. This study demonstrates that children with CP between 6 and 14 years of age can tolerate intensive locomotor training and, with appropriate modifications, can complete an fMRI series. This study supports further studies designed to investigate training-dependent plasticity in children with CP.
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PMID:Ankle dorsiflexion fMRI in children with cerebral palsy undergoing intensive body-weight-supported treadmill training: a pilot study. 1720 75

Neuromuscular electrical stimulation can improve motor function in those affected by paralysis, but its use is limited by a high rate of muscular fatigue. Variable stimulation patterns have been examined in young adults with and without spinal cord injury, but much less investigation has been devoted to studying the effects of variable stimulation patterns administered to older adults or those paralyzed by stroke. Significant changes occur in the neuromuscular system with age that may affect the response to variable stimulation patterns. We administered three, 3-min intermittent stimulation patterns to the median nerves of 10 individuals with hemiplegia from stroke and 10 age-matched able-bodied adults: (1) constant 20 HZ, (2) a pattern that began at 20 HZ and progressively increased to 40 HZ in the latter half of the task, and (3) a 20-HZ pattern that switched to a 20-HZ doublet pattern after 90 s. In the able-bodied group the doublet pattern produced significantly higher force time integrals (FTI) (1409.72 +/- 3.15 N s) than the 20-40-HZ pattern (1067.46 +/- 1.15 N s) or the 20-HZ pattern (831 +/- 1.87 N s). In the poststroke individuals the doublet pattern also produced the highest FTI (724.04 +/- 2.02 N s), and there was no significant difference between the 20-40-HZ (636.42 +/- 1.65 N s) and 20-HZ (583.64 +/- 3.02 N s) patterns. These results indicate that protocols that incorporate doublets in the later stages of fatigue are effective in older adults and in older adults with paralysis from stroke.
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PMID:Variable stimulation patterns for poststroke hemiplegia. 1908 75

Improved treatments and rehabilitation for cerebral palsy (CP) have led to an increased number of children with CP surviving into adulthood. Adults with CP show an increased prevalence of pain, fatigue, and musculoskeletal dysfunction, leading to a decrease in ambulatory function. Recent work has demonstrated the potential benefits of intensive task-specific gait training, including the use of robotic-driven gait orthoses, on motor recovery in children with CP. In contrast, reports of interventions aimed at improving motor function in adults with CP are lacking. This case study reports on the outcomes of a 6-week intervention of robotic-assisted gait training administered to a 52-year-old woman with right hemiplegia attributable to CP. Improvements were noted in balance, walking speed, and time to negotiate stairs at posttraining and follow-up. Gait analysis showed an increase in step length and a reduction in the period of double support. In conclusion, robotic-assisted gait training may be beneficial in enhancing locomotor function in adults with CP.
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PMID:Robotic gait training in an adult with cerebral palsy: a case report. 2012 16

Multiple sclerosis (MS) is the most frequent demyelinating disease of the central nervous system, with versatile manifestations--relapsing-remitting or progressive--and an unpredictable course, with prognoses ranging from minimal neurological impairment to severely disabled. Disease modifying agents can minimize relapse rate and slow disease progression. Yet most patients suffer relapses and progression despite use of these agents. Several of the manifestations of MS may cause overall decrease in the performance of the aviator. These include cognitive impairment, fatigue, and depression. Episodes of spasms, dysarthria, ataxia, parasthesias, diplopia, and hemiplegia, as well as drug side effects may also affect flight. Seizures and episodes of vertigo may occur suddenly and result in in-flight incapacitation. We present our experience with two aviators with definite MS and a navigator with probable MS. The various manifestations of MS are specifically addressed with an emphasis on the aeromedical implications.
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PMID:Return to flight with multiple sclerosis: aeromedical considerations. 2123 9

Loss of arm and hand function is common after stroke. An implantable, 12-channel, electromyogram (EMG)-controlled functional electrical stimulation neuroprosthesis (NP) may be a viable assistive device for upper-limb hemiplegia. In this study, a research participant 4.8 yr poststroke underwent presurgical screening, surgical installation of the NP, training, and assessment of upper-limb impairment, activity limitation, and satisfaction over a 2.3 yr period. The NP increased active range of finger extension from 3 to 96 degrees, increased lateral pinch force from 16 to 29 N, increased the number of objects from 1 to 4 out of 6 that the participant could grasp and place in a Grasp-Release Test, and increased the Arm Motor Abilities Test score by 0.3 points. The upper-limb Fugl-Meyer score increased from 27 at baseline to 36 by the end of the study. The participant reported using the NP at home 3-4 d/wk, up to 3 h/d for exercise and household tasks. The effectiveness of the NP to assist with activities of daily living was dependent on the degree of flexor tone, which varied with task and level of fatigue. The EMG-based control strategy was not successfully implemented; button presses were used instead. Further advancements in technology may improve ease of use and address limitations caused by muscle spasticity.
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PMID:Implanted neuroprosthesis for assisting arm and hand function after stroke: a case study. 2351 54

This chapter gives a concise overview of the Acquired Immunodeficiency Syndrome (AIDS), with special emphasis on clinical aspects relevant to rehabilitation professionals. AIDS is a novel form of an acquired immune deficit now known to be caused by the recently recognized Human Immunodeficiency Virus (HIV). Symptoms result from the direct effects of the virus on the immune system and the nervous system, which appear to be the primary targets. Much of the morbidity and mortality, however, is caused by opportunistic infections which occur in patients unable to mobilize the appropriate immune defenses against them. Characteristic, but previously rare, neoplasms also occur due to a failure of immune regulation. Improved medical care, however, has changed AIDS from a rapidly fatal disease to one where survival may be prolonged. The rehabilitation setting, the physical disability caused by AIDS, along with the psychosocial and economic impact of the disease on the patient have become increasingly important. Fatigue, decreased endurance, weight loss, edema, blindness and swallowing difficulties may all contribute to functional impairment. Neurological involvement is frequent and may cause dementia, hemiplegia, spastic paraparesis, painful neuropathies and proximal or distal muscle weakness. The clinical features and functional impact of these symptoms on the patient with AIDS is discussed, and the appropriate rehabilitation interventions outlined. Psychosocial and vocational issues are addressed as they pertain to the different clinical presentations.
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PMID:AIDS. 2393 Nov 67


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