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

Homosynaptic depression of H-reflex was studied in 25 healthy persons and 33 patients with hemiplegia. The mean duration of the homosynaptic depression in healthy persons was 5200 ms. After the initial relative facilitation the time course of the homosynaptic depression corresponded to a logarithmic function of the interval between the conditioning and testing stimuli. The homosynaptic depression in patients with hemiplegia decreased depending on the degree of the muscular spasticity.
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PMID:[Homosynaptic depression of the monosynaptic spinal reflex in healthy people and patients, suffering from a cerebral stroke]. 281 45

When spasticity becomes severe and harmful, in spite of physical and medical therapy, neurosurgery can give functional improvement. This paper deals with the long term results of Selective Peripheral Neurotomies of the Tibial Nerve and Selective Posterior Rhizotomies in the Dorsal Root Entry Zone, in 123 patients with spastic disorders localized to the limbs. The micro-techniques and intra-operative electro-stimulation for identification of the nervous structures responsible for the spastic components, can give a substantial reduction of the harmful spasticity, without suppressing the useful muscle tone and impairing the residual motor and sensory functions. The results were effective, with a 1 to 13 year follow-up (5 on average), in 89% of 47 Selective Peripheral Neurotomies of the tibial nerve for spastic foot, in 92% of 53 Selective Posterior Rhizotomies for paraplegia and in 87% of 23 Selective Posterior Rhizotomies for hemiplegia. In the most severe situations ("comfort" indications), correction of the abnormal postures and relief of pain facilitated nursing and physiotherapy. Sometimes there was reappearance of some useful voluntary movements. In the less affected patients ("functional" indications), the suppression of the harmful spastic components made the persistant capacities more effective.
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PMID:Microsurgical procedures in the peripheral nerves and the dorsal root entry zone for the treatment of spasticity. 316 6

Electrical stimulation of paralyzed muscles has been shown to affect their spasticity, especially in patients with hemiplegia. But little has been reported on the long-term effects of such stimulation on individuals with spinal cord injury. This paper documents initial quadriceps spasticity in 31 spinal cord injured subjects, and the effect of four to eight weeks of reconditioning using electrical stimulation. Spasticity was quantified through the use of a normalized relaxation index (R2n) obtained from a pendulum drop test. The reconditioning protocol consisted of twice daily 20-minute exercise sessions at least four hours apart, six days per week. Spasticity and stimulated quadriceps torque were measured during one to three evaluations performed at least one day apart at the beginning of the program, and at four and eight weeks. There was no significant difference in average initial measures of spasticity between left and right legs and no effect of time since injury on average R2n values. Significant differences were seen for right leg average baseline R2n values when grouped by lesion level or completeness. Quadriplegic individuals were more spastic than paraplegic individuals, and subjects with incomplete lesions were more spastic than those with complete lesions. These findings are interrelated since most of the quadriplegic subjects (14 of 16) had incomplete lesions. Most participants had increased spasticity after four weeks of reconditioning but not after eight weeks. However, only eight subjects completed eight weeks of reconditioning. Subjects who had the greatest increases in spasticity also had the greatest gains in stimulated torque, both after four and eight weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Spasticity in spinal cord injured patients: 2. Initial measures and long-term effects of surface electrical stimulation. 326 2

A double-blind study was carried out in 105 patients with chronic spasticity associated with hemiplegia in order to compare the efficacy and tolerability of tizanidine with that of diazepam. Dosage was increased progressively, if tolerated, to a maximum of 24 mg tizanidine or 30 mg diazepam per day at the end of 2 weeks. The optimum dosage was then maintained for 6 weeks. Efficacy and tolerability parameters were assessed after 2 and 8-weeks' therapy. Patients on tizanidine but not those on diazepam showed a statistically significant improvement in functional status, as assessed by walking distance on flat ground. Analysis of the stretch reflex in four groups of muscles showed that both tizanidine and diazepam reduced the duration of contractions and increased the angle at which contraction occurred, but there were no significant differences between the two drugs. Clonus of the triceps surae resolved in 48% of tizanidine and 40% of diazepam patients. Evaluation of the effect of therapy revealed an improvement with each drug in approximately 83% of patients, with the overall evaluation being slightly (but non-significantly) in favour of tizanidine. There were fewer discontinuations of treatment in the tizanidine group as a result of side-effects. It would appear, therefore, that tizanidine is an effective and well-tolerated drug in the treatment of cerebral spasticity.
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PMID:A multi-centre, double-blind trial of tizanidine, a new antispastic agent, in spasticity associated with hemiplegia. 328 29

Three patients with adult-acquired hemiplegia are described with the unusual dynamic deformity of spasticity of the triceps muscle. This deformity produces motor imbalance with the triceps overpowering the elbow flexors, thus impeding volitional elbow flexion. The nature of the deformity was defined by electromyography of the muscle groups about the elbow, which demonstrated out-of-phase inhibitory electrical activity of the triceps muscle. Treatment consisted of V-Y lengthening of the triceps muscle to achieve agonist-antagonist motor balance. The operation improved hand placement for all three patients.
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PMID:Triceps spasticity in traumatic hemiplegia: diagnosis and treatment. 330 May 95

The relationship between the interruption of the human pyramidal tract and its attendant clinical manifestations has been a matter of concern to neurologists and neurosurgeons for over a century. We presently report three cases of unilateral pyramidal tract ischemic lesions within the cerebral hemispheres who presented with a contralateral pure spastic hemiplegia syndrome. In none could we find any disturbance in the somatosensitive evoked potentials of the four limbs. The review of some cases on record since the time of Charcot and Erb has made it clear that the pyramidal syndrome is a valid clinical concept which should be qualified according to the particular animal species one is referring to. In man, it manifests itself by paresis, hyperactive muscular reflexes, spasticity and Babinski sign. Based on this evidence we propose the idea of a "differential control" exerted by the pyramidal tract upon the segmental neuronal pool as its key mode of normal functioning.
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PMID:[Pure spastic hemiplegia of pyramidal origin]. 340 87

I undertook this study to determine the test-retest variability and reliability of the pendulum test for muscle spasticity performed with the Cybex II isokinetic dynamometer. Thirty patients, with intracranial lesions and hemiplegia of 15 days' to 3 years' duration, were tested four times, consecutively. With the patients lying supine, the angle of flexion, at which the knee first reversed direction after the leg was dropped, was measured on each goniogram from the dynamometer chart recorder. The mean differences between the angles of reversal and the angles of maximum possible knee flexion (the relative angle of reversal) for the first through the fourth trials were 27.2, 27.0, 26.3, and 25.6 degrees, respectively. The relative angle of reversal did not differ significantly between trials. The mean difference between the largest and smallest relative angle of reversal for each of the subject's trials was 6.1 degrees. The intraclass correlation coefficient between the relative angle of reversal for the four trials was .96. Because the test variability was not significant and because the correlation between trials was high, the test may merit broader application to patients with intracranial lesions. Further investigation of variability across days and after treatments is advised.
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PMID:Variability and reliability of the pendulum test for spasticity using a Cybex II isokinetic dynamometer. 357 22

The incidence of shoulder pain and the statistical relationship between it and five other variables (patient age, time since onset of hemiplegia, range of hemiplegic shoulder external rotation, spasticity and weakness) were investigated retrospectively. Of 50 consecutive hemiplegic patients whose records were reviewed, 36 had shoulder pain. The variables significantly (p less than 0.01) correlated with shoulder pain were: time since onset of hemiplegia (r = 0.45) and ROSER (r = -0.61). The relationship between shoulder pain and range of shoulder motion remained significant when other factors were partialled out. The relationship between shoulder pain and time since onset was not significant when the affect of range of shoulder motion was partialled out. Therefore, range of shoulder external rotation was considered the factor related most significantly to shoulder pain. This finding suggests that shoulder pain demonstrated by hemiplegia patients may be, in part, a manifestation of adhesive capsulitis.
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PMID:Shoulder pain in hemiplegia: statistical relationship with five variables. 374 Oct 75

Pure motor hemiplegia (PMH) is, in most cases, caused by a lacunar infarction. However, pure motor monoparesis (PMM), i.e., isolated motor involvement with spasticity in one limb, has drawn little attention. We studied prospectively 5 patients with PMM and found that it was always due to a mass lesion in the contralateral superficial cerebral hemisphere. Our observation suggests that PMM should not be regarded as simply a variant of PMH.
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PMID:Spastic pure motor monoparesis. 378 79

This review deals with the long-term results of selective peripheral neurotomy (SPN) of the tibial nerve and selective posterior rhizotomy (SPR) in 123 cases of severe spastic syndromes in the limbs. The microtechniques and preoperative electrostimulation for identification of the nervous structures responsible for the spastic components give to these methods an advantage of a substantial reduction of the harmful spasticity, without suppressing the useful muscle tone and impairing the residual motor and sensory functions. The results were effective, with a 1- to 13-year follow-up, in 89% of 47 SPN of the tibial nerve for spastic foot, in 92% of 53 SPR for paraplegia and in 87% of 23 SPR for hemiplegia.
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PMID:Microsurgical selective procedures in peripheral nerves and the posterior root-spinal cord junction for spasticity. 383 53


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