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

Reciprocal reflex connections were studied in capsular hemiplegia and spastic paresis with spinal cord lesions, using Lloyd's technique. Effects of conditioning stimulation of the tibial or peroneal nerve on the H reflex in the antagonists were examined. Stimulus intensity was controlled with reference to the threshold of the M wave. Weaker stimulation than this threshold was regarded as stimulation of group I afferents. It aroused no subjection sensation in intact subjects. Early and strong inhibition, comparable to Ia inhibition in the cat (Lloyd 1946), was observed from weak stimulation of the tibial nerve on the pre-tibial (flexor) H reflex, but not from the peroneal nerve on the triceps surae (extensor) H reflex in capsular hemiplegia. Alcohol block of extensor motor points resulted in reduction of spasticity without further paralysis in the blocked muscle and a remarkable increase in strength of the antagonist pre-tibial muscles. These results suggest that an extensor spasticity withe flexor weakness, which is common in capsular hemiplegia, may be due to an imbalance of reflex activities via Ia muscle afferents, and that a part of flexor weakness can be restored by "disinhibition' by reduction of Ia inflow from extensor muscles. Ia inhibition was also observed in one third of cases with spinal cord lesions at rest. It returned to normal after recovery from spastic paresis by radical therapy in some cases.
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PMID:Reciprocal Ia inhibition in spastic paralysis in man. 28 52

Outcomes in self-care following rehabilitation in 226 patients were correlated with 11 stroke syndromes, reflecting several pathophysiologic disturbances subsequent to either infarction or hemorrhage in cerebral or vertebro-basilar vessels. Self-care was scored on a 20-point scale for bed movements, transfers, feeding, dressing, personal hygiene, and bathing. Interjudge error among therapists did not exceed 2.5%. Mean score in left cerebral infarction without aphasia was used as a referent value. Scores in left cerebral infarction with aphasia and right parietal lobe syndrome with and without spatial agnosia were similar to the referent. Brain stem dysfunction with spasticity and right cerebral infarction with paresis and spatial agnosia fell below the referent value (Pless than 0.05). Higher levels were achieved in the syndromes of left and right anterior cerebral artery territories, brain stem dysfunction with ataxia, and left parietal lobe syndrome with comprehension aphasia, although t-values were not significant. Length of stay among the 11 groups was fairly uniform except for the group with brain stem dysfunction with spasticity and the group with left hemiplegia with spatial agnosia. These groups indicated rather severe disabilities. Aside from neurologic dysfunction the range of scores was influenced by associated cardiopulmonary involvement.
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PMID:Neurophysiologic syndromes in stroke as predictors of outcome. 68 54

The case of a left handed patient, a woman 59 years old, who some days after the onset of a right hemiplegia with slight motoric and sensoric aphasic disorders, presented reverse (en miroir) reading and writing is described. Difficulties in the recognition of the right and left side could be revealed during the examination. No hemianopia was noted but an "unwillingness" to turn the eyes to the right side, without paresis, was noted. This could be, in relation with the disorder of the orientation in the space and the reanimation of primitive phasic functions, the basic mechanism that explains the above described symptom of reverse reading and writing.
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PMID:[Mirror reading and writing]. 72 75

Fifty patients were hospitalised at Vientiane during May and June 1975. Infection was caused by consumption of pork meat (som-mou, lap mou and lap leuat). After an incubation period of 8 to 11 days intermittent diarrhoea followed by constant fever and orbital oedema occurred. Several days later diffuse myalgias occurred. Three patients presented neurological symptoms: left hemiplegia flexible paraplegia and limb paresis; these symptoms regressed spontaneously. 87% of the clinically suspected cases had specific serum antibodies (IFI, ID, IE). Hyperleucocytosis and hypereosinophilia were a constant factor. Anti-AH antibodies were detected by the Widal test. The histopathology characteristic of myositis was seen in the 12 muscle biopsies. Also observed was the precystic state of the larvae which is in agreement with the early timing of the samples which were obtained during the 3rd and 4rd week of infection.
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PMID:[Human trichinosis. A recent epidemic in Vientiane (Laos) (apropos of 32 cases)]. 103 24

Dorsal column lesions in the high cervical region of the monkey result in severe defects of movements projected into space and contactual orienting reactions of the forelimbs. The hindlimbs are less affected provided a pathway through the lateral columns, Morin's tract, remains intact. Interruption of this pathway results in a defect of hindlimb function similar to that of the forelimbs. Cerebellar ablations in monkeys result in postural and movement disorders, including hypotonia of limb extensor muscles. An important mechanism underlying the hypotonia is a depression of the responses to muscle extension of spindle primary afferents owing to a decrease of fusimotor activity. In the decerebellate animal abnormalities of limb trajectory during active movements projected into space (cerebellar "dysmetria") appear to result principally from dysfunction of systems separate from the peripheral fusimotor efferent-spindle afferent reflex arc. Precentral cortical ablation results initially in a contralateral hypotonic hemiparesis, later in a hypertonic hemiparesis. A depression of the responses of muscle spindle afferents occurs during the hypotonic phase, but during the hypertonic phase spindle function returns to normal levels. Accordingly a depression of fusimotor function appears to be important in the hypotonic phase of hemiplegia; however, there is no evidence that an enhancement of fusimotor function underlies the hypertonic phase. Bilateral section of the medullary pyramids results in an enduring hypotonic paresis. Abnormalities of contactual orienting responses of limbs are similar to those following dorsal column lesions. Responses of spindle primary afferents are depressed during the initial stages after acute pyramidotomy, then approach but do not reach normal levels. It is concluded that the dorsal columns constitute an afferent, and the pyramidal tracts an efferent, pathway important in oriented contactual reactions of the limbs. The hypotonia resulting from cerebellar lesions, precentral ablation, and pyramidal tract section stems, at least in part, from a depression of the fusimotor innervation of muscle spindle afferent activity.
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PMID:Primate models of postural disorders. 105 89

We have studied the intracranial cerebral circulation in 6 patients with bilateral ischaemic lesions of the internal carotid artery in the extracranial segment (2 significant bilateral stenosis cases; 1 case with bilateral thrombosis and 3 cases of unilateral thrombosis and significant contralateral stenosis). All the patients were males, their age being between the 5th and 8th decade. In a single case the neurological examination showed secondary left hemiplegia and recent right paresis of remittent type, while the other 5 patients had only transitory ischaemic attacks with hemiparesis or transitory aphasia. The lesions were revealed by means of duplex system echotomography (Aloka-Hellige Model SSD 630) and spectral analysis of Doppler signal (Vasoscan-Sonicaid) and they were confirmed later by bilateral carotid arteriography in all patients. The intracranial circulation was also followed up by non-invasive methods, making use of spectral-analysis of the Doppler signal with pulsed wave on TC-2 64-B apparatus. The cases studied by us, which present pathogenic situations more rarely encountered, have shown that none of them observed a 'mathematical model' of compensation of blood flow (BF). More exactly, 2 patients with the same type of lesions and topography did not have a unique model of compensation of BF. It seems that both the possibilities of individual self-regulation of cerebral BF and the extracerebral factors, especially those belonging to cardiac activity, are decisive in the compensatory activity of cerebral circulation, while the modalities in which this is accomplished depend chiefly upon the functional condition of the collateral arteries as a whole.
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PMID:Modalities of compensation of cerebral circulation through the circle of Willis in stenoses and occlusions of extracranial arteries. 135 74

We report herein a case of a intraspinal hematoma in a 9-year-old boy with factor IX deficiency. Replacement of factor IX resulted in resolution of symptoms. The most frequent presentations of intraspinal hematomas are neck or back pain, paresis, sensory impairment, and urinary retention. Intraspinal hematomas may have devastating sequelae, including hemiplegia and quadriplegia. The occurrence or development of sequelae are related to the length of time between onset of symptoms and factor replacement. Whenever the physician suspects intraspinal hematoma, immediate replacement should be given to obtain levels of 80-100% prior to any imaging studies. Factor levels should be maintained at 30-50% for 10-14 days while the patient is monitored closely with serial neurological examinations. Most patients respond to factor replacement, but laminectomy should be considered for intractable or progressive cases.
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PMID:Intraspinal hematomas in hemophilia. 153 Jan 22

The intracranial cerebral circulation was studied in 6 patients with bilateral ischemic lesions due to lesions of the internal carotid artery in the extracranial segment (2 significant bilateral stenosis cases; 1 case with bilateral thrombosis and 3 cases of unilateral thrombosis and significant controlateral stenosis). All the patients were males their age ranging between the 5th and 8th decades of life. In a single case, the neurological examination showed secondary left hemiplegia and recent right paresis of remittent type whereas the other 5 patients had only transient ischemic attacks with hemiparesis or transient aphasia. The lesions were revealed by duplex system echotomography (Aloka-Hellige Model SSD-630) and spectral analysis of Doppler signal (Vasoscan-Sonicaid) and were later confirmed by bilateral carotid arteriography in all patients. The intracranial circulation was also watched by noninvasive methods using the spectral analysis of the Doppler signal with pulsed wave on TC-2 64-B apparatus. As for the modalities of blood flow compensatory mechanisms by the circle of Willis, it may be noted that in none of the patients investigated did the collateral supply observe a "mathematical model".
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PMID:Modalities of collateral supply of cerebral circulation through the circle of Willis in stenoses and occlusions of extracranial carotid arteries. 163 3

Paraparesis (paraplegia) refers to partial (-paresis) or complete (-plegia) loss of voluntary motor function in the pelvic limbs. Similar involvement of all four limbs is termed tetraparesis (tetraplegia). Paraparesis generally results from spinal cord lesions caudad to the second thoracic spinal cord segment, whereas tetraparesis occurs because of lesions craniad to this segment (see discussion of spinal cord lesion localization in The Neurologic Examination and Lesion Localization, on page 328). The limbs may be affected equally; however, asymmetric lesions cause greater clinical involvement on the ipsilateral side. Strictly unilateral lesions at C1-T2 result in clinical involvement on only the affected side of the body (hemiparesis, hemiplegia). Monoparesis (monoplegia) occurs subsequent to unilateral T2-S1 lesions. Trauma and neoplasia are the most common spinal cord diseases affecting cats. Urinary and fecal incontinence often occur concomitant with paresis. General concepts relating to disorders of micturition are discussed at the conclusion of this chapter.
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PMID:Paraparesis (paraplegia), tetraparesis (tetraplegia), urinary/fecal incontinence. Spinal cord diseases. 180 59

A 67-year-old woman with medial medullary infarction is reported, including clinical manifestations, MRI and angiographical findings, and results of evoked potentials. She suffered from contralateral hemiplegia and disturbance of deep sensation. Motor paresis of the tongue was absent. Magnetic resonance imaging revealed a lesion in the medial portion of the medulla oblongata. The 17 cases previously reported with medial medullary infarction are reviewed. Only 3 cases had triad of medial medullary infarction, contralateral hemiparesis, deep sensory disturbance, and ipsilateral hypoglossal paresis. Therefore, lesion detection is necessary to diagnose medial medullary infarction. Most infarctions limited to the upper third of the medulla were caused by occlusions of vertebral arteries or their branches and prognosis was good. In contrast, infarctions in the lower two thirds were caused by occlusions of anterior spinal arteries and their branches and the prognosis was poor. Thus localization of the lesion using MRI plays an important role to predict the prognosis.
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PMID:[Medial medullary infarction demonstrated by MRI]. 218 65


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