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

Equinus in hemiplegic children is multifactorial. In some cases it is due to a short muscle, in others to simple foot-drop, tonic spasticity, rigidity, compensation for a short limb, fixed flexion contracture at the hip, dominantly inherited forefoot deformity, forefoot equinus secondary to chronic toe-walking, or abnormalities of the visco-elastic properties of the muscle, with true intramuscular contracture. This neurophysiological study confirms that hemiplegia in children is not a homogeneous condition. Some have tonic spasticity; some, although stiff, show electrical silence on stretching; some appear to have a short muscle, with no hypertonicity; and others have hypertonicity in relation to position (i.e. rigidity). A short muscle is not always associated with tonic spasticity with reciprocal inhibition. Weakness can occur without spasticity. Speed of movement of toes, ankle and hip is also significantly reduced.
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PMID:Neurophysiology of lower-limb function in hemiplegic children. 177 40

Hypoglycemia causes a variety of neurologic symptoms, and yet it is rarely responsible for such a sudden, focal neurologic deficit as hemiplegia. Herein we described a rare case of what was believed to be transient hypoglycemic hemiplegia. An 80-year-old woman was admitted to the hospital on June 10, 1988, following frequent episodes of abnormal behavior and transient weakness of the right extremities. These symptoms, similar to those of cerebrovascular diseases, characteristically occurred early in the morning and disappeared after breakfast. On admission no definite abnormalities were disclosed on neurologic examination. Neuroradiological evaluations by CT, cerebral angiography and single photon emission CT failed to demonstrate abnormalities. The patient remained stable until the following morning, when she suddenly became restless and confused and developed total aphasia and the right hemiplegia. The blood sugar was estimated to be 34 mg/dl and electroencephalogram (EEG) showed continuous slow wave activities involving the bilateral fronto-parietal region. Intravenous injection of glucose solution instantaneously resulted in disappearance of both neurologic symptoms and EEG abnormality. Serum insulin level was found extremely increased ranging from 7000 to 8000 microU, eventually leading to a diagnosis of insulin autoimmune syndrome. Hemiplegia due to hypoglycemic attack was reviewed in the literature, and the pathogenesis and EEG findings were also discussed.
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PMID:[Transient hypoglycemic hemiplegia due to insulin autoimmune syndrome--a case report]. 218 65

Hemiplegia is the most frequent form of paralysis in humans and involves face, arm and leg on one side of the body. Diseases localized in the cortex, the cerebral white matter (corona radiata) and the internal capsule usually manifest themselves by weakness or paralysis of the face, the arm and the leg on the opposite side. In the causation of hemiplegia, vascular diseases of cerebrum and brainstem exceed all others in frequency. Trauma ranks second, and other important causes are brain tumor, encephalitis or abscess and demyelinating diseases.
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PMID:[Hemiplegia: diagnosis and differential diagnosis]. 223 64

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

We encountered two patients with right middle cerebral artery infarction who showed a unique eye sign not described so far. Both had suddenly developed central facial weakness, hemiplegia and hemisensory deficit in the left side. Anosognosia for the left hemiplegia, motor impersistence and left unilateral spatial neglect were also present. Initially they showed difficulty in keeping their eyes closed to the same degree on both eyes. However, this symmetrical motor impersistence of eye closing developed into a differential pattern over the days. Thus, on verbal command to close the eyes, the right eye in the non-paretic side would be closed continuously and excessively and in the left eye in the paretic side would be closed slightly and impresistently. This dissociation of eye closure was not observed in spontaneous eye closure. This symptom is close to the contralateral motor impersistence of eye closure which has been attributed to the right hemispheric lesion. But the concurrence of the ipsilateral overcontraction of the orbicularis oculi has not been described to the authors' knowledge. We proposed a hypothesis on this unique right-left dissociation of eye closing behavior.
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PMID:[Right-left dissociation of voluntary eyelid closure following right middle cerebral artery infarction]. 236 31

A 15-year-old boy suddenly developed a headache, followed by progressive weakness of the right extremities. A computed tomographic scan obtained on admission showed a low-density area in the left putamen extending to the internal capsule. No neurological deficits were observed other than slight dysarthria and right hemiparesis. Left carotid angiography showed the characteristic "string of beads" deformity of fibromuscular dysplasia (FMD) extracranially and complete occlusion of the internal carotid artery at the C2 portion. The right carotid artery and both vertebral arteries were normal. Anastomosis of the left superficial temporal and middle cerebral arteries was performed 1 month after the onset. The patient recovered quickly from the hemiplegia and was discharged with no neurological deficits. Angiograms obtained 3 months later showed not only patency of the bypass, but also recanalization of the intracranial internal carotid artery. Cervico-cephalic FMD mainly affects middle-aged women, and is uncommon in children; only nine childhood cases have been reported. This disorder may play an important role in the genesis of strokes among children.
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PMID:[Fibromuscular dysplasia with cerebral infarction in children. Case report]. 248 41

We reported a case of mitochondrial encephalomyopathy with repeated stroke-like episodes. A 33-year-old single male was admitted to our hospital because of stroke-like episodes with visual field defect, hemiplegia and convulsion repeated seven times for the past seven years. There were no abnormalities on the physical examination. He was hallucinative and perseverative and had mental deficiency. Muscle weakness and atrophy were not prominent, and generalized hyporeflexia were present without pathological reflexes. Myoclonus was not observed. Serum CK and blood gas analysis were normal (pH 7.398). Although blood levels of lactate and pyruvate were almost within normal limit, lactate was elevated by 20WATT-15 minutes exercises. On the contrary, the CSF levels of lactate and pyruvate were elevated markedly. CT of the brain revealed the presence of the low density areas in the right occipital and the left frontal lobes. Cranial 4 vessels studies were unremarkable. EEG showed the diffuse slowness with spike and wave complex. CT of the muscles were normal. A specimen obtained from the left biceps brachii muscle showed ragged-red fibers without obvious myogenic or neurogenic changes, and accumulations of abnormal mitochondria with paracrystalline inclusion bodies were observed by electron microscopy. However, mitochondrial abnormalities were not seen in the vessel walls in the biopsied muscle. Activities of complex I + III, II + III, IV in mitochondria were normal. Clinical features of this case were consistent with MELAS. However, this case showed no muscle weakness, short stature and lactic acidosis which characterize MELAS, and the onset of this case was later than those cases that were reported before.
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PMID:[A case of mitochondrial encephalomyopathy characterized by repeated stroke-like episodes]. 250 53

We report a 9 year-old boy with MELAS. High dosed oral thiamine administration and high fat diet induced remarkable neurological and biochemical improvement. His mother had episodic headaches and hemiplegia, probably MELAS. He complained muscle weakness and repeated episodes of vomiting started from 2 years of age. High levels of serum lactate and pyruvate were recognized, but with no metabolic acidosis. He developed generalized muscle weakness, growth retardation, generalized convulsions and stroke-like episodes at 5 years old. Optic nerve atrophy and mental retardation gradually appeared. A muscle biopsy at 5 years old revealed numerous ragged-red fibers with excess accumulation of lipid droplets and glycogen particles. Scattered fibers had no cytochrome c oxidase (CCO) activity representing focal CCO deficiency. An electron microscopy showed markedly increased number of giant mitochondria filled with markedly proliferated complicated cristae. Pyruvate dehydrogenase complex level in the fibroblasts was within normal ranges. Serum carnitine level was normal. With oral administration of thiamine hydrochloride (1000 mg) and high fat diet (60-70%), muscle weakness improved, and lactate and pyruvate levels in the serum reduced to normal ranges, whereas the mental deterioration, muscle atrophy, pes cavus progressed very slowly. He died from cardiac and renal failures at 9 years old. Autopsied muscles showed a marked decrease in cytochrome c oxidase activity (biochemically 12.8% of the normal level), and almost all muscle fibers had no cytochrome c oxidase activity histochemically. The progression of the MELAS was probably in parallel with the decrease in CCO activity.
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PMID:[A case of MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes) with progressive cytochrome c oxidase deficiency]. 255 13

This article presents a 4-year-old boy who suffered from weakness of the right extremities since birth. Physical examination revealed mild mental retardation and right spastic hemiplegia. No seizures were noted. A brain CT scan showed bilateral clefts along Sylvian fissures, more marked on the left side, which communicated with the lateral ventricle. The septum pellucidum was absent. There was an evident squaring of the frontal horns. The CT findings were consistent with the diagnosis of schizencephaly. When a patient with mental retardation and spastic hemiplegia or diplegia fails to show a history of perinatal cerebral insult, the possibility of schizencephaly should be considered. In that case, a brain CT scan is a rapid and accurate diagnostic tool.
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PMID:[Schizencephaly: report of one case]. 263

A case of recurrent internal carotid stenosis, one year after carotid endarterectomy, due to strangulation by scarring composed of digastric muscle, hypoglossal nerve and a branch of external carotid artery (ECA) is reported in this paper. A 34-year-old male suddenly became nauseated and developed right hemiplegia and dysphasia. He was admitted to a hospital, and the symptoms and signs improved gradually during a period of several weeks. A left carotid angiography, performed in another hospital, revealed a stenosis and wall irregularity around the highly-situated carotid bifurcation. He was transferred to our clinic with a view to being operated on. On admission, neurological examination disclosed a mild right motor weakness and motor dysphasia. A right carotid angiography revealed good cross circulation to the opposite. An EEG monitoring under the Matas test showed no outbreaks. With diagnosis of an embolism arising from carotid atheromatous plaque, a carotid endarterectomy was performed successfully. A postoperative angiography revealed good patency without stenosis nor wall irregularity around the carotid bifurcation. The postoperative and out-clinic condition was uneventful. However, one year after the operation, a left carotid angiography revealed recurrent internal carotid stenosis in a high degree. A second operation was performed and the operative findings showed an internal carotid stenosis due to strangulation by scarring composed of digastric muscle, hypoglossal nerve, a branch of ECA and connective tissue. The scarring was decompressed and a postoperative angiography revealed an improvement of the stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of recurrent internal carotid stenosis, after carotid endarterectomy, due to strangulation by scarring]. 277 Sep 64


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