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

Upper airway flow mechanics and arterial blood gas measurements were used to assess the efficacy of subtotal arytenoidectomy for treatment of induced left laryngeal hemiplegia in horses. Measurements were collected with the horses at rest, and trotting or pacing on a treadmill (6.38 degrees incline) at speeds of 4.2 and 7.0 m/s. Experimental protocols were performed after right common carotid artery exteriorization (baseline), after left recurrent laryngeal neurectomy (LRLN), and after left subtotal arytenoidectomy. At baseline, increasing treadmill speed progressively increased peak inspiratory and expiratory flow (VImax and VEmax, respectively), peak inspiratory and expiratory transupper airway pressure (PuI and PuE, respectively), respiratory frequency (f), tidal volume (VT), minute volume (VE), and heart rate. Inspiratory and expiratory times (TI and TE, respectively) and arterial oxygen tension (PaO2) decreased with increased treadmill speed; inspiratory and expiratory impedance (ZI and ZE, respectively) did not change. After LRLN, VImax, f, and PaO2 significantly (P less than 0.05) decreased at exercise, whereas PuI, TI, and ZI significantly increased. Minute volume decreased at exercise after LRLN, but the changes were not significant; LRLN had no effect on VEmax, PuE, ZE, heart rate, arterial carbon dioxide tension (PaCO2), or VT. Subtotal arytenoidectomy did not improve upper airway flow mechanics or blood gas measurements impaired by laryngeal hemiplegia.
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PMID:Failure of subtotal arytenoidectomy to improve upper airway flow mechanics in exercising standardbreds with induced laryngeal hemiplegia. 239 98

The purpose of this project was to attempt restoration of abduction of a recently denervated left dorsal cricoarytenoid muscle in the horse by anastomosing the first cervical nerve to the abductor branch of the left recurrent laryngeal nerve. Ten horses were used in the study. In six horses the left recurrent laryngeal nerve was transected and ligated while the ventral branch of the left first cervical nerve was anastomosed to the abductor branch of the left recurrent laryngeal nerve. The remaining four horses also had the left recurrent laryngeal nerve transected and ligated but had no nerve anastomosis performed. Each horse was evaluated preoperatively, and at one week, three and six months after surgery, by endoscopy and determination of upper airway resistance. The endoscopy was performed with the horses breathing room air and while breathing 10% carbon dioxide. All ten horses showed endoscopic signs of complete laryngeal hemiplegia immediately postoperatively. Starting at three months postoperatively clonic movements of the left arytenoid cartilage were observed in four of the six reinnervated horses but not in the sham operated horses. At the sixth postoperative month five reinnervated horses had clonic movements of the left arytenoid cartilage. The comparison of upper airway resistance measurements before surgery and at one week, three and six months after surgery showed no significant differences in either control or experimental horses. Following euthanasia at six months postoperatively, the left and right dorsal crioarytenoid muscles were compared for evidence of reinnervation. No significant difference in weight was noted in the reinnervated horses but the left dorsal cricoarytenoid muscle weighed less than the control horses.
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PMID:Attempts to restore abduction of the paralyzed equine arytenoid cartilage. III. Nerve anastomosis. 271 87

We recorded the EMG of parasternal intercostal muscles in 25 patients with flaccid hemiplegia during quiet spontaneous breathing, voluntary hyperventilation, and CO2-induced hyperventilation. The respiratory drive was abnormal on the hemiplegic side and the function of the intercostal muscles was affected specifically during voluntary hyperventilation.
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PMID:The effect of acute hemiplegia on intercostal muscle activity. 319 67

Sixteen patients with an early dense hemiplegia due to cerebrovascular accidents were shown to have a greater degree of hypoxia than 16 matched control patients. The patients with hemiplegia had a reflex compensatory fall in arterial carbon dioxide tensions (PaCO2) with possible reduction in cerebral blood flow. Oxygen treatment led to an increase in PaCO2 in the patients with hemiplegia, but the increase in oxygen tensions in these patients was significantly less than that in the control group, suggesting increased pulmonary shunting as the cause for the hypoxia. Oxygen treatment may improve cerebral blood flow and oxygenation and have a useful role in the early management of patients with a dense hemiplegia.
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PMID:Hypoxia in patients with acute hemiplegia. 641 96

Hemiplegia after carbon monoxide (CO) poisoning is rare since only 9 such lesions have been reported from among 1480 cases of poisoning. The patient reported was a 43 year-old man with a left hemiplegia with coma following CO poisoning. Right carotid angiography demonstrated a hypoglossal artery supplying both posterior cerebral arteries. Left carotid angiography showed a dolichocarotid artery supplying the territories of the anterior and middle cerebral arteries on both sides. Complete regression of the hemiplegia occurred after 2 months following rapid administration of hyperbaric oxygen. Normal CT scan images and cerebral blood flow rates on follow-up examination suggest that the left hemiplegia was due to the combined effects of arterial anomalies and CO poisoning.
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PMID:[Hemiplegia during carbon monoxide poisoning revealing multiple cerebral artery abnormalities including the hypoglossal artery]. 646 90

A standardised incremental exercise test was performed by 9 racehorses with idiopathic laryngeal hemiplegia (ILH), 1 horse with maxillary sinus cysts, 1 horse with epiglottic entrapment, 1 horse with a lesion on the vocal folds, and 1 horse with pharyngitis. Two of the horses with ILH were retested after laryngoplasty and ventriculectomy. The findings were compared with those from 20 normal racehorses. Heart rate, plasma lactate concentration, arterial blood gases, stride frequency, oxygen uptake (VO2) and carbon dioxide production were assessed during treadmill exercise on a +10% slope. The group of horses with ILH had significantly (P < 0.01) lower peak VO2 values (136 +/- 5 ml/kg/min) than did the normal group (154 +/- 3 ml/klg/min). These values represent mean +/- sem. Horses with ILH also had significantly higher (P < 0.05) arterial carbon dioxide tensions (PaCO2) at 10 m/s and lower speeds at a heart rate of 200 bpm (V200) than the normal group. The horse with maxillary sinus cysts had higher PaCO2 tension at 10 m/s than normal, and abnormal values for several cardiorespiratory and metabolic indices. Horses with vocal fold lesions, aryepiglottic entrapment and pharyngitis had arterial blood gas and cardiorespiratory indices that were similar to those of normal horses. One horse which underwent corrective surgery for ILH showed improvements in arterial blood gases and cardiorespiratory indices during exercise, while the other horse had values which were the same as, or worse than, values before surgery. We conclude that the measurement of arterial blood gases and cardiorespiratory indices during treadmill exercise is useful in determining the effect on exercise capacity of various upper airway abnormalities in racehorses.
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PMID:Cardiorespiratory and metabolic responses to exercise in horses with various abnormalities of the upper respiratory tract. 854 42

We report the case of a 25-year-old woman undergoing a laparoscopic cholecystectomy, who suffered, one min after the beginning of intraperitoneal insufflation of CO2 (2.5 L at a pressure of 10 mmHg), a sudden decrease to 0.8 L.min-1 of the aortic blood flow (ABF), monitored in the descending aorta by an oesophageal echo-Doppler probe, associated with a decrease of PetCO2 to 15 mmHg and of SpO2 readings to 88%. Despite the lack of simultaneous changes in heart rate and arterial pressure, pulmonary gas embolism (GE) was suspected. The pneumoperitoneum was exsufflated and CPR was started because of circulatory inefficiency. Ten min later, efficient spontaneous cardiac activity restarted, whereas PetCO2 and ABF returned rapidly to normal values. At this time, a typical gas noise was clearly obtained through the oesophageal Doppler transducer. The patient remained in deep coma (GCS:6) with a left sided hemiplegia. However, she fully recovered after four sessions of hyperbaric oxygenation. Simultaneous continuous monitoring of ABF and PetCO2 allows an undelayed recognition of major circulatory disturbances, before significant changes in heart rate and arterial pressure occur.
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PMID:[Diagnosis of heart arrest caused by CO2 embolism during laparoscopic surgery by monitoring of aortic blood flow and capnography]. 857 8

The relationship between different grades of laryngeal function, as assessed by endoscopy at rest, and the measurements of indices of gas exchange and exercise capacity was assessed during a standardised treadmill exercise test in 149 horses. Horses with abnormalities other than idiopathic laryngeal hemiplegia (ILH) were excluded from the study and laryngeal function was graded according to an established system. There were no significant differences in age, weight, maximum oxygen uptake, maximum carbon dioxide production, maximum respiratory exchange ratio, maximum oxygen pulse and run time between the grades. Blood lactate concentration at 10 m/s was greater (P < 0.01) in horses with grade 5 laryngeal function than other grades. Minimum PaO2 (P < 0.001) and SaO2 (P < 0.01) were lower and maximum PaCO2 (P < 0.001), higher in horses with grades 4 and 5 laryngeal function than other grades. Horses with grade 4 function had a lower minimum CaO2 (P < 0.01) than horses with other grades. Minimum PAO2 decreased from grades 1 and 2 to grades 4 and 5 (P < 0.05). The minimum alveolar ventilation was lower (P < 0.05) in horses with grades 4 and 5 laryngeal function compared to other grades. The results of this study indicate that endoscopic assessment of laryngeal function at rest, using a simple grading system, provides an indication of dynamic changes in ventilation and the effects on blood gases during exercise. From the data, we suggest that horses that have some movement of the left arytenoid cartilage but are unable to achieve full abduction have similar ventilatory effects and blood gas responses during maximal exercise to those with complete paralysis. Some horses with grade 3 laryngeal function had blood gas results similar to those of horses with grades 4 and 5 laryngeal function, indicating that discrepancies may occur between the resting assessment and laryngeal function during strenuous exercise.
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PMID:Cardiorespiratory responses to exercise in horses with different grades of idiopathic laryngeal hemiplegia. 903 57

The diaphragm muscle (DIAm) has a large reserve capacity for force generation such that in rats, the transdiaphragmatic pressure (Pdi) generated during ventilatory behaviors is less than 50% of maximal Pdi (Pd(imax)) elicited by bilateral phrenic nerve stimulation. Accordingly, we hypothesized that following unilateral denervation (DNV), the ability of the contralateral DIAm to generate sufficient Pdi to accomplish ventilatory behaviors will not be compromised and normal ventilation (as determined by arterial blood gas measurements) will not be impacted, although neural drive to the DIAm increases. In contrast, we hypothesized that higher force, non-ventilatory behaviors requiring Pdi generation greater than 50% of Pd(imax) will be compromised following DIAm hemiparalysis, i.e., increased neural drive cannot fully compensate for lack of force generating capacity. Pdi generated during ventilatory behaviors (eupnea and hypoxia (10% O2)-hypercapnia (5% CO2)) did not change after DNV and arterial blood gases were unaffected by DNV. However, neural drive to the contralateral DIAm, assessed by the rate of rise of root mean squared (RMS) EMG at 75 ms after onset of inspiratory activity (RMS75), increased after DNV (p<0.05). In contrast, Pdi generated during higher force, non-ventilatory behaviors was significantly reduced after DNV (p < 0.01), while RMS75 was unchanged. These findings support our hypothesis that only non-ventilatory behaviors requiring Pdi generation greater than 50% of Pd(imax) are impacted after DNV. Clinically, these results indicate that an evaluation of DIAm weakness requires examination of Pdi across multiple motor behaviors, not just ventilation.
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PMID:Impact of unilateral denervation on transdiaphragmatic pressure. 2564 47

The vast clinical manifestations of carbon monoxide (CO) poisoning can involve the neurological, neuropsychological and cardiac systems as well as others. In this case report, we describe our management of a 64-year-old woman exposed to CO in her apartment. Her presentation was unusual in that she had symmetric globus pallidus lesions, no evidence of thrombosis, but the lateralizing neurologic manifestation of severe hemiplegia.
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PMID:Hemiplegia and bilateral globus pallidus infarcts after carbon monoxide poisoning: case report. 2957 Dec 38


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