Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A chart review of 23 girls diagnosed with the Rett syndrome (RS), seen at Oregon Health Sciences University-Child Development and Rehabilitation Center was conducted to identify specific motor problems. Hypotonia, loss of transitional movements, ataxia, motor apraxia, spasticity, kyphoscoliosis, and foot deformities proved to be characteristics of this syndrome. Clinical experience of the author and other therapists involved in the treatment of girls with RS suggests that physical therapy is useful in the management of these patients to maintain or increase motor skills and control deformities. Therapy techniques the author has found useful are presented and responses unique to RS patients are described.
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PMID:Motor disabilities in the Rett syndrome and physical therapy strategies. 234 13

Two young males in their thirties are reported with a clinical history and examination indistinguishable from typical females with the Rett syndrome. Both had normal early development. The first patient had a regression by the end of the second year. He was late in walking, had prominent hand-wringing from the age of 4 years, and non-progressive dystonia from the age of 14 years. He is still ambulatory. Seizures which started at the age of 18 months have been easily controlled. The second patient has had a severe seizure disorder since the age of 7 months. In his early teens, he lost ambulation and his height and weight fell below the 2nd percentile. He has severe foot dystonia without spasticity. Both patients have a normal head size and no evidence of atrophy on a CT scan of the brain. Both had kyphoscoliosis in their teens. It is difficult to evaluate the incidence of such cases. Little attention being paid to the normal early development, they hide behind vague diagnoses such as cerebral palsy, static encephalopathy, and behavior disorder. Dystonia is often confused with spasticity, the lack of paralysis is not appreciated, apraxia and hand wringing are assumed to be self-stimulatory behaviors.
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PMID:The Rett syndrome in males. 234 22

We describe a 56-year-old man who had a progressive pseudobulbar palsy, spastic tetraparesis, forced laughing and disturbance of voluntary eyelid closure, and was clinically compatible with chronic progressive spinobulbar spasticity. Magnetic resonance images (MRI) revealed atrophy of the bilateral motor cortices and single photon emission tomography after intravenous injection of N-isopropyl-p-iodoamphetamine iodine-123 (IMP-SPECT) showed hyporadioactivity in the same regions. Electrophysiological studies on supranuclear paralysis of eyelid closure demonstrated that so-called apraxia and motor impersistence coexisted and that in attempts to keep the eyelid closed the inhibition of basal activity of the levator palpebrae superioris muscle and activation of the orbicularis oculi muscle were insufficient, indicating the impaired reciprocity of these ocular muscles. The corresponding lesion of these eyelid symptoms was considered to be the bilateral motor cortices.
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PMID:Chronic progressive spinobulbar spasticity with disturbance of voluntary eyelid closure. Report of a case with special reference to MRI and electrophysiological findings. 237 50

Diagnostic criteria for Rett syndrome (RS) were developed by representatives of the International Rett Syndrome Association and the Centers for Disease Control for use in future clinical and epidemiological studies. Necessary criteria are: normal prenatal and perinatal period; normal psychomotor development through the first 6 months of life; normal head circumference at birth, with subsequent deceleration of head growth; loss of purposeful hand skills; severely impaired expressive and receptive language; apparent severe mental retardation; and gait apraxia and truncal apraxia/ataxia. Supportive criteria include breathing dysfunction, seizures, spasticity, scoliosis, and growth retardation. The diagnosis of RS is considered tentative until 2 to 5 years of age. The differential diagnosis includes other disorders associated with mental retardation, cerebral palsy, and seizure disorders. These diagnostic criteria for RS should foster reliable communication among investigators and enhance the epidemiological and clinical research of this important disorder.
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PMID:Diagnostic criteria for Rett syndrome. The Rett Syndrome Diagnostic Criteria Work Group. 245 7

Computerized analysis of gait was performed in six patients with hydrocephalus (mean age, 75.7 years), for comparison with other elderly patients with gait problems and age-matched controls. A decrease in velocity and stride, an increase in sway, and the proportion of time spent in double-limb stance were nonspecific features correlated with declining performance. Certain features appeared to characterize hydrocephalic gait when compared among groups; cadence was diminished, and there was a reduction of step height and a decreased counterrotation of the shoulders relative to the pelvis. An abnormal tendency toward cocontraction in antagonist muscle groups was observed in electromyographic data from the leg muscles, suggesting that the normal phased activation of muscle groups is disturbed. Although data are not conclusive, we believe that the gait disorder in normal-pressure hydrocephalus reflects a subcortical motor control disorder rather than a phenomenon of spasticity or apraxia.
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PMID:Gait disorder in late-life hydrocephalus. 382 77

Local injections of botulinum toxin is a well-accepted treatment for focal dystonias, hemifacial spasms and strabismus. Its use by skilled neurologists has been reported to be safe and effective. We report our experience with botulinum toxin injections in 108 patients with various central nervous system disorders. Botox was effective in upper face dystonia (86% improvement), spastic dysphonia (92% improvement), platysma muscle spasms and spasmodic torticollis (range of movement 61%, pain and tension 90%). It was also very effective in a few patients with apraxia of eyelid opening, parkinsonian jaw tremor, teeth clenching, palatal myoclonus and adductor leg spasticity. No serious side effects were recorded. Botulinum toxin is a useful symptomatic treatment for many neurological disorders, and one of the leading mode of treatments in the new subspecialty in neurology called "Interventional neurology."
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PMID:Interventional neurology: botulinum toxin as a potent symptomatic treatment in neurology. 798 70

Approximately 40% to 60% of infants born prior to 32 weeks' gestation experience an IVH. The impact of unregulated CBF precipitating an IVH has ramifications far beyond the walls of the neonatal intensive care unit. Infants who survive alterations in CBF may experience impaired neurologic development. Cerebral ischemia can lead to poor articulation, dysphasia, attention deficit, low intelligence quotient, dyspraxia, dyssynergia, spasticity, and short-term memory dysfunction. The neurologic and intellectual development of these premature infants must continue to be a crucial factor in planning their nursing care.
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PMID:Impaired cerebral vascular blood flow in the premature infant. 833 90

We reported a rare case who had hypoxic-encephalopathy causing frontal apraxia of gait. The patient, a 34-year-old female, was admitted in July, 1994, complaining of difficulty in walking after anoxic brain damage caused by ventricular arrhythmia. She had difficulty in raising her feet, which appeared to be rooted to the floor. There was no evidence of motor paralysis, spasticity, rigidity or sensory loss, but she did show frontal lobe signs such as foot grasp reflex and Gegenhalten. Cranial MRI showed slight atrophy of the frontal lobe. On T2 weighted image, high-intensity areas were detected at the posterior internal capsule and corona radiata. Single photon emission CT (123I-IMP) demonstrated a low perfusion area which included the inferomedical part of the frontal lobe. After 8 months of hospitalization, her postural instability and unsteady gait slowly improved without treatment as frontal signs such as foot grasp reflex disappeared. We speculate that her apraxia of gait may result from grasp reflex and Gegenhalten.
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PMID:[A case of frontal gait apraxia caused by hypoxic encephalopathy]. 916 59

Multiple sclerosis (MS) is associated with an increased risk of falling resulting from visual disturbances, difficulties with gait and balance, apraxia of gait and peripheral neuropathy. These factors often interact synergistically to compromise the patient's gait stability. It has long been recognized that walking involves a cognitive component and that simultaneous cognitive and motor operations (dual-task) such as talking while walking may interfere with normal ambulation. Talking while walking reflects an example of a dual-task which is frequently impaired in MS patients. Impaired dual-task performance during walking may compromise the patient's gait and explain why in some circumstances, MS patients unexpectedly lose their balance and fall. Frontal lobe dysfunction, which commonly occurs in MS patients, may disrupt dual-task performance and increase the risk of falling in these patients. This report concerns a 36 old man with remitting-progressive MS with an EDSS score of 5.5 who experienced marked increase in spasticity in the legs and trunk and worsening of his gait and balance, occasionally resulting in falling, when talking while walking. His gait and balance improved dramatically after he received two successive transcranial treatments, each of 45 minutes, with AC pulsed electromagnetic fields (EMFs) of 7.5 picotesla flux density. Simultaneously, there was improvement in dual-task performance to the extent that talking while walking did not adversely affect his ambulation. In addition, neuropsychological testing revealed an almost 5-fold increase in word output on the Thurstone's Word-Fluency Test, which is sensitive to frontal lobe dysfunction. It is suggested that facilitation of dual-task performance during ambulation contributes to the overall improvement of gait and balance observed in MS patients receiving transcranial treatment with AC pulsed EMFs.
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PMID:Treatment with electromagnetic fields improves dual-task performance (talking while walking) in multiple sclerosis. 952 59

We report a 73-year-old woman who presented progressive motor clumsiness, cortical sensory loss, and focal parietal lobe atrophy. She was well until one year prior to the present admission when she suffered from what appeared to be mild Fisher syndrome from which she showed excellent recovery. However, soon she noted a gradual onset of difficulty in hand movements and in the recognition of objects by hands. Neurologic examination revealed an alert and well oriented Japanese woman without dementia. Cranial nerves were unremarkable. Although, she did not have aphasia, apraxia, or agnosia, she showed marked clumsiness in skilled hand movements such as using chopsticks, hand writing, and buttoning. She had no motor weakness, ataxia, rigidity, or spasticity. Deep tendon reflexes were symmetrically diminished. Sensory examination revealed cortical sensory loss such as disturbances of two point discrimination, weight sensation, and stereotactic sensations. Her motor clumsiness appeared to be caused by her cortical sensory loss. MRI revealed marked focal atrophy in the bilateral parietal lobe, particularly in the postcentral gyrus and the adjacent association areas. Recently, neurodegenerative disorders with focal brain atrophy such as corticobasal degeneration, Pick's disease, and dementia of frontal lobe type have been reported, however, our patient does not fit to any of these known disorders nor clinical features are distinctly different from Alzheimer's disease. Our patient may be another example of progressive cerebral degeneration with emphasis on the parietal cortex.
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PMID:[A patient with focal bi-parietal atrophy presenting motor clumsiness and cortical sensory loss]. 971 Nov 23


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