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

The bulbocavernosus reflex was investigated electrophysiologically in 14 normal adult male subjects and in 80 patients with neurogenic bladders and/or impotence due to various neurological causes as well as in patients with functional impotence. The glans penis was stimulated superficially by single electrical shocks and the reflex responses were recorded from the bulbocavernosus (BC) and the striated anal sphincter muscles by means of concentric needle EMG electrodes. In all normal subjects, the BC reflex was recorded from the BC muscle as a stable and constant response having a mean latency of 36.1 msec. A response from the external anal sphincter was obtained in only 21% of the subjects investigated. In 13 patients with cauda equina lesions, the BC reflex was either absent or was present with a prolonged latency. Twenty-two patients with polyneuropathy of various causes were also investigated; in these patients the latency of the BC reflex was significantly greater than in the normal controls, but the most abnormal results were obtained in cases of alcoholic polyneuropathy. In the 19 cases of spinal cord disease with spasticity the BC reflex response was very intense, often with after discharges but latency values were within normal limits. In the 16 cases with functional impotence, the BC reflexes were basically normal; but in 3 cases, the threshold of the reflex was significantly raised, and in 1 case a prolonged latency was observed. The value and the practical application of the BC reflex in the BC reflex in the differential diagnosis of bladder dysfunction and of impotence was stressed.
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PMID:Bulbocavernosus reflex in normal men and in patients with neurogenic bladder and/or impotence. 18 Feb 61

A geographic isolate of tropical spastic paraparesis (TSP) in Tumaco, Colombia, is described. Fifty confirmed cases were identified (29 men, 21 women) with an estimated prevalence ratio of 98 cases per 100,000 population. Patients with identified cases ranged in age from 24 to 75 years (mean, 46.5). TSP begins with burning feet, leg stiffness, spastic bladder, and, in men, impotence. Patients exhibited leg weakness, spasticity, hyperreflexia, and scissoring gait. Babinski, Chaddock, and Hoffmann signs could be elicited. Ankle reflexes and vibratory sensation of the feet were decreased. Intellectual function, coordination, and cranial nerves remained normal. TSP is a slowly progressive disorder but so far there have been no deaths from it. Forty cases in this report began between 1971 and 1980; the earliest documented case began in 1952. Living conditions and occupations of the patients were typical for the region. Yaws had occurred in 74% of confirmed cases. No likely etiological neurotoxic or nutritional factors were identified. TSP also has been described in India, Africa, the Seychelles, and Jamaica.
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PMID:Tropical spastic paraparesis: a neuroepidemiological study in Colombia. 400 58

Dementia, a syndrome of acquired intellectual deterioration, is an etiologically nonspecific condition that can be permanent or reversible. When evaluating demented patients, a careful exposure history will determine the possible role of drugs, metals, or toxins. Physical examination may reveal focal deficits in cases of intracranial mass lesions and spasticity or ataxia of the lower limbs if hydrocephalus is present. Coexistence of dementia and a peripheral neuropathy usually indicates the existence of a toxic or metabolic disorder. Depressed mood, sleep disturbance, anorexia, impotence, constipation, and psychomotor retardation indicate the presence of a depressive syndrome. Asterixis, myoclonus, and postural tremor are common in toxic-metabolic dementias, whereas resting tremor, choreoathetosis, or rigidity occur in progressive extrapyramidal disorder. EEG is focally abnormal in cases of cerebral mass lesions and shows generalized slowing in toxic-metabolic encephalopathies. CT will aid in the identification of hydrocephalus, subdural hematomas, and intracranial mass lesions. A thorough laboratory evaluation including complete blood count, erythrocyte sedimentation rate, electrolytes, blood urea nitrogen and blood sugar, liver and thyroid function tests, serum calcium and phosphorus levels, B12 and folate levels, serum copper and ceruloplasmin, VDRL, chest X-ray, electrocardiogram, and lumbar puncture may demonstrate treatable disorders that are adversely affecting intellectual function. Elderly individuals are particularly susceptible to the effects of toxic or metabolic disorders, and a mild dementia may be exaggerated by relatively minor fluctuations in metabolic status. Treatable causes of dementia should be sought in all demented patients.
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PMID:Treatable dementias. 635 58

Thirteen paraplegias after decompression have been treated in the 5 centres of Lyons, Geneva, Mulhouse, Basel and Strasbourg. All these cases are somehow comparable: 12 males, 1 female, skilled and well-trained divers are involved from 27 to 50 years. Submersion between 30 and 42 metres, during 15 to 30 minutes. Ascension with or without decompression stops. Beginning with sudden posterior thoracic, 4 feeling sick, 2 becoming briedly unconscious, paralysis after a while (until 1 hour). All have received hyperbaric oxygenation (from 1 to 5 hours later), with an improvement for 10. Neurological findings. 5 tetraplegics, 7 para-(5 with Brown-Sequard), and one LI. Quickly, the tetraplegics improved to a thoracic level. In two cases, paraplegia remained complete at thoracic level. The others had a better evolution; the paralysis improved slowly, with marked spasticity, impaired sensation did not improve to such an extent, often localised at a lower level, with sexual impotence. Micturitions became normal but with often urine leakages. This rather favourable evolution allowed 11 to go back to work.
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PMID:Paraplegia during skin-diving. (13 cases). 699 Mar 50

The family of alpha(2)-adrenergic receptors (alpha(2)-ARs) comprises three subtypes which are each endowed with specific functions. alpha(2)-agonists and alpha(2)-antagonists are part of the clinician armamentarium since several decades; however, none of the compounds so far available is subtype selective. For long, clonidine and yohimbine have been used for the treatment of hypertension and impotence respectively, but both have been superseded by newer drugs. This review attempts, by a comprehensive analysis of the literature, to cover the present clinical use and the potential therapeutic interest of alpha(2)-agonists or antagonists. From the clinical data, it is concluded that, with the exception of a few particular situations, alpha(2)-agonists are only of limited utility as a monotherapy. By contrast, they offer several powerful advantages when used in adjunctive therapy. In perioperative settings, alpha(2)-agonists are extremely valuable adjuncts to anesthetics and analgesics for the induction of anxiolysis, maintenance of sedation, management of pain and prevention of shivering. In the ophthalmic clinic, they are used to lower intra-ocular pressure during laser surgery of the eye. As a daily medication, alpha(2)-agonists are also of interest for the treatment of glaucoma, muscle spasticity, opiate withdrawal, and behavior disorders. The alpha(2)-antagonists are useful antidotes for reversing the threatening effects of agonist overdose, but currently there are very few indications. New applications are under investigation, and new molecules with more refined subtype-selectivity may emerge, so the clinical utility of both alpha(2)-agonists and antagonists will undoubtedly expand in the future.
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PMID:Interest of alpha2-adrenergic agonists and antagonists in clinical practice: background, facts and perspectives. 1726 5

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is an inherited neurodegenerative disorder with symptoms of spastic ataxia, neuropathy, pyramidal sign, finger and foot deformities, and hypermyelination of retinal nerve fibers. SACS is mutated in ARSACS. The clinical diversity of ARSACS is recognized, which sometimes makes its diagnosis difficult. By using homozygosity mapping, we identified a novel homozygous c.12020C > T missense mutation in a consanguineous Japanese family with atypical clinical features. In addition to the absence of spasticity and hypermyelinated retinal nerve fibers, the present case had urinary dysfunction, impotence, and severe constipation, indicating the possibility of autonomic dysfunction. Furthermore, we showed the diagnostic usefulness of MRI even for the case of atypical clinical features. It had been considered that cases without obvious spasticity were very rare, however recent reports on atypical cases as well as our case indicate that ARSACS cases without obvious spasticity might be more frequent than previously thought. We should be aware of atypical features of ARSACS for the correct diagnosis.
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PMID:A novel SACS mutation in an atypical case with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). 2289 8