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)

In 1970 we carried out the first electrode implantation of the conus medullaris of a 17-year-old male paraplegic to control the emptying of his paralyzed bladder. Our patient has used electromicturition for 6 years to successfully empty his bladder and prevent urinary infection. To date, a total of 11 paraplegic patients have been implanted (6 males, 5 females). The cause of the paraplegia was the result of trauma, and the implants were performed from 16 days to 15 years postinjury. All the patients had experienced numerous urinary infections and required constant catheter drainage, and it was the opinion of our urologic associate that current methods of control of the bladder problem were of no avail. The bladder was considered to be atonic in 7 patients and spastic in 4. The results indicate that after a follow-up of 1--6 years, 8 patients have complete control of voiding by electrical stimulation (4 female, 4 male). 2 of the males required partial sphincterotomy to improve emptying, but none of the females experienced sphincter interference. One male quadriparetic patient died 7 months postimplantation of pneumonia and hepatitis. There have been no infections related to the implantable device; however, 1 female broke the connecting wires to the spinal cord electrode during a paraplegic basketball game. In addition to the induced electrical contraction of the bladder, we have observed increased autonomic activity below the level of the spinal cord transection, improved defecation, reduction of spasticity in the paralyzed legs, penile erection in males, and reduction of decalcification of the long bones. This group of patients represents the longest use of an implantable electronic device to control bladder function.
 ...
PMID:Electrical stimulation of the conus medullaris in the paraplegic. A 5-year review. 30 11

Patients with spinal cord injury or multiple sclerosis were surveyed for the presence of extreme foot deformities and spasticity. Pes cavus and claw toes were found in eight of 80 spastic spinal cord injury and two of 20 multiple sclerosis patients. Pes cavus and claw toes were not found in 29 flaccid spinal cord injury patients. Pes cavus and claw toes were associated with flexor reflexes which could be elicited by pin prick proximal to the knee, suggesting extreme spasticity--and by low excitatory thresholds for the anterior tibialis as indicated electromyographically. Complications of severe spasticity associated with spinal cord injury and multiple sclerosis include pes cavus and claw toes, mediated in part by spasms of the anterior tibialis.
Paraplegia 1979 Feb
PMID:Pes cavus and claw toes deformity in patients with spinal cord injury and multiple sclerosis. 43 69

A polystyrene bead vacuum wheelchair cushion has been tried with several patients with abnormal postural reflex activity. Excess spasticity can be reduced by this means and sitting comfort enhanced.
Paraplegia 1979 Feb
PMID:The polystyrene vacuum wheelchair cushion. 43 73

Twenty patients with spinal cord injury underwent serial electromyographic examinations. Fibrillation potentials and positive waves were noted in six patients in the spinal shock phase. In another subject, these potentials were found 27 months after injury. Our finding of significant slowing in the NCV of both nerves, indicates that lower motor neurons are indeed affected by upper motor neuron lesions. The H-reflex studies showed an increase in the mean H/M ratio. This may indicate an increase of reflex motor neuron excitability. No clear correlation was found between this increase and the degree of clinical spasticity. With repeat investigations, after a period of physical activity, a trend to reduction of the H/M ratio was noted with no clinical confirmation of reduction in spasticity. These findings emphasise the need for not assigning diagnostic terms to EMC abnormalities, but rather identifying them as neurophysiological changes which must be interpreted in the light of the clinical picture.
Paraplegia 1977 Nov
PMID:Electrodiagnostic investigation of motor neuron and spinal reflex arch (H-reflex) in spinal cord injury. 59 14

Based on the experience to date with central cord syndrome, most or all of the following conditions should be present before considering transurethral sphincterotomy: (1) minimal neurological recovery within 6 months of injury; (2) four plus spasticity in patients over the age of 50 years; (3) prolonged intermittent catheterisation over 6 months, with persistent residual urine over 300 ml; (4) persistent and repeated use of diazepam, dantrolene sodium to control pelvic floor spasticity; (5) demonstrable detrusor-sphincter dyssynergia.
Paraplegia 1977 May
PMID:Management of neurogenic bladder dysfunctions following acute traumatic cervical central cord syndrome (incomplete tetraplegia) [proceedings]. 89 53

In decompression sickness and during some surgical procedures, air emboli that form sometimes cause serious damage if the gas bubbles find their way to the vital organs. Paralysis of the spinal cord is one of the most serious manifestations induced by air emboli. Exposure to compression chambers is effective in air emboli treatment, but availability of chambers is inadequate and the treatment is lengthy. Until now there has been no fully effective injectable agent that can remedy the damage caused by air embolization. In this work levodopa was chosen as an injectable drug that might help to improve recovery from experimental paraplegia because of the reported effects of levodopa on muscle tone, spasticity and locomotion. To induce air emboli, the descending aorta of rats was chronically cannulated. Two weeks later, after full recovery from surgery, air was injected through the chronically implanted cannula into unanesthetized rats (0.35 ml of air per 100 g, during 4 sec). The paraplegia (paralysis of both hind legs) was manifested 2-10 minutes later. Only animals that had total paraplegia, without any sensation, were used in the experiments. Levodopa was administered 2 minutes after paraplegia was established. The levodopa treatment was repeated each day during one week. After six days, ten levodopa treated (intra-arterially) animals in a group of twelve and six levodopa treated (intraperitoneally) animals in a group of eight recovered completely from paraplegia. In control groups only three from thirteen (untreated), or two from twelve (solvent administration) animals recovered from paraplegia.
 ...
PMID:Recovery from experimental paraplegia after levodopa administration. 96 98

This study has evaluated the changes in the characteristics of the H-reflex induced by distention of the urinary bladder in patients with complete lesions of the spinal cord. These findings were compared to induced changes in the systolic blood pressure and some degree of correlation was noted. It is well recognised that distention of the urinary bladder can exert a significant influence on the state of both somatic and autonomic reflex activity in spinal man. Although the mode of action of this stimulus has not been fully delineated, it is of some clinical importance since it may intensify muscular spasticity and autonomic hyperreflexia. This study was undertaken to further explore this relationship utilising the H-wave as a measure of segmental reflex activity. When appropriate, the effect of bladder distention on arterial blood pressure was also measured and an attempt made to correlate these observations with the H-wave findings.
Paraplegia 1976 Aug
PMID:Alterations in the H-reflex in the paraplegic induced by bladder distention. 97 56

An evaluation of dorsal longitudinal myelotomy in the management of spasticity of the lower limbs has been done in 17 patients. The follow-up has varied from 1 month to over 2 years. Most patients achieved satisfactory relief from spasticity. Eight patients have died after the operation in chronic care hospitals. In all except one, the spasticity had been relieved. Eight out of the nine living patients have benefited from myelotomy. Recurrence of spasticity following the first operation occurred in four patients, two of whom improved after a repeat myelotomy. In the presence of fixed contractures of the hip and knee joints, a satisfactory clinical result may not be obtained after the myelotomy.
Paraplegia 1976 Nov
PMID:Dorsal longitudinal myelotomy. 99 17

In a patient with Holmes-Adie syndrome, and in another with tabes dorsalis, a transverse cord lesion resulted in a severe, but flaccid paraplegia with absent tendon reflexes. Flexor spasms were severe in both patients, but spasticity was absent. The significance of these observations is discussed in relation to the functional and anatomical disorder in these two syndromes.
 ...
PMID:Flaccid paraplegia: a feature of spinal cord lesions in Holmes-Adie syndrome and tabes dorsalis. 114 18

A sound anatomical and physiological basis has now been provided for the endoscopic operations which are carried out for the relief of urethral obstruction due to spasticity of the external sphincter. However, the operation 'external sphincterotomy' was originally applied empirically to cases with sacral areflexia in which the mechanism of the obstruction was obscure. It now seems that plain muscle contraction under sympathetic control and influenced by posture is probably responsible and there are prospects of relief from the use of alpha-adrenergic blocking agents. When endoscopic incision is required, the operation might be better designated 'internal membranous urethrotomy'.
Paraplegia 1976 Feb
PMID:A further look at the rationale of 'external sphincterotomy'. 126 79


1 2 3 4 5 6 7 8 9 10 Next >>