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)

Nine patients (7 with amyotrophic lateral sclerosis, 1 with progressive spinal amyotrophy and 1 with chronic anterior poliomyelitis) were treated by sequential intravenous administration of 240 mg of TRH over one hour every two weeks. Results were assessed by an analytical evaluation of muscle strength before and 24 h after each infusion and by objective and subjective evaluation of spasticity. Significant improvement, as shown by statistical analysis, was noted in muscle strength in the 9 patients by 5 infusions over a 4-week period and a sub-group of 5 patients treated by 8 infusions over 10 weeks. Continued use of this therapy is justified by the need to determine its long-term effects and the psychological improvement noted in some patients after an even transient improvement in motor performance. However this treatment is obviously not curative.
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PMID:[Treatment of amyotrophic lateral sclerosis with thyrotropin releasing hormone]. 308

In children valgus deformities of the ankle joint are usually due to neurological conditions (spina bifida, poliomyelitis, spasticity). The deformity is characterized by a shortened fibula, wedging of distal tibial epiphysis and valgus tilt of the talus. Other conditions producing similar deformity include congenital and acquired fibular pseudarthroses, multiple exostoses and some cases of tarsal synostosis. Early treatment of a progressive valgus in multiple exostoses is mandatory. The author describes a case of ankle valgus following an undiagnosed traumatic section of tibialis posterior tendon. After predictable failure of a Grice procedure, a persisting good correction was obtained by fibula lengthening combined with talus reposition and fixation on os calcis.
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PMID:[Valgus deformities of the ankle in children]. 358

Dysfunction of the rhabdosphincter results from an increase (dyssynergia) or decrease in activity of either neurological or non-neurological origin. We have defined dyssynergia as the absence of urethral relaxation and/or sphincter contraction during and/or before detrusor muscle contraction. Non-invasive exploratory methods include flowmetry, anal contact EMG and an abdominal pressure or EMG examination. Invasive techniques are of various types: urethro-cystometry with EMG, via the perineum in males and the endo-urethral approach in females, provides quantitative data on extent of altered function and relative involvement of either smooth or striated muscle sphincters. An essential complement to urodynamic exploration is a conventional mictional cystogram. We have proposed an etiologic classification of dyssynergia: tonic dyssynergia is pathognomonic of supra-sacral medullary lesions while clonic dyssynergia reflects the bladder-sphincter conflict, whether it be of neurologic or other origin. Clonic dyssynergia in patients with neurologic affections is seen mainly in those with supra-sacral medullary lesions at whatever level, and with a 50 to 100% frequency. Its serious nature is not related to the bladder-sphincter equilibrium but to the high pressures developed by the system. The neurologic rhabdosphincter presents characteristic persistent reflex activity at the spinal shock phase and a possible course leading to fibrosis. In patients without neurologic disease the terms dyssynergia or pseudodyssynergia are used depending on whether the sphincter contraction during bladder contraction is involuntary or voluntary. To explain this non-neurologic pseudodyssynergia, Lapides suggested as a basis the theory of the evolution of sphincter control, Tanagho that of sphincter spasticity. In reality it involves a vicious circle centered on the bladder-sphincter conflict, entry being possible at various levels: bladder instability, urethral instability, urethral hypersensitivity, rhabdosphincter spasticity. These disturbed functions induce the urethral syndrome, repeated urinary infections, reflux and sometimes even renal stasis. Deficient sphincter activity of neurologic origin presents pathognomonic electromyographic signs; from a functional point of view valid data can be obtained from measurement of variations in maximum urethral pressure during a retention effort. Among the neurologic etiologies, the rhabdosphincter is only rarely affected by poliomyelitis or amyotrophic lateral sclerosis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The striated sphincter of the urethra. 3: Urodynamic and physiopathologic study of the striated sphincter]. 639 28

This study investigated the clinical manifestations and outcomes of central nervous system (CNS) infection by enteroviruses. Cases with CNS involvement among all enterovirus-culture-positive cases from January 1995 to June 2003 were retrospectively reviewed. Among 1028 enterovirus-culture-positive cases, there were 333 cases involving the CNS. Of these, the ratio of male to female subjects was 1.78, and the mean (+/- standard deviation) age was 6.83 +/- 5.9 years; 21 were premature neonates, and 10 failed to thrive. Disease entities included 282 cases of aseptic meningitis (84.7%), 44 cases of encephalitis (13.2%), and 7 cases of encephalomyelitis/polio-like syndrome (2.1%). Of these cases, 97.9% (326/333) had fever with peak body temperature at 38.9 degrees C, 85% had headache and vomiting, 70% had meningeal signs, 64% had neck stiffness, 16.6% (55/333) had change of consciousness, 5.4% (18/333) had seizures and 5.2% (17/333) had myoclonic jerks. Mannitol was administered in 77.2% of patients (257/333), along with intravenous immunoglobulin in 6.6% (22/333). Twelve cases received ventilator support. One patient died of hand-foot-and-mouth disease, encephalitis plus cardiopulmonary failure, and 2 premature neonates died of hepatic failure, disseminated intravascular coagulation, sepsis-like syndrome and myocarditis. Eighteen had neurologic sequelae, including 7 with limb weakness, 5 with epilepsy, 2 with sixth cranial nerve palsy, 3 with cerebral palsy, 4 with psychomotor retardation, 2 with spasticity, and 1 with hearing loss. Factors associated with unfavorable outcomes (death or sequelae) included younger age (p=0.0003), higher peak white blood cell count (WBC) [p=0.0009] and skin rash (p=0.005). Younger age and higher peak WBC were poor prognostic factors of severe enterovirus CNS infection. Death was related to neonatal enterovirus infection and enterovirus 71 infection in young children.
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PMID:Clinical features and factors of unfavorable outcomes for non-polio enterovirus infection of the central nervous system in northern Taiwan, 1994-2003. 1634 42

Cold applications are sometimes of pronounced symptomatic benefit in some rheumatic disorders such as acute myalgia; in the temporary relief of spasticity; in helping to release tight structures in poliomyelitis and allied diseases; and in temporary recovery of energy in multiple sclerosis.
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PMID:Topical cryotherapy-use for relief of pain and spasticity. 1873 22

Since ancient times, the aim of orthopedic surgery has been to correct limb and joint deformities, including those resulting from central nervous system lesions. Recent developments in the treatment of spasticity have led to changes in concepts and management strategies. The increase in life expectancy has increased the functional needs of patients. Orthopedic surgery, along with treatments for spasticity, improves the functional capacity of patients with neuro-orthopaedic disorders, improving their autonomy. In this paper, we describe key moments in the history of orthopedic surgery regarding the treatment of patients with central nervous system lesions, from poliomyelitis to stroke-related hemiplegia, from the limbs to the spine, and from contractures to heterotopic ossification. A synthesis of the current surgical techniques is then provided, and the importance of multidisciplinary evaluation and management is highlighted, along with indications for medical, rehabilitation and surgical treatments and their combinations. We explain why it is essential to consider patients' expectations and to set achievable goals, particularly before surgery, which is by nature irreversible. More recently, specialized surgical teams have begun to favor the use of soft-tissue techniques over bony and joint procedures, except for spinal disorders. We highlight that orthopedic surgery is no longer the end-point of treatment. For example, lengthening a contractured muscle improves the balance around a joint, improving mobility and stability but may be only part of the problem. Further medical treatment and rehabilitation, or additional surgery, are often necessary to continue to improve the function of the limb. Despite the recognized effectiveness of orthopedic surgery for neuro-orthopedic disorders, few studies have formally evaluated them. Hence, there is a need for research to provide evidence to support orthopedic surgery for treating neuro-orthopedic disorders.
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PMID:Orthopaedic surgery for patients with central nervous system lesions: Concepts and techniques. 3029 Feb 82