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)

From June, 1989 to March, 1991, 24 cases with various spinal disorders were treated in our department using the Dick technique. The results were as follows: In the fresh fracture group (7 cases), all the spine fractures were reduced anatomically: the 2 cases without neurological defects returned to work 3 months after operation; the 3 cases with incomplete paraplegia had rapid neurological recovery; and the 2 cases with complete paraplegia showed no recovery after operation. In the late fracture group (10 cases), traumatic kyphotic curves were partially reduced and back pain was decreased markedly in all: Muscle power was increased significantly in 3 cases; spasticity was remarkably improved in 2 cases; 3 cases obtained complete cure of incontinence; and 4 cases had no significant improvement. In 3 cases with ankylosing spondylitis, the initial average kyphotic curve was 73.3 degrees, while the postoperative average curve was 28.3 degrees. The result of treatment of spinal stenosis due to degenerative spondylolisthesis (1 case) was good; slipping vertebrae were stabilized and fused with the Dick system after thorough decompression. In 1 tumor and 2 Tb-spine cases, the patients recovered and were ambulatory soon after operation.
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PMID:The application of Dick instrumentation in spine surgery. 142 57

Spasticity and flexor spasms can be most incapacitating in SCI victims. Muscle relaxants, physiotherapy and elimination of triggering factors must be tried before opting for peripheral surgery or alcohol block. The choice of alcohol block or peripheral surgery depends in whether damage to the spinal cord is complete or incomplete. Results of both the procedures are satisfactory in rightly chosen patients. Alcohol block is a simple, safe and effective method of treating spasticity in the patients of complete paraplegia. The effect is immediate and almost permanent. However, alcohol block is contra-indicated in the patients of incomplete paraplegia where peripheral surgery is a better choice.
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PMID:Treatment of intractable spasticity in spinal cord injured patients. 142 73

Fourteen cats underwent 500-g/cm dorsal impact injuries to the spinal cord and the placement of stimulating electrodes above and below the level of injury at T8. After recovery from the surgical procedure and the development of spasticity, each animal participated in several trials of spinal cord stimulation (SCS). Cord stimulation was provided above or below the level of injury using currents of less than 0.75 mA at 100 Hz. Electromyogram changes in hamstring and quadricep muscles (during spasms induced by dorsiflexion of the paw) were monitored. All animals showed complete paraplegia and, at 3 weeks, severe spasms. Spasticity was aggravated by SCS delivered above the level of injury. Spasms were markedly suppressed by monopolar stimulation delivered below the level of the lesion. Effects were maximal with the negative electrode applied to the cord and were slightly less with reversal of polarity. Muscle excitation was seen before diminution of spasms when bipolar currents were used. All effects lasted only as long as currents were delivered. These animal trials suggest that the effects of SCS are directly related to the current and its type. Beneficial effects were seen only when currents were delivered below the level of injury; this suggests that SCS activates local inhibitory processes or depolarizes local excitatory pathways. The poor results with bipolar stimulation do not support action on a multisynaptic cord system in short term stimulation.
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PMID:Spinal cord stimulation for amelioration of spasticity: experimental results. 349 82

The potassium channel blocking drug 4-aminopyridine (4-AP) was administered to eight patients with chronic spinal cord injury, in a therapeutic trial based on the ability of the drug to restore conduction of impulses in demyelinated nerve fibers. The study was performed using a randomized, double-blind, crossover design, so that each patient received the drug and a vehicle placebo on different occasions, separated by 2 weeks. Drug and placebo were delivered by infusion over 2 h. An escalating total dose from 18.0 to 33.5 mg was used over the course of the study. Subjects were evaluated neurologically before and after the infusion. Two subjects returned for a second trial after 4 months and were examined daily for 3 to 4 days following drug infusion. Side effects were consistent with previous reports. Administration of the drug was associated with significant temporary neurologic improvement in five of six patients with incomplete spinal cord injury. No effect was detected in two cases of complete paraplegia and one of two severe incomplete cases (Frankel class B). Improvements in neurologic status following drug administration included increased motor control and sensory ability below the injury, and reduction in chronic pain and spasticity. The effects persisted up to 48 h after infusion of the drug, and patients largely returned to preinfusion status by 3 days. Compared with the more rapid elimination of the drug, these prolonged neurologic effects appear to involve a secondary response and are probably not a direct expression of potassium channel blockade.
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PMID:4-Aminopyridine in chronic spinal cord injury: a controlled, double-blind, crossover study in eight patients. 832 Jul 29

From June, 1989 to March, 1991, 24 cases were treated in our department with the Dick technique. The study population included 7 patients with fresh horacolumber spine fracture, 10 with late spinal fracture (15 of the above 17 cases had incomplete paraplegia), 3 with ankylosing spondylitis, 2 with tuberculosis, and one each with spondylolisthesis and spine tumor. The results of these 24 cases were as follows. In the fresh fracture group, all the spine fractures were reduced completely. The 2 patients without neurological defects returned to work 3 months after operation. The 3 with incomplete paraplegia had rapid neurological recovery and could walk with a brace 3 months after surgical treatment. The 2 with complete paraplegia did not recover after toperation. In the late fracture group, traumatic kyphotic curve were reduced partially and back pain was decreased markedly in all 10 cases. Muscular power was increased significantly in 3 cases; they are all able to walk with a cane. Spasticity was remarkably improved in 2 patients after operation; they can now walk with crutches. Three patients obtained complete cure of incontinence. Four patients had no significant improvement. In the 3 patients with ankylosing spondylitis, the initial average kyphotic curve was 73.3 degrees, while the postoperative average curve was 28.3 degrees. The result in treating spinal stenosis due to degenerative spondylolisthesis was good: the slipping vertebrae were stabilized and fused with the Dick system after thorough decompression. In the tumor and Tb-spine cases, the patients recovered and were ambulatory soon after operation, thanks to rigid internal fixation.
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PMID:[The application of Dick instrumentation in the field of spine surgery]. 832 36

Charcot spine, also known as neuropathic spinal arthropathy, is a late complication of traumatic spinal cord injury that can produce pain and further disability. We report five cases of Charcot spine occurring in patients with previous traumatic spinal cord injury that we have identified at our institution from 1985 to 1994. All patients had complete paraplegia with levels of neurologic injury ranging from T7 to T12. Common presenting symptoms included back pain, loss of spasticity, change in bladder function, and audible noises with motion. The diagnosis of Charcot spine was made from 6 to 31 years after original spinal cord injury. In four cases where a surgical fusion had been performed, the Charcot joint developed within two spinal segments below the caudal end of the fusion. Radiological studies, especially plain films and computed tomography, were helpful in making the diagnoses. Immobilization of the affected joint is an essential element of treatment. Surgical repair and stabilization were performed in four patients and has been recommended to the other patient. Early diagnosis and proper treatment is important in preventing the progression of this disorder.
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PMID:Charcot spine as a late complication of traumatic spinal cord injury. 904 6

Complete spinal cord injury (SCI) is characterized, in part, by reduced fatigue-resistance of the paralyzed skeletal muscle during stimulated contractions, but the underlying mechanisms are not fully understood. The effects of complete SCI on skeletal muscle Na(+),K(+)-adenosine triphosphatase (ATPase) concentration, and fiber type distribution were therefore investigated. Six individuals (aged 32.0 +/- 5.3 years) with complete paraplegia (T4-T10; 1-19 years since injury) participated. There was a significantly lower Na(+),K(+)-ATPase concentration in the paralyzed vastus lateralis (VL) when compared to either the subjects' own unaffected deltoid or literature values (from our laboratory, utilizing the same methodology) of VL Na(+),K(+)-ATPase concentration for the healthy able-bodied (141.6 +/- 50.0, 213.4 +/- 23.9, 339 +/- 16 pmol/g wet wt., respectively; P < 0.05). There was also a significant negative correlation between the Na(+),K(+)-ATPase concentration in the paralyzed VL and years since injury (r = -0.75, P < 0.05). These findings are clinically relevant as they suggest that reductions in Na(+),K(+)-ATPase contribute to the fatigability of paralyzed muscle after SCI. Unexpectedly, the VL muscles of our subjects had a higher proportion of their area represented by type I fibers compared to literature values for the VL of the healthy able-bodied (52.6 +/- 25.3% vs. 36 +/- 11.3%, respectively; P < 0.05). As all our subjects had upper motor neuron injuries and, therefore, experienced muscle spasticity, our findings warrant further investigation into the relationship between muscle spasticity and fiber type expression after SCI.
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PMID:Na+,K+-ATPase concentration and fiber type distribution after spinal cord injury. 1469 96

Patients with an acute complete spinal cord injury (SCI) present a syndrome called "spinal shock". During spinal shock the loss of tendon reflexes and flaccid muscle tone is associated with a low persistence of F-waves and loss of flexor reflexes while H-reflexes are well elicitable. When clinical signs of spasticity become established, the electrophysiological parameters show little change. The divergent course of clinical signs of spasticity in their possible neuronal correlates indicate the occurrence of non-neuronal changes contributing to spasticity. - When signs of spinal shock had disappeared in patients with incomplete and complete paraplegia a locomotor pattern can be induced and trained under conditions of body unlaoding using a moving treadmill. In complete and incomplete paraplegic patients an increase of gastrocnemius electromyographic activity occurs during the stance phase of a step cycle with a daily locomotor training, coincident with a significant decrease of body unloading. In contrast to this, neither clinical nor electrophysiological examination scores improve. The locomotor pattern depends on the level of lesion: the higher the level of spinal cord lesion the more 'normal' is the locomotor pattern. This suggests that neuronal circuits underlying 'locomotor pattern generation' in man is not restricted to any specific level of the spinal cord, but extends from thoraco-lumbal to cervical levels.
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PMID:Recovery from spinal cord injury--underlying mechanisms and efficacy of rehabilitation. 1533 7

Extramedullary hematopoiesis (EMH) is a common manifestation in beta-thalassemia, but can also occur in several clinical hematologic disorders or neoplasms. It has been reported in almost all sites of the body. Often asymptomatic, it can be manifested by compression of the adjacent organs. Spinal cord compression as a consequence of EMH in the intraspinal epidural space is an extremely rare complication. We report a case of a 34 year old man who was hospitalised for complete paraplegia and spasticity of both lower limbs; spinal cord compression on D4-D8 by EMH was diagnosed by MRI and confirmed by histologic examination.
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PMID:[Cord compression secondary to extramedullary hematopoiesis in a patient with beta-thalassaemia]. 1577 16

Mobility after spinal cord injury (SCI) is among the top goals of recovery and improvement in quality of life. Those with tetraplegia rank hand function as the most important area of recovery in their lives, and those with paraplegia, walking. Without hand function, emphasis in rehabilitation is placed on accessing one's environment through technology. However, there is still much reliance on caretakers for many activities of daily living. For those with paraplegia, if incomplete, orthoses exist to augment walking function, but they require a significant amount of baseline strength and significant energy expenditure to use. Options for those with motor complete paraplegia have traditionally been limited to the wheelchair. While wheelchairs provide a modified level of independence, wheelchair users continue to face difficulties in access and mobility. In the past decade, research in SCI rehabilitation has expanded to include external motorized or robotic devices that initiate or augment movement. These robotic devices are used with 2 goals: to enhance recovery through repetitive, functional movement and increased neural plasticity and to act as a mobility aid beyond orthoses and wheelchairs. In addition, lower extremity exoskeletons have been shown to provide benefits to the secondary medical conditions after SCI such as pain, spasticity, decreased bone density, and neurogenic bowel. In this review, we discuss advances in robot-guided rehabilitation after SCI for the upper and lower extremities, as well as potential adjuncts to robotics.
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PMID:Robotic Rehabilitation and Spinal Cord Injury: a Narrative Review. 2998 63


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