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 rare case of intramedullary schwannoma of the spinal cord has been reported, The patient was a 30-year-old woman, who began to notice weakness in her right leg approximately 6 months prior to admission, followed 4 months later by numbness and weakness of the right arm. The above symptoms were progressively getting worse, and she was admitted to Hokkaido University Hospital on February 23, 1974. Neurological examination revealed slow speech, bilateral horizontal nystagmus, absent gag reflex and weakness of right trapezius muscle. Spasticity was noted in 4 extremities, in addition to right hemiparesis. All deep tendon reflexes were hyperactive, right more than left, with bilateral Hoffmann's and Babinski's signs. Vibration sense was diminished below the level of bilateral iliac crests. A tumor around the foramen magnum was suspected, however plain skull and neck, laminogram of cervical spines, vertebral arteriogram, fractional pneumoencephalogram and myodil myelogram failed to disclose abnormalities. Manometric Queckenstedt test showed a partial block on flexion, with CSF protein of 56 mg/dl. Air myelogram clearly visualized the presence of an intramedullary tumor at the level of the medullo-spinal junction. Subtotal removal of the intramedullary tumor at C1 was performed, which proved to be a schwannoma histologically. 14 such cases are reported in the literature and summarized on Table I, including our case. Clinical features of tumors around the foramen magnum are fairly complexed, and some radiological examinations might not be conclusive. It is stressed that air myelogram is extremely valuable in the diagnosis of lesions around the foramen magnum.
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PMID:[A case of intramedullary spinal schwanoma (author's transl)]. 98 97

The results of the present electrophysiological investigation have shed some light on the mechanisms underlying many clinical signs, at least, in patients with capsular hemiplegia. A tentative interpretation of them is given below. Cerebral lesions due to haemorrhage or infarction in the area of the middle cerebral artery interrupt an extensive part of the corticospinal tract and disturb many other descending pathways involved in voluntary performance. In consequence, a marked reduction in the ability to drive the spinal motor apparatus occurs, resulting in weakness of motor power. Here, we refer only to muscle power but not to performance. For example, the disturbance of voluntary contraction by clonus is disregarded (cf. fig. 8). On the other hand, the same lesions also release the spinal reflexes from inhibition by the higher levels of the brain and cause increased excitability in flexors and extensors. In the lower extremity, this is much more makred in extensors and extensor spasticity becomes a dominant sign clinically. Any release effect on the flexor system is largely cancelled by the high activity of the reciprocal Ia inhibitory pathway from extensors and only a fragment of it is occasionally revealed in some patients as an H-reflex in pre-tibial muscles or as weak Ia inhibition of the triceps surae. Reduced driving power of the brain may be compensated by raised excitability in the spinal cord and spastic extensors are thus naturally in a better condition to preserve motor power. Flexor muscles are doubly crippled by reduced descending impulses and strong reciprocal inhibition by the Ia impulses from the spindles of the extensor muscles.
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PMID:Reciprocal Ia inhibition in spastic hemiplegia of man. 100 Feb 87

Dantrolene sodium has been given to 45 patients suffering from dyskinetic syndromes: 33 were suffering from spastic syndromes, either secondary to cerebral lesions at birth, or to other cerebral lesions, or to cord lesions; 9 were affected by infantile dystonic syndromes; 1 by dystonia muscolorum deformans and the last 2 patients were suffering from parkinsonism. The best dosage schedule was individual and ranged from 50 mg to 300 mg a day. In this range, the majority of the spastic patients showed reduction of spasticity, unrelated with the site of pathology: a slight one in 12 patients, a moderate one in 9 and a marked one in 2. On the contrary, slight improvement has been noticed in only two of the patients suffering from dystonic syndromes. In no case side effects has been noticed. In all patients who underwent slight or moderate improvement only, we tried to obtain better results on spasticity by growing the dosage schedules; but we have always noticed side effects, that is weakness or drowsiness and, sometimes, urinary uncontinence. Moreover 2 patients showed evidence of transitory metabolic side effects. Therefore our experience shows that dantrolene sodium is an useful drug into the therapy of spasticity, even if often a slight of moderate improvement only is achieved. Slow increase in dosage schedule, repeated laboratory controls and alternate periods of treatment and suspended treatment should be observed.
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PMID:[Clinical study of dantrolene sodium in the treatment of spastic and dystonic syndromes]. 102 44

Rehabilitation services for the severely brain injured are often inadequate and one of the chief factors responsible is undue emphasis on the contribution of physical disability with scant attention to the serious emotional and intellectual handicaps incurred. Weakness, spasticity and dysphasis tend to recover eventually to a variable extent but mental handicap is often the cause of serious and lasting disablement. For a determination of the outcome of severe brain injury in terms of its effect on daily living, the relation between physical disability, mental handicap and social reintegration has been assessed quantitatively. Three assessment scales have been constructed and used in a study of 58 severely brain damaged patients. This revealed that the duration of post-traumatic amnesia correlates highly with the degree of social, mental and physical disability incurred. Daily living was affected primarily by impairment of intellect and personality and, to a lesser extent, by physical incapacity, but only rarely by the developments of symptoms of mental illness. Using the Wechsler Adult Intelligence Scale, the time course of cognitive recovery was also assessed. Recovery curves and the relation of cognitive impairment to social and physical handicap will be demonstrated.
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PMID:Assessment of the psychosocial outcome after severe head injury. 104 90

Spastic or hyperreflex bladder dysfunction can cause frequency, urgency, and incontinence. Detrusor activity was inhibited by FES (functional electrical stimulation) applied to the anal sphincter causing decreased bladder spasticity and increased bladder capacity. FES is indicated for incontinence not only because of weakness of the pelvic floor but also because of hyperreflex bladder.
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PMID:Bladder inhibition with functional electrical stimulation. 110 26

A 19-year-old girl with carpal and tarsal osteolysis has been presented. The clinical course was characterized by normal early growth and motor development followed by the insidious onset in early childhood of a progressive, peripheral joint destruction, especially in the tarsal and carpal bones. The patient's course was complicated by acquired spasticity from platybasia, scoliosis, generalized muscle weakness, mild growth failure and corneal clouding.
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PMID:Carpal and tarsal osteolysis. 120 35

Ten patients with spastic drop foot were treated by local injections of botulinum toxin A (botulinum toxin A haemagglutinin complex). The purpose was to improve stance and gait and/or to facilitate physiotherapy and patient care. Various calf muscles were injected using EMG guidance. The average dose used was 23 ng. Prior to and 4 weeks after treatment, positions of the upper and lower ankle joint at rest and the corresponding end positions of passive and active movement were determined. In addition, changes of spasticity and pain, the transmission phenomenon and stance and gait were evaluated. Most patients showed improvement of some aspects of the spastic drop foot. Positions of the upper and lower ankle joint were improved in most of the patients, as were the other parameters examined. Except for weakness of the injected muscles no side-effects were observed. The results appear promising and may be optimized in further trials by using higher doses of the toxin.
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PMID:Local botulinum toxin in the treatment of spastic drop foot. 140 18

Fifty consecutive children are described with spastic cerebral palsy treated with selective functional lumbar and sacral rhizotomy and followed for a minimum of 6 months. In all patients, spasticity improved postoperatively, but this was not necessarily accompanied by a functional improvement. Eighteen children who could not walk preoperatively were able to do so after rhizotomy. All 17 children who could walk preoperatively could do so following surgery, and in 15, gait was improved. Complications included transient urinary dysfunction in 4 children and sensory loss in 1. The operative procedure evolved with time: the technique of replacement laminotomy was refined; the electrophysiologic basis for selection of nerve rootlets changed after studies of nonspastic controls; smaller percentages of the L3 and L4 roots were sectioned in an attempt to prevent postoperative weakness of quadriceps, and there was a trend in the most recent patients to cut a smaller portion of all the posterior roots.
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PMID:Selective functional posterior rhizotomy for treatment of spastic cerebral palsy in children. Review of 50 consecutive cases. 141 40

Two patients who had severe spinal spasticity with painful flexor spasms were treated with oral baclofen with relief of symptoms. The various drugs to treat severe spastic weakness and flexor spasms and their mode of action are briefly discussed.
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PMID:Pathophysiology and treatment of spasticity: report of two cases. 827 May 66

Between 1979 and 1991, spinal arachnoid cysts were found in 11 patients aged 19 months to 18 years (mean age 5 1/2 years). Of the 11 patients, six had a myelomeningocele and one diastematomyelia. The presenting symptoms included radicular pain (one patient), progressive weakness (three), increasing scoliosis (one), worsening spasticity (three), and recurrent urinary tract infections and progressive constipation (one). Two patients showed no symptoms from the spinal arachnoid cyst. The distribution of lesions was as follows: cervicomedullary (one patient), cervical (one), cervicothoracic (two), thoracic (four), lumbar (two), and sacral (one). Four of the 11 arachnoid cysts (all intradural) were located anterior to the spinal cord, three of which were in children with a myelomeningocele. Only two of the cysts were extradural; both were found in the lumbosacral region, and one was associated with diastematomyelia. Eight patients were treated with fenestration and/or resection of the cyst wall. Three patients with anterior cysts were treated with shunts, a cyst-to-pleural space shunt in two and a cyst-to-subarachnoid space shunt in one. All of the patients either improved or exhibited an arrest in the progression of their symptoms. Spinal arachnoid cysts are a treatable cause of progressive neurological deficits and, in this series, were frequently found in patients with neural tube defects.
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PMID:Spinal arachnoid cysts in the pediatric age group: an association with neural tube defects. 150 83


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