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)

In this report we present the case of a 16-year-old patient, born in Macedonia, who complained of abdominal and back pain and developed paraparesis. On admission to hospital, he showed a paraplegic syndrome, the level of sensation being T7, together with high-grade paraparesis of the lower extremities and spasticity and urinary incontinence. The protein content of the CSF was raised to 183 mg/dl. CT and MRI of the thoracic spine showed cystic lesions at the level of the 6th and 7th thoracic vertebrae, in the paravertebral area and in the 7th rib on both sides. The antibody titer of Echinococcus in the serum was positive. To treat this problem, corporectomy of the 6th to 8th thoracic vertebrae was performed, the area being bridged by a corticospongoid pelvic bone graft and with instrumental support of the 5th to 9th thoracic vertebrae. Histological examination revealed multilocular Echinococcus lesions. Under long-term treatment with mebendazole, the neurological deficits decreased in the postoperative phase.
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PMID:[High-grade transverse syndrome caused by echinococcus cysts]. 771 54

We report a series of 26 patients affected by a Chiari I malformation treated at our department between 1987 and 1993. All patients underwent pre- and postoperative evaluation by magnetic resonance imaging (MRI). Sequential perioperative motor evoked potential (MEP) recordings were performed in 8 patients. The preoperative symptoms can be divided into four subgroups: cephalgias (84.6%), cranial nerve deficits (69.2%), motor deficits (76.9%), sensory deficits (73%). Twenty-five out of 26 patients underwent craniovertebral decompression, 1 a transoral anterior decompression. One patient died 2 months after surgery because of progressive pulmonary failure. We registered following postoperative complications transient hypoglossal palsy (1 case), vertigo (2 cases), meningitis (1 case), minor CSF leaks (3 cases). Cephalgias subsided in 17 and improved in 4 out of 22 patients. Cranial nerve deficits improved in 8 and were stabilized in 7 out of 18 patients. A limited recovery of trigeminal function was possibly due to nuclear lesions. Five patients whose vestibular disturbances were not relieved by surgery were put on a course of carbazepine. Vertigo resolved in one case and in two others improved. While hypesthesia improved after decompression, the other sensory deficits were stabilized in 5% of the patients. Spasticity improved in 12 out of 18 patients, but weakness only in 7 out of 17 patients. Motor disturbances were always detected by MEP-recording. MEP-characteristics were not specific, resembling those of patients with other intra-, extramedullary myelopathies. Functional recovery was not matched by an improvement of the MEP parameters. MEP may be used as tool for surveillance of patients whose clinical findings are not progressive and are not at first surgical candidates.
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PMID:Cranio-cervical decompression for Chiari I malformation. A retrospective evaluation of functional outcome with particular attention to the motor deficits. 772 49

The administration of baclofen, a GABAb agonist, by direct infusion into the CSF by means of a programmable device, may avoid the undesired side effects of the oral administration of both the same and other antispastic drugs while giving a marked reduction of spasticity. The preliminary results on 12 patients show the total efficacy of this procedure in reducing spasticity markedly.
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PMID:The treatment of spasticity by intrathecal administration of baclofen: a preliminary personal experience. 793 43

Staphylococcal meningitis associated with implantation of an intrathecal drug pump for spasticity was successfully treated by intrathecal vancomycin delivered by the same pump. This produced high CSF antibiotic levels, and the pump and catheter system did not have to be removed. We are unable to identify a similar case reported in the literature to date.
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PMID:Staphylococcal meningitis following Synchromed intrathecal pump implant: a case report. 800 14

The continuous spinal administration of baclofen has been shown to have therapeutic benefit in the management of spasticity in humans with neuraxial injuries. The present study systematically investigated the potential spinal neurotoxicity of continuous intrathecally-infused baclofen in dogs. Male beagle dogs were prepared with chronic lumbar intrathecal catheters connected to subcutaneously implanted infusion pumps. Three groups of dogs received 28 days of infusion of saline (vehicle: 1 ml/24 hrs; N = 10), 200 micrograms/ml/24 hrs baclofen (N = 10) or 2000 micrograms/ml/24 hrs baclofen (N = 10). A mild, dose-dependent anti-nociception and muscle weakness was observed. Independent assessment of spinal histopathology in dogs sacrificed and perfusion fixed at 28 days of treatment revealed a mild fibrotic reaction to the catheter, but there were no changes distinguishable from vehicle infused animals which could be ascribed to any dose of intrathecal baclofen. Cisternal CSF protein and cells in samples taken at sacrifice were also not different for the three groups. These findings with chronic intrathecally administered baclofen in this dog model jointly support the lack of toxicity of chronic intrathecal baclofen at concentrations up to 2000 micrograms/ml.
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PMID:Toxicology of baclofen continuously infused into the spinal intrathecal space of the dog. 816 85

We report a 47-year-old woman with SLE, who developed meningeal signs and consciousness disturbance. She noted an onset of fever, and swelling and pain in her face, hands and feet in 1990. She was seen in another hospital and the diagnosis of SLE was made. She was treated with prednisolone with marked improvement in her symptoms. She was well with 5 mg of oral prednisolone daily until January of 1991, when she developed fever, myalgia and weakness in her legs. She was admitted to the medical service of our hospital on August 5. She was receiving 15 mg of prednisolone daily. Gram positive rods were cultured from her blood on August 5. She became incoherent 2 days later, and had a convulsive episode on August 8. After the convulsion, she lost consciousness from which she did not recover. Her CSF contained 304/3 microliters cells, 29 of which were neutrophils, 6 lymphocytes, 90 others, and 179 destructed cells. The CSF protein content was 345 mg/dl, and glucose 23 mg/dl. A neurological consultation was asked on August 9. Physical examination at that time revealed a semicomatous woman. Respiration was 30/min and regular. BP 132/82 mmHg, heart rate 122/min and regular, and BT 39.6 degrees C. General physical examination was unremarkable. Pertinent neurologic findings were positive Kernig sign and spasticity in all four limbs. Brain stem reflexes were retained. Upon painful stimulation, withdrawal response was elicited both lower extremities. She was treated with pipiracillin, latamoxef and phenobarbital, however, she had frequent seizures. She was deeply comatose on December 10. She became flaccid and no more meningeal signs were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 47-year-old woman with meningeal signs and consciousness disturbance]. 821 15

A 63-year-old woman had suffered from progressive weakness and wasting of the right lower limb for seven years. In the lower limbs, there were profound muscular atrophy and weakness on the right, and mild weakness with spasticity on the left. Muscle strength of the upper limbs was normal. Sensory examination was normal except for paresthesias below the right knee. Anti-HTLV-I antibody titer was raised both in serum and in the CSF. Motor nerve conduction studies of the lower limbs showed small compound muscle action potentials and somewhat slow conduction velocities, more evident in the right side. F-wave was evoked only in the left tibial nerve and its latency was increased. Sensory nerve conduction studies were normal in the lower limbs. Somatosensory evoked potentials (SEPs) after tibial nerve stimulation at the ankles showed increased interpeak latencies between lumbar N20 and scalp P37. Nerve conduction studies in the upper limb were normal. Single fiber electromyography suggested anterior horn involvement not only in the lumbosacral cord but also in the cervical cord. Weakness and spasticity improved after oral administration of prednisolone. The SEPs findings and a favorable response to prednisolone excluded the possibility of amyotrophic lateral sclerosis. This case is a clinical variant of HTLV-I-associated myelopathy presenting profound atrophy of unilateral lower limb.
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PMID:[HTLV-I associated myelopathy presenting with profound atrophy of unilateral lower limb]. 825 34

To study the effect and mechanism of electrical stimulation in treating spinal spasticity, we used electroacupuncture (EA) on the surface of 2 couples of acupoints. The short term application (30 min) of high-frequency EA (100 Hz) produced an immediate antispastic effect in contrast to the low-frequency EA (2 Hz). After application of high-frequency EA (2 times/day, 30 min/time) for 3 months, antisplastic effect was stable. To keep this antispastic effect, the high-frequency EA must be used permanently. Recent experimental results showed that low and high frequency EA release MEK and dynorphin respectively from the spinal cord in humans. We infer that by enhancing the production of dynorphin in CSF, high-frequency EA decrease the excitability of the motor neurons in the anterior horns through the kappa opiate receptors, thus ameliorating the muscle spasticity of spinal origin.
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PMID:[Transcutaneous electric stimulation at acupoints in the treatment of spinal spasticity: effects and mechanism]. 831 80

Control of severe spasticity and its associated features with administration of baclofen directly into the CSF via an intrathecal pump has radically improved the management of patients resistant to oral therapy. This article reviews the rationale and clinical indications for this technique, and the outcome and complications encountered.
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PMID:Intrathecal baclofen in severe spasticity. 844 26

Spasticity is a frequent and complex sequel to spinal cord injury. The neurochemical basis for the origin of spasticity is largely unknown. Glycine is among the most abundant neurotransmitters in the spinal cord. However, the role of glycine and related compounds in spasticity have received little attention. An ischemic spinal cord injury was created in rabbits, by an intraaortic balloon occlusion technique, which produced lower limb spasticity. A catheter was inserted into the cisterna magna and the spinal cord was bathed with 100 microM solutions of glycine, strychnine, D-serine, beta-alanine, MK-801, or artificial CSF for 4 hours at a rate of 10 microliters/min. H-reflexes were monitored before and during infusion by stimulating the posterior tibial nerve and recording from the plantar surface of the foot. Glycine, D-serine, and MK-801 depressed the H wave, strychnine produced a heightened H wave, and beta-alanine caused no significant changes. These results indicate that glycine and related compounds may influence spasticity.
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PMID:The influence of glycine and related compounds on spinal cord injury-induced spasticity. 874 6


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