Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hodgkin's disease (HD) has been reported in association with the acquired immunodeficiency syndrome (AIDS) only occasionally, and these patients seemed to have aggressive unusual HD. We report an additional case of HD in a 50-year-old homosexual man with a marked change of his clinical course after the development of seropositivity to human immunodeficiency virus (HIV). In 1978, HD stage IIIA, nodular sclerosing type, was diagnosed and treated with splenectomy and total nodal radiotherapy, which led to a complete response lasting till 1985. The patient then reported to our clinic with generalized lymphadenopathy and paresis of the m. biceps and m. triceps due to an infiltration of C6/C7 by HD. Laboratory findings revealed a T4/T8 ratio of 0.5 and HIV antibodies. He was given chemotherapy (COPP), but after a good initial response he developed pulmonary infiltration of HD. Therapy was changed to ABVD, but the patient did not respond to treatment and died of progressive HD in 1986. We therefore conclude that the natural history of HD in patients at risk for AIDS may be altered to a higher malignant form, and treatment modalities used in these patients must be further evaluated.
Cancer Detect Prev 1988
PMID:Atypical presentation of Hodgkin's disease in a patient at risk for the acquired immunodeficiency syndrome. 318 Jan 29

A retrospective analysis of 70 pediatric patients (less than 16 years of age) with histologically proven or presumed primary neoplasms of the thalamus, hypothalamus, and brainstem, treated with combined surgery and postoperative radiotherapy or radiotherapy alone at the Washington University Medical Center from January 1950 through December 1983, is reported. Overall survival for all patients at 5 and 10 years was 34.9% and 32.7%, respectively. Follow-up of the 22 surviving patients ranged from 3.0 to 20.0 years (median, 10.6 years). Statistical analysis of multiple prognostic factors was performed. Prognostic factors found by single variate analysis to significantly influence survival were primary site of disease, extent of surgery, race, cranial nerve paresis at diagnosis, and dose of radiation. Factors evaluated but found to be insignificant were age at diagnosis, duration of symptoms before diagnosis, sex, and volume irradiated. Multivariate analysis revealed that only total radiation dose and race were of prognostic significance.
Cancer 1987 Dec 15
PMID:Irradiation of primary thalamic and brainstem tumors in a pediatric population. A 33-year experience. 367 19

Epidural application of local anesthetics or opiates is commonly used for treatment of severe pain or arterial obstruction. We discuss two cases of complications following peridural anesthesia. As an acute complication, a lumbar epidural hematoma developed hours after placement of the catheter and caused sciatic pain and nearly complete paraplegia. The hemorrhage might have been promoted by heparinization. After decompressive hemilaminectomy the patient recovered but was disabled by a persistent paresis. The second patient suffered from renal failure, arterial obstruction, and phantom limb pain. A peridural catheter was kept in place for 6 weeks. Five months later the patient developed severe sciatica. Spinal computed tomography showed compression of the cauda at the L4/5 level (Fig.4) caused by an abscess that was opened and drained. After insertion of a gentamicin - PMMA - chain (Septopal), the wound healed primarily but the patient suffered from persistent pain. The incidence of vessel puncture after insertion of a peridural catheter is about 1%-10%. The risk of hemorrhage, perforation of the dura, and nerve root irritation is increased in scoliotic or elderly patients with a narrow spinal canal. Persistent pain after removal of the catheter is the most important sign. Although paraplegias following peridural catheterization can occur without anticoagulants, even low-dose heparinization is potentially dangerous. The risk of infectious complications after long-term peridural catheterization may be up to 20%. Hematogenous metastatic infection is more common in patients with malignancies or multiple risk factors than continuous immigration of bacteria. Epidural hematomas and spinal abscesses can cause disability and persistent neurological deficit in spite of aggressive surgical and antibiotic therapy.
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PMID:[Lumbar epidural hematoma and spinal abscess following peridural anesthesia]. 368 76

An acute episode of encephalopathy after the infusion of 16 g methotrexate is reported in a 12-year-old girl with osteogenic sarcoma. The complication occurred during the 11th treatment course, when severe vomiting and diarrhea were followed by a low urine output with consecutive toxic concentrations of methotrexate in serum and cerebrospinal fluid leading to severe systemic and central nervous system toxicity. The onset of the central nervous system toxicity was acute with slurred speech, paresis of the external rectus eye muscles, ataxia, and hemiparesis, and symptoms resolved completely after 30 hours by treatment with calcium leucovorin and forced diuresis. After management of the cerebral and systemic toxicity, high-dose methotrexate treatment could be reinstituted, and was followed by no further complications. In contrast to the transient cerebral dysfunctions, probably caused by embolization of tumor tissue in the early course of high-dose methotrexate treatment, the acute neurologic syndrome observed in the current case after the prolonged use of methotrexate seemed to be related to direct central nervous system toxicity of the drug.
Cancer 1984 May 01
PMID:Transient encephalopathy during the late course of treatment with high-dose methotrexate. 658 97

Extensive lower limb paresis developed in three patients with terminal cancer following internal iliac (hypogastric) artery embolization. This procedure was carried out for control of hemorrhage in two of the patients and for reduction of the bulk of metastatic tumor in another. The embolic materials used resulted in extensive obliteration of small and large vessels of the posterior and anterior divisions of the internal iliac artery. The paresis is attributed to the resulting ischemia of the sciatic and femoral nerves; previous radiotherapy may also have been a contributing factor. To reduce the incidence of paralysis, identification of the bleeding vessels and selective embolization are recommended. If this cannot be achieved, and the catheter lies in the main stem, it is recommended that the emboli should not be smaller than Gelfoam pledgets (1 X 1 X 10 mm) to preserve the peripheral circulation and lessen the risk of complication.
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PMID:Paresis following internal iliac artery embolization. 684 68

The effects of long-term administration of doxorubicin in adult rabbits and in a rhesus monkey were studied. Eleven rabbits were given cumulative doses of 2--24 mg/kg over a period of 5--28 weeks. The monkey received a total of 20 mg/kg during a 10-month period. One rabbit exhibited hind leg paresis, but all of the other animals in the study remained clinically free of neurologic signs. Rabbits given less than 12 mg/kg of doxorubicin had only mild degenerative changes in dorsal roots and a few necrotic neurons in the dorsal root ganglia, but these lesions were much more severe in all rabbits when a cumulative dose greater than 16 mg/kg was given. The monkey also had severe ganglioneuropathy, suggesting that primates may also be susceptible to this toxic effect of doxorubicin. Although neurotoxicity has not been observed with the dose schedules of doxorubicin used in clinical practice, the tendency of this drug to damage both postmitotic neural and cardiac cells may provide added understanding of the clinically important doxorubicin cardiomyopathy.
Cancer Treat Rep 1982 Jun
PMID:Ganglioneuropathy in rabbits and a rhesus monkey due to high cumulative doses of doxorubicin. 708 39

Chronic Aspergillus meningitis and cerebral vasculitis occurred in a 67-year-old man. He experienced periorbital pain that increased in severity during a ten-month period. Although no focal neurologic deficits were initially present, oculosympathetic paresis, corneal hypesthesia, and optic neuropathy developed. This is the first report, to our knowledge, of paratrigeminal syndrome with optic neuropathy due to aspergillosis. The case was also unusual because it was chronic and there was no extracerebral infection or predisposing factors, such as underlying malignancy or collagen vascular disease.
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PMID:Optic neuropathy and paratrigeminal syndrome due to Aspergillus fumigatus. 711 50

A case of epidermoid carcinoma in the cerebello-pontine (CP) angle is presented. A 42-year-old male was admitted with a complaint of experiencing double vision for four months in January, 1992. During neurological examination, right abducens palsy, right facial dysesthesia, and atrophy of the right temporal muscle were noted. Magnetic resonance (MR) imaging revealed a mass of low intensity in the right CP angle, which was prominently enhanced with gadolinium. Malignancy was suspected because the tumor on MR enlarged rapidly in a month, so the first surgical resection was performed. Suboccipital exploration of the right CP angle was performed in February. At first, a fragile, pearly part of the mass typical of epidermoid was exposed behind the seventh and eighth cranial nerve complex. Then, a grayish, fibrous part was exposed, which involved the fifth cranial nerve and was attached to the tentorium and the brainstem. Histological diagnosis of the fragile part of the tumor revealed a typical epidermoid cyst and that of the fibrous part was squamous cell carcinoma. During postoperative examinations on other parts of the body, such as endoscopic studies of the trachea and the esophagus, no abnormality was shown. Therefore the tumor was diagnosed as a primary intracranial epidermoid carcinoma. Post-operatively, conventional fractionated external-beam focal irradiation was carried out, which caused regression of the residual tumor for eleven months. Subsequently, palsy of the right side of the tongue and paresis of the contralateral side of the extremities and face developed with increase of the right abducens palsy. MR imaging indicated regrowth of the tumor. The second operation via the subtemporal approach was unsuccessful, because the tumor was fibrous and firmly attached to the brainstem.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case report of epidermoid carcinoma in the cerebello-pontine angle]. 747

160 patients with various intra- or extracranial pathologies were treated by microsurgical facial nerve reconstruction at Nordstadt Neurosurgical Clinic between 1978 and 1993. Facial nerve reconstruction was accomplished along the anatomical course of the facial nerve from its origin at the brainstem, within the mastoid, at the stylomastoid foramen and within the face. Mostly, reconstruction was indicated because of nerve discontinuity (n = 61), whereas facial nerve reanimation with a donor nerve such as the contralateral facial nerve or the ipsilateral hypoglossal nerve was indicated in 99 cases of loss of a proximal nerve stump. Depending on the site of the lesion reinnervation started at 5 to 15 months postoperatively lasting for 2 to 3 years with overall satisfactory results. 69% of all the patients regained good symmetry on rest, complete eye closure equivalent to House-Brackmann-Score III: Patients with complete failures either suffered of non-related diseases such as cancer leading to death before the estimated time of recovery or were exposed to radiation or received facial nerve reconstruction after long-standing facial deficit and marked muscular atrophy. The indication of the adequate method depends on the clinical course with or without preexisting facial paresis, on considering the intraoperative state of the facial nerve, the identification and microsurgical preparation of adequate nerve stumps, as well as on the adaptation techniques and the postoperative guidance of the patient. We conclude that facial nerve reconstruction by transplantation at either site of the nerve course or by reanimation with a donor nerve are effective and reliable procedures of treatment leading to satisfactory functional and cosmetic results.
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PMID:Indication, technique and results of facial nerve reconstruction. 772 35

We report a 55-year-old man with papilledema and multiple cranial nerve palsies. He was well until 52 years of age when there was an onset of progressive difficulty in initiating urination; he visited the urology service of our hospital where a diagnosis of prostate cancer was made; the cancer was invading the bladder and was metastasizing to lymph nodes and bones. He was treated with oochiectomy and estrogen preparations with some improvement in his symptoms. Two years later, he developed difficulty in urination again, and transurethral resection of the tumor was performed in 1991. In December 1991, he noted tingling and numb sensation in his left face, which had become progressive worse within the next one month, and he developed blepharoptosis and deafness all on the left side. He was admitted to the urology service on February 4, 1992, and a neurological consultation was asked. On physical examination, general findings were unremarkable, except for lymph node enlargements of about 0.5 to 1.0 mm in size in cervical and inguinal regions. On neurologic examination, he was alert with normal mental activities; higher cerebral functions were intact. He had normal vision and visual fields, however, papilledema was present bilaterally; pupils and light reactions were normal. Extraocular muscles were intact on the right side, however, moderate restriction was noted in the left eye in that all the extraocular muscles except for the medial rectus were weak; blepharoptosis was noted on the left; no nystagmus was present. The sensation was diminished in the left face, and left facial paresis of the peripheral type was also noted; the taste sensation was also diminished in the left anterior two thirds of the tongue. He had sensorineural deafness on the left side. The other cranial nerves appeared intact. He walked normally; no weakness or muscle atrophy was noted; muscle tone was normal and no ataxia was observed. Deep reflexes were normally elicited and symmetric; the plantar response was flexor. No meningeal signs were present. Laboratory examination revealed following abnormalities: Hb 7.1 g/dl, platelet 47,000/cmm, WBC3,800/cmm, LDH 950IU/l, PAP232ng/ml (normal less than 1.6), PA2.631ng/ml (normal less than 7.4); a small amount of effusion was noted in the left pleural cavity; cytological examination of the fluid was class V. A cranial CT scan as well as MRI were entirely normal, as was the spinal tap. He was treated with glycerol, however, there was progressive increase in the pleural effusion, and he developed dyspnea; moist rale had become audible in the end of February.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 55-year-old man with prostate cancer, papilledema, and multiple cranial nerve palsies]. 794 37


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