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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The reflexlocomotion acc. to VOJTA is a neurophysiologic facilitation system for the whole CNS and neuromuscular apparatus. It consists of all components, in a reciprocal manner of locomotion: (i) automatic control of posture, (ii) uprighting, (iii) aimed movements. Consequently the indications for this type of kinesiologic facilitation are really extensive. In this article the following complete list of indications is described: CCD (central coordination disorder), CP (cerebral palsy), peripheral paresis, Spina bifida (MMC), Myopathies, congenital malformations, orthopaedic problems, traumatic cross sections, neuromuscular dysfunctions etc. Further the experiences of the treatment in each disease are discussed. Even EMG-detections have shown the effect of the therapy in peripheral and central damage. Therefore a good prognosis for improvement and rehabilitation can be given in a large number of disorders, irrespective of age.
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PMID:VOJTA neurophysiologic therapy. 153 38

In the United States, an estimated 274,000 persons have cerebral palsy (CP), a neurologic condition defined as a group of nonprogressive disorders in which an abnormality of the central nervous system can result in motor dysfunction (e.g., paresis, involuntary movement, and incoordination). CP is the third leading cause of the need for assistance with basic life activities and the fifth leading cause of activity limitation. An adult with CP may require adaptive housing to improve accessibility (e.g., to entrances and toilet facilities), attendant care to assist with activities of daily living, and/or nursing care to meet specific health-care needs. These needs can be met through a variety of residential accommodations. However, because the residential environment has a considerable impact on well-being and quality of life, the accommodations should be in the least restrictive environment and, when possible, community-based. This report summarizes an assessment of characteristics of adults with CP to determine which factors are associated with placement in a more restrictive environment.
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PMID:Residential arrangements for adults with cerebral palsy--California, 1988. 189 22

The hip joints of children with spastic cerebral palsy, notably in those with more severe forms of paresis as well as those with bilateral or tetraparetic involvement, are in any case exposed to extraordinarily great risks. Totally inconspicuous at birth, constant dominance of the spastically contracting hip adductor and flexor muscles leads to gradually advancing malpositioning of the femoral heads, along with flattening of the hip socket and its eventual total destruction. Complete dislocation of the hip joints results, in very severely affected cases already at age 2-3, but in the majority of children only several years later. In this equally tragic as, on the other hand, almost invariably preventable maldevelopment, the wheelchair takes on a doubly crucial role. This, for one, has to do with the many hours the child has to spend in it every day. On account of the fact that the regular wheelchair, above all when "sportively styled", is forcing both legs, i.e. the thighs and lower legs as well as the feet, to adopt a strictly parallel position, it enhances, and accelerates, the highly undesirable development of spastic hip dislocation. If, however, the wheelchair is redesigned in an appropriate manner, i.e. provided with an abduction seating orthosis, along with laterally repositioned foot rests, it will in the majority of cases be possible to prevent the development of hip dislocation. Detailed guidelines to achieve this end are included, and instructions are given for adapting commercially available wheelchairs.
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PMID:[Prevention of hip dislocation in children with spastic paralysis by using a specific therapeutic wheelchair]. 194 19

This series involves 29 patients treated for chronic pain (9 patients) or severe spasticity (20 patients). The surgical technique used was the microsurgical D.R.E.Z.-tomy technique as described by Sindou. In the first group, three patients had malignant pain, while the six others had deafferation pain. In the second group, spasticity involved the upper limb in 13 patients and the lower limbs in 7 patients. Out of 20 patients, one-third suffered from cerebral palsy. In the first group, results one year after surgery were excellent or good in 7 out of the 9 patients. In the group treated for spasticity, a significant decrease in spastic disorders was observed in 16 of the 20 patients over a 1 to 4 year follow-up period. There was also an improvement of voluntary movements in 11 patients and a decrease in pain in 15 patients belonging to this group. A number of complications were noted: cerebrospinal fluid leakage in two cases, painful anesthesia in the C5 to T1 territory in one case, transient paresis of the upper limb in six cases. One patient died as a result of an expansive pneumatocele (3.4% of cases).
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PMID:[Surgery of the radiculo-spinal cord junction in the treatment of chronic pain and incapacitating spasticity. Report of a series of 29 patients]. 226 43

Cerebral palsy or paresis as a chronical syndrome of a lost or disturbed function neuromuscular origin, because of the complex impairment undoubtedly requires a precise and early diagnostic undertaken by a neuropsychiatrist. The whole further reeducational treatment depends on the correct established neurologic diagnosis as well as on the degree of the existed impairment. Speaking about the early diagnosing, we consider the age at the end of the first year of life, but if there is an extrapyramidal impairment or so called "limit case", usually only in the second year of age one is able to give a correct diagnosis. All this mentioned is very important in order to get to know and understand the problem itself, because we treat previous points of view according to which it is not possible to treat a child under the age of 3 years-conservative.
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PMID:[Experience with the diagnosis of cerebral palsy]. 500 63

The current notion of spasticity as a velocity-dependent increase of muscle response to imposed stretch was mainly derived from studies performed under stationary experimental conditions. To address the issue of a spastic muscle behaviour under dynamic conditions, we conceived a novel approach, aimed at quantitatively assessing motor output over the lengthening periods which take place during unperturbed functional movements. Application to the analysis of overground walking in children with spastic cerebral palsy (CP) revealed that, for representative lower limb muscles, the relationship between EMG levels and estimated muscle lengthening rate displays either increased gain or reduced velocity threshold. Parallel measurement of gait kinetics frequently showed congruent increase of the mechanical resistance to joint rotation. Abnormalities preferentially targeted the lengthening contractions occurring around the ground contact period of the stride. The pathophysiological profile of what is clinically defined as 'spastic' gait in CP children did not only consist of dynamic spasticity, as described above. Most often it resulted from the simultaneous contribution of other factors, including paresis, co-contraction, immature and non-neural components.
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PMID:Spasticity and 'spastic' gait in children with cerebral palsy. 959 71

Twenty-four children with infantile cerebral palsy (6 girls and 18 boys aged 3-17 years), surgically treated in the years 1993-1997, were involved in the study. Neurological-orthopaedic examinations and computer tomography (CT) of the head allowed precise diagnosis and understanding of its pathology. The group consisted of 10 patients with hemiplegia, 10 with diplegia and 4 with severe quadriplegia. In 18 children changes in the brain were largely dependent on the clinical type of paresis. In hemiparesis, unilateral changes, such as cerebral cortex atrophy with enlarged ventricles, were predominant. Diplegia cases frequently showed periventricular damage to the white matter. Brain tomography in severe quadriplegia did not always correspond to the clinical condition. CT examinations revealed no abnormalities in the brain in 6 out of 24 cases. Since the results of rehabilitation were not satisfactory, 29 surgical procedures were performed in the presented group of patients, with improved the course of therapeutic rehabilitation or nursing care in all the children.
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PMID:Morphological brain damage, functional disorders and the possibilities of their treatment in children with infantile cerebral palsy. 997 49

We present two case reports with severe hypoxic encephalopathy at birth. Studies carried out in the NICU included cranial ultrasonography, CT, and MRI. Due to abnormalities found by the latter two they were referred to our center at the age of two months and one month, and then an early Vojta therapy commenced. Changes were monitored periodically by assessing their spontaneous movements, postural reactions and neurological manifestations. The first case presented with ventricular hemorrhage and was diagnosed as having severe CCD (central coordination disturbance) with the risk of athetotic type cerebral palsy. The second case presented with severe low density in the frontal and temporo-parietal white matter and was diagnosed as having moderate CCD with the risk of mental retardation or brain atrophy. Although their status fluctuated temporarily, the two infants didn't show any paresis or mental retardation. Recently the studies on mechanisms of brain plasticity have advanced. The findings of our experience might suggest that the plasticity of an immature brain could be enhanced by the very early Vojta therapy. We propose that a therapeutic intervention should commence early before clinical symptoms become evident.
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PMID:[Experience of very early Vojta therapy in two infants with severe perinatal hypoxic encephalopathy]. 1056 91

We report our experience with intraoperative laryngeal electromyography (L-EMG) using direct laryngoscopy and placement of monopolar electrodes under general anesthesia in the evaluation and management of laryngeal dysfunction in pediatric patients. In this series of case studies, we present clinical data on 30 pediatric patients with known or suspected anatomic or neurologic laryngotracheal disorders evaluated with placement of shielded monopolar electrodes into the thyroarytenoid muscles during direct laryngoscopy under general anesthesia. Diagnoses included congenital vocal fold paralysis (VFP), laryngotracheal stenosis, cerebral palsy, laryngeal tumors, traumatic vocal fold dysfunction, and postsurgical VFP. The impact of L-EMG on patient management was assessed. We found that L-EMG objectively supported clinical findings, but provided new objective data relevant toward management recommendations in only a few selected pediatric patients with new-onset vocal fold paralysis or paresis or infiltrative laryngeal tumors, and in selected postsurgical cases involving decannulation decisions. The prognostic utility of L-EMG in newborns with congenital VFP has not been established. A normal L-EMG recording indicates an intact neuromuscular axis, but does not guarantee vocal fold mobility or guarantee muscle function in a partially denervated or deconditioned muscle. The potential for false-negative recordings is the major limitation of this technique.
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PMID:Intraoperative pediatric laryngeal electromyography: experience and caveats with monopolar electrodes. 1140 43

Kernicterus is a preventable life-long neurologic syndrome caused by severe and untreated hyperbilirubinemia during the neonatal period. High levels of bilirubin are toxic to the developing newborn. In full-term infants, hyperbilirubinemia symptoms include severe jaundice, lethargy, and poorfeeding. Features of kernicterus may include choreoathetoid cerebral palsy, mental retardation, sensorineural hearing loss, and gaze paresis. Kernicterus is not a reportable condition in the United States, and its prevalence is unknown; however, a pilot registry at a Pennsylvania hospital documented 90 cases in 21 states from 1984 to June 2001 (L. Johnson, Pennsylvania Hospital, Philadelphia, personal communication, 2001). This report summarizes case histories of four full-term, healthy infants who developed kernicterus and underscores that to prevent kernicterus, newborns must be screened and promptly treated for hyperbilirubinemia.
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PMID:Kernicterus in full-term infants--United States, 1994-1998. 1142 29


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