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

According to the literature, in Europe 0.4-1.2 cases of obstetrical plexus brachial paresis occur per 1000 births. A 4-6 times higher energy in axial delivery of the newborn leads to a neurotmesis of the plexus. If the energy used is more than 10 times higher, root avulsion occur. Early operative therapy for obstetrical plexus paresis is mandatory. The best period for an operation is between the 3rd and 6th months of age. CT and MRI imaging as well as electrophysiological investigations are of the utmost importance. Birch, Gilbert and Gu think there is an indication for operation if no active elbow flexion can be performed at the age of 6 months. Primary coaptation is easier in babies than in adults. However, large defects have to be a bridged by autologous nerve grafts. For root avulsions, neurotization with the accessory and phrenic nerves (Gu) is being used more and more. In 362 children with 52 operated cases, after a follow-up from 2 to 10 years, we found 37 functional, useful recoveries. Nine operations were unsatisfactory and two had poor results. In four cases the operation was unnecessary.
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PMID:[Birth-related brachial plexus paralysis]. 993 79

To evaluate the effects of transfer of the trapezius and/or latissimus dorsi with the teres major for treatment of dysfunction of the shoulder in obstetrical brachial plexus palsy (OBPP), 34 patients with paresis of the abductors and external rotators, as well as co-contraction of the adductors in abduction, who had undergone reconstructive operations, were followed-up for at least 1 year. Of these, transfer of the latissimus dorsi with attached teres major to the insertion of the infraspinatus (single procedure), was performed in 25 cases, and transfer of both latissimus dorsi with teres major and trapezius (to the humerus) in nine (combined procedure). Gilbert's grading system was used for evaluation. The results showed that in spite of improvement of external rotation in most of the cases, abduction was improved in only 13 of the 25 cases with a single procedure, and that eight of nine cases with a combined procedure gained improvement of both external rotation and abduction. These results indicated that, for improvement of both abduction and external rotation of the shoulder in OBPP, transfer of the latissimus dorsi with the teres major can be performed only when abduction is > or =90 degrees; otherwise, transfer of the trapezius should be added.
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PMID:Applying transfer of trapezius and/or latissimus dorsi with teres major for reconstruction of abduction and external rotation of the shoulder in obstetrical brachial plexus palsy. 1202 32

The interactions between developing neurology and psychiatry in Paris are of interest, in a city which was the main center for studies on the nervous system and its disorders during the nineteenth century. Contrary to a common view, and in spite of an established tradition for mental diseases, emerging neurology had a much stronger influence on psychiatry ('alienism') than the reverse. This was largely due to the school built up by Jean-Martin Charcot, which was organized around the study and management of hysteria. Although Charcot himself always claimed his disinterest in mental medicine, he stimulated the development of an original scientific approach to nervous system conditions, along with a structured academic teaching, while alienism paradoxically remained stuck in organicism, after Antoine Bayle's report in 1822 of 'arachnitis' as the substratum of general paresis of the insane. Contrary to alienism, the young neurological school was able of self-criticism, and progressively underscored mental factors in hysteria. This led to the paradox that neurologists were active in a disease with a recognized lack of organic lesion, while alienists were postulating brain lesions in all mental disorders. The neurological activity thus indirectly and involuntarily led to the first developments of psychodynamic concepts in mental diseases. The academic evolution led to the launch of a faculty chair of mental and brain diseases in 1875, which was taken over for nearly half a century by direct pupils of Charcot: Benjamin Ball, Alix Joffroy, and Gilbert Ballet held the position until 1916, supporting the development of modern psychiatry in general hospitals, while alienism progressively disappeared at the turn of the century.
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PMID:From alienism to the birth of modern psychiatry: a neurological story? 1969 Apr 18

At the time of Jean-Martin Charcot, Paris--the main center for studies on the nervous system and its disorders--was home to critical exchanges between the developing discipline of neurology and psychiatry. Contrary to the commonly held view, and in spite of an established tradition concerning mental diseases, emerging neurology had a much stronger influence on psychiatry ('alienism') than the reverse. This was largely due to the school built up by Jean-Martin Charcot himself, which was organized around the study and management of hysteria. Although Charcot always claimed to be uninterested in mental medicine, he stimulated the development of an original scientific approach to nervous system conditions, based on Claude Bernard's method, along with structured academic teaching. Conversely, alienism paradoxically remained stuck in organicism, after Antoine Bayle's report in 1822 of 'arachnitis' as the substratum of general paresis of the insane. Contrary to alienism, the young neurological school was capable of self-criticism, and progressively highlighted mental factors in hysteria. This led to the paradox that neurologists were active in a disease with no organic cerebral lesion, while alienists were postulating brain lesions in all mental disorders. Pushed by Charcot, the academic evolution led to the launch of a faculty chair of mental and brain diseases in 1875, which was taken over for nearly half a century by his direct pupils Benjamin Ball, Alix Joffroy and Gilbert Ballet, who held the position until 1916, supporting the development of modern psychiatry in general hospitals, while alienism progressively disappeared at the turn of the century.
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PMID:Birth of modern psychiatry and the death of alienism: the legacy of Jean-Martin Charcot. 2093 43