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)

A case reported here is one year-old girl, who was admitted to our neurosurgical service because of gradually increasing swelling in the left lumbar region, and maldevelopment and paresis of the left leg since birth. From the level of L-2 to S-1, there was a 8 X 7 xm subcutaneous swelling of lipomatous consistency with well-defined margins. Of particular characteristics was that the swelling didn't cross the midline and was entirely located in the left paravertebral region (Fig. 1). In the spine no gap could be felt between the spinous processes. There was no evidence of hydrocephalus, but she bad marked right sided scoliotic deformity of the lumbar region, and dislocation of hip joint and club-foot on the left side. Rectum-bladder-vaginal fistula with defect of anus and hypoplasia of kidney on the left side were also detected. Skiagram of the lumbosacral spine revealed marked right-sided scoliosis at the level of L-1 and hypoplasia of left pedicles, accompanied with marked dilation of transverse diameter of spinal canal between the level of L-1 to S-2. Defect of laminae of lumbosacral spine was not definately determined. Conray myelogram showed presence of cyst protruding laterally to the left paravertebral region probably through defect of lamina on the left side at the level of L-5 (Fig 2). At operation, it was confirmed that meningomyelocele protruded out laterally through the defect of half of lamina at the level of L-5. Massive lipoma was noted inside as well as outside the dura mater. Neural elements were replaced inside the spinal canal and the dura repaired. The postoperative period was uneventful. Diagram of defect of lamina at the level of L-5 and its relationships to the meningomyelocele sac is shown in Fig. 3. Meningocele or meningomyelocele which lays in the paravertebral lumbar region is very rare (Table 2), but the possibility of this disease should always be considered when we examine the patients with lipomatous or cystic swelling in the paravertebral lumbar region, especially when the patients present the neurological symptoms or signs.
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PMID:[A case of paravertebral lumbar meningomyelocele (author's transl)]. 79 50

This paper focuses on vocal cord paralysis in children after operation for tracheoesophageal fistula and/or esophageal atresia. We reviewed the charts of 65 children who were operated upon for congenital esophageal atresia and/or tracheoesophageal fistula during a period from 1964 to 1974. Ten of these children manifested laryngeal symptoms. Five had laryngeal paralysis. Two were untreated. One was treated with cordectomy and stent. Two were treated successfully with the Thornell arytenoidectomy, one of these being done without a tracheotomy in place. Mention is made of a third case of bilateral vocal cord paralysis due to hydrocephalus treated successfully by the Thornell procedure. Follow-up laryngoscopy was done on 21 children without laryngeal symptoms whiich revealed two previously unsuspected vocal cord paralyses and one vocal cord paresis which cleared.
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PMID:Laryngeal problems following infant esophageal surgery. 93 91

The authors present a series of six patients with large symptomatic benign pineal cysts and review the 27 patients previously reported in the literature. Patients with symptomatic pineal cysts most often present with one of three syndromes: 1) paroxysmal headache with gaze paresis; 2) chronic headache, gaze paresis, papilledema, and hydrocephalus; or 3) pineal apoplexy with acute hydrocephalus. Surgical intervention with radical cyst removal is the treatment of choice for all symptomatic pineal cysts. Complete cyst removal is desirable; however, radical subtotal resection is appropriate if the cyst cannot be easily separated from the quadrigeminal plate. Ventricular shunting should be reserved for patients with persistent hydrocephalus after cyst resection.
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PMID:Surgical management of symptomatic pineal cysts. 143 32

Twenty-seven newborn infants (birth weight, 1503 +/- 776 g; gestational age, 31 +/- 3 wk) (mean +/- standard deviation) with rapidly progressive posthemorrhagic hydrocephalus and increased intracranial pressure were treated by external ventricular drainage. The progression of hydrocephalus was arrested during the drainage period in each patient. The drainage was kept in place for 23 +/- 9 days, the longest drainage period being 48 days. In 16 of 23 surviving patients, progressive ventricular dilation recurred after removal of the drainage, requiring a definitive shunt implantation (nine ventriculoatrial, seven ventriculoperitoneal). For the remaining seven infants, no further therapy was necessary. Implantation of the permanent shunt was done days 28 to 88 (body weight, 2400 +/- 950 g). Bacterial cultures from cerebrospinal fluid and/or the tip of the ventriculostomy catheter were negative in 175 instances and positive in 11 instances (7 patients). No clinical or biochemical evidence of ventriculitis was noted. Four of the 27 patients died of causes unrelated to external ventricular drainage. Twenty-three infants survived. Seventeen of 23 survivors suffered from intraventricular hemorrhage Grade 3; in 7, neurological and developmental outcomes were classified as normal; 9 patients experienced mild to moderate paresis and/or mild to moderate developmental delay; and only 1 patient was severely retarded. Six patients with parenchymal lesions had severe motor and/or developmental handicaps. We consider external ventricular drainage an effective and safe therapy in newborn infants with rapidly progressive posthemorrhagic hydrocephalus and increased intracranial pressure. The ultimate outcome, however, depends mainly on the mode and the extent of the primary brain lesion.
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PMID:External ventricular drainage for treatment of rapidly progressive posthemorrhagic hydrocephalus. 164 Nov 10

The object of the study are 126 children with internal hydrocephalus treated within the period 1978-1990. The children were preoperatively divided into six groups according to the etiology of the hydrocephalus. Disorders of the visual functions accompanying elevated intracranial pressure (setting sun 51, syndrome of the aqueduct of Sylvius 14, paresis of craniocerebral nerves 9, nystagmus 8, optic atrophy 4) were established preoperatively in 48.4% of the children. 44 of the children were revised because of malfunction of the shunt with the following neuroophthalmological symptoms: setting sun 6, paresis of craniocerebral nerves 9, syndrome of the Sylvius aqueduct 6, papilledema 6, optic atrophy 9 and nystagmus 5. The fact that a great many changes in the visual functions sometimes precede the manifestations of the changes in CT image determines their significance for early diagnosis and treatment.
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PMID:Neuroophthalmological symptoms in children treated for internal hydrocephalus. 184 Aug 20

During the period from January 1st 1983 up to the end of April 1989 in the Neurology Department and the Neurosurgery Department 1417 patients were treated due to subarachnoidal hemorrhage. Among these patients in 275 cases the inner hydrocephalus was diagnosed using computer tomography (19.4%). In 17 cases (6.2%) hydrocephalus was treated surgically. In all patients the ventricle-atrial Pudenz valve was implanted; in 15 patients the valve was implanted for low pressure and in 2 for moderate pressure. The diagnostics was based on the computed tomography and angiography of cerebral vessels. In all cases large hydrocephalus was diagnosed (the anterior horn index in the computed tomography was below 3.0). The most frequent clinical symptoms were: urine incontinence (15 cases), disturbances of orientation (8 cases), akinetic mutism (8 cases) and paresis of extremities (7 cases). Above symptoms together with radiologic image presented indication for the valve implantation. Very good and good results were obtained in 13 patients, bad results in 2 cases, 2 patients died. Longer observation showed that 6 patients remain in satisfactory state, 3 patients are in bad state and 3 others died.
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PMID:[Immediate and late results of surgical treatment of hydrocephalus after subarachnoid hemorrhage]. 208 43

We describe 3 cases of Chiari type II malformation presenting with bilateral internuclear ophthalmoplegia (INO). Although prominent, the INO was not an isolated sign in any of the patients; superimposed abduction paresis was present in 2, and deficits in smooth pursuit, optokinetic nystagmus, and vestibulo-ocular responses were present in 3. Two had hydrocephalus: 1 was clinically unchanged without therapy after 5 years; the other did not improve with shunting. Findings in our 3 patients, along with the 4 previously reported, confirm that INO is 1 manifestation of widespread brainstem or cerebellar dysfunction. Its origin is probably multifactorial, related to hydrocephalus, vascular compromise, direct neuronal distortion, or congenital neural malformation.
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PMID:Internuclear ophthalmoplegia in the Chiari type II malformation. 224 33

Three patients with nonneoplastic hydrocephalus had bilateral paresis of the trochlear nerves. Associated signs, including paresis of upgaze, light-near dissociation of the pupils, and convergence-retraction nystagmus, suggested rostral involvement of the mesencephalon. Trochlear nerve paresis and accompanying signs improved after revision of ventricular shunts in two patients. Bilateral trochlear nerve paresis may be a localizing sign of involvement of the superior medullary velum (the anatomic site of trochlear nerve decussation) by a dilated sylvian aqueduct and/or downward pressure from an enlarged III ventricle.
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PMID:Bilateral trochlear nerve paresis in hydrocephalus. 252 54

Fourteen patients with ventricular cerebrospinal fluid shunts in place for chronic hydrocephalus presented with a history and neurological deficits usually associated with high intracranial pressure (ICP) caused by an obstructed shunt system. However, the symptoms were characteristically present when the patient was upright and active, and were usually relieved by lying down. The symptoms of intermittent headache, nausea, emesis, lethargy, and diplopia were associated with paresis of upward gaze or minimal strabismus. Measurement of ICP showed unexpected dramatically low levels with a marked drop in pressure when the patient was in the upright position, whereas ICP was near normal when the patient was supine. The low ICP was corrected by insertion of a high-pressure Flo-Control valve into the shunt system already in place. Postoperatively, the immediate clinical improvement and more normal ICP measurements were striking. The important clinical finding in this group of patients was the presence of disabling symptoms which occurred when the patients were up and active and which were relieved by lying down. Measurements of ICP with the patient in the supine and then in the upright position were critical in establishing an accurate diagnosis of symptomatic low ICP in these hydrocephalic patients with indwelling shunts. With the patient in the Trendelenburg position, ICP showed a marked increase, as expected; in some patients this position was prescribed as treatment for several days before surgery.
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PMID:Symptomatic low intracranial pressure in shunted hydrocephalus. 334 12

During the 6 year period from January 1980 to December 1985 44 patients with infection of the central nervous system by Gnathostoma spinigerum or Angiostrongylus cantonensis were admitted to the Division of Neurology, Ramathibodi Hospital, Bangkok, Thailand. In 16 patients the diagnosis could be confirmed serologically by means of ELISA techniques. In gnathostomiasis encephalitis, myelitis, radiculitis and subarachnoid haemorrhage formed the majority of clinical syndromes. Intracerebral haematoma and transitory obstructive hydrocephalus are described in this report as being caused by Gnathostoma spinigerum infection for the first time. In angiostronglyus infections the clinical syndrome of meningitis was predominant, but one patient, whose angiostrongyliasis was proved serologically, also showed bilateral paresis of abducens nerve. The main laboratory finding was eosinophilic pleocytosis in the CSF (greater than 10%) which in patients originating or returning from South-East-Asia, particularly Thailand, is highly suggestive of these parasitic infections. Increasing transcontinental travel, influx of refugees and those seeking asylum as well as importation of food from South East Asian countries demand greater awareness of these parasitic infections even in Central Europe.
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PMID:Eosinophilic meningitis and radiculomyelitis in Thailand, caused by CNS invasion of Gnathostoma spinigerum and Angiostrongylus cantonensis. 335 33


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