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

Irradiation neuropathy is a term for the damage to peripheral nerve tissue due to irradiation. Brachial irradiation plexopathy is irradiation neuropathy affecting the brachial plexus. This is most frequently a complication of irradiation therapy for cancer of the breast. The incidence varies considerably and is lowest with low total doses of irradiation and limited fractions. The latent period varies from months to several years. The neurological manifestations are paraesthesiae in the fingers, pain, hypaesthesia, hypalgesia, disaesthesia, paresis, hyporeflexia, muscular atrophy and possibly vegetative disturbances. Horner's syndrome may occur. Lymphoedema is observed in approximately on third of the patients. The course of brachial irradiation plexopathy is progressive. No specific treatment is available. The diagnosis is based on the case history, clinical picture, electrodiagnosis and CT of the brachial plexus region. The most important differential diagnosis is metastatic infiltration in the brachial plexus. These two conditions are differentiated best by means of CT guided surgical exploration and histological examination of the tissue. The irreversible nature of brachial irradiation plexopathy and its marked resistance to treatment are such that the optimal irradiation hygienic rules must be observed.
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PMID:[Brachial irradiation plexopathy]. 255 Oct 86

Recently a subset of chronic demyelinating inflammatory polyneuropathies with asymmetrical involvement limited to upper limbs, at least at the onset, resembling a multifocal mononeuropathy has been described. Electrodiagnostic testing disclosed multifocal CB outside the common entrapment sites has been described. We report a 55 years old man with a 4 years history of paresis, numbness, fasciculations, myokymia, cramps and mild amyotrophy. Electrophysiological evaluation showed proximal multifocal conduction block and abundant spontaneous activity as fasciculations, myokymia and scarce denervation activity. The importance of taking into account this entity in the differential diagnosis of patients with suspected mononeuritis multiplex or motoneuron disease is emphasized. The nosologic place of this entity is also discussed.
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PMID:[Multifocal polyneuropathy with persistent conduction blockage. A new subset of chronic inflammatory polyneuropathies]. 255 98

From 1969-1985, 106 people contracted tetanus in Finland. The outcome of the disease was good in 78 cases (returned to work), poor in 27 (12 died, 5 institutionalized and 10 retired) and unknown in 1. Poor outcome was the result of a disease requiring respirator treatment. Other clinical factors significantly correlated with poor outcome were blood pressure lability, hyperglycemia, hyperthermia, tachycardia and anticoagulation therapy. Forty people who were representative of the whole series with regard to sex, age and severity of disease attended a follow-up study on average 7 years and 4 months later. Forty age- and sex-matched controls had the same examinations, and compared with them, the 40 patients still had significantly more muscle fatigue and cramps, nervousness, decreased mental capacity and difficulties in balance, speech and memory. They also had more clinical findings, such as peripheral paresis, muscular atrophy, decreased or absent tendon reflexes and decreased mental capacity than the controls.
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PMID:Outcome and neurological sequelae of patients after tetanus. 261 76

Two cases of a rare peripheral neurological disease (neuralgic amyotrophy of the lower extremity) are presented, with clinical symptoms (severe sciatic pain with motor paresis) that pose differential diagnostic difficulties against a hernia of a lumbar disk. Because of a tendency to heal by itself, the disease has a good prognosis. The diagnosis is based on a process of exclusion of herniated disks, lesions of the lumbar plexus in tumors or after radiation therapy, hematoma of the psoas after coagulation disturbances, birth, or trauma, and nutritive disruptions of the nervous system as in diabetes mellitus. Knowledge of the symptoms of this--in orthopedics--mostly unknown disease and critical interpretation of the clinical and medical-technical data are important to avoid wrong indications for surgery.
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PMID:Neuralgic amyotrophy of the lumbar area. Case report. 278 27

It is demonstrated in five exemplary cases that a neuralgic amyotrophy with particular involvement of the long thoracic nerve was the cause of a postoperative serratus paresis. In any case liability claims, it is essential for an expert's opinion on postoperative serratus paresis to differentiate this pathology from intraoperative injuries caused by pressure. Above all the interval between operation and the first manifestation of symptoms, as well as the development of distinct pain count against an intraoperative plexus lesion.
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PMID:[Postoperatively developing serratus paresis as a legal problem]. 349 77

Numerous studies have been devoted to the various histopathologic changes of the surface of the tongue. The muscles of the tongue and their changes in the process of ageing as well as in neurogenic atrophies, however, have not been systematically examined so far. Enlarging upon previous studies, an autopsy material of 170 tongues from all age groups was histologically examined in order to identify the steps in the development of age-related atrophy. These are characterized by a histometrically documented atrophy of the musculature with progressive lipomatosis. Fatty infiltration starts in the 2nd/3rd decade at three sites of predilection: body, root and tip of the tongue in the region of the anterior lingual gland (NUHN). The age-dependent atrophy and the known clinical behaviour of neurogenic atrophies of the tongue are correlated with the histopathology of three typical forms: a neurogenic myasthenic atrophy of the tongue with high-grade symmetrical fatty replacement as an expression of a progressive myasthenic denervation; a lipomatous atrophy of the tongue as a late stage of poliomyelitis and long-term treatment in the "Iron Lung", and a lipomatous hemiatrophy due to posttraumatic extracranial hypoglossus paresis. The paretic part of this tongue consists of 85-90% fatty tissue. The different degrees of muscular atrophy of the tongue are largely compensated by metaplasia of fatty tissue in the perimysium following muscular degeneration (in the sense of a fatty replacement). With the exception of general and severe myasthenic atrophy, size, form and function of the tongue fail to show any significant changes in age-related atrophy and hemiatrophy.
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PMID:Histopathology of different types of atrophy of the human tongue. 358 8

A 79 years-old man suffered gait disturbance for more than ten years. During the last year the gait worsened. Twenty days after having developed a right hemiparesis, he died from cardiorespiratory failure. Neurological signs were characterized by cogwheel rigidity, distal paresis and amyotrophy of the legs. E.M.G. demonstrated a denervation; ulnar conduction velocity was 38 m/s. The sural nerve biopsy showed a loss of myelinated fibres and no onion-bulb-like formations. A sister (72 years) and two nephews (51 and 39 years) also suffer gait disturbance. The E.M.G.'s demonstrate denervation of the legs. The amplitudes of the motor and sensory nerves are reduced and conduction velocities range between 39 and 59 m/s. Pathologic examination of the propositus showed recent left frontal subcortical infarction, partial neuronal depopulation of the substantia nigra and Lewy inclusions. Microscopic examination of the spinal cord showed integrity of the posterior columns, anterior and posterior spinal roots, cauda equina, and of a thoracic posterior root ganglion. The anterior horns showed a mild gliosis and a slight neuronal depopulation with a few pale or atrophic neurons and very rare neuronophagias. This is believed to be the first autopsy report of a dominant sensory motor neuropathy of the neuronal type. The relative integrity of the spinal cord suggests that the peripheral motor and sensory neurons are affected to the greatest degree at their distal extremity.
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PMID:[Anatomo-clinical study of a neuronal form of Charcot-Marie-Tooth disease]. 633 Aug 34

Unilateral electrolytic lesions were produced in the left trigeminal motor nucleus (TMN) of six guinea pigs at 49 days of age. Masticatory mandibular movement and EMG data were collected prior to lesioning and at 4 and 12 days postlesion. After the animals were killed 60 days postlesion, dissection and maceration revealed muscular atrophy and craniofacial asymmetries on the lesion side. Analyses of prelesion and postlesion mandibular movement and EMG data indicated significant (p less than 0.05; p less than 0.01) changes in chew cycle durations, dimensions, and EMG activity patterns. Shifts in EMG durations of working- and balancing-side muscles were strongly related to most of the observed skeletal asymmetries. Data indicated that muscular paresis and altered neuromuscular activity can effect skeletal changes in the mammalian craniofacial complex; total muscular paralysis is not a prerequisite for profound morphologic changes. Altered manifestation of masticatory central pattern generators within the central nervous system may also account for variations in craniofacial form and function.
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PMID:Masticatory movements and EMG activity following electrolytic lesions of the trigeminal motor nucleus in growing guinea pigs. 658 59

Seven cases are reported in which syringomyelia was confirmed by neuroradiological studies and surgical procedures. Dissociated sensory loss was noted in four patients in this series. Peripheral paresis and muscular atrophy in arms and hands were found in all seven patients. In only two of the patients the wide spinal canal were found in the lateral view of plain cervical spine films. Assimilation of the atlas to the occipital bone was seen in two patients. Arnold-Chiari malformation was found by myelography and posterior fossa craniectomy in four patients. Metrizamide CT cisternography was found to be useful to demonstrate Arnold-Chiari malformation. Gas myelography was performed on six patients. A collapsing cord was demonstrated in four patients. In other two patients the study was not successful because of technical problem and the association of communicating hydrocephalus. Computed tomography, haad scanner, was done on six patients. Plain CT was not useful diagnostic study for the diagnosis of Arnold-Chiari malformation or syringomyelia. This study and other reports suggest that the most reliable radiological diagnostic method of syringomyelia is gas myelography and demonstration of the collapsing cord. CT of the spinal cord requires further improvement, however, CT with high resolution and metrizamide will improve diagnostic accuracy.
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PMID:[The diagnosis of syringomyelia (author's transl]. 724 38

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


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