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

This is a report of a patient with pains in the shoulders and arms, atrophies of the small muscles of the hands, and paraspasms of the legs. After having suffered from the disease for eight to nine years, the patient was diagnosed as having cervical myelopathy. Measurements of the bony cervical vertebral column, which were made on a lateral roentgenogram, showed extreme narrowness of the spinal canal, the measured values obtained being below the lower limit. In addition, the cervical canal was narrowed at three levels by the formation of projections on degenerate disks. This suggested the most effective surgical treatment: Vetral clearance of disks, removal of prominences, and fusion of the three levels through the use of four bone dowels. Subsidence of pains in the shoulders and arms, improvements of paresis of the hands, and considerable improvement of paraspams of the legs were observed postoperatively. This particular case shows that surgical intervention may be considered a possible method of therapy even in the case of narrowness of the cervical canal, a condition that was aggravated here by a number of degenerate disks. In such situations it is possible for the cervical canal to be considerably relieved by clearing the disks, removing the projections and crests, and making use of the special technique of fusion or joining together so that improvement will be possible even in those cases where the disease has already arrived at a progressive state.
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PMID:[Possibilities of cervical fusion surgery in the spinal canal with intervertebral disk degeneration, Therapeutic and case-report contribution]. 6 79

Gas myelography is not a new technique, but its acceptance in neuroradiologic diagnosis has been relatively recent. Previously reported series have emphasized the benign nature of this technique and the lack of significant accompanying complications. From a series of 174 gas myelograms performed during a four-year period, two reports are presented wherein transient exacerbation of neurologic deficit followed exchange of cerebrospinal fluid and gas under pressure by the lumbar route. One patient with cervical spondylotic myelopathy experienced an increase in paresis, while another was found to have marked fasciculations. Speculation regarding possible mechanisms involved with these complications is presented. It is suggested that exchange of cerebrospinal fluid and gas under pressure via the lumbar route be used with caution in those patients with compromised cervical spinal cords.
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PMID:Neurologic complications of gas myelography by the lumbar route. 103 Mar 19

We investigated the question as to whether transcranial magnetic stimulation of nerve structures can be used to obtain an objective description of motor impairment in humans with cervical nerve root compression or myelopathies. We were able to show that paresis is correlated with an increase in the latency of the evoked muscle potentials. Application of the method in the fields of orthopaedics and neurosurgery permits a description of motor deficits in cervical compression radiculopathy and myelopathy. Although the value of the method for orthopaedic and neurosurgical purposes is not yet completely clear, our experience does indicate interesting possibilities in the diagnostic evaluation of diseases of the cervical spine.
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PMID:[Diagnostic possibilities of transcranial magnetic stimulation in diseases of the cervical spine]. 139

Chronic compressive myelopathy was induced in domestic rabbits by implanting bone morphogenetic protein on the ligamentum flavum of the lumbar spine, and the resulting spinal cord lesion was studied histopathologically. In addition, morphometry of myelinated nerve fibers of the white matter in the pathologic specimens was performed to elucidate the mechanisms of cord injury. No loss of white matter nerve fibers was seen when the cord compression ratio (sagittal diameter/transverse diameter) was > 45%, although 6 months later myelin thinning was present throughout the white matter. When the cord compression ratio was < or = 45%, loss of fibers, particularly of large fibers, was seen in the superficial layer of the white matter, with the nerve fibers remaining after 6 months showing decreased diameters. No motor paresis was evident in any animal. These histologic changes represent the early pathologic condition induced by chronic cord compression.
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PMID:Histopathologic and morphometric study of spinal cord lesion in a chronic cord compression model using bone morphogenetic protein in rabbits. 146 13

Three patients with spinal dural arteriovenous fistula presented with acute and/or progressive myelopathy. The thoracic cord was focally enlarged and poorly defined on MR images in two of the patients. One individual showed focal cord atrophy, and one demonstrated abnormal intrathecal vessels. In all patients MR studies revealed cord enhancement after IV administration of gadopentetate dimeglumine. The MR findings are believed to represent disruption of the blood-cord barrier associated with cord ischemia and/or infarction, which, in turn, is caused by venous stasis resulting from the fistula. The diagnosis in each case was confirmed by the combined results of myelography, spinal arteriography, and surgery. Surgical excision or embolization of the fistula produced a poor return of lost function but an arrest in the progression of paresis. One of the patients had constant severe back and leg pain postoperatively, and a follow-up MR study 5 months after surgery showed focal atrophy and persistent enhancement of the thoracic cord. The patient with preoperative focal cord atrophy had an MR examination 1 year prior to surgery, which revealed enhancement of the cord similar to that seen on the immediate preoperative MR study. This patient also had severe pain in the back and lower extremities preoperatively, which accompanied her progressive paraparesis. It is believed that long-standing enhancement of the spinal cord in patients with dural arteriovenous fistula probably results from chronic progressive venous ischemia, which may be irreversible and cause pain of a central type.
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PMID:Venous infarction of the spinal cord resulting from dural arteriovenous fistula: MR imaging findings. 188 56

The latent period to forelimb paresis following photon irradiation of the cervical spinal cord was evaluated in Sprague-Dawley rats ranging in age from 9 days to adulthood. The radiation was administered dorsally in single fractions, and in 15-day-old animals, to different lengths of the rostral cord and in doses ranging from 16 to 38 Gy. The duration of the latent period was found to be directly proportional to the age of the animal at the time of irradiation, and independent of radiation dose or the volume of the cervical cord which was irradiated. In the majority of paretic animals, the irradiated segment of the spinal cord demonstrated white matter necrosis. The results indicate that in the developing rat, the manifestations of radiation myelopathy are delayed by an interval determined in part by the age of the animal at the time of irradiation.
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PMID:The effect of age on the latency of radiation myelopathy. 189 62

Ten patients with involuntary leg movements due to myelopathy were studied clinically and polysomnographically. The clinical manifestation and polysomnographical findings of involuntary leg movements were identical to sleep-related periodic leg movement (PLM) (nocturnal myoclonus). Since 2 patients had complete transection of spinal cord due to injury or vascular accident, the spinal cord deprived of supraspinal influences was considered to generate the rhythm of PLM. Suppression of the leg movements during REM sleep was not obvious in the patients with complete transection of spinal cord. In addition, PLM alternated from one side to the other 1-4 times a night with intervals of 1-4 h in all patients. This alternation also seemed to be from the spinal cord. This PLM of spinal cord origin was different from spinal myoclonus in their clinical features although both were generated within the spinal cord. PLM of spinal cord origin showed a triple flexion of the ankle, knee and hip, and this was very similar to a flexor withdrawal reflex which all patients exhibited. Therefore, it was suggested that PLM of spinal cord origin has a common mechanisms with spinal automatism. Although all patients had extensor plantar responses, PLM preceded the paresis in three patients and the severity of paresis was variable. There was no laterality of left and right PLMs even in patients with weakness of the leg on one side. This suggested that PLM of spinal cord origin might be induced by the interruption of the tract which was separate from, but runs near the corticospinal tract.
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PMID:Sleep-related periodic leg movements (nocturnal myoclonus) due to spinal cord lesion. 191 96

Vertebral body replacement after spondylectomy, combined with microsurgical decompression and anterior plating, was performed in 22 patients as an aggressive therapeutic approach to multisegmental cervical spondylosis. The patients were 13 men and 9 women, ranging in age from 32 to 74 years. In 19 patients, the typical signs of cervical myelopathy were present. In three patients, pain was the major symptom, accompanied by moderate spastic paresis and hyperreflexia. Apart from cervical myelography and computed tomographic scanning, which was performed in 10 patients, magnetic resonance imaging was the radiological procedure of choice in 12 patients. During spondylectomy, one vertebra was removed in 14 patients, two vertebrae in seven patients, and three vertebrae in one patient. The time of postoperative follow-up ranged from 8 to 46 months, with an average interval of 21 months. In all 22 patients, satisfactory bony fusion was achieved as demonstrated by radiological control examinations. Seventeen patients (77%) were symptom free or had only minor residual symptoms. Three (14%) patients had intermittent nuchal or cervicobrachial pain, which responded well to analgesic medication or the application of a soft collar. Two (9%) patients still had myelopathic but not incapacitating symptoms. Of 15 patients who were employed before surgery, 13 returned to a full-time job. The only severe complication of surgery was a prevertebral abscess that healed without sequelae. It is concluded that aggressive surgical therapy of multisegmental cervical spondylosis by a combination of vertebrectomy, decompression (using the surgical microscope), bone grafting, and osteosynthesis is a straightforward and promising procedure for the treatment of this debilitating disease.
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PMID:Multisegmental cervical spondylosis: treatment by spondylectomy, microsurgical decompression, and osteosynthesis. 194 28

Vacuolar degeneration was constantly induced in the CNS of 4-week-old ICR mice by intracerebral or intranasal inoculation of JHM-CC virus, a small plaque mutant of mouse hepatitis virus (JHM). Most animals showed no symptoms or only mild hindlimb paresis. Irrespective of clinical manifestations, the virus was isolated from the CNS up to days 14 to 16. Viral antigen expression in the CNS tissue was most extensive around days 5 to 7 and became undetectable on day 14. Viral antigens were localized almost exclusively to neurons, and the temporal sequence of viral antigen distribution after intranasal inoculation clearly indicated the virus spread through the olfactory and limbic systems into the brainstem and spinal cord, and possible cell-to cell transmission of the virus within the CNS. Vacuolar changes, most conspicuous in the brainstem and spinal cord, were steadily progressive up to 4 weeks after infection, but became indistinct by 4 months. Although the distribution of vacuolar lesions largely agreed with that of viral antigen-positive cells, the severity of vacuolation did not correlate with that of inflammation. Intramyelinic splitting, periaxonal edema, and swollen neurites were major ultrastructural substrates for vacuolar changes. This model could provide a better understanding of new types of neurologic disorders associated with viral infections, including vacuolar myelopathy in AIDS.
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PMID:Vacuolar degeneration in mice infected with a coronavirus JHM-CC strain. 216 Oct 91

We report a case of AML (M 4) with eosinophilia who developed meningeal relapse and transverse myelopathy. A 37-year-old woman was admitted to our hospital because of lymphadenopathy and ecchymosis. One week prior to admission, she noticed swelling of the cervical lymph nodes and bleeding tendency. On admission, low-grade fever, gingival swelling, generalized lymphadenopathy, and ecchymosis on the lower legs were found. A white blood cell count was 93,900/microliters with 82% blast cells, and a platelet count was 24,000/microliters. A bone marrow was composed of 45.3% myeloblasts, 27% monocytes and 7.1% eosinophils. Chromosome analysis revealed inv(16). The diagnosis of M4Eo was made. About one year after she gained complete remission, she was readmitted because of disturbance of urination. There was a sign of transverse myelopathy at the seventh vertebral level, and blast cells were detected in the cerebrospinal fluid. Despite of radiation and chemotherapy, paresis of lower extremities and sensory disturbance were persistent, and the patient died on 52th hospital day.
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PMID:[Acute myelomonocytic leukemia with Inv(16) (p13 q22) relapsed in transverse myelopathy]. 221 77


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