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)

Three patients with midbrain lesion are described who showed trigeminal sensory symptoms in the contralateral side. Two with ischemic stroke showed partial oculomotor paresis while the third with probable vascular malformation had trochlear palsy. Considering their clinical manifestations and magnetic resonance findings, their sensory changes are believed to be caused by the involvement of the crossed trigeminothalamic fibers near the ocular motor nuclei.
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PMID:Trigeminal sensory symptoms due to midbrain lesions. 846 41

In a representative population of ambulant and home-dwelling 76-year-old citizens in Sweden (n = 565), dizziness was reported in about one third of the sample and more frequent in women. The dizzy subjects had more locomotor disorders, angina, urinary incontinence, stroke/paresis, and mental disorders than the non-dizzy. Unsteadiness was the most frequently reported sensation of dizziness and was more common in women than in men. Dizziness had a detrimental influence on all quality of life dimensions and daily life areas, as measured by the Nottingham Health Profile (NHP), except home life and, in women, social life. Dizzy subjects reported more frequently memory problems and anxiety than non-dizzy subjects. Dizziness showed a significant correlation with nervousness and depression in men. Dizziness seems to be one of the most important single symptoms with a negative influence on well-being in old age. It should be recognized as a serious complaint, especially in men, and, therefore, recorded in regular screenings in the elderly.
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PMID:Health-related quality of life and dizziness in old age. 864 3

The debilitating loss of function after a stroke has both primary and secondary effects on sensorimotor function. Primary effects include paresis, paralysis, spasticity, and sensory-perceptual dysfunction due to upper motor neuron damage. Secondary effects, contractures and disuse muscle atrophy, are also debilitating. This paper presents theoretical and empirical benefits of aerobic exercise after stroke, issues relevant to measuring peak capacity, exercise training protocols, and the clinical use of aerobic exercise in this patient population. A stroke, and resulting hemiparesis, produces physiological changes in muscle fibres and muscle metabolism during exercise. These changes, along with comorbid cardiovascular disease, must be considered when exercising stroke patients. While few studies have measured peak exercise capacity in hemiparetic populations, it has been consistently observed in these studies that stroke patients have a lower functional capacity than healthy populations. Hemiparetic patients have low peak exercise responses probably due to a reduced number of motor units available for recruitment during dynamic exercise, the reduced oxidative capacity of paretic muscle, and decreased overall endurance. Consequently, traditional methods to predict aerobic capacity are not appropriate for use with stroke patients. Endurance exercise training is increasingly recognised as an important component in rehabilitation. An average improvement in maximal oxygen consumption (VO2max) of 13.3% in stroke patients who participated in a 10-week aerobic exercise training programme has been reported compared with controls. This study underscored the potential benefits of aerobic exercise training in stroke patients. In this paper, advantages and disadvantages of exercise modalities are discussed in relation to stroke patients. Recommendations are presented to maximise physical performance and minimise potential cardiac risks during exercise.
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PMID:Benefits of aerobic exercise after stroke. 872 2

The impact of the acute and chronic phase of stroke on in vivo mediated immune functions was prospectively analysed in patients with mono- and multifocal brain lesions. The cutaneous delayed-type hypersensitivity (DTH) reaction to purified protein derivate was used as an in vivo measure of antigen specific T cell reactivity. Stroke patients have been tested prospectively for DTH reactivity at two separate occasions, 6-12 months apart. Both sides of the body were tested at each occasion. The DTH response on the paretic side changed significantly with time, from being smaller on the paretic side as compared with the contralateral one early after the onset of stroke, to become significantly larger (p = 0.017) in the chronic phase of the disease. In addition, stroke patients showed a significantly larger (p = 0.001) DTH reactivity bilaterally in the chronic phase of the stroke than in the early phase. When patients with single brain lesion and multiple brain lesions were analyzed separately, the increase of DTH reactivity on the paretic side between the 2 challenges was significant (p = 0.016) only in patients with the monofocal disease. We conclude that stroke induces i. an inhibition of DTH reactivity on the paretic side as compared with the non-paretic one in the acute phase but a lateralized enhancement of the DTH reactivity in the chronic phase of the disease, ii. a systemic increase of DTH reactivity in the chronic phase of the disease. Clinical factors positively correlated with these aberrations are: i. right sided, subcortical brain lesion, ii. paresis associated with impaired sensitivity, iii. minor stroke.
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PMID:Stroke induced lateralization of delayed-type hypersensitivity in the early and chronic phase of the disease: a prospective study. 878 30

The clinical effects were compared between a thrombolytic agent (urokinase) and a thromboxane synthetase inhibitor (sodium ozagrel) in patients with acute lacunar infarction. All patients had some degree of neurological deficits, which corresponded to the lesions on computerized tomography or magnetic resonance imaging. Urokinase of 420,000 units was given over two days in 11 patients, 160 mg/day of sodium ozagrel was administered for two weeks in 23 patients. The study was followed up to one month after the onset. Urokinase treatment improved motor paresis in 45.5-62.5% of the patients, sodium ozagrel in 68.4-86.7%. Using the combined score of motor paresis and conscious disorder, urokinase group revealed 44.4-45.5% improvement, but sodium ozagrel group 81.0-89.5% (p < 0.05). The rates of suppressive effect in progressing stroke and complete recovery were higher in sodium ozagrel group. Sodium ozagrel was clinically more efficient than urokinase in patients with lacunar infarction.
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PMID:[Clinical effects of urokinase and sodium ozagrel in patients with acute symptomatic lacunar infarction]. 888 28

In the Riordan (bridle) transfer, the posterior tibialis muscle as motor is routed through the interosseous membrane and anastomosed into a "bridle" formed by the distal tibialis anterior and peroneus longus muscles. In theory, the bridle provides inversion/eversion balance even if the transfer effects only tenodesis. However, the procedure has been criticized because its insertion is not into bone. This review analyzes the use of bridle transfer in flaccid paresis involving musculature innervated by the peroneal nerve. Surgery was performed 1 to 3 years after injury for patients with traumatic etiology. Ten patients are reviewed at 61 months' mean follow-up. Eight patients had traumatic peroneal nerve loss. Two had neuromuscular etiology. Evaluation included review of records, telephone interviews, and physical examinations. Data on functional status included walking barefoot running, need for bracing, return to duty, and patient satisfaction. Physical examination recorded ankle position and motions, gait findings, and results of static electromyograms. All patients were able to walk barefoot, but 6 of 10 had a mild to moderate limp. Five patients returned to running initially; only two were able to keep running. Nine patients were brace-free initially (polio sequela required bracing initially), and four others returned to bracing. Of these, two experienced an acute "tearing" and dorsiflexion loss, one sustained a prolonged gradual loss of dorsiflexion, and one sustained a contralateral cerebrovascular accident. Only three of seven patients returned to active duty, and one is on jump status. All patients were satisfied with their initial result. Only two patients had no detectable swing phase problems (both returned to active duty). Five patients had peroneal nerve exploration with repair or neurolysis; two of them sustained complete transections. Postoperative electromyograms showed insignificant, if any, nerve return. The Riordan transfer works well for neuromuscular flaccid paresis and in patients with peroneal nerve injuries with low demands. It may stretch out over time to the point of acute failure in patients with high demands. Concurrent peroneal nerve exploration and repair did not seem to be beneficial in this small study.
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PMID:Bridle transfer for paresis of the anterior and lateral compartment musculature. 890 87

Reliable, simple and safe criteria are needed for the early prediction of short-term outcome in patients with acute ischemic stroke. The aim of our study was to evaluate, in terms of their individual and combined power, the prognostic value of a few widely available clinical and instrumental variables obtained during the acute phase. The study involved 351 consecutive patients who were examined within 48 hours of their first ischemic stroke. Eight variables were chosen: age, initial level of consciousness, limb paresis, arterial blood pressure, glycemia, the results of electrocardiography and electroencephalography, and the infarct size revealed by computed tomography. Mortality and disability were evaluated on Day 30, when the variables that significantly correlated with disability were the severity of limb paresis, electroencephalographic abnormalities, infarct size and (less significantly) the level of consciousness and hyperglycemia. There was no statistical correlation with blood pressure. Logistic analysis confirmed only infarct size, the severity of limb paresis and electroencephalographic abnormalities as independent variables. The variables that significantly correlated with early death were the severity of limb paresis, infarct size, electrocardiographic abnormalities, the level of consciousness, electroencephalographic abnormalities and hyperglycemia. More intriguingly, logistic analysis confirmed only the electroencephalographic and electrocardiographic abnormalities as independent variables. The predictive prognostic value of limb paresis, infarct size, the level of consciousness and hyperglycemia is well known, but we would like to stress the fact that only a few independent variables are predictive of early death (electroencephalographic and electrocardiographic abnormalities) and poor recovery (infarct size, the severity of limb paresis, electroencephalographic abnormalities). The prognostic value of electroencephalography may express the potential involvement of dynamic non-structural phenomena, such as penumbra ischemica and diaschisis.
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PMID:Value of early variables as predictors of short-term outcome in patients with acute focal cerebral ischemia. 893 27

The influence of rhythmic music on gait symmetry was investigated in 12 healthy subjects and 12 stroke patients with mild leg paresis walking on the treadmill. For the measurement, new insoles containing air-filled chambers developed by W.O.M were used. Symmetry deviation was determined as the mean signless difference between left and right swing phases of some 100 strides. In 6 patients, the symmetry deviation decreased by more than 1% of the stride duration some 40 steps after switching on the music. The improvement correlated with the initial symmetry (r2 = 0.61) exclusively in the healthy controls. In order to differentiate individual predictors of the improvement in symmetry, such as cognitive performance in terms of recognizing the beat of the music and the motor performance in terms of synchronizing the movements of the legs to the music, we analysed foot tapping with the patient in the seated position. For both patients and healthy subjects, the mean time difference between beat and foot movement was less than +/-1/32 beat. Individual scatter of mean 8% correspond in the case of healthy subjects to the figures found in the literature for finger movements, and the corresponding figures for the patients are more than twice this. The individual synchronisation performance during walking to music correlates to that during foot tapping (r2 = 0.47) exclusively in the group of healthy controls.
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PMID:[Effect of music on gait symmetry of stroke patients on a treadmill]. 901 31

A new classification of motor disorders in patients after brain hemisphere's stroke as well as with its sequelae was proposed on the basis of clinical electromyographic studies. The classification validity was confirmed by mathematic statistic methods. The classification was composed of motor syndromes and is based on the following criteria: the severity of paresis, the correlation between gravity of paresis of the upper and lower limbs, muscular spasticity, alteration of integral estimation of active movements (the motor algorithm). The most informative signs of classification are the following: the paresis gravity, the degree of muscular spasticity, the alteration of motor algorithm, the parameters of stimulative electromyography. The described classification permits to carry out differentiated actions of neurorehabilitation directed to intensification of effectivity of treatment after hemisphere's stroke.
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PMID:[A new classification of the motor disorders in patients who have had a cerebral stroke]. 907 87

A multicentre, double-blind, randomized study was performed in 179 patients with acute ischaemic stroke resulting in limb paresis. The purpose was to compare the safety and efficacy of Org 10172 (1250 anti-Xa Units s.c. once daily) and heparin sodium (5000 IU s.c. twice daily) in preventing deep-vein thrombosis (DVT). Prophylaxis started within 72 hours of the onset of stroke and continued for at least 9 days. To detect DVT, patients underwent a daily 125I-fibrinogen leg scanning which, if found positive, was followed by venography. A first computed tomography scan of the brain was performed at screening to rule out cerebral haemorrhage and a second at cessation of treatment to detect any haemorrhagic transformations. At the 2-3-months' follow-up period the patients were examined for signs and symptoms of DVT or pulmonary embolism. On an intention-to-treat analysis, DVT occurred in 14.6% of patients receiving Org 10172 and in 19.8% of those receiving heparin during the treatment period (p = 0.392, NS). Pulmonary embolism was diagnosed in one patient in each group. Major conversion to a symptomatic haemorrhagic brain infarct was found in one patient in each group. Death occurred in 13.5% of patients treated with Org 10172 and in 6.7% of patients treated with heparin (p = 0.135, NS). Deaths were mainly related to pulmonary infection and cerebral oedema, thus considered to be due directly to the clinical status of the patients. 1250 anti-Xa Units of Org 10172 once daily is both safe and as effective as 5000 IU of heparin sodium twice daily given for DVT prophylaxis in patients with acute ischaemic stroke of recent onset.
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PMID:A multicentre, double-blind, randomized study to compare the safety and efficacy of once-daily ORG 10172 and twice-daily low-dose heparin in preventing deep-vein thrombosis in patients with acute ischaemic stroke. 923 47


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