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

Neurogenic bladder dysfunction can be difficult to manage and is usually impossible to cure. This case report describes neurosurgical treatment of a case of recurrent urinary incontinence in a 56 years old woman who was previously treated on four occasions with vaginal repair operations with no beneficial effect. Cystometry revealed detrusor hyperreflexia (supranuclear bladder paresis). Myelography demonstrated cervical spinal cord compression. She was treated with spondylodesis of the cervical spine with complete relief of incontinence. 18 months postoperative cystometry was normal and after three years she was free of symptoms.
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PMID:Recurrent urinary incontinence treated neurosurgically. 738 93

A 26-year-old housewife, born of consanguineous parentage, began to have gait and speech disturbance. Her brother had died from suffocation because of dysphagia. At thirty-two, she developed difficulty in swallowing, clumsiness and incontinence. When she was thirty-six she had pseudobulbar palsy, vertical gaze paresis, hyperreflexia and muscular atrophy of the upper half of the body. CT scan showed cerebral atrophy. Her mental function progressively deteriorated and amyotrophic lateral sclerosis associated with dementia was suspected. She died at the age of thirty-seven. Diagnosis was made only by autopsy. There was no particular general pathologic finding excepting aspiration pneumonia. Microscopical examination revealed numerous distended neurons with accumulation of light brown pigments by Luxol fast blue/H & E stains, especially in hypothalamus, substantia nigra and nuclei of oculomotor nerves. To a lesser extent such neurons were noted ubiquitously. The stored material was mainly composed of lipofuscin and ceroid. Ultrastructurally they presented the various structures which have previously been reported, except for finger print profiles. The pigmentary deposits were shown to be immunoreactive with polyclonal antibody directed against amyloid beta-protein.
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PMID:[Dementia and amyotrophy in Kufs disease. The adult type of neuronal ceroid lipofuscinosis]. 774 8

This paper reviews the methodological issues in the epidemiological study of the outcome from stroke. Data are presented from an unselected series of patients in whom the underlying stroke pathology is clearly defined. Although the natural history varies among the different pathological subtypes of stroke, simple clinical baseline measures of the severity of the neurological deficit (incontinence, loss of consciousness and severity of paresis) and premorbid level of disability and social functioning independently predict disability-free survival by 1 year, and may help direct management and research.
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PMID:Baseline measures and outcome predictions. 780 Jan 6

The validity of a clinical classification system was assessed for subtypes of cerebral infarction for use in clinical trials of putative stroke therapies and clinical decision making in a population based stroke register (n = 536) compiled in Perth, Western Australia in 1989-90. The Perth Community Stroke Project (PCSS) used definitions and methodology similar to the Oxfordshire Community Stroke Project (OCSP) where the classification system was developed. In the PCSS, 421 cases of cerebral infarction and primary intracerebral haemorrhage (PICH), confirmed by brain imaging or necropsy, were classified into the subtypes total anterior circulation syndrome (TACS), partial anterior circulation syndrome (PACS), lacunar syndrome (LACS), and posterior circulation syndrome (POCS). In this relatively unselected population, relying exclusively on LACS for a diagnosis of PICH had a very low sensitivity (6%) and positive predictive value (3%). Comparison of the frequencies and outcomes (at one year after the onset of symptoms) for each subgroup of first ever cerebral infarction in the PCSS (n = 248) with the OCSP (n = 543) registers showed uniformity only for LACI. For example, there were 27% of cases of TACI in the PCSS compared with 17% in the OCSP (difference = 10%; 95% confidence interval (95% CI) 4% to 16%) and 15% of cases in the PCSS compared with 24% in the OCSP were POCI (difference = 9%; 95% CI 3% to 15%). Case fatalities and long-term handicap across the subgroups were not significantly different between studies, but the frequencies of recurrent stroke were significantly greater for POCI in the OCSP compared with the PCSS. Although this classification system defines subtypes of stroke with different outcomes, simple clinical measures-level of consciousness, paresis, disability, and incontinence at onset-are more powerful predictors of death or dependency at one year. It is concluded that simple clinical measures that reflect the severity of the neurological deficit should complement this classification system in clinical trials and practice.
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PMID:Validation of a clinical classification for subtypes of acute cerebral infarction. 793 76

A 3-year-old girl with left hemiparesis suffered from bilateral paresis, motor rigidity, gait disturbance, axial hypotonia, dysarthria, apathy, and incontinence. After steroid therapy, mild improvement occurred, but muscle weakness, gait disturbance, and rigidity remained. Leigh encephalopathy was excluded on the basis of muscle biopsy and laboratory findings. Computed tomography and serial magnetic resonance imaging at an early stage revealed right-sided dominant lesions in the putamen and caudate nucleus and later bilateral striatal lesions, appearing as hyperintense signals on T2-weighted images and mixtures of hypo- and hyperintense signals on T1-weighted images. This is the first demonstration of serial magnetic resonance imaging findings in infantile bilateral striatal necrosis.
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PMID:Serial MRI in infantile bilateral striatal necrosis. 802 66

A 67-year old male patient was admitted to our clinic because of slowly developing dementia. Severe dysfunction of memory, confusional states and urinary incontinence were observed. A diagnosis of general paresis was made by positive serology for syphilis and CSF examination. The patient's condition improved markedly after high-dose penicillin G treatment.
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PMID:[Development of dementia]. 825 71

Diagnosis of malignant histiocytosis (MH), a disorder characterized by systemic proliferation of morphologically atypical histiocytes and their precursors, in an 8-year-old neutered female Golden Retriever was based on light and electron microscopic and immunohistochemical findings. Clinically, the dog presented with unilateral forelimb lameness. Eight days after surgical exploration of a swollen brachium, the dog developed sudden onset of posterior paresis, fecal and urinary incontinence, and a flaccid tail. Necropsy revealed infiltrative and nodular lesions in the right forelimb and regional lymph nodes, thoracic and abdominal cavities, and lumbar epidural space. Gross lesions were not found in the lungs or integument. Histopathologic examination showed infiltrates of atypical histiocytes in skeletal muscle, joint, and regional lymph nodes of the right forelimb; intercostal muscle; lung; liver; spleen; pancreas; kidneys; and spinal dura. Most tumor infiltrates were nodular and composed of loosely aggregated cells that were 10-30 microns in diameter with abundant eosinophilic to foamy cytoplasm, had central or eccentric nuclei, and were periodic acid-Schiff negative. Many binucleated cells, multinucleated giant cells, and mitotic figures were seen. Tumor cells contained phagocytosed erythrocytes, mononuclear cells, and some leukocytes. Ultrastructural features of tumor cells included cytoplasmic lipid droplets, lysosomes, and phagolysosomes. Immunohistochemical studies on paraffin-embedded sections showed positive reactivity to human T-cell Ag (clone UCHL-1) and for lysozyme, alpha-1-antitrypsin, and cathespin B. Polyclonal intracellular immunoglobulin reactivity and lectin binding (peanut, soybean, and wheat germ agglutinins and concanavalin A) were also demonstrated. Criteria for diagnosis of malignant histiocytic tumors and differential diagnosis are discussed.
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PMID:Disseminated malignant histiocytosis in a golden retriever: clinicopathologic, ultrastructural, and immunohistochemical findings. 833 7

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

Myeloencephalopathy is an uncommon manifestation of equine herpesvirus 1 (EHV-1), but it can cause devastating losses during outbreaks on individual farms. Clinical signs of neurologic disease reflect a diffuse multifocal hemorrhagic myeloencephalopathy secondary to vasculitis and thrombosis. Sudden onset and early stabilization of signs, including ataxia, paresis, and urinary incontinence; involvement of multiple horses on the premises; and recent history of fever, abortion, or viral respiratory disease in the affected horse or herdmates are typical features, although there is considerable variation between outbreaks in epidemiologic and clinical findings. Prevention is difficult because many asymptomatic horses are infected latently with EHV-1 myeloencephalopathy and because vaccines do not confer protection against neurologic manifestations of infection. This article reviews the pathogenesis, pathology, clinical manifestations, diagnosis, and treatment of EHV-1 myeloencephalopathy and discusses prevention and control of equine herpesviral infections in the context of their epidemiology.
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PMID:Equine herpesvirus 1 myeloencephalopathy. 910 43

Spinal arteriovenous malformations are uncommon disorders associated with considerable difficulty in diagnosis and treatment. They are divided into dural arteriovenous fistulas and intradural medullary spinal cord angiomas. In this retrospective series of six patients the clinical outcome of embolization is presented. The patient material consisted of three dural fistulas and three cord angiomas, one of which bled causing sudden paresis, pain and incontinence. In the remaining five patients the symptoms were progressive consisting of paraesthaesias, paraparesis, pain and incontinence. The clinical status of four patients was not changed after the treatment, one deterioriated and one improved. There were no bleedings after the therapy. In one patient spinal angiography for follow-up was performed and recanalization was seen in the dural fistula after particle embolization. Also, in one cord angioma embolized with particles reflow appeared in the immediately repeated angiography. For permanent angioma occlusion tissue adhesive is preferred as embolic material. Surgical therapy as an alternative or adjuvant to embolization is discussed with a review of the literature. Early timing of the therapeutic intervention is stressed to avoid the development of irreversible ischaemic medullopathy and to prevent haemorrhage. The therapeutic procedures at the early stage of the disease may be curable or, at least, halt the progression of the symptoms. Cross-sectional imaging studies and myelographies may reveal the lesion. For the definitive diagnosis of spinal angioma with its vascular feeders and for the evaluation of its occlusion grade after the therapy selective spinal angiography is needed.
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PMID:Diagnosis and embolizing of spinal arteriovenous malformations. 945 83


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