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

We review our two-team operative technique and results of anterior retroperitoneal lumbosacral spine exposure for diskectomy, partial corpectomy, and spinal instrumentation. Seventy-two patients with lumbar spondylosis and associated symptomatic radiculopathy had this exposure between January 1, 2000 and January 1, 2002. A single disc space was isolated in 54 patients. Multilevel exposure was achieved in 18 patients. Main outcome measures included intra- and postoperative complications, blood transfusion requirements, duration of ileus, incidence of erectile/sexual dysfunction, and length of hospital stay. A single small bowel enterotomy and iliac vein laceration, both repaired primarily, were the only intraoperative complications. Perioperative blood transfusions were required in 13 patients (18%). Mean length of postoperative ileus was 3.5 days and average length of hospital stay was 5 days. Postoperative complications occurred in 7 patients (9.7%). These included erectile dysfunction (2), transient unilateral lower extremity paresis (1), acute acalculous cholecystitis (1), femoral vein thrombosis (1), pneumonia (1), and acute myocardial infarction (1). There were no genitourinary or other major vascular injuries. A two-team approach for lumbosacral spine instrumentation via anterior retroperitoneal exposure capitalizes on unique specialty-specific surgical skills. This paradigm facilitates safe lumbosacral spine surgery and major perioperative complications are rare.
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PMID:Anterior retroperitoneal lumbosacral spine exposure: operative technique and results. 1261 53

Herpes zoster (HZ) is essentially a viral disease of the posterior root ganglia and sensory nerve fibers, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, motor involvement can be seen as well. If classic cutaneous lesions are present, HZ-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be suspicious, especially if the weakness occurs before the cutaneous lesions have appeared, or weeks after they have subsided. We present a patient with HZ-related motor paresis due to radiculopathy in the cervical segments whose motor symptoms and signs appear as major clinical features.
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PMID:Zoster paresis. 1283 88

This retrospective study aims to discuss and compare our results with those previously mentioned in the literature with regard to C5-C6 radiculopathy that occurs after decompression carried out for cervical spondylotic myelopathy. There are few reports in the literature referring to the incidence of the C5-C6 radiculopathy following cervical decompression procedures. Some authors believe that the postoperative cord shift is the most likely cause. From January 1994 to November 2002, 121 patients underwent cervical corpectomies for cervical spondylotic myelopathy. The preoperative and the postoperatively discovered paresis have been assessed according to the criteria of the British Medical Council. The Nurick Scale was used to grade the severity of the myelopathic changes. The follow-up period varied from 4 to 111 months with an average of 50 months. Symptoms of C5 and/or C6 radiculopathy appeared in 10 patients (8.2%) postoperatively. Aggravation of a preoperative C5 and/or C6 radiculopathy was seen in 3 patients, while 7 patients developed a new C5 and/or C6 radiculopathy in the immediate postoperative period. These motor deficits resolved completely in 7 patients within 7 months of surgery, whereas a residual motor weakness remained in the other 3 patients. The postoperative C5 motor deficit is not infrequently associated with partial involvement of the C6 root. The lesions can be either unilateral or bilateral with a statistically average frequency of 8%. The prognosis is generally favorable. Our results did not support the hypothesis that the claimed cord shift phenomenon is a possible aetiology.
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PMID:The incidence of C5-C6 radiculopathy as a complication of extensive cervical decompression: own results and review of literature. 1537 14

A patient with left shoulder girdle weakness secondary to herpetic myotomal paresis is reported. Needle electromyography revealed denervational discharge from the left supraspinatus, deltoid, and brachioradialis muscles, compatible with a radiculopathy that was relevant to his myotomes affected by zoster infection. The patient was managed with range-of-movement and strengthening exercises as well as pain relief for post-herpetic neuralgia. Further studies are required to determine whether antiviral treatment can limit the extent of motor deficit and hasten recovery. Zoster paresis should be one of the differential diagnoses of girdle muscle weakness.
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PMID:Herpetic shoulder paresis in a Chinese elderly patient. 1621 61

A 47-year-old male presented with painful swelling of the right calf. His medical history was negative, except for a herniation of disc LIV-V 5 years before. Physical examination revealed unilateral calf hypertrophy with moderate weakness of plantarflexion, mild paresis of dorsiflexion. Electromyography showed a peripheral neurogenic lesion in the right anterior tibial muscle, but normal findings were obtained from the unaffected quadriceps muscle. Histological examination of the right gastrocnemic muscle showed neurogenic changes with typical targetoid fibers, but no pathological changes were present in the quadriceps muscle. Chronic asymmetric spinal muscular atrophy is an infrequent neuromuscular disease and because of asymmetric appearance, it might be difficult to distinguish from other, acquired neurogenic muscle diseases such as radiculopathy caused by intervertebral disc herniation. Our case confirms that muscular hypertrophy can follow partial denervation in humans.
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PMID:Asymmetric calf hypertrophy of neurogenic origin. 1718 92

We describe a rare complication of myelography. A subarachnoid filling defect was apparent on the postmyelographic CT but not on conventional myelography. MR imaging performed later showed a spinal subarachnoid hematoma (SSAH), extending from L3 to L5. Lumbar puncture may rarely be a cause for SSAH and is more common in patients with coagulopathy. Significant back pain, paresis, radiculopathy, and even altered consciousness or meningeal signs may herald an SSAH.
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PMID:Spinal subarachnoid hematoma resulting from lumbar myelography. 1729 83

We present the case of a 62-year-old woman with abdominal segmental paresis consequent to radiculopathy caused by zoster, which was confirmed by electroneuromyography. The paresis resolved completely within three months. Recognition of this complication caused by zoster, which is easily misdiagnosed as abdominal herniation, is important for diagnosing this self-limited condition and avoiding unnecessary procedures.
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PMID:Abdominal wall protrusion following herpes zoster. 1756 96

Spinal manifestations of vertebral artery dissection (VAD) are rare events and are typically symptomatic with neck pain and ischemic brain injury. We report a patient presenting with unusual peripheral paresis of the right upper limb due to an intramural hematoma of the right vertebral artery with local compression of C5 and C6 as the cause of cervical radiculopathy. These symptoms completely resolved after anticoagulation and physical therapy.
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PMID:Vertebral artery dissection presenting with ispilateral acute C5 and C6 sensorimotor radiculopathy: A case report. 1876 83

The objective of the study was to investigate how patients with sciatica due to disc herniation rate the bothersomeness of paresthesia and weakness as compared to leg pain, and how these symptoms are associated with socio-demographic and clinical characteristics. A cross-sectional study was conducted on 411 patients with clinical signs of radiculopathy. Items from the Sciatica Bothersomeness Index (0 = none to 6 = extremely) were used to establish values for paresthesia, weakness and leg pain. Associations with socio-demographic and clinical variables were analyzed by multiple linear regression. Mean scores (SD) were 4.5 (1.5) for leg pain, 3.4 (1.8) for paresthesia and 2.6 (2.0) for weakness. Women reported higher levels of bothersomeness for all three symptoms with mean scores approximately 10% higher than men. In the multivariate models, more severe symptoms were associated with lower physical function and higher emotional distress. Muscular paresis explained 19% of the variability in self-reported weakness, sensory findings explained 10% of the variability in paresthesia, and straight leg raising test explained 9% of the variability in leg pain. In addition to leg pain, paresthesia and weakness should be assessed when measuring symptom severity in sciatica.
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PMID:The bothersomeness of sciatica: patients' self-report of paresthesia, weakness and leg pain. 1948 93

The ventriculus terminalis (VT) is a virtual cavity of the conus medullaris that appears during embryonic life. The occurrence of its dilatation is very rare in adulthood. Only 27 cases have been documented so far. We present the case of a 47-year-old woman who presented with hypoesthesia and dysesthesia of the lower limb, distal paresis, and urinary dysfunction evolving for the past 5 years. Electrophysiology confirmed radiculopathy. MRI revealed a cystic dilatation of the VT. Surgery consisted in laminectomy with myelotomy and fenestration. Histology showed a simple cubic ependymal epithelium. Progression has been favorable concerning the motor deficit and sphincter dysfunction but neuropathic pain has persisted for 6 months. The data are similar to those found in the literature. The sex ratio is 6:21, the mean age is 45. Symptoms appear on average over 2 years with lower limb pain (71%), sphincter dysfunction (71%), lumbago (64%), motor deficits (57%), and sensory disorders (47%). Imaging demonstrated cystic dilatation in the conus medullaris filled with cerebrospinal fluid without contrast enhancement. The histology analysis showed a simple ependymal epithelium with no tumoral process. The fenestration of the cyst allows complete recovery of symptoms in 52% of cases and partial recovery in 43%. The VT seems to be a whole nosologic entity in itself. Myelotomy with fenestration provides good results on motor and sphincter symptoms, whereas the benefit in terms of pain is subject to discussion.
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PMID:[Ventriculus terminalis dilatation in adults: A case report and review of the literature]. 2009 92


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