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)

Medial medullary infarction is characterized by ipsilateral hypoglossal nerve palsy, contralateral hemiparesis sparing the face, and contralateral disturbance of deep sensation. Although it is possible to make a clinical diagnosis in typical patients, diagnosis is difficult if hypoglossal nerve palsy is absent. We describe a patient with medial medullary infarction without hypoglossal nerve palsy. The patient suffered from left hemiplegia and homolateral disturbance of deep sensation. Magnetic resonance imaging revealed the site of the lesion to be in the medial portion of the upper medulla oblongata. The result of somatosensory evoked potential testing was compatible with disturbance of the medullary medial lemniscus. In a review of the literature, we examined the relation between clinical features and lesion location in 16 patients with medial medullary infarction and compared these to the present patient. Motor paresis was present in every patient, while disturbance of deep sensation was recorded in nine of 13 patients and hypoglossal nerve palsy in six of 14 patients. In atypical patients with medial medullary infarction (such as the present patient), magnetic resonance imaging is necessary to detect the lesion and to make a clinical diagnosis.
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PMID:Magnetic resonance imaging of medial medullary infarction. 234 1

This study presents particular clinical manifestations in 7 patients with autoiMmune diseases: rheumatoid purpura with right crural nerve paresis (1 case), Stevens-Johnson syndrome with encephalomyeloradicular syndrome (1 case) and left Wallenberg syndrome (1 case), rheumatoid arthritis with right parieto-occipital syndrome (1 case) and Gowers local panatrophy (1 case), systemic lupus erythematosus with confusional state and meningeal syndrome (1 case) and left ictal hemiplegia (1 case). The importance of neurological clinical manifestations at the onset or during the evolution of the autoimmune diseases is emphasized.
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PMID:Particular neurological aspects in vascular autoimmune diseases. I. Rheumatoid purpura, Stevens-Johnson syndrome, rheumatoid arthritis and systemic lupus erythematosus. 260 78

The relationship between the interruption of the human pyramidal tract and its attendant clinical manifestations has been a matter of concern to neurologists and neurosurgeons for over a century. We presently report three cases of unilateral pyramidal tract ischemic lesions within the cerebral hemispheres who presented with a contralateral pure spastic hemiplegia syndrome. In none could we find any disturbance in the somatosensitive evoked potentials of the four limbs. The review of some cases on record since the time of Charcot and Erb has made it clear that the pyramidal syndrome is a valid clinical concept which should be qualified according to the particular animal species one is referring to. In man, it manifests itself by paresis, hyperactive muscular reflexes, spasticity and Babinski sign. Based on this evidence we propose the idea of a "differential control" exerted by the pyramidal tract upon the segmental neuronal pool as its key mode of normal functioning.
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PMID:[Pure spastic hemiplegia of pyramidal origin]. 340 87

143 patients with acute onset of hemiplegia transferred to our unit for rehabilitation were analysed retrospectively for the development of deep vein thrombosis or pulmonary emboli. 26% of the patients had suffered thromboembolic events, in more than half of the cases within the initial four weeks after hospital admission. Hemiplegia seems to be the main risk factor for thromboembolic complications, whereas age and sex had no further impact on the rate of occurrence in our series. Nor did we find a correlation between the extent of the paresis in the involved lower extremity or the degree of restriction of mobility and the incidence of thromboembolic disease. Because of the high frequency of thromboembolic complications in our patients we recommended prophylactic treatment with low dose heparin given subcutaneously, followed by oral anticoagulant therapy with vitamin K antagonists, provided there are no contraindications.
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PMID:[Thromboembolism complications following acute hemiplegias]. 342 73

During the 6 years between 1980 and 1985, 39 nursing home patients were admitted to the Hvidovre Burns Unit in Copenhagen with accidental burns. These patients accounted for 20 per cent of all burn patients above the age of 69 years admitted during this period. The median age of the patients was 80 years. Two-thirds of them suffered from burns of less than 15 per cent of their total body surface area. The mortality rate was 64 per cent. All patients were burned in single-person accidents, most often while sitting alone in their own living room, and smoking materials were involved in 85 per cent of the injuries. Senility, hemiplegia and other neurological diseases with tremor or paresis were frequently present in the victims. Several preventive measures are proposed, including smoking under supervision, use of flame-resistant aprons of adequate size, flame-resistant materials in chairs, etc., and installation of smoke detectors in rooms where patients smoke. A possible relation between the marked incidence of these accidents during weekends or holidays, at a time when staff numbers are reduced in the nursing homes, is discussed.
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PMID:The nursing home patient--a burn-prone person. An epidemiological study. 344 26

A patient with long-standing upper limb lower motor neurone paresis more recently developed homolateral upper motor neurone hemiplegia. Subsequent primary generalised osteoarthritis spared only the paralysed upper limb. Detailed review of reported cases suggest that the "protective" effect of paralysis against subsequent development of arthritis is not as clearly established as generally believed.
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PMID:Paralysis and unilateral arthritis: is the association established? 400 86

EMG denervation activity was studied in patients without peripheral neuron disorder but with upper motor neuron lesions. The time course of such central denervation activity, the local distribution and the quantitative relationship between denervation activity and the degree of paresis and spasticity were also studied. A total of 101 patients, who had developed hemiplegia or hemiparesis as a result of a cerebral vascular accident, underwent needle electromyographic examination at regular intervals in proximal and distal muscle groups. The maximum observation time was 1 year. Denervation activity in cases of central paresis first occurred 2-3 weeks after stroke. This could be observed most frequently in the distal arm and hand muscles. In the course of weeks and months the frequency of the denervation activity decreased in parallel with the development of spasticity and the increasing voluntary innervation. The occurrence and the dynamic properties of the denervation activity in cases of central paresis support the assumption of a trans-synaptic degeneration of alpha-motoneurons and of a compensating segmental "sprouting" of afferents.
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PMID:Denervation activity in the EMG of patients with upper motor neuron lesions: time course, local distribution and pathogenetic aspects. 619 9

In 31 patients with completed stroke (n = 30) or PRIND (n = 1) a brain SPECT with 123I-labeled amphetamines was performed. In 14 (= 45%) of the respective patients--suffering from long-lasting hemiplegia--crossed cerebellar diaschisis was present. The interval between onset of the disease and time of examination varied between 1 week and 7 years. On the other hand, patients without crossed cerebellar diaschisis did not, with one exception, suffer from hemiplegia. It is likely that this phenomenon is caused by the reduction of spino-cerebellar stimuli due to the paresis of the respective extremities.
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PMID:[Cause of crossed cerebellar diaschisis in cerebrovascular disease]. 633 45

Clinical features of ten Japanese children with cerebrovascular Moyamoya disease are reported and non-Japanese paediatric cases of the disease are reviewed from the world literature. The most common initial manifestations were headache in four cases (40%), motor deficit and convulsion in three cases (30%). As their recurrent and/or residual symptoms, eight children (80%) developed motor deficit consisting of hemiplegia in five cases and paresis or weakness of the extremities in three cases, and four (40%) had headaches. The mode of presentation in our cases was similar to that of non-Japanese cases, in addition to a female preponderance. Electroencephalographic findings of prominent high voltage delta bursts following hyperventilation and slowness of returning to the normal pattern, seen in all hyperventilated cases, is one of the features. Of 15 carotid arteries visualised in ten patients, sites of occlusion or stenosis were seen between the bifurcation of the posterior communicating artery and that of the anterior cerebral artery or the middle cerebral artery in 13 arteries, with a vascular network in the basal ganglia. This study suggests that if hyperventilation procedures produce prominent high voltage delta bursts during electroencephalography in children with headache and/or motor deficit, cerebrovascular disease, especially Moyamoya disease, should be suspected.
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PMID:Cerebrovascular Moyamoya disease. 637 Jun 99

An observation by Mach (1906) on the sense of effort during hemiplegia has been confirmed. Two patients, who became suddenly hemiplegic, without sensory symptoms, noted that attempts to move when first paralysed were not accompanied by a sense of effort, but that attempts to move when movement first returned were accompanied by distinct sensations of effort or heaviness. This absence of a sense of effort during upper motor neuron paralysis without sensory signs did not occur either in a group of patients with pure lower motor neuron paralysis or in patients with clinically complete spinal transection. Previous studies have suggested that signals of motor command or effort, which arise at levels rostral to spinal motoneurons, contribute to the estimation of weights and tensions (see McCloskey et al., 1974; Gandevia and McCloskey, 1977a). One interpretation of the return of a sensation of effort as hemiplegia progresses to paresis is that activity in corticofugal paths contributes to generation of the sense of effort. During complete hemiplegia there is no neural traffic in motor corticofugal paths below the internal capsule and a sense of effort is absent. But, during paresis, there is increased neural traffic in the uninterrupted corticofugal fibres and there is a strong sense of effort or heaviness. Alternatively, a subcortical structure with a critical ascending projection to motor cortical areas may co-operate in generation the sense of effort. Afferent information, while important for calibrating and scaling the sense of effort which usually signals force or weight, is not essential for generation of a crude signal of descending motor command or effort.
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PMID:The perception of motor commands or effort during muscular paralysis. 646 86


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