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

Endoscopic carpal tunnel release is a new technique for treatment of carpal tunnel syndrome. The benefits of this procedure are a small skin wound with less local pain, the fact that the hand can quickly be used again, and earlier return to work or other activities. We present the preliminary results of the 3-month follow-up of 88 patients out of a prospective study of 100 patients. All patients were operated on using the one-port technique. Six additional decompressions had to be abandoned and open release was performed. Of the patients with pain, 73.6% (68/88) were completely pain-free and in 13.2% (9/68) pain improved in more than 50%. Subjective symptoms like paresthesia and numbness of the hand disappeared completely in 77.2% (64/83). Sensory deficits disappeared in 50% (33/66). Ten of 17 patients with preoperative paresis of the abductor pollicis brevis muscle and 11/14 with paresis of the opponens pollicis muscle had normal motor function 3 months after the operation. The complication rate concerning nerve lesions was 2.3%. The return to work time was 21 days (range 3-49 days). According to clinical symptoms, our preliminary results do not seem to have any benefits compared to the conventional open technique, and the costs for the endoscopic procedure are markedly higher. The complication rate after the learning curve period is approximately the same as open carpal tunnel release.
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PMID:[Experiences with endoscopic surgery in treatment of carpal tunnel syndrome. Preliminary results of a prospective study]. 931 84

This is a case report of the 2nd oldest patient reported in the literature with transverse myelitis after mumps, and the 1st with magnetic resonance imaging (MRI) correlation. He is a 38-year-old Chinese man presenting with bilateral lower limb weakness and numbness, and urinary retention starting 3 weeks after an attack of mumps parotitis. Clinically, there was mild lower limb paresis, absent plantar responses and reduced pain sensation below the umbilicus. MRI revealed cord swelling and increased T2 signal from T7 to T11. Cerebrospinal fluid showed 23 cells/mm3 and 55 mg protein/dl. He received a 5-day course of intravenous methylprednisolone 0.5 g/d. The sensory and motor deficits improved over 2 weeks; urinary symptoms improved over the next year. Transverse myelitis following mumps is recognizable clinically and radiologically, and potentially responsive to methylprednisolone.
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PMID:Transverse myelitis following mumps in an adult -- a case report with MRI correlation. 940 4

A 34-year-old woman presented with numbness in both lower limbs and weakness of right lower limb twenty six days after a primary varicella infection (chickenpox) associated with fever and rash. Neurological examination revealed numbness of both lower limbs, more severe on the right side, mild paresis of the right lower limb, particularly in the tibialis anterior muscle, and absent ankle jerk on the right. After admission, hyperalgesia appeared at the thoracic 10-12 levels. The T2-weighted MRI of the spinal cord revealed a high signal intensity lesion at the Th 9 level and gadolinium enhancement was seen in that lesion as well as in the bilateral posterior radicles and the left anterior radix at the Th 9 level. On needle electromyography, fasciculation was found in the right tibialis anterior and gastrocnemius muscles. The temporal dispersion of F-wave was seen in the right peroneal nerve. We diagnosed the patient suffered from radiculomyelitis following the primary varicella infection. The secondary immunological mechanism rather than direct viral invasion is most likely in our patient, because (1) neither VZV DNA, nor anti-VZV antibody was positive in the CSF, and (2) the duration was relatively long between the development of skin rash and that of neurological symptoms.
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PMID:[A case of radiculomyelitis following chickenpox in adulthood]. 1058 25

The 39-year-old male in this report was a victim of C4 spinal cord injury for 7 years. He was regularly followed up at our pain clinic and psychiatric out-patient department (OPD) for treatment of his chronic pain with morphine, anticonvulsant and sedatives. At the night of December 15, 1997, he took approximately 0.1 gm of morphine and a certain number of flurazepam pills. On the next day, he experienced numbness and paresis in both legs in association with painful swelling of both thighs. Then he sought medical advice at our hospital and was admitted for investigation on December 20, 1997. Laboratory examination revealed elevated creatine kinase activity, increased urine myoglobin concentration and raised plasma creatinine, signifying the development of acute muscle damage. The excreted urine morphine concentration was as high as 6,384 ng/mL. Increased PYP uptake in the proximal portion of both thighs was noted on muscle scan. These abnormalities were resolved gradually over two weeks under conservative treatment. Morphine-induced rhabdomyolysis complicated by acute renal failure was highly suspected.
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PMID:Rhabdomyolysis-induced acute renal failure after morphine overdose--a case report. 1060 51

We report a 51-year-old man with mild left central facial palsy and left Avellis' syndrome due to a small medullary infarction. On admission, neurological examination revealed hoarseness, dysphasia, absent left gag reflex, palsies of the left vocal cord and left soft palate, and hypalgesia and thermohypesthesia on the right side of the trunk and extremities. In addition, he had a mild left central facial palsy. He had no nausea, vomiting, vertigo, hiccups, nystagmus, Horner's sign, facial numbness, or paresis or ataxia of the limbs. A T2 weighted MRI showed a small, high signal intensity area in the left dorsal region of the medulla and this lesion was presumed to involve the nucleus ambiguus and a part of the spinothalamic tract. These findings suggest that an aberrant supranuclear pathway, looping around the nucleus ambiguus to the facial nucleus exists in our patient.
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PMID:[A case of Avellis' syndrome with ipsilateral central facial palsy due to a small medullary infarction]. 1096 64

We report a 58-year-old woman with pontine lesion presented with subacute onset of unilateral gustatory disturbance accompanied by facial numbness, and hearing loss. Neurologic examination revealed superficial hypesthesia and paresthesia on the right side of the face, right peripheral type facial paresis, ageusia on the right half of the tongue and right sensorineural deafness. No other neurologic signs were observed, and laboratory data were all normal. Brain MRI revealed a small lesion in the right dorsolateral tegmentum of the middle pons. Electrogustometry showed marked reduction in the sense of taste on the right half of the tongue. ABR showed diminished amplitude in the IV-V wave of the right side, while SEP and VEP were normal. The clinical diagnosis was demyelinating lesion and intravenous methylprednisolone (1 g/day) was administered for 3 consecutive days, resulting in prompt improvement in the symptoms. The lesion was suspected of affecting ipsilateral side of the spinal trigeminal nerve tract and the nucleus, the intraaxial infranuclear facial nerve fiber, the lateral lemniscus adjacent to the superior olivary nucleus and the central gustatory tract. Our case suggests that the central gustatory pathway projecting from the nucleus of the solitary tract to the parabrachial nucleus, presumed to be pontine taste area, ascends ipsilaterally and is located laterally from the medial lemniscus.
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PMID:[A case of ipsilateral ageusia, sensorineural hearing loss and facial sensorimotor disturbance due to pontine lesion]. 1100 34

We described a surgical case of growing cavernous angioma located at the pontomedullary junction. This 52-year-old woman presented with symptoms caused by a small hemorrhage in the right cerebellopontine angle. Magnetic resonance images (MRI) suggested cavernous angioma as the underlying pathology. 9 months after the first episode, the second hemorrhage occurred with a deteriorated neurological state that disappeared under conservative treatment except for right facial paresis and hearing disturbance. During careful observation for 1 year, the size of the lesion gradually increased on MRI and additional neurological deficits including left hemiparesis and right abducent nerve palsy were diagnosed. The first operation was carried out through the right lateral suboccipital approach, but only partial removal of the cavernous angioma was accomplished due to the overlying seventh and lower cranial nerves. After more than 4 months, a third hemorrhagic episode was presented with a sudden onset of right cerebellar signs and facial numbness. The cavernous angioma grew in size to reach the ventrolateral corner of the 4th ventricle with dense hemosiderin deposition around the core lesion on MRI. An enhancement inside the lesion was also demonstrated after gadolinium-diethylenetriaminepenta-acetic acid administration. The second operation through the midline suboccipital approach was selected for the complete resection of the residual cavernous angioma. The lesion was too hard to resect without internal decompression. The pontine part of the lesion was almost totally resected, but manipulation for the medullary part to create a discrete layer between the lesion and surrounding neural tissues was unsuccessful and generated severe bradycardia, so this part of the cavernous angioma had to be left. The problems for the management of cavernous angioma in the brain stem should be discussed, especially focussing on the surgical indication in reference to our experience and previous literatures.
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PMID:[A surgical case of growing cavernous angioma at the pontomedullary junction]. 1107 Sep 10

The previously undescribed association of a spinal dural arteriovenous fistula with syringomyelia was found in a 60-year-old male, who developed increasing paresis, numbness of both lower extremities and sphincteric dysfunction. Symptoms and signs were attributed to a syringomyelia at T5-L1 and an arteriovenous spinal dural fistula at L1. The fistula was successfully immobilised with N-butyl-cyano-acrylate. Six months after the procedure, all abnormalities had nearly disappeared. Whether the relation between the fistula and the syringomyelia was coincidental or causative could not be determined.
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PMID:Spinal dural arteriovenous fistula associated with syringomyelia. 1110 72

This case report first reviews the intracranial tumors associated with symptoms of trigeminal neuralgia (TN). Among patients with TN-like symptoms, 6 to 16% are variously reported to have intracranial tumors. The most common cerebellopontine angle (CPA) tumor to cause TN-like symptoms is a benign tumor called an acoustic neuroma. The reported clinical symptoms of the acoustic neuroma are hearing deficits (60 to 97%), tinnitus (50 to 66%), vestibular disturbances (46 to 59%), numbness or tingling in the face (33%), headache (19 to 29%), dizziness (23%), facial paresis (17%), and trigeminal nerve disturbances (hypesthesia, paresthesia, and neuralgia) (12 to 45%). Magnetic resonance imaging with gadolinium enhancement or computed tomography with contrast media are each reported to have excellent abilities to detect intracranial tumors (92 to 93%). This article then reports a rare case of a young female patient who was mistakenly diagnosed and treated for a temporomandibular disorder but was subsequently found to have an acoustic neuroma located in the CPA.
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PMID:Trigeminal neuralgia due to an acoustic neuroma in the cerebellopontine angle. 1120 49

An axonal sensory neuropathy is a frequent complication in the course of HIV infection; more than 30% of all HIV-infected individuals will develop a polyneuropathy. Low CD4 cell counts and high HIV RNA loads increase the risk. This neuropathy causes pain, paresthesias and burning sensations and/or numbness in the feet, which sometimes occurs in the hands as well. Neurological examination reveals sensory deficits in a stocking and glove distribution and depressed or absent ankle reflexes, without severe paresis. The cause of the sensory neuropathy is unknown. Either the HIV infection or certain other infections, for example cytomegalovirus, may play a role in the pathogenesis; vasculitis may be a process associated with this. Some antiretroviral drugs within the nucleoside analogue group cause a neuropathy but the pathogenesis of this remains unclear. Amitriptyline, tramadol and carbamazepine can be used for symptomatic treatment. The efficacy of lamotrigine and gabapentin has yet to be confirmed.
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PMID:[Sensory neuropathy in HIV infection: pathogenesis and therapy]. 1133 55


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