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

Medial medullary infarct (MMI) is a rare type of brain stem infarction. Its clinical picture was characterized by contralateral hemiparesis, deep sensory disturbance, and ipsilateral hypoglossal paresis, but conjugate deviation or nystagmus is uncommon as initial symptom. Case 1: A 73-year-old man developed vomiting and vertigo. Examination revealed right conjugate deviation and horizontal nystagmus beating toward the left side, and numbness on his right upper limb,but no hypoglossal nerve palsy. Cranial MRI demonstrated an infarction in the left paramedian region of the upper medulla and thrombus of the left vertebral artery. Case 2: A 74-year-old man suffered from dizziness and nausea. He showed left conjugate deviation and right-beating horizontal nystagmus without Horner syndrome or hypoglossal nerve palsy. MRI disclosed an infarction in the right upper medial medulla. MRA revealed the right dissecting vertebral artery. Case 3: A 71-year-old man developed vertigo when watching at TV. He showed transient left conjugate deviation and transient motor paresis on the left upper limb. MRI showed the thickened wall of the right vertebral artery but no abnormal ischemic lesion. Digital subtraction angiograms revealed the dissecting right vertebral artery. All ischemic events limited to the upper third of the medulla were caused by the vertebral artery lesions, and prognosis was good. The unilateral MMI lesion in the nucleus prepositus hypoglossi and/or the medullary reticular formation caused contralesional shift of the eyes and ipsilesional nystagmus. The upper MMI will be characterized by a triad of contralateral hemiparesis, deep sensory disturbance and abnormal ocular motor findings.
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PMID:[Conjugate deviation in ischemia of medial medullary oblongata--report of three cases]. 1737 Jun 54

A 72-year-old Japanese male developed disseminated herpes zoster and could not easily walk due to right drop foot and pain. He soon developed numbness and pain on the left side of his face, and noticed difficulty closing his left eye. The left angle of his mouth dropped. The patient was diagnosed as having a double mononeuropathy (a left facial nerve paresis and a right peroneal nerve paresis) following disseminated herpes zoster. Given that the patient was elderly and had diabetes mellitus, the patient appeared to be an immunocompromised host. We also describe other rare complications of herpes zoster from the published work.
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PMID:Isolated double herpes zoster paresis involving the left facial nerve and the right peroneal nerve following disseminated herpes zoster. 1740 47

Tolosa Hunt syndrome is a rare disorder caused by nonspecific inflammation in the cavernous sinus/superior orbital fissure and/or orbital apex. It is clinically characterized by alternating remissions and exacerbations, and manifested as diplopia associated with unilateral periorbital hemicranial headache. The symptoms include blepharoptosis, which is usually mild if present, bulbomotor paresis involving the pupil, and loss of sensation in the area supplied by the first division of the trigeminal nerve. Therapy for Tolosa-Hunt syndrome are systemic steroids. The course of disease in a 25-year-old man hospitalized for painful ophthalmoplegia and diplopia is presented. The history included severe pain on rightward eye movement and parabulbarly on the right, considerable defect in the area supplied by the first division of the trigeminal nerve, right hemicrania, and diplopia on looking to the left, right, upward and downward that developed after four days. A month before, the patient was observed at neurology department for severe right hemicrania. Current status included severe pain parabulbarly on the right, discrete proptosis with mild ptosis on the right eye, restricted right eye bulbar motoricity on looking nasally, nasally upward and downward, and loss of sensation in the area supplied by the first division of the trigeminal nerve. Pupilar motoricity was normal. Upon admission, neuroradiologic examination (orbit CT) and brain MR were performed, and therapy with systemic corticosteroids was initiated ex iuvantibus, in consultation with a neurologist. At 24 hours of corticosteroid therapy, the pain subsided, whereas diplopia disappeared almost completely after 5 days, now being only occasionally recorded on looking to the left and upward.
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PMID:[Painful ophthalmoplegia--Tolosa-Hunt syndrome]. 1804 75

Takayasu arteritis is a rare vasculitis of the aorta and its branches. Neurological manifestation usually results from central nervous system ischaemia. We report a case presenting with unilateral paresis of the cranial nerves (V, IX and XII nerve) caused by a vascular conflict due to Takayasu arteritis. A 38-year-old male was admitted to the hospital complaining of dysarthria, dysphagia, numbness of the right side of the tongue and a headache localized behind the right eye. The symptoms had sudden onset. Neurological examination revealed isolated trigeminal, glossopharyngeal and hypoglossal nerve dysfunction on the right side without other neurological symptoms. Magnetic resonance angiography showed internal carotid artery dissection and prominent thickening of walls of both vertebral arteries as well as the left renal artery with narrowing of lumen. Compression of glossopharyngeal and hypoglossal nerves and the trigeminal ganglion was a result of a markedly dilated intracranial segment of the right carotid artery. The clinical and radiological findings were consistent with the diagnosis of Takayasu arteritis.
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PMID:[Compression neuropathy of cranial nerves in the course of Takayasu arteritis]. 1822 78

Lateral rectus muscle (LRM) palsy due to a nuclear or fascicular sixth nerve lesion is rare as the presenting sign of multiple sclerosis (MS). It is more common to find this palsy in the company of other nearby cranial nerves deficits. Facial numbness in association with a LRM palsy or paresis may go unappreciated and therefore underreported. We report an unusual patient with a LRM palsy, facial anesthesia, ataxia and as the initial manifestation of MS. There was a demyelinating lesion in the pons seen on magnetic resonance imaging (MRI).
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PMID:Lateral rectus muscle palsy, facial numbness and ataxia as the initial manifestation of multiple sclerosis. 1850 11

The clinical presentation of intravascular lymphoma (IVL) is generally nonspecific and misleading and its course from onset to death is rapid. We report a case in a 70-year-old right-handed man who presented after 1 month of numbness and progressive paresis in both lower limbs and 20 days of urinary and bowel involvement. MRI of the cervical and lumbar spine with contrast failed to show signal change in the spinal cord. But brain MRI with contrast showed patchy lesions in the subcortical white matter of bilateral centrum semiovale and periventricular area. The patient's condition worsened rapidly. He died 3 months after the first occurrence of symptoms. Autopsy revealed intravascular large B-cell lymphoma. Our report indicates that myelopathy can be the initial manifestation of this disease. Brain biopsy is indicated when neurological deterioration with abnormalities is progressive in cerebral MR imaging and when tumor is suspected.
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PMID:A case of intravascular B-cell lymphoma presenting as myelopathy and diagnosed post mortem. 1862 Jul 7

We report a rare case of multiple cranial nerve palsy associated with pregnancy, the cause of which remained to be clarified despite of extensive inspections. A 28-year-old woman with type 1 diabetes on insulin therapy developed left oculomotor nerve palsy in the fourth month of pregnancy. Her symptoms improved after one month's administration of vitamins B1 and B12. Numbness appeared in the left side of the face in the 8th month of pregnancy, and then moved to the right side in two weeks. Dysarthria and dysphagia occurred one month later. Bulbar symptoms were worsened, and she became unable to eat or drink. Neurological examination revealed disturbance of sensation in the right side of the face, soft palate paresis, and bilateral atrophy and fasciculation of the tongue. Extensive laboratory examinations including immunological and endocrinological studies, cerebrospinal fluid examination and brain magnetic resonance imaging were unremarkable. These symptoms remitted spontaneously after delivery, and the methylprednisolone pulse therapy accelerated the improvement. Neurological examination done one year after delivery showed complete recovery of the symptoms except for persistent tongue atrophy.
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PMID:[Recurrent multiple cranial nerve palsy in a gravida with type 1 diabetes, that remitted after delivery and with steroid therapy]. 1893 78

Primary angiosarcoma of the spine is rare. To our knowledge, primary angiosarcoma in the posterior element of the spine has not been reported previously. A 39-year-old man suffered progressive numbness and paresis of the bilateral lower limbs. Neuroimaging showed a large dorsal extradural tumor compressing the spinal cord at the T11 level with bony destruction of the left foramen and posterior elements. Spinal angiography revealed a hypervascular tumor in the left T11 region. Successful preoperative endovascular embolization, laminectomy and removal of the tumor were performed.
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PMID:Primary spinal angiosarcoma. 2007 66

Radicular leg pain, combined with numbness and intermittent radicular paresis while walking or standing are typical symptoms of a narrow spinal canal of the lumbar spine. Medical history and lumbar myelogram are usually sufficient to localize the source of pain. We prefer the myelogram to CT-scan or MRI because it gives a longitudinal view of the whole lumbar spine, is easy to read and is also possible in the presence of a scoliotic deformity or claustrophobia. Between 1987 and 1993, 76 patients with symptomatic lumbar spinal stenosis were treated operatively by the same surgeon. Results are available for 74 patients. In all patiens, a decompression was performed, a fusion was performed in 64 patients. The follow-up ranges from 1 to 5.7 years (average 2.7 years). 59 patients (80 %) were happy with the result and would like to be operated again in the same conditions. 8 of the 15 unhappy patients had, objectively, a good result but were unsatisfied for other reasons. Our results show, that operative treatment of the lumbar spinal stenosis is a rewarding task. Decompression usually results in a dramatic decrease of the leg pain and improvement of the walking distance. Advanced age in not a contraindication for this kind of surgery. Decompression combined with fusion results in a longer operative time and greater blood loss and is only indicated in the presence of an instability in a younger patient or massive preoperative back pain. Key words: spinal stenosis, claudication, lumbar spine, decompression, fusion.
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PMID:[Degenerative spinal canal stenosis in lumbar spine: clinical view and treatment.]. 2047 Jun 11

Economy class stroke syndrome is a cardiovascular complication associated with long periods of travel, only a few cases have been reported after long drives, however. The patient, a 62-year-old professional driver, had driven a truck for 2 days with minimal rest. While driving, he noted left foot paresis and numbness, along with geographical disorientation. Magnetic resonance imaging of the brain revealed multiple cerebral embolisms in the bilateral cerebral hemisphere. The only complications representing a stroke risk in this patient were a patent foramen ovale and an anterior septal aneurysm, as detected by transesophageal echocardiography. The patient was diagnosed with paradoxical cerebral embolism following his long drive. This case report examines the paradoxical cerebral emboli documented in a patient following a long period of driving.
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PMID:Economy class stroke syndrome after a long drive. 2065 11


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