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)

During the last seven years 14 patients with lumbar disc hernias were admitted who presented with a short period of sciatica before experiencing relief of pain accompanied by paresis. Ten patients had marked paresis and were operated on, most of them during the first week after the start of paresis. Three patients had minor paresis in regression, and one patient suffered complete paralysis for five months. These four patients were not operated on. Motor function improved significantly in nine out of ten operated patients. Four of them had no paresis at all. The three patients with mild paresis in regression still showed some motor impairment 9-24 months later, and the condition of the patient with paralysis remained unchanged. In conclusion, patients who develop painless sciatica and marked paresis deteriorate seriously, and early surgery is necessary in order to avoid permanent disturbance of motor function.
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PMID:[Atypical sciatica. Decreasing pain and increasing paresis--a serious sign]. 798 78

The protein concentration in the cerebrospinal fluid (CSF) is often increased in patients with sciatica, probably due to leaking of plasma proteins through the blood-nerve root barrier into CSF. Positive straight leg raising test, paresis, altered sensibility, reduced reflexes, and type of treatment were related to the CSF protein concentrations in 180 patients with sciatica caused by verified lumbar disk herniation. Significantly higher values of the CSF/serum albumin ratio and the CSF/serum immunoglobulin G ratio were found both in patients with positive straight leg raising test results and paresis compared with patients with no clinical findings. In the patients who had undergone emergency surgery, the same ratio parameters were significantly higher when compared with those who had undergone routine surgery and those had not undergone surgery. Elevated CSF proteins seem to be important indicators of the functional status of the nerve root and a measure of the degree of seriousness of sciatica. The interaction of smoking on CSF proteins was also studied.
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PMID:Cerebrospinal fluid protein concentrations related to clinical findings in patients with sciatica caused by disk herniation. 818 84

We studied 180 adult patients admitted to the Neurological Department, Haukeland Hospital in Bergen, Norway, for a period of 5 years from 1984 to 1988. One hundred fifty-seven patients were followed up 3.9-9.0 years after admittance to the Neurological Department. The purpose of this study was to find out if the total cerebrospinal fluid (CSF) protein concentration could predict the outcome of lumbar disc surgery or conservative treatment in patients with sciatica. Neurologic and radiologic parameters were also included in the investigation. The increase of the CSF total protein concentration in sciatica without spinal block is assumed to be due to leak of plasma proteins into the CSF from the nerve root. A relationship between CSF protein concentrations and certain clinical parameters has been found. At myelography, 10 ml of CSF was collected for analysis. The patients were evaluated for involvement of the nerve root and/or the dural sac, respectively. The neurologic parameters investigated were: straight leg raising tests, paresis, disturbances of sensibility, and altered reflexes. At follow-up, the patients were asked to fill in questionnaires concerning job function, sick leave or disability pension, subjective physical disability and pain perception, and a clinical examination with the same neurologic parameters was performed. Elevated CSF total protein concentration was related to chronic leg pain, leg pain, and subjective physical disability at follow-up. Nonoperated women reported higher subjective physical disability scores and were more often on sick-leave or disability pension than were men at follow-up. Lateral prolapses were associated with good job function outcome and less risk for sick-leave or disability pension. Reduced lower extremity reflexes, laterally located disc herniation and elevated CSF total protein concentration were associated with a favorable long-term outcome in patients with sciatica. CSF proteins as objective measures on nerve root injury are discussed. CSF total protein concentration can be regarded as an indicator of the functional status of the nerve root and a prognostic factor in patients with sciatica.
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PMID:Cerebrospinal fluid protein concentrations in patients with sciatica caused by lumbar disc herniation: an investigation of biochemical, neurologic, and radiologic predictors of long-term outcome. 943 16

Percutaneous laser discectomy (PLD) was performed in 273 patients with herniated disc-induced lumbosacral radiculitis. Indications for PLD were based on clinical and neurological findings and results of MR tomography: no benefit from conservative treatment, pain syndrome in the lumbago stage and sciatica not presenting with severe paresis and with herniated intervertebral discs down to 6 mm in size across.
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PMID:[Laser puncture diskectomy in discogenic lumbosacral radiculitis]. 962 42

A total of 41 patients who had undergone percutaneous nucleotomy for a single level lumbar disc herniation were clinically examined after a mean postoperative follow-up of 5 years (range 4 to 7 years). There were 14 (34%) male and 27 (66%) female patients with a mean age of 49 years. By intra-operative discography, the herniation had been graded as a protrusion in 21 (51%) patients and as a prolapse in 20 (49%) patients. At the time of the investigation, sciatica had completely recovered or markedly diminished in 32 (78%) patients, and 29 (71%) patients had returned to work. Evaluated by a 100 mm visual analog pain scale (VAS), the postoperative pain relief was statistically significant (p < 0.0001). Clinical signs and symptoms of segmental instability of the lumbar spine were detected in 10 (24%) patients. Instability was significantly associated with an unsatisfactory long-term outcome in the patients with the occurrence of sciatica (p = 0.003) and low back pain (p = 0.001) as well as the VAS score (p = 0.005) and Oswestry index (p < 0.0001). Clinical investigation revealed sensory deficits in the leg in 12 (29%) patients, weakness of the extensor hallucis longus muscle in 5 (12%) patients and a total peroneal paresis in one (2%). The patellar and achilles tendon reflexes were depressed in 2 (5%) and 5 (12%) patients, respectively. During the follow-up period, recurrent disc herniation was detected in 3 (7%) patients who were all re-operated on. In addition, 3 (7%) patients were re-operated on for other back problems. Corroborating earlier findings, the results of this study indicate that percutaneous nucleotomy is an effective and safe alternative to open surgery in the treatment of patients with a small prolapse or a protrusion.
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PMID:Long-term outcome of patients who underwent percutaneous nucleotomy for lumbar disc herniation: results after a mean follow-up of 5 years. 1039 88

We conducted a systematic review of the literature from 1965-1994 to assess the value of history and physical examination in the diagnosis of sciatica due to disc herniation; we also included population characteristics and features of the study design affecting diagnostic value. Studies on the diagnostic value of history and physical examination in the diagnosis of sciatica due to disc herniation are subject to important biases, and information on numerous signs and symptoms is scarce or absent. Our search revealed 37 studies meeting the selection criteria; these were systematically and independently read by three readers to determine diagnostic test properties using a standard scoring list to determine the methodological quality of the diagnostic information. A meta-analysis was performed when study results allowed statistical pooling. Few studies investigated the value of the history. Pain distribution seemed to be the only useful history item. Of the physical examination signs the straight leg raising test was the only sign consistently reported to be sensitive for sciatica due to disc herniation. However, the sensitivity values varied greatly, the pooled sensitivity and specificity values being 0.85 and 0.52, respectively. The crossed straight leg raising test was the only sign shown to be specific; the pooled sensitivity and specificity values were 0.30 and 0.84, respectively. There was considerable disagreement on the specificity of the other neurological signs (paresis, sensory loss, reflex loss). Several types of bias and other methodological drawbacks were encountered in the studies limiting the validity of the study results. As a result of these drawbacks it is probable that test sensitivity was overestimated and test specificity underestimated.
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PMID:Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation: a systematic review. 1055 36

Herpes zoster is a disease which occurs secondary to the reactivation of varicella-zoster virus. Motor involvement in acute herpes zoster is rare. We report a case of sciatica L5 due to herpes zoster infection with motor loss. Typical skin lesions occurred one week before the sciatica. Radiological finding did not explain the paresis. The diagnosis of zoster sciatica with motor involvement was suspected. Serological tests and cerebrospinal fluid examination established the diagnosis. The antiviral and physical treatment was conducted in order to improve functional outcome.
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PMID:[Sciatica with motor loss revealing meningoradiculitis due to varicella-zoster virus]. 1840 19

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

Spinal meningiomas usually present with slowly progressive symptoms of cord and root compression, while a sudden clinical onset is very rare. A 35-year-old previously symptom-free woman presented sudden right sciatica and weakness of her right leg following a fall with impact to her left foot. A neurological examination showed paresis of the right quadriceps, tibial and sural muscles, increased bilateral knee and ankle reflexes and positive Babinski sign. Magnetic resonance imaging (MRI) revealed the presence of a spinal T11 meningioma in the left postero-lateral compartment of the spinal canal; at this level, the spinal cord was displaced to the contralateral side with the conus in the normal position. At surgery, a meningioma with dural attachment of the left postero-lateral dural surface was removed. The intervention resulted in rapid remission of both pain and neurological deficits. Spinal meningiomas may exceptionally present with sudden pain and neurological deficits as result of tumour bleeding or post-traumatic injury of the already compressed nervous structures, both in normal patients and in those with conus displacement or tethered cord. In this case, the traumatic impact of the left foot was transmitted to the spine, resulting in stretching of the already compressed cord and of the contralateral lombosacral roots. This case suggests that low thoracic cord compression should be suspected in patients with post-traumatic radicular leg pain with normal lumbar spine MRI.
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PMID:Sudden post-traumatic sciatica caused by a thoracic spinal meningioma. 2731 67

Herpes zoster is a common viral disorder that typically shows characteristic painful skin lesion. Motor neuropathy rarely complicates herpes zoster infection, and it may be overlooked without suspicion. Here, we report a case of a herpes zoster patient who presented with sciatica and paresis, but without the typical skin lesion. The patient was initially misdiagnosed as having other disorders including trauma or spine lesion. Electrodiagnostic study and magnetic resonance imaging (MRI) helped to make an accurate diagnosis and localize the motor nerve involvement of herpes zoster.
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PMID:A Case of Herpes Zoster Presented with Lower Limb Paresis. 3019 46


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