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)

A 68-year-old man developed strabismus after having sub-Tenon's anesthesia for cataract extraction and intraocular lens implantation. An ipsilateral hypertropia with superior oblique muscle paresis developed in the operated eye. The hypertropia appeared 1 day after surgery and resolved 1 month later. Although sub-Tenon's anesthesia is considered safer than other methods of local anesthesia, strabismus may occur.
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PMID:Superior oblique muscle paresis after sub-Tenon's anesthesia for cataract surgery. 988 91

Conversion syndromes are frequent among medically unexplained somatic symptoms in neurology. A careful differential diagnosis must be carried out in a psychiatric consultation service. In a prospective study lasting for over four years 169 patients with pseudoneurological signs of conversion were included. From a clinical point of view the following conversion syndromes were presented: astasia/abasia: 27.2%, paresis/plegia: 24.3%, aphonia: 1.8%, hyp-/anaesthesia: 21.9%, blindness: 5.3%, non-epileptic seizures: 19.5%. According to the diagnostic criteria of DSM-III-R three subgroups were differentiated: conversion disorder (n = 132), somatisation disorder (n = 28), factitious disorder (n = 9). Intermittent courses of illness were prevailing in conversion disorder, whereas chronic courses predominated in the other two subgroups. High rates of psychiatric comorbidity were typical signs of somatisation disorder. Frequent autodestructive motives (suicidality, deliberate and covert self-harm, chronic pain, high rate of operations) in illness behaviour had to be registered in somatisation and factitious disorder. Both subgroups were characterised by frequent traumatic events during early development. Important socio-economic aspects of illness behaviour above all in somatisation and factitious disorder were underlined. The results are discussed in terms of psychiatric differential diagnosis and psychiatric comorbidity, psychodynamic evaluation, illness behaviour and therapeutic options in a C/L-service.
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PMID:[Conversion syndromes in neurology. A psychopathological and psychodynamic differentiation of conversion disorder, somatization disorder and factitious disorder]. 1006 84

The use of botulinum toxin A (BTXA) in childhood strabismus is still a matter of debate. This study investigates the indications for and outcome of BTXA therapy in children at our institution. From 1985 to 1995, 237 children up to and including 16 years of age were treated with BTXA for strabismus. We undertook a retrospective study of 163 (69%) children from this group. Factors considered were age; anaesthesia; number of, indication for and outcome of injections; complications and follow-up. There were three major indications for the use of BTXA in children: firstly to improve binocular function, secondly as a post-operative diplopia test or for cosmetic reasons, and thirdly in the investigation or treatment of paralytic and restrictive strabismus. In the first group (54 children), BTXA produced improved binocular function in 54% of all patients treated and in 49% of those with a minimum follow-up of 12 months. In the second group (82 children), 88% showed informative post-operative diplopia tests and 44% had more than one injection to maintain improved cosmetic alignment. The third group comprised 27 children with a range of diagnoses, including 1 third nerve paresis, 12 unilateral or bilateral sixth nerve pareses, 7 unilateral or bilateral Duane's syndromes, 5 lost or fibrosed muscles and 2 others. This group had a range of outcomes which are discussed in the text. BTXA is useful in the treatment of a select group of children with strabismus. If there is evidence of threatened or recently lost binocularity, or risk of creating or worsening diplopia after surgery, it is a useful therapeutic tool. In children with strabismus of unusual cause it has diagnostic value.
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PMID:Botulinum toxin in childhood strabismus. 1042 Feb 15

Of all vascular anomalies, venous malformations are the most common, and they have a propensity for the head and neck. The authors retrospectively analyzed 40 patients with craniofacial venous malformations who underwent sclerotherapy between October of 1994 and June of 1996 to determine (1) the results of sclerotherapy with ethanol and/or sodium tetradecyl sulfate, (2) the types and rate of complications, and (3) whether outcome correlated with age, sex, location, size, tissues involved, morphology (lobular or varicose), venous outflow, or number of sclerotherapy sessions. The authors also reviewed the results after sclerotherapy and contour resection (n = 18). Comparisons between the results with ethanol and sodium tetradecyl sulfate and between sclerotherapy alone and sclerotherapy and resection combined were not done. The study was composed of three parts. They were (1) a review of records and imaging studies, (2) a panel evaluation of pretreatment and posttreatment photographs, and (3) a questionnaire that determined the patient's (or parent of the patient's) impression of therapy. Interrater and intrarater agreement were analyzed. Sclerotherapy was performed in an angiographic suite, under general anesthesia, using absolute ethanol and/or sodium tetradecyl sulfate. Complications of the treatment included acute blistering (50 percent), hemoglobinuria (28 percent), deep ulceration (13 percent), and nerve injury (7.5 percent). Two patients suffered transient facial paresis, and one had permanent unilateral vocal cord paralysis. Thirty patients (75 percent) were rated as having marked improvement or as being cured by all three members of the panel; 10 patients (25 percent) were rated as having no change or only slight improvement by one or more members of the panel. Interrater reliability was moderately positive, and intrarater reliability was highly positive. Thirty-seven patients or parents of patients (93 percent) responded to the questionnaire. The outcome was considered to be marked improvement or cured in 28 patients (76 percent), and nine respondents (24 percent) described only minor improvement or no change. Logistic regression analysis revealed that only male sex and number of sclerotherapeutic procedures were significant multivariate predictors of outcome. Size, location, tissues involved, morphology, or venous outflow were not determinant. In conclusion, sclerotherapy with ethanol or sodium tetradecyl sulfate is an effective and safe treatment for craniofacial venous malformations. Often, sclerotherapy has to be repeated. For extensive perioral malformations, combined sclerotherapy and resection give the best result.
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PMID:Sclerotherapy of craniofacial venous malformations: complications and results. 1059 69

Unilateral vocal cord paralysis or the loss of vocal cord tissue results in incomplete glottic closure (internal-paresis) with a consequent hoarseness and poor voice quality. Improving glottic incompetence, instead of the previously used paraffin, teflon is a widely accepted and most commonly used substance at present for vocal cord medialization. Using intracordal teflon injection of for decades had proven that it has limitations and potential complications to the human body. Beside the well-known external "phono-surgical" methods, a wide interest has been shown in endolaryngeal phono-surgery and in finding the ideal and most available biocompatible substances for the procedure. Papers have been issued about the promising results of autologus fat injection for medialization of the paralyzed vocal fold in the early '90s. In this paper the authors report on their slightly modified endolaryngeal intracordal autologus fat injection procedure, and its promising results. The first three patients (a left side glottic paralysis, a bilateral internal paresis and a left side internal paresis) experienced an improvement in their voice right after the medialization procedure, what remained the same during the 11 months follow-up period. Using supraglottic jet ventilation during general anaesthesia provides very good access to the operating field. Monitoring of neuro-muscular block makes possible an intraoperative examination of glottic closure by the protective reflex of the larynx. Incouraged by this initial results the authors suggest the autologus fat as an easy available, ideal substance for increasing (augmenting) the loss of vocal cord tissue.
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PMID:[Endolaryngeal lipoaugmentation of the vocal cords]. 1076 23

Monitoring of myogenic motor evoked potentials (MEPs) induced by transcranial electrical stimulation has become a promising tool for intraoperative monitoring. We described 2 patients who had developed significant decrease in MEP during the insertion of iliosacral screws for reconstruction of pelvic fractures. In both patients, MEPs were successfully obtained prior to the insertion under general anesthesia and partial neuromuscular blockade (propofol, ketamine, fentanyl, and nitrous oxide in oxygen: vecuronium), but reduced in association with the insertion. In one patient, they were restored by the re-insertion of screw and no new neurological deficits were observed postoperatively. However, in another patient, the decrease was not normalized and he suffered from paresis of the lower extremities after the surgery. We consider that intraoperative changes in MEPs could precisely predict postoperative motor function.
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PMID:[Monitoring of motor evoked potentials during insertion of iliosacral screws for reconstruction of pelvic fracture in two patients]. 1084 83

One hundred and thirteen double-muscled Belgian blue calves (69 males and 44 females) with spastic paresis (52 unilateral and 61 bilateral) were treated surgically by partial tibial neurectomy under caudal epidural anaesthesia. Telephone inquiries made at least three-and-a-half months later established that good results were obtained in 83.2 per cent of the calves; a considerable improvement was reported in 4.4 per cent which still had intermittent spastic contractions; severe hyperflexion of the hock necessitating early slaughtering was recorded in 4.4 per cent of the calves; and in 8 per cent there was little or no improvement.
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PMID:Partial tibial neurectomy in 113 Belgian blue calves with spastic paresis. 1097 47

The lower cranial nerves (CN. IX-XII) are responsible for the nerve supply of the pharyngolaryngeal region. Loss of innervation is manifested by dysphagia, aspiration, altered speech production, dyspnea and/or stridor, and visible loss of movement. In general electrophysiological testing should be applied in every kind of paresis. Beside standard equipment for electromyography limited special equipment is necessary. Examination under local anaesthesia is possible and can serve as a basis for therapeutic consequences. In this article general aspects as seen from an oto-rhino-laryngological standpoint are presented.
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PMID:[Electrophysiological diagnosis of the caudal cranial nerves]. 1119 66

We report our experience with intraoperative laryngeal electromyography (L-EMG) using direct laryngoscopy and placement of monopolar electrodes under general anesthesia in the evaluation and management of laryngeal dysfunction in pediatric patients. In this series of case studies, we present clinical data on 30 pediatric patients with known or suspected anatomic or neurologic laryngotracheal disorders evaluated with placement of shielded monopolar electrodes into the thyroarytenoid muscles during direct laryngoscopy under general anesthesia. Diagnoses included congenital vocal fold paralysis (VFP), laryngotracheal stenosis, cerebral palsy, laryngeal tumors, traumatic vocal fold dysfunction, and postsurgical VFP. The impact of L-EMG on patient management was assessed. We found that L-EMG objectively supported clinical findings, but provided new objective data relevant toward management recommendations in only a few selected pediatric patients with new-onset vocal fold paralysis or paresis or infiltrative laryngeal tumors, and in selected postsurgical cases involving decannulation decisions. The prognostic utility of L-EMG in newborns with congenital VFP has not been established. A normal L-EMG recording indicates an intact neuromuscular axis, but does not guarantee vocal fold mobility or guarantee muscle function in a partially denervated or deconditioned muscle. The potential for false-negative recordings is the major limitation of this technique.
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PMID:Intraoperative pediatric laryngeal electromyography: experience and caveats with monopolar electrodes. 1140 43

Until now, no optimal local anaesthetic drug with long lasting effect and low toxicity has been developed. Fomocaine (CAS 17692-39-6), introduced in the German extrapharmacopoela (DAC) in 1979, is a local anaesthetic, which is largely in accordance with these aspects. Now the basic ether fomocaine, its metabolites O/Se 9 (CAS 3006-96-0), O/Se 10 (CAS 31719-76-3), O/Se 11, O/Se 12 (CAS 64264-21-7) and M5 and its chiralic derivatives O/G 3 and O/G 5 were compared with procaine (CAS 59-46-1) and characterised more in detail in rats. The metabolism of fomocaine was investigated earlier with 14C-fomocaine in rats and beagle dogs. Rac-O/G 3 and Rac-O/G 5 could be separated into the enantiomers via the diastereomeric salts. Basing on standard methods for the testing of the local anaesthetic effects (estimation of infiltration and conduction anaesthesia in rat tail, measurement of corneal anaesthesia) and using a couple of tests characterising the side effects and toxicity of local anaesthetic (paresis of the N. ischiadicus, tissue irritation, determination of the approximative i.p. LD50) it can be concluded that: a) The very good surface anaesthesia caused by fomocaine could be stated, but, as expected, concerning conduction anaesthesia, procaine is better qualified for clinical use. b) Fomocaine is much more effective in conduction and surface anaesthesia than its chiralic derivatives O/G 3 and O/G 5. c) Differences between the two enantiomers of the O/G-substances have been found, but these little discrepancies are without practical relevance. In the case of O/G 5, agonistic effects of both enantiomers could be shown. d) Fomocaine undergoes extensive biotransformation with subsequent formation of 14 metabolites. Five of them (O/Se 9-O/Se 12; M5) are N-free and do not show any pharmacological activity. e) Compared to other local anaesthetics, fomocaine is relatively non-toxic (nearly no tissue irritation, high approximative LD50), however, surprisingly the toxicity of the reference substance procaine has been found to be lower after i.p. administration instead of i.v. administration in comparison with fomocaine.
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PMID:Local anaesthetic effectivity and toxicity of fomocaine, five N-free fomocaine metabolites and two chiralic fomocaine derivatives in rats compared with procaine. 1145 75


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