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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Most of the previous literature concerning otologic problems in compressed gas environments has emphasized middle ear barotrauma. With recent increases in commercial, military, and sport diving to deeper depths, inner ear disturbances during these exposures have been noted more frequently. Studies of inner ear physiology and pathology during diving indicate that the causes and treatment of these problems differ depending upon the phase and type of diving. Humans exposed to simulated depths of up to 305 meters without barotrauma or decompression sickness develop transient, conductive hearing losses with no audiometric evidence of cochlear dysfunction. Transient vertigo and nystagmus during diving have been noted with caloric stimulation, resulting from the unequal entry of cold water into the external auditory canals, and with asymmetric middle ear pressure equilibration during ascent and descent (alternobaric vertigo). Equilibrium disturbances noted with nitrogen narcosis, oxygen toxicity, hypercarbia, or hypoxia appear primarily related to the effects of these conditions upon the central nervous system and not to specific vestibular end-organ dysfunction. Compression of humans in helium-oxygen at depths greater than 152.4 meters results in transient symptoms of tremor, dizziness, and nausea plus decrements in postural equilibrium and psychomotor performance, the high pressure nervous syndrome. Vestibular function studies during these conditions indicate that these problems are due to central dysfunction and not to vestibular end-organ dysfunction. Persistent inner ear injuries have been noted during several phases of diving: 1) Such injuries during compression (inner ear barotrauma) have been related to round window ruptures occurring with straining, or a Valsalva's maneuver during inadequate middle ear pressure equilibration. Divers who develop cochlear and/or vestibular symptoms during shallow diving in which decompression sickness is unlikely or during compression in deeper diving, should be placed on bed rest with head elevation and avoidance of maneuvers which result in increased cerebrospinal fluid and intralabyrinthine pressure. With no improvement in symptoms after 48 hours, exploratory tympanotomy and repair of a possible labyrinthine window fistula should be considered. Recompression therapy is contraindicated in these cases...
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PMID:Diving injuries to the inner ear. 40 82

We report the vasocapacitance of the cerebral circulation, as determined by cerebral blood flow reactivity to induced hypercapnia using fluoromethane positron emission tomography, in 32 patients with unilateral anterior circulation transient ischemic attacks. A hemodynamic subset of eight patients, defined based on exertional, positional, orthostatic, or cardiac dysrhythmic induction of symptomatology, is characterized by multiple (median, 4.5 attacks per patient), brief (median, 2.5 minutes per attack), continued episodes of hemispheric ischemia including focal limb shaking. Symptomatic middle cerebral artery flow territories show significantly lower (p less than 0.04) and more asymmetric (p = 0.036) vasodilatory responses in the hemodynamic subset. Although ipsilateral internal carotid artery occlusion is more prevalent in the hemodynamic subset, the features of age, mean arterial blood pressure, carbon dioxide values, serum glucose, serum hematocrit, and number or type of risk factors do not differ significantly between groups. These studies of vasocapacitance help validate clinical criteria for cerebral hemodynamic events with an objective physiologic measurement.
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PMID:Cerebral vasocapacitance and TIAs. 278 50

The effects of acute hypercapnia on human thermoregulation during cold exposure were investigated by immersion of eight male subjects to the neck in a 15 degrees C water bath until their core temperatures dropped to 35 degrees C or until 1 h of immersion had elapsed. Air was inspired throughout each experiment, with the exception of a 15-min period commencing with the attainment of an esophageal temperature (Tes) of 36.5 degrees C, during which subjects inspired a gas mixture containing 4% CO2, 20% O2, and 76% N2. Oxygen uptake (VO2, L.min-1), inspired minute ventilation (Vi, L.min-1), esophageal temperature (Tes, degrees C), rectal temperature (Tre, degrees C), mean unweighted skin temperature (Tsk, degrees C), mean heat flux (Q, W.m-2), and electromyographic activity (EMG, mV) of the trapezius and masseter muscles were recorded continuously. VO2 and integrated EMG activity (IEMG) were used as the primary indicators of shivering thermogenesis. Shivering EMG was attenuated immediately following the switch of the inhaled gas mixture from air to 4% CO2. For both the masseter and trapezius muscles the IEMG was significantly suppressed (p < 0.05) during the hypercapnic period. The IEMG values preceding the switch to the hypercapnic mixture were 15% greater than those during the CO2 period. Similarly, IEMG values in the post-CO2 period were 55% greater than during the CO2 period. It is concluded that acute periods of hypercapnia during cold exposure may result in transient suppression of shivering tremor, but this does not appear to affect thermal balance, as reflected in the absence of any significant effect on Tes.
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PMID:Shivering thermogenesis during acute hypercapnia. 806 70

An 83-year-old man presented with episodes of right sided retro-orbital pain, visual disturbance, involuntary jerks of his left arm and less frequently his left leg. The symptoms could be triggered by exercise, heat or cough. EEG recordings revealed no epileptic discharges. Duplex ultrasonography showed an occlusion of the right internal carotid artery. Blood flow velocity in the right middle cerebral artery was reduced and vasomotor reactivity to hypercapnia was absent. Reduction of his antihypertensive medication rendered the patient asymptomatic. The combination of transient visual blurring, retro-orbital pain and contralateral limb shaking can be an unusual manifestation of carotid occlusive disease. In such a case, the symptoms may be managed successfully by the elevation of blood pressure.
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PMID:Transient visual blurring, retro-orbital pain and repetitive involuntary movements in unilateral carotid artery occlusion. 963 1

This case report intends to focus attention on hemodynamic TIAs as cause of repetitive involuntary movements (RIMs) as differential diagnosis of simple partial motor seizures. We report two patients with episodic unilateral limb shaking lasting up to several minutes and which could be triggered by orthostasis, heat or physical exertion. Repeated EEG recordings revealed no epileptic discharges. In both patients, duplex ultrasonography revealed an occlusion of the internal carotid artery (ICA) contralateral to the side of the RIMs. Blood flow velocities in the middle cerebral artery ipsilateral to ICA occlusion were reduced and vasomotor reactivity to hypercapnia was absent. After elevation of blood pressure both patients became asymptomatic. We suggest that in patients with episodes of RIMs, Doppler sonography and tests of cerebral vascular reserve capacity should be performed to search for a hemodynamic origin of these symptoms.
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PMID:[Hemodynamically-induced transitory ischemic attacks. A differential focal motor seizures diagnosis?]. 983 81

1. The effects of controlled atmosphere stunning on the behaviour, physiology and carcase and meat quality of broiler chickens were studied experimentally in a pilot scale plant. 2. Gas mixtures tested were: single phase anoxic mixture (90% Ar in air, <2% O(2)); single phase hypercapnic anoxic mixture (60% Ar, 30% CO(2) in air, <2% O(2)); and biphasic hypercapnic hyperoxygenation mixture (anaesthetic phase, 40% CO(2), 30% O(2), 30% N(2); euthanasia phase, 80% CO(2), 5% O(2), 15% N(2)). 3. Anoxic stunning resulted in the least respiratory disruption, mandibulation and motionlessness, but most head shaking, leg paddling and twitching. Loss of posture occurred soonest with hypercapnic anoxia with the earliest and most twitching and wing flapping in individuals and earliest leg paddling. Biphasic birds were most alert, exhibited most respiratory disruption and mandibulation, and had the latest loss of posture and fewest, but longest bouts of wing flapping and least leg paddling and twitching. 4. Significant and sudden bradycardia and arrhythmia were evident with all gas mixtures and were not related solely to anoxia or hypercapnia. Birds stunned by Ar anoxia showed a slightly more gradual decline from baseline rates, compared with hypercapnic mixtures. 5. Few differences were found between gas mixes in terms of carcase and meat quality. Initial bleeding rate was slowest in biphasic-stunned birds, but total blood loss was not affected. Acceleration of post-mortem metabolism in anoxic-stunned birds was not sufficient to allow de-boning within 5 h without the risk of tough meat. 6. On welfare grounds and taking into account other laboratory and field studies, a biphasic method (using consecutive phases of anaesthesia and euthanasia) of controlled atmosphere stunning of broilers is potentially more humane than anoxic or hypercapnic anoxic methods using argon or nitrogen.
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PMID:Controlled atmosphere stunning of broiler chickens. I. Effects on behaviour, physiology and meat quality in a pilot scale system at a processing plant. 1770 94

As blood levels of carbon dioxide increase (hypercapnia) in lung disease such as chronic obstructive pulmonary disease (COPD), patients can show signs of delirium, becoming increasingly confused and sleepy. They may also have wrist tremor, muscle twitching, seizures and dilation of conjunctival and superficial facial blood vessels.
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PMID:Use of non-invasive ventilation. 2773 15

The precise neural circuitry that mediates arousal during sleep apnea is not known. We previously found that glutamatergic neurons in the external lateral parabrachial nucleus (PBel) play a critical role in arousal to elevated CO2 or hypoxia. Because many of the PBel neurons that respond to CO2 express calcitonin gene-related peptide (CGRP), we hypothesized that CGRP may provide a molecular identifier of the CO2 arousal circuit. Here, we report that selective chemogenetic and optogenetic activation of PBelCGRP neurons caused wakefulness, whereas optogenetic inhibition of PBelCGRP neurons prevented arousal to CO2, but not to an acoustic tone or shaking. Optogenetic inhibition of PBelCGRP terminals identified a network of forebrain sites under the control of a PBelCGRP switch that is necessary to arouse animals from hypercapnia. Our findings define a novel cellular target for interventions that may prevent sleep fragmentation and the attendant cardiovascular and cognitive consequences seen in obstructive sleep apnea. VIDEO ABSTRACT.
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PMID:A Genetically Defined Circuit for Arousal from Sleep during Hypercapnia. 2910 5