Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 43-year-old patient with clinically established diagnosis of multiple sclerosis had the nuchal-paretic sign. Neck flexion caused reversible deterioration of gait and increased the weakness of the right lower extremity. Although the sign is not pathognomonic for multiple sclerosis it is a peculiar pyramidal sign suggesting demyelination especially in the cervical part of the spine. Mechanical stretching of the demyelination plaques in the cervical spine reduces probably the density of the action current generated at the nodes of the demyelinated fibres.
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PMID:[Nuchal-paretic sign in multiple sclerosis]. 180 64

Transcranial magnetic stimulation was performed on 25 patients with definite multiple sclerosis. Motor evoked potentials were recorded from the anterior tibial muscle. Central motor conduction time was calculated using the equation (F + M-1)/2 by stimulation of the common peroneal nerve. Motor evoked potentials were capable of detecting subclinical pyramidal tract lesions in multiple sclerosis. In patients with multiple sclerosis, the incidence of abnormality of motor and somatosensory evoked potentials was similar. Central motor conduction time was correlated with overall and pyramidal tract subscores on the Kurtzke Disability Status Scale and the Scripps Neurological Rating Scale. Central motor conduction time abnormalities correlated best with the presence of a Babinski's sign but also correlated significantly with weakness and hyperreflexia.
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PMID:Lower extremity motor evoked potentials in multiple sclerosis. 195 19

This report describes a rare complication after the resection of a tumor of the posterior fossa, the "one-and-a-half" syndrome. The one-and-a-half syndrome is a disturbance of horizontal eye movements in which patients have lateral gaze palsy in one direction and internuclear ophthalmoplegia in the other direction. The patient was a 54-year-old woman who developed headaches, diplopia, and blurred vision over 6 months. Computed tomographic scans and magnetic resonance imaging demonstrated an enhancing, mixed density, midline mass of the cerebellum. After a resection of the mass, an anaplastic astrocytoma, the patient complained of more severe diplopia and facial weakness. An examination disclosed a left one-and-a-half syndrome, left peripheral facial paralysis, dysarthria, dysphagia, mild left hemiparesis, dysmetria of the left upper limb, and truncal ataxia. The brain stem showed no abnormalities on postoperative computed tomographic scans. After 4 months of follow-up, the one-and-a-half syndrome had not improved, even though other signs had improved or resolved. This syndrome is caused by damage to structures within the pontine tegmentum: the medial longitudinal fasciculus, the ipsilateral paramedian pontine reticular formation, or the ipsilateral abducens nucleus. Multiple sclerosis and brain stem infarction are the most common causes of the one-and-a-half syndrome. Less frequently, it is caused by primary and metastatic tumors of the brain stem and cerebellum. Rarely, the one-and-a-half syndrome can develop postoperatively after the removal of tumors of the posterior fossa. The mechanism of pontine tegmental injury remains unknown.
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PMID:"One-and-a-half" syndrome after a resection of a midline cerebellar astrocytoma: case report and discussion of the literature. 196 11

Higher cerebral dysfunctions such as aphasia, apraxia and agnosia have seldom been reported in multiple sclerosis (MS). 12 year-old right-handed boy felt unsteadiness of the body and headache for several days. Two months later, he had the same episode and complained of visual disturbance, and weakness and sensory disturbance on the face and the extremities. Additionally, he showed amnestic aphasia, acalculia, ideomotor apraxia, finger agnosia and right-left disorientation. Cerebrospinal fluid examinations revealed increases IgG, myelin basic protein and neuron specific enolase (11%, 25 ng/ml and 28.8 ng/ml, respectively). X-ray CT scan and MRI-CT examinations revealed sclerotic lesions on the left parietal white matter and the right mid-brain. The diagnosis was made as MS. He was treated with m-PSL (methyl-prednisolone) pulse therapy for three weeks and consecutively treated with PSL for four weeks. He recovered gradually, but visual disturbance and facial palsy remained. After seven months MRI-CT showed a high signal intensity on the left parietal white matter in spite of the disappearance of the lesion on X-ray CT scan. We suggest that these higher cerebral dysfunctions may result from the lesion of the left parietal white matter which produces a disconnection between each cortical area.
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PMID:[Multiple sclerosis with higher cerebral dysfunction: a case report]. 199 97

Central motor conduction times for the adductor pollicis muscle, the twitch force of that muscle to scalp magnetic motor cortex stimulation, and the maximum force of phasic voluntary contraction of the same muscle were measured in 15 patients with multiple sclerosis. Two tests of manual dexterity of the same hand also were studied: the Purdue pegboard test, and the maximal frequency of a scissors movement of the thumb and index finger. The patients had normal strength or minimal weakness of the intrinsic muscles of the hand on clinical examination. The mean central motor conduction times for the adductor pollicis muscle for the patients were longer than normal, the peak twitch force of the adductor pollicis muscle evoked by cortical stimulation and the maximum force of a phasic voluntary contraction of the adductor pollicis muscle were smaller than normal. There were strong correlations between all these measures. Central motor conduction time in the patients was inversely correlated with voluntary phasic force and the twitch force after cortical stimulation. That is, the longer the central motor conduction time, the weaker the force. Prolonged central motor conduction time is likely to be accompanied by conduction block in corticomotoneuron pathways. The correlation of central motor conduction time with voluntary phasic force and the twitch force most likely reflects the degree of conduction block and temporal dispersion rather than delay in conduction per se. These results indicate that objective assessments of phasic muscle strength may reveal correlations with central motor conduction time that are not evident on conventional clinical examination which assesses tonic muscle contraction strength.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Correlation of phasic muscle strength and corticomotoneuron conduction time in multiple sclerosis. 199 80

A 23-year-old woman developed acute respiratory failure in the course of multiple sclerosis. The lack of bulbar dysfunction, the presence of quadriplegia, and the bilateral diaphragmatic weakness indicated the presence of spinal cord lesions involving pyramidal tracts bilaterally. Magnetic resonance imaging revealed a cervical demyelinating lesion between C1 and C3.
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PMID:Acute respiratory failure in multiple sclerosis. 229 51

In a group of 39 multiple sclerosis (MS) patients with at least average intelligence quotients (IQ), performances were examined in tests requiring language usage and figure copying. Numbers of correct, digressive and erroneous responses were analysed and compared with those obtained in 24 healthy volunteers, matched to the patients group for socio-economic status. The examined specific tasks yielded no additional contribution to the prevalence estimation of cognitive deterioration (18%), as based on an assessment of general intelligence. Linguistic or cognitive-constructional problems were no more severe or more frequent in MS patients than those in control subjects. Upon writing or copying figures, pencil stroke and pencil pressure were deficient. Speed of reading aloud and of colour naming was decreased in the MS group, the most probable explanation being impaired control of the phonatory apparatus, oculomotor problems or weakness of colour vision. Decreases in speed of performance are not necessarily of cognitive origin. Differences between the present and previous reports based on similar tasks, appear to be connected partly with differences in patient selection. Of the present group, all MS patients were in quiescent disease stages, depression was mild or absent and physical handicap was less than in most studies reporting definite specific deficits.
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PMID:Performances of multiple sclerosis patients in tasks requiring language and visuoconstruction. Assessment of outpatients in quiescent disease stages. 233 67

A 56 year-old man presented with vertigo and the right sided weakness. Neurological examination revealed a lethargic man with good orientation to three spheres. His neck was supple. He had anisocoria, the right pupil being larger than the left by 1.5 mm with sluggish light reaction bilaterally. He had exotropia of the right eye in primary gaze. The abduction of both eyes were full with terminal horizontal nystagmus. The adduction of both eyes were quite limited in each eye. He had a limited upward gaze with poor convergence. These were interpreted as the syndrome of the medial longitudinal fasciculus (MLF) bilaterally. He had a depressed gag reflex on the right side with tongue deviation to the right. He had a mild weakness of the right side limb and also had the right sided hemihyperesthesia including his face to pain and temperature. Twenty four hours after the onset, the left brachial angiography revealed a complete occlusion of the rostral portion of the basilar artery without visualization of the posterior cerebral and superior cerebellar arteries bilaterally. CT scans three days after the onset revealed a low density area in the mid pons with extension rostrally up to the mesencephalon. Four days later he became quadriplegic with bilateral horizontal gaze palsy. No more internuclear ophthalmoplegia is noted on both sides. The midline location of the MLF in the pons, and the separate blood supplies by different paramedian branches of the basilar artery, form the anatomical explanation for the frequent unilaterality of vascular and bilaterality of demyelinating lesions. Bilateral MLF syndrome has been considered almost pathognomonic of multiple sclerosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Bilateral internuclear ophthalmoplegia in association with basilar artery occlusive disease]. 235 Sep 28

In a hospital-based study of 400 patients with multiple sclerosis (MS), 42 per cent of patients who had had MS for 10 years or more had benign disease. Early age of onset and a long first remission were significantly associated with a good prognosis. There was a suggestion that initial presentation with paraesthesiae and possibly optic neuritis were associated with a benign prognosis, but the only significant finding was the association between limb weakness and a poor outcome (p less than 0.05). Fewer patients with benign disease had a progressive element to their disease than those in the more disabled group (p less than 0.001). The only laboratory test which was associated with a benign prognosis was the absence of CSF myelin basic protein in remission. Abnormalities of visual evoked response, CSF IgG and peripheral blood T lymphocytes appeared to have no value in assessing prognosis in the patients studied.
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PMID:A clinical and laboratory study of benign multiple sclerosis. 242 74

We assessed the effects of respiratory muscle training (RMT) in patients with multiple sclerosis (MS) on vital capacity (VC), maximal static inspiratory (PImax) and expiratory (PEmax) pressures and maximal voluntary ventilation (MVV). Eight patients (mean age 53, range 42 to 65 years) with stable disease and respiratory muscle weakness (RMW; VC = 83%, PImax = 64%, PEmax = 41%, MVV = 62% of predicted value) underwent a 4 +/- 1 week RMT program using inspiratory and/or expiratory resistive loads. Results showed changes in PImax (+31%, p less than 0.02), PEmax (+31%, p less than 0.05), and MVV (+21%, p less than 0.05); VC was unchanged (+1%). Thus in these patients, RMT improved respiratory muscle strength and ventilatory capacity. RMT may be an additional method of rehabilitation in selected patients with MS, in whom RMW contributes to exercise intolerance, coughing and talking impairment.
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PMID:Respiratory muscle training in multiple sclerosis: a pilot study. 246 71


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