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)

Sixteen patients suffering from spasticity due to multiple sclerosis were treated with baclofen and tizanidine in a partially blind cross-over study. No significant difference in efficacy was found. The most striking difference was seen in the side-effects: baclofen frequently caused more or less severe muscle weakness and even falling during walking and standing. Treatment with tizanidine produced an apparent improvement of mobility in some patients suffering from moderate or marked paresis associated with a marked spasticity of their legs. Isometric muscle strength did not show any significant changes during either treatment. The different impact of baclofen and tizanidine on mobility and weight support seems to be related to their different site of action in spasticity.
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PMID:Tizanidine versus baclofen in the treatment of spasticity in multiple sclerosis patients. 337 47

Central motor conduction (CMC) was evaluated in 32 normal subjects and 83 patients with multiple sclerosis, and the findings were correlated with clinical signs and evoked potential data. CMC time was obtained from the latency difference in responses from the abductor muscle of the little finger to magnetic stimulation of the motor cortex and electrical stimulation at the C-7/T-1 interspace. Mean CMC time in normal subjects was 6.2 msec (SD 0.86 msec), and amplitudes of responses to cortical stimuli were at least 18% of those obtained with stimuli at the wrist. CMC was abnormal in 60 patients with multiple sclerosis (72%); this correlated well with brisk finger flexor jerks (p less than 0.005). CMC was abnormal in 79% of patients with weakness of the abductor muscle of the little finger and in 54% with a normal muscle. Neurological examination was normal in 7 arms with abnormal CMC. Visual evoked potentials were abnormal in 67%, somatosensory evoked potentials in 59%, and brainstem auditory evoked potentials in 39% of those tested. For each procedure more subjects had abnormal CMC and normal evoked potentials than the reverse. The technique is of value for demonstrating and documenting central motor pathway lesions in multiple sclerosis, especially when physical signs are equivocal.
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PMID:Magnetic brain stimulation: central motor conduction studies in multiple sclerosis. 343 84

A patient with multiple sclerosis is reported in whom neck flexion produced a reversible deterioration in gait and an increase in the degree of pyramidal weakness of the lower limbs. The name McArdle's sign is proposed.
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PMID:McArdle's sign in multiple sclerosis. 343 5

The anti-spastic effect of a new drug, tizanidine, was compared with that of baclofen in a double-blind clinical trial; 40 seriously handicapped patients with multiple sclerosis (MS) were randomly allocated treatment with one or the other drug for a 6-week period. The antispastic effect was evaluated by clinical criteria. The optimal daily dose of both drugs varied considerably from patient to patient, and was on the average 23 mg for Tizanidin and 59 mg for baclofen. To the extent an antispastic effect was observed, the 2 drugs appeared to be equally effective when given at a 1:2 ratio (mg tizanidine: mg baclofen). Side effects of both drugs were sleepiness, muscular weakness and dry mouth. Tizanidine had a mild depressive effect on blood pressure. Sudden withdrawal of both drugs was accompanied by a transient relative increase of spasticity in approximately half the patients. There were no other changes suggesting physical or psychological dependence. The present study underscores that neither baclofen nor tizanidine are ideal antispastic drugs, and emphasize the need for further research.
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PMID:The treatment of spasticity in multiple sclerosis: a double-blind clinical trial of a new anti-spastic drug tizanidine compared with baclofen. 355 79

To overcome some of the disadvantages of the current percutaneous surgical approaches to trigeminal neuralgia, we offer balloon compression rhizolysis (BCR) as an alternative. Guided by fluoroscopy, a 4 French Fogarty catheter is introduced into Meckl's cave, and its balloon is inflated tightly for a few minutes with soluble contrast agent to compress the gasserian ganglion and rootlets, under light endotracheal anesthesia. All patients experience immediate pain relief, with mild numbness in all three divisions, but with corneal sparing. Often, weakness of ipsilateral mastication appears transiently. In 33 procedures performed in 25 patients aged 48 to 86, with a follow-up period of 6 months to 7 years, there were 25 long-lasting cures (76%) and 8 recurrences. These results are fully comparable to those of other "destructive" procedures. There was no anesthetic complication and no mortality. The The advantages of this procedure, besides its efficacy and low rate of dysesthesia, include absence of discomfort for the patient, short operative time, technical ease for the neurosurgeon, minimal morbidity, and no risk to corneal sensation. We think that microvascular decompression (MVD) should be the first operation considered for trigeminal neuralgia, but we BCR as the procedure of choice in the aged and medically infirm, especially when V1 pain is present, in patients with multiple sclerosis, for recurrences after other procedures, and in virtually any situation in which MVD is, for some reason, not feasible.
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PMID:Balloon compression rhizolysis in the surgical management of trigeminal neuralgia. 361 71

Thirty-two patients with spasticity due to multiple sclerosis were entered into a randomized, double-blinded, placebo-controlled crossover trial of the gamma-aminobutyric acid agonist, progabide. Each patient was treated with a maximum of 45 mg/kg of progabide during each of two four-week treatment periods, separated by a two-week washout. Twenty-five participants completed the study; seven failed to complete the study due to adverse events. Progabide was associated with lessened spasticity. There was no loss of motor power associated with progabide. The physician, patients, and study nurse coordinator all declared preferences for progabide for treatment of spasticity. Ten participants (40%) chose to remain on progabide in an open, long-term follow-up protocol. Seven serious adverse events occurred. One consisted of fever and weakness without infection; the other six consisted of elevated aspartate aminotransferase and alanine aminotransferase levels, four of which were asymptomatic. All adverse events resolved entirely when the drug was stopped. Progabide is an effective antispastic agent and its antispastic effect is not accompanied by increased motor weakness. The use of the drug, however, is associated with a high incidence of adverse events, which will likely limit progabide's therapeutic usefulness.
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PMID:The GABA-agonist progabide for spasticity in multiple sclerosis. 363 75

The disability outcome related to the presenting signs and symptoms was studied retrospectively in 193 patients with definite multiple sclerosis (MS). Patients whose first sign was motor weakness were found to be more severely disabled, at all stages throughout the course of the disease, than patients with other presenting signs or symptoms. Patients whose disease manifested initially with sensory disturbances or paraesthesiae proved to be less seriously disabled than other patients at all stages of the disease. A similar tendency was found in patients presenting with optic neuritis (ON) for the first 20 years of the disease; after that, their disability was comparable to that of patients with other presenting complaints. The difference during the first 20 years of the disease is mainly due to the asymptomatic period after initial manifestation of optic neuritis.
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PMID:Presenting signs and symptoms in multiple sclerosis. 371 65

A 25-year-old white man presented with acute multiple sclerosis manifested by right blindness, difficulty urinating, and paresthesias and weakness of both legs. Retinal examination revealed a distal occlusion of the descending branch of the superior temporal arteriole leading to an area of retinal ischemia of the right eye. The optic disc was edematous, and there were focal areas of periphlebitis. All retinal signs resolved in three weeks, and the only abnormality that persisted was a pale right optic disc. The finding of small arteriolar disease is unusual and may represent another possible pathogenetic mechanism in multiple sclerosis.
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PMID:Retinal arteriolar occlusion in multiple sclerosis. 371 37

Pulmonary functions at rest and cardiorespiratory responses to low speed treadmill walking were investigated in 24 patients (P), (mean age, 38 years; range, 20 to 56 yr) with multiple sclerosis and compared with a control group (C). The following parameters were significantly (p less than 0.01) different in P from those in C. At rest in P, the residual volume to TLC ratio was 21% greater, respiratory muscle strength index was 28% lower, and heart rate (HR) was 11 beats/min-1 higher. During treadmill walking at a given speed, HR, minute ventilation (VE), and O2 consumption (VO2) were all elevated (37 to 119%). In addition, the energy cost of walking, per unit distance, above resting, was 2 to 3 times greater, with mean +/- SEM values for P of 0.299 +/- 0.019 and C of 0.147 +/- 0.006 at 2 km/h and 0.275 +/- 0.042 and 0.110 +/- 0.005 (for P and C, respectively) ml O2 kg-1 m-1 at 4 km/h; the HR and VE/VO2, also when referred to a given VO2, were higher. We conclude that a high energy cost of walking may be an important contributing factor to breathlessness and leg fatigue in patients with multiple sclerosis. Poor conditioning, altered cardiovascular control, and respiratory muscle weakness may play additional roles.
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PMID:Energy cost of walking and exertional dyspnea in multiple sclerosis. 377 62

A 38 year-old wife, of belgian origin and residency, suffered from a left retrobulbar optic neuritis in 1973, with as only sequel dyschromatopsia and central scotoma enlargement. In 1985, 12 years later, she complained of a progressive weakness of the right hand, and developed a spastic tetraplegia within four months. The C.T. Scan showed white matter hypodensities, without mass effect or contrast enhancement, first limited to the left centrum semiovale and later on with multifocal character. Somatosensory evoked potentials after stimulation of the right median nerve demonstrated only lemniscus medialis response. Multiple sclerosis was initially suspected. Analysis of lymphocytes subsets however showed a markedly reduced helper population with as a result a very low H/S ratio, and the serology was found positive for HTLV-III-LAV, thus demonstrating the diagnosis of acquired immune deficiency syndrome (AIDS). Visceral autopsy demonstrated only a CMV pneumonia. Autopsy of the brain showed typical lesions of progressive multifocal leukoencephalopathy (PML). This case is compared with 20 previously published observations of PML associated with AIDS and appears rather unusual due to the association of unfrequent clinical peculiarities: previous, probably coincidental, retrobulbar optic neuritis, female patient, lack of risk factor and clinical symptoms of AIDS. The diagnostic difficulties in the present case are emphasized.
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PMID:[Progressive multifocal leukoencephalopathy mimicking multiple sclerosis as the sole clinical manifestation of acquired immunodeficiency syndrome]. 381 29


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