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)

In this case the patient was a 62-year-old male with a chief complain of sensory disturbance of the extremities. In January 1987 he was diagnosed as having bronchial asthma by a neighboring doctor and began to receive prednisolone (PSL) therapy at his hospital on an ambulatory basis. Later on, in January 1990, he developed dyspnea, epigastralgia, ecchymoses and muscle weakness of the lower extremities, with which he was admitted to the neighboring hospital, where he was started on treatment of asthmatic attacks with 30 mg/day of PSL. However, because muscle weakness of his extremities became gradually worse, he was transferred to our hospital. Physical examination on admission revealed an absence of knee and ankle jerk, sensory loss in the bilateral hands, legs and feet and diminished muscle strength of the extremities. Significant laboratory findings included leukocytosis, eosinophilia (4743/mm) and elevated serum IgE concentration (4900 IU/ml). Histologic evidence of vasculitis with an associated infiltration by eosinophils was noted on skin biopsy. These findings led to a diagnosis of Churg-Strauss syndrome. Treatment was started with PSL at 40 mg/day. However, as asthmatic attacks and eosinophilia were refractory to the conventional therapies, concomitant lobenzarit disodium (CCA), 240 mg/day was initiated. On increasing the dosage of CCA to 320 mg/day because of unsatisfactory symptomatic responses elicited at the initial dose level, the patient became free from an asthmatic attack with a return to normal of his eosinophilic count. He was discharged virtually asymptomatic while being placed on a regimen of PSL at 5 mg/day.
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PMID:[Successful treatment with lobenzarit disodium in case of Churg-Strauss syndrome]. 811 38

It is very rare for neurosurgeons to encounter cases of spinal cord injury caused by a broken acupuncture needle. A 45-year-old man was referred to our clinic because of urinary retention about two weeks after acupuncture therapy (a needle was broken during treatment). The patient showed no motor weakness, or sensory disturbance. The needle was seen transversely stabbing the spinal cord at C1/2 on CT imaging and X-ray film. In all of the reported seven cases of longitudinal stab injuries (posterior puncture), sensorimotor disturbances were present. In transverse stab injuries (lateral puncture), however, two cases did not show motor weakness but sensory disturbance. The centrifugal pathway for micturition in the spinal cord lies in the middle one third of the lateral columns and in the width of the central canal. The patient complained of urinary retention because the bilateral descending fibers might have been stabbed by the needle. Surgical treatment relieved the patient from his complaint.
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PMID:[Spinal cord stab injury by acupuncture needle: a case report]. 811 10

A 32-year-old woman experienced subacute onset of weakness in her left leg, urinary retention and difficulty in extending her right middle and third finger. She subsequently suffered episodes of myelopathy, optic neuritis and cerebellar ataxia over a period of several years. Brain MRI showed multiple areas of high signal intensity on T2-weighted images, consistent with multiple sclerosis (MS). However spinal MRI revealed no abnormal findings. In her most recent episode, at age 40 she developed paraparesis. Neurologic examination revealed down beat nystagmus on gazing to the right, horizontal jerk nystagmus gazing to the left, weakness of the right middle and third fingers and paraparesis associated with spasticity of the right leg. Sensory disturbance below C3 and diminished vibration and position sense in both legs were also observed. The patient could not stand or walk, and urinary disturbance was present. Spinal MRI revealed syrinx formation at the level of vertebral bodies C2 to C6. The syrinx within the cervical cord diminished in size after four months, but the patient was unable to walk unaided and had moderate sensory disturbance as before. This finding suggests that the prognosis of MS with syrinx formation following repeated episodes of myelopathy is not always favorable. We believe that functional recovery in MS with syringomyelia is affected by the severity of the demyelination and/or gliosis caused by MS rather than by the presence of the syrinx.
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PMID:[Multiple sclerosis with syringomyelia--case report]. 813 3

A 44 year old man complained of a left flank pain. The epidural block was performed. After two hours he suddenly experienced severe back pain, lower limb numbness and weakness of the legs. The physical examination revealed the flaccid paraplegia and the disturbance of pain and touch sensation. But his proprioceptive sensation was preserved. The paraplegia gradually disappeared and he had no neurological deficit. Judging from the unique sensory disturbance, the anterior spinal artery syndrome was suspected.
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PMID:[Transient paraplegia following the epidural block]. 818 89

The patient was a 65-year-old man who had noted mild weakness of the right hand since summer, 1990. In October, 1990, he had fever and developed apparent weakness of the upper extremities. Neurological examination on admission revealed distal dominant muscle weakness and atrophy of the upper extremities with fasciculation. Deep tendon reflexes were diminished in the upper limbs and exaggerated in the lower ones. No sensory disturbance or cerebellar signs were recognized. Laboratory examination of his blood showed leukocytosis and elevated levels of acute reactants. The needle EMG showed a neurogenic pattern. MRI study of the neck disclosed narrowing of the intervertebral space between C7 and Th1 and a low signal intensity of these vertebral bodies on T1 weighted image. Treatment with antibiotics improved his neurological symptoms and the abnormal MRI findings. The present case was diagnosed as having cervical spondylitis. Neurological symptoms and signs associated with cervical spondylitis have been reported to be paraplegia or quadriplegia. Like the present case, however, cervical spondylitis should also be considered as one of the diseases which could show symptoms and signs very similar to those of motor neuron disease.
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PMID:[A case of cervical spondylitis mimicking motor neuron disease]. 819 73

Ossification of ligamentum flavum was reported usually lower thoracic and lumbar region, and rarely seen in the cervical region. Calcification of cervical ligamentum flavum is also relatively rare. We report a case of ossification and another of calcification of cervical ligamentum flavum, and discussed the difference of the clinical and radiological features in these conditions. Case 1: A 55-year-old man presented with numbness of the left shoulder and urinary dysfunction. Neurological examination revealed weakness, muscle atrophy and elevated deep tendon reflexes of the left extremities. CT showed ossified mass protruding into the right side of the canal and compressing the spinal cord at C 3/4 and C 4/5. MRI showed low intensity mass both on T1- and T2-weighted images and severe compression of the spinal cord. Left side partial hemilaminectomy with foraminotomy, so called "key hole" foraminotomy, satisfactorily decompressed the cord with clinical improvement. Case 2: A 70-year-old woman complained numbness of both hands for two years. She had sensory disturbance of both hands and spastic gait disturbance. Cervical X-ray films showed calcified nodules on the inner surface of lamina at C4/5. Axial CT demonstrated calcification in the ligamentum flavum at the C4/5 and C5/6 levels. MRI showed posterior spinal cord compression at the C4/5 and C5/6 levels. Osteoplastic laminotomy and removal of the affected ligamentum flavum were performed with successful result. Only 8 cases ossification of cervical ligamentum flavum above C6/7 have been so far reported. All are Japanese; four male and four female cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ossification and calcification of the cervical ligamentum flavum--case reports]. 821 11

Spinal cord compression (SCC) is a relatively uncommon but frequently disabling complication of metastatic breast cancer. We have conducted this retrospective study of 70 patients with SCC secondary to breast cancer with the aims of determining risk factors for its development and predictors of outcome. Median age at diagnosis of breast cancer was 51 years with median time to SCC 42 months. All patients had radiological evidence of bone metastases at the time of SCC, and only five were not known to have bone metastases prior to SCC. The most frequent symptom of SCC was motor weakness (96%) followed by pain (94%), sensory disturbance (79%) and sphincter disturbance (61%). Ninety-one percent of patients had at least one symptom for more than a week. Radiotherapy (RT) was given as primary treatment in 43 cases, whilst 21 had decompressive surgery and seven of these went onto have postoperative radiotherapy. Six patients were deemed too unwell for either modality. Following treatment, 96% of those who were ambulant before therapy maintained the ability to walk. In those unable to walk, 45% regained ambulation, with RT and surgery being equally effective. Median survival following SCC was 4 months, with no significant difference between those treated by RT or surgery. The most important predictor of survival was ability to walk after treatment, followed by time from diagnosis of breast cancer to SCC. We conclude that the majority of patients have warning symptoms of SCC and that nearly all will have evidence of spinal bone metastases before compression occurs. The results suggest that earlier diagnosis and intervention could improve outcome. There was no evidence of benefit from surgery over radiotherapy as primary treatment, survival in both treatment groups being poor.
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PMID:Spinal cord compression in breast cancer: a review of 70 cases. 821 11

Arteriovenous (AV) fistulas of cerebral and spinal arteries are characterized angiographically by an immediate AV transition without a capillary bed or "nidus" as occurs in AV malformations (AVM's). The clinical presentation, morphology, radiology, and treatment of 12 patients with cerebral AV fistulas and of 12 patients with spinal AV fistulas are reviewed. In the patients with cerebral lesions, headache and seizure disorders were the most common presentations followed by subarachnoid hemorrhage, cardiac failure, progressive neurological dysfunction, and incidental detection on prenatal ultrasound study. In patients with spinal AV fistulas, weakness and sensory disturbance in the lower extremities were the most frequent clinical presentations followed by back pain, disturbances of micturition, and grand mal seizure. The etiology of the symptom complex produced by AV fistulas in each of these locations differed, with venous hypertension being important in spinal cord lesions. Of the patients with cerebral lesions, nine had a single AV fistula, one had two fistulas, and two had multiple fistulas. An AVM was observed in five patients with fistulas (two large, three small). Nine patients exhibited extramedullary AV fistulas of the spine, of whom eight had a single fistula and one had three fistulas; three patients had intramedullary spinal AV fistulas. An arterial aneurysm was found in association with two fistulas, one cerebral and one spinal. Venous ectasias or varices, frequently exhibiting mural calcification, were observed to be prominent in all AV fistulas involving cerebral arteries and in two involving spinal arteries. The location and size of the venous complexes reflected the diameter of the fistula. In addition to conventional imaging techniques (cerebral angiography, computerized tomography, and magnetic resonance (MR) imaging), MR angiography was a helpful adjunct in the evaluation of fistulas. Treatment strategies employed for AV fistulas in both locations included open surgical and endovascular procedures, frequently used in combination. A satisfactory outcome was observed in all patients.
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PMID:Arteriovenous fistulas of the brain and the spinal cord. 827 Oct 12

A 41-year-old woman had radical mastectomy for breast cancer with metastasis of axial lymph nodes three years previously. In February 1990, she noticed swelling of lymph nodes in right suparclavicular region. A lymph node biopsy revealed cancer cells. Immediately, radiation therapy was performed. However, in August serum levels of CA 15-3 and LDH were markedly elevated. Two months later the patient complained of severe headache, dysarthria, shoulder pain and anorexia. Neurological examination revealed stiff neck, weakness of bilateral facial muscles, deviation of tongue to the left and no sensory disturbance. A CSF sample by lumbar puncture showed 26/mm3 in cell counts, 204 mg/dl of protein and 11 mg/dl of glucose. In addition, CSF cytology revealed malignant cells four to five times as large as lymphocytes. Immediately, and intrathecal administration of methotrexate (MTX) was started. However, one week later she developed complete paraplegia with sensory disturbance below the L1 levels and an incontinentia urine. CSF examination performed again, and showed 97/mm3 in cell counts, 792 mg/dl of protein and 91 mg/dl of glucose. On October 10, a CT scan of the head showed contrast enhancement along cerebellar folia and narrowing of quadrigeminal cistern. On November 31, sagittal T1W1 with Gadolinium revealed an enhancing stripes along the spinal cord at the Th10 to L4 levels. This finding was suggested to be meningeal carcinomatosis. On December 8, she died. At autopsy, brownish hemorrhagic mass was noticed in the bilateral cerebellar tonsils, and severe downward displacement of the tonsils.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of meningeal carcinomatosis showing myelopathy--detection of TNF-alpha in infiltrating CSF cells and brain tissue sections of cerebellum]. 831 90

A case of familial juvenile parkinsonism with dementia, orthostatic hypotension, neurogenic bladder and constipation was reported. He had been in a good health until the age of 28 when a finger tremor occurred on effort to hold hands in a definite position, and disturbances in gait and speech were noted. These symptoms were relieved by levodopa treatment followed by dyskinesia and motor fluctuations. Three years later, he complained of faintness, constipation and urinary frequency. The neurological examination revealed mentally sound male with masked face, tremor and rigidity in his extremities, and short step gait with lateropulsion. Urodynamic study showed uninhibited bladder. In the following years, orthostatic hypotension, dysuria and urinary retention developed gradually. He became mentally loose and was unable to take medicines appropriately. When in the Nishiojiya Byoin National Sanatorium, he tried to snake out the hospital many times. His parents and a brother suffered from Parkinson's disease and juvenile parkinsonism, respectively, suggesting an autosomal dominant inheritance. On admission to our hospital, he was apathetic. He had masked face, bilateral postural tremor, frozen gait and dyskinesia in the right lower extremity. Little bradykinesia or rigidity was noted. His muscle tone and deep tendon reflexes were decreased but neither muscular wasting, weakness, ataxia nor sensory disturbance was observed. Laboratory data including ceruloplasmin, copper, dopamine-beta-hydroxylase and lysosomal enzyme activities were normal except for mild anemia. A cranial CT scan revealed mild cortical atrophy in the frontal and temporal lobes, but nerve conduction study and cortical evoked potentials showed no abnormality. While in the hospital, his mental functions deteriorated to the state of dementia and orthostatic hypotension became apparent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Familial juvenile parkinsonism with dementia and autonomic failure--a case report]. 833 79


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