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 42-year-old woman developed lower extremity weakness and sensory loss 1 year after external and intracavitary radiotherapy for Stage IB carcinoma of cervix. She has been followed for 5 years posttreatment, and the neurologic abnormalities have persisted, but no evidence of recurrent carcinoma has been found. We believe this to be a rare case of sacral plexus radiculopathy developing as a late complication after radiotherapy. Suggestions are made for improving the radiotherapy technique to prevent this complication in future cases.
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PMID:Sacral plexus injury after radiotherapy for carcinoma of cervix. 216 90

The purpose of this study was to evaluate the natural history of morphologic changes within the lumbar spine in patients who sustained lumbar disc extrusions. All patients in this study were treated nonoperatively for radicular pain and neurologic loss. The following questions were addressed: 1) Does perithecal or perineural fibrosis result when extrusions are not removed surgically, and 2) Do disc extrusions spontaneously resolve, and, if so, how rapidly? The study population consisted of 11 patients with extrusions and radiculopathy. All patients were successfully treated nonoperatively. All had a primary complaint of leg pain and all had positive straight leg raising reproducing their leg pain at less than or equal to 60 degrees. Additionally, 87% had muscle weakness on a neurologic basis in a root level distribution corresponding to the site of disc pathology. Computed tomographic (CT) examinations were obtained on all patients at the inception of treatment. These studies were compared with follow-up MRI studies. The initial CT scans were evaluated for the following criteria: disc size and position, thecal sac effacement, nerve root enlargement or displacement, and evidence of central or intervertebral canal stenosis. In addition to the pathomorphology evaluated on the CT scans, follow-up MRI studies also evaluated disc hydration at the herniated and contiguous levels, and the presence of perithecal or perineural fibrosis. The following grading system was used to evaluate change in fragment size on the follow-up studies: Grade 1-0 to 50% decrease in size; Grade 2-50 to 75% decrease in size; Grade 3-75 to 100% decrease in size.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The natural history of lumbar intervertebral disc extrusions treated nonoperatively. 221 16

Nineteen consecutive patients who had a symptomatic pseudarthrosis after a failed anterior cervical arthrodesis were treated by a posterior nerve-root decompression and arthrodesis. The indications for the operation were radiculopathy in the absence of myelopathy and evidence of a pseudarthrosis on lateral flexion and extension radiographs. The average duration of follow-up was forty-four months (range, twenty-four to fifty-four months). A solid fusion was achieved in all patients, and the radiculopathy was relieved in all but one. The motor weakness that had been present in four patients preoperatively resolved completely.
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PMID:Pseudarthrosis of the cervical spine after anterior arthrodesis. Treatment by posterior nerve-root decompression, stabilization, and arthrodesis. 239 87

Weakness of the hand is a common problem in the elderly. When joint and vascular diseases have been ruled out, a systematic anatomic approach to the possible neurologic causes can be used to sort through nonspecific symptoms and the complexity of hand anatomy. Syndromes of the peripheral nerves supplying the hand (ie, median, ulnar, radial) are common and are generally caused by compression of these nerves in their pathway through the elbow, forearm, or wrist. Other common causes of hand weakness include lower motor neuron syndromes involving the brachial plexus; cervical radiculopathy amyotrophic lateral sclerosis; and myasthenia gravis. Along with a careful history and physical examination, several tests are helpful in discerning the nature and location of lesions. Electromyography, magnetic resonance imaging, computed tomography, and myelography may all be used to exclude or support a diagnosis.
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PMID:Hand weakness in elderly patients. 253 9

The functions of autonomic nervous system were systematically evaluated in a case of causalgia in the upper limbs after neck trauma. A 14-year-old boy had had hard blow on his nucha in a rough fight. After one week, a sustained burning pain, swelling and skin color change developed in the left upper limb. These symptoms also appeared in the right upper limb after 6 weeks. The physical examinations disclosed edema, reddish moist skin, and atrophic nail in the upper limbs. The neurological examinations showed a radiating pain to the upper limbs caused by the neck movement or pressure on the supraclavicular fossae, weakness of the upper limbs and left lower limb, and loss of sensation in the 5th to 8th cervical and first thoracic dermatomal segments. Deep tendon reflexes were diminished in the upper limbs and exaggerated in the lower limbs. Neither Horner syndrome nor sphincter disturbance was observed. He was diagnosed as being the cervicothoracic radiculopathy and cervical myelopathy due to the mechanical force. The burning pain disappeared with oral administration of guanethidine. On the examinations of the autonomic functions, the sweating response to the thermal stimulation was absent above the 5th thoracic dermatomal segment. The sweating response to the intradermal acetylcholine was decreased in the second and third thoracic dermatomal segments. The systolic hypotension with increasing pulse rate occurred on standing. The reactive elevation of the blood pressure to the intravenous tyramine was absent. The excessive elevation of the systolic blood pressure was induced by the subcutaneous injection of epinephrine. These results indicated the dysfunction of the sympathetic postganglionic sudomotor and vasomotor fibers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Causalgia in the upper limbs following neck trauma: existence of widespread dysfunction of sympathetic postganglionic fibers]. 268 35

Of 2023 patients treated for acute spinal injuries, 729 sustained acute injuries in thoracic and lumbar regions; 295 surgically treated patients were reviewed for evidence of postoperative neurological complications. Of the 295 patients, 150 were intraoperatively monitored using somatosensory-evoked potentials (SSEP). Six patients (4%) revealed intraoperative deterioration of the SSEP; however, only one of the six revealed a new postoperative neurological deficit (0.7%). The remaining 145 patients were included in the unmonitored or wake-up test group in which ten (6.9%) demonstrated new postoperative deficits. Of the 11 patients with new postoperative neurological deficits, eight patients demonstrated motor weakness, two had radiculopathy, and one had bowel-bladder incontinence. The intraoperative use of SSEP was not able to identify subtle alterations in neurological function; however, due to early warning, SSEP appears capable of preventing profound surgically induced neurological alterations. A new protocol is designed for the management of intraoperative neurological deterioration as detected by SSEP.
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PMID:Operative neurological complications resulting from thoracic and lumbar spine internal fixation. 319 20

Twenty patients admitted to hospital with congestive heart failure were evaluated for severe concomitant lumbosacral and leg pain. In each instance the discomfort was worse at night and progressively decreased with a resolution of the pulmonary edema. Neurologic and electromyographic examinations in all but four patients were normal with reflexes, strength and straight leg raising testing normal. An absent Achilles reflex was recognized in two, a diminished knee jerk reflex in one and in a third, weakness in the extensor hallucis longus. Lumbar spinal stenosis was identified in all of the patients with a concomitant degenerative spondylolisthesis present in nine instances and in an additional two a spondylolisthesis with interruption of the neural arch. It is theorized that diminished right heart compliance can induce a sufficient increase in venous volume and pressure within the paravertebral plexus of Batson to acutely exacerbate a chronic lumbar spinal stenosis. In support of this hypothesis, the multiple factors involved in the pathomechanics and physiology of lumbar radiculopathy, spinal stenosis and the role of the paravertebral plexus of veins are examined. Specifically, their response to altered volume and pressure gradients tending to induce venous "creep" as well to alterations in posture and diurnal cycles are reviewed.
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PMID:Night pain associated with diminished cardiopulmonary compliance. A concomitant of lumbar spinal stenosis and degenerative spondylolisthesis. 340 61

Lesions of the seventh cervical (C7) root are common and cause a readily recognised neurological syndrome. Recognition of this pattern is essential in differentiating C7 root lesions from lesions of the brachial plexus or peripheral nerves. Serratus anterior weakness is not generally included in this syndrome. We report six verified cases of C7 radiculopathy in which weakness of the serratus anterior was present in addition to the usual findings. This was manifest as winging of the scapula, when pushing forward against a wall, either with the hands at shoulder level or, in some cases, only when the hands were lowered to waist level. This latter method of testing places the muscle at a mechanical disadvantage and reveals partial paralysis. Analysis of this clinical finding complements anatomical evidence suggesting that the powerful lower digitations of the muscle may be primarily supplied by the C7 root in some cases. Scapular winging, apparent either in the usual position or the modified position described here, should be recognised as consistent with a diagnosis of C7 radiculopathy. When present, this sign serves to differentiate C7 radiculopathy from lesions of the brachial plexus or radial nerve.
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PMID:C7 radiculopathy: importance of scapular winging in clinical diagnosis. 373 20

A 25-year-old man with multifocal weakness and fasciculation was thought to have motor neuron disease. Signs progressed for 1 year, plateaued, and 3 years later resolved almost completely. There was no evidence of paraproteinemia, lymphoproliferative disorder, or vasculitis, and myelography was normal. Electrodiagnostic study disclosed multifocal, acute and chronic denervation that evolved into a picture consistent with residuals of old multifocal radiculopathy without active denervation. Prolongation of F response, absence of H-reflex, and conduction block in a proximal nerve segment suggested multifocal demyelination. A proximal motor neuropathy, perhaps demyelinating, may cause some of the benign motor neuron syndromes that simulate motor neuron disease.
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PMID:Slow resolution of multifocal weakness and fasciculation: a reversible motor neuron syndrome. 374 96

173 patients suffering from symptoms of cervical disc herniation or spondylosis were surgically treated during 1975 through 1984 by Cloward's method via the anterior route or by total or hemilaminectomy with Epstein's foraminotomy via the posterior route. Of the 41 patients with disc herniation, 37 had radiculopathy as the main disorder and only 4 myelopathy. Of the 132 spondylosis cases radiculopathy was the main disorder in 92 and myelopathy in 40 cases. The operative route was selected according to the site of the osteophytes or disc herniation. The criteria for operative treatment were persistent radicular pain, motor weakness and progressive muscle atrophy, or evidence of cord compression. All patients underwent myelography preoperatively and sometimes also x-ray computed tomography. A clear correlation between the roentgenographic findings, clinical signs and symptoms served as the prerequisite for operative treatment. Follow-up review an average of 55 months after the operation showed excellent or good results in 80% of the disc herniation cases, but in only 35% of those with spondylosis. However, in the latter group pain relief was obtained in 76% of cases. In the spondylosis series there were significant correlations between the parameters of severity of disease and duration of symptoms and the surgical results, whereas in the disc herniation series no clear correlations were observed. Gait disturbances associated with myelopathy were only minimally relieved. There was no clear correlation after surgery between the degree of the disease and working capacity, but the duration of preoperative disability was significant in this respect. Postoperative complications were infrequent and no severe complications occurred.
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PMID:Comparative retrospective study of patients operated for cervical disc herniation and spondylosis. 381 69


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