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 26-year-old woman noticed discoloration and swelling of the left foot after standing or sitting for a long period of time. Four months later, she developed dysesthesia in the left leg and foot and extreme tenderness of the left foot; developed subsequently claudication. At age 15, the patient had severe low back pain for 1 year and had been diagnosed as having lumbar disk herniation. Recurrent disk herniation was suspected, although myelogram and postmyelogram CT scan reportedly were nondiagnostic. The patient was admitted to our hospital 6 months following the onset of dysesthesia. Physical examination revealed weakness and atrophy of the entire left lower extremity, allodynia of the left foot, and dysesthesia in the left L5 myotomes. Hypertrichosis was obvious, and the left foot was cool on touch. Roentgenography of the left lower extremity revealed patchy osteoporosis of the distal epiphyse of the left tibia and fibula and in some of tarsal bones. Intravenous administration of phentolamine reduced tenderness, which was highly suggestive of reflex sympathetic dystrophy (RSD). A repeat CT scan revealed extraforaminal, left-sided disk herniation at L4/5. We diagnosed RSD secondary to L5 radiculopathy and performed a left L2, 3 lumbar sympathetic block. Allodynia was relieved, and the patient was able to walk without claudication. Reports of RSD secondary to lumbar disk herniation are rare. In one case, transient lumbar sympathetic block was effective in alleviating symptoms of RSD, although, required surgery. Our patient was more severely disabled than patients in other reports, yet, lumbar sympathetic block still was effective.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Reflex sympathetic dystrophy secondary to lumbar disk herniation]. 815 14

An epidemiological survey of cervical radiculopathy in Rochester, Minnesota, 1976-90, through the records-linkage system of the Mayo Clinic ascertained 561 patients (332 males and 229 females). Ages ranged from 13 to 91 years; the mean age +/- SD was 47.6 +/- 13.1 years for males and 48.2 +/- 13.8 years for females. A history of physical exertion or trauma preceding the onset of symptoms occurred in only 14.8% of cases. A past history of lumbar radiculopathy was present in 41%. The median duration of symptoms prior to diagnosis was 15 days. A monoradiculopathy involving C7 nerve root was the most frequent, followed by C6. A confirmed disc protrusion was responsible for cervical radiculopathy in 21.9% of patients; 68.4% were related to spondylosis, disc or both. During the median duration of follow-up of 4.9 years, recurrence of the condition occurred in 31.7%, and 26% underwent surgery for cervical radiculopathy. A combination of radicular pain and sensory deficit, and objective muscle weakness were predictors of a decision to operate. At last follow-up 90% of our population-based patients were asymptomatic or only midly incapacitated due to cervical radiculopathy. The average annual age-adjusted incidence rates per 100,000 population for cervical radiculopathy in Rochester were 83.2 for the total, 107.3 for males and 63.5 for females. The age-specific annual incidence rate per 100,000 population reached a peak of 202.9 for the age group 50-54 years.
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PMID:Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. 818 59

Twenty-nine patients underwent surgery for far lateral herniated nucleus pulposus. Average patient age was 65 years in the 14 male and 15 female patients involved. The L4-5 disc was the most commonly herniated level (59%) followed by L3-4 (31%), L5-S1 (7%), and L2-3 (3%). All patients were initially seen with radiculopathy and 23 patients (79%) had motor weakness. A pars interarticularis sparing technique is described for approaching this type of disc herniation. This approach allows direct visualization of the disc and involved root. The results are encouraging with 72% of patients having good or excellent relief of pain. Seventy-one percent of those with preoperative weakness had no weakness or improvement in strength postoperatively. In general, far lateral herniated nucleus pulposus occurs in older patients and at high lumbar disc levels. Postoperative results are similar to the more common posterolateral herniated nucleus pulposus in patients of the same age group. A surgical approach is described to better address the less familiar anatomy.
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PMID:Surgical treatment for the far lateral herniated lumbar disc. 821 56

This study investigates the long-term neuropsychiatric manifestations of single or combined chemicals: manganese; zinc phosphide; lead, mercury, and TNT; and pesticides among exposed industrial workers. We found that 75% of the exposed subjects as a whole and 50% of those exposed to each of Zinc phosphide and pesticides presented with more than one neuropsychiatric symptoms or signs. The main signs were mask faces, hyporeflexia, hyperreflexia, peripheral neuropathy, static tremors, radiculopathy, muscle weakness, mental changes, fasciculations and tremors, wasting, hypotonia, abnormal deep reflexes, and sensory hyposthesia. Neurological manifestations were confirmed by electromyography and their severity was related to the duration of exposure and confirmed as well by electroencephalography. These results are discussed and their implications high-lighted.
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PMID:Neurobehavioral changes among workers in some chemical industries in Egypt. 824 23

Twenty-four patients with unilateral cervical locked facets were treated between 1986 and 1990. The primary mechanisms of injury were vehicular accidents (58%) and altercations (38%). The level of unilateral facet dislocation was C5-C6 (41%), C6-C7 (25%), C3-C4 (17%), and C4-C5 (17%). Seventeen (70%) came to the hospital with radiculopathy, five (20%) were normal, and two (10%) had spinal cord injuries. Plain films showed subluxation but no fracture. All patients had a cervical computed tomographic scan. Fracture in addition to facet locking was seen in 12 (50%) of 24 scans: 5 with facet fracture, 4 with facet/laminar fractures, 2 with facet/laminar/body fractures, and 1 foramen transversarium fracture. On the basis of CT findings, closed reduction was thought to be contraindicated in two cases. Five patients (22%) underwent successful closed reductions. Two of the patients with closed reductions were placed in a halo but again had subluxation. Thus, 24 patients underwent surgery for open reduction, posterior spinous process wire fixation, and facet wiring to struts of the iliac crest for bony fusion. The initial surgery was successful in 23 (96%) of 24 patients. One patient experienced subluxation and underwent further surgery for anterior cervical fusion/plating. Two wound infections were treated, and there were no deaths or neurological worsening. At 1 year, all deficits had improved. Of 16 radiculopathies, 3 (19%) had persistent 4/5 weakness, and the rest were normal, including 2 delayed-diagnosis patients who both showed improvement from 2/5 to 5/5 strength within 1 week of surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of unilateral locked facet of the cervical spine. 826 79

Three patients with diabetic radiculopathy (DR) are presented. The clinical aspects of DR, its management, and differential diagnosis are reviewed. Diabetic radiculopathy commonly presents with severe unilateral pain of sudden onset that is usually located in the lower extremity, frequently in the proximal segments. Occasionally, bilateral asymmetric pain may be observed. The pain is severe and may require narcotic medications. Sphincteric involvement is rare. Weakness of hip or thigh muscles, decreased sensation and hypo- or areflexia are commonly observed. The clinical picture can resemble that of high lumbar disc herniation. Electrodiagnostic and radiological studies may help differentiate between the two conditions.
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PMID:Diabetic lumbar radiculopathy: sciatica without disc herniation. 830 43

The anterior interosseous neuropathy is a rare focal neuropathy with typical clinical and electromyographic features. Most commonly reported etiologies include lesion of the median nerve following fracture of the radius and ulna, acute or repeated trauma or prolonged pressure on the forearm. In some cases, no predisposing factors can be elicited. Over a one-year period, two young women in their late twenties were evaluated for weakness of the flexor pollicis longus, flexor digitorum profundus of the 2nd and 3rd fingers, and pronator quadratus muscles that occurred within a month following parturition. Nerve conduction studies and concentric needle electrode examination of the upper extremities performed respectively 3 and 10 months after the onset of symptoms confirmed a severe anterior interosseous neuropathy and excluded more common conditions such as carpal tunnel syndrome, cervical radiculopathy or brachial plexopathy. The prognosis was unfavorable in both cases.
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PMID:Anterior interosseous neuropathy in the postpartum period. 838 61

We evaluated the results of the Robinson method of anterior cervical discectomy and arthrodesis with use of autogenous iliac-crest bone graft, at one to four levels, in 122 patients who had cervical radiculopathy. A one-level procedure was done in sixty-two of the 122 patients; a two-level procedure, in forty-eight; a three-level procedure, in eleven; and a four-level procedure, in one. The average duration of clinical and roentgenographic follow-up was six years (range, two to fifteen years). The average age was fifty years (range, twenty-five to seventy-eight years). Preoperatively, 118 patients had pain in the arm, fifty-five had weakness of one or more motor roots, and seventy-seven had sensory loss. At the time of follow-up, eighty-one patients had no pain in the neck, twenty-six had mild pain in the neck, nine had moderate pain in the neck, four had mild radicular pain, and two had a combination of mild radicular pain and moderate pain in the neck. One hundred and eight patients had no functional impairment, and fourteen had a slight limitation of function during the activities of daily living. Nine of eleven patients who had symptoms related to a change at one level cephalad or caudad to the site of a previous arthrodesis had another operative procedure. Lateral roentgenograms of the cervical spine, made in flexion and extension, showed a pseudarthrosis at twenty-four of 195 operatively treated segments. Sixteen of the patients who had a pseudarthrosis were symptomatic, but only four had sufficient pain to warrant revision. The risk of pseudarthrosis was significantly greater after a multiple-level arthrodesis than after a single-level arthrodesis (p < 0.01). At the time of the most recent follow-up, fifty-three of the fifty-five patients who had had a motor deficit had had a complete recovery, and the two remaining patients had had a partial recovery. Seventy-one of the seventy-seven patients who had had a sensory loss had regained sensation. None of the patients had an increased neurological deficit postoperatively. Our results suggest that the Robinson anterior cervical discectomy and arthrodesis with an autogenous iliac-crest bone graft for cervical radiculopathy is a safe procedure that can relieve pain and lead to resolution of neurological deficits in a high percentage of patients.
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PMID:Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. 840 51

Although surgery is often recommended as the definitive treatment for radiculopathy when definite disc herniation is demonstrated with imaging techniques, complete improvement can occur with nonoperative treatment. However, what happens to the disc in the latter circumstance is not well defined. We report the first prospective study in subjects with proven radiculopathy and definite disc herniation who improve with nonoperative management to determine what occurs to the herniated disc material. Eighteen subjects with lower extremity pain or paresthesia, positive straight leg raising, weakness in a myotomal distribution, reflex asymmetry, or electromyogram evidence of radiculopathy were studied. Subjects were admitted to the study if computed tomography (CT) scanning demonstrated definite disc herniation corresponding to the side and level of the radiculopathy. After complete clinical improvement, repeat CT scan was performed at six to 18 months after the initial study. The CT scans were interpreted separately by two neuroradiologists. Disc herniations were characterized by size (large, moderate, or minimal); the presence of absence of free fragments; and location. Follow-up scans were compared with the original study and characterized as resolved, improved, or unchanged. Fourteen subjects completed the study, an additional three had operative treatment, and one refused repeat scanning. Subjects were followed an average of 30.4 months with no recurrence of radicular symptoms during this follow-up period in 13 patients. One had recurrence of symptoms at 21 months and surgery at 26 months. Six follow-up scans (43%) were interpreted as completely resolved, five (36%) as improved, and three (21%) as unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prospective evaluation of the course of disc herniations in patients with proven radiculopathy. 842 May 16

We studied neuromuscular complications in a cohort of 520 patients with liver transplantation. Perioperative mononeuropathy developed in 9 patients. The peroneal nerve, radial nerve, and cutaneous branch of the femoral nerve were affected in 2 patients each. Two patients had herpes zoster-associated radiculopathy, and 1 patient had Horner's syndrome. Recovery was good in most patients. In 7 patients, severe quadriplegia complicated the perioperative course. In 5 patients, electrophysiologic studies suggested acute necrotic myopathy, and muscle biopsy specimens showed evidence of rhabdomyolysis in 1 patient. Outcome in survivors was good, all recovering completely. We conclude that neuromuscular complications in liver transplantation are uncommon (less than 1%) and do not significantly contribute to morbidity. Mononeuropathies may have iatrogenic perioperative causes, and rhabdomyolysis may be an important cause of generalized muscle weakness after liver transplantation.
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PMID:Neuromuscular complications associated with liver transplantation. 860 18


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