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 fast restoration of impared voluntary muscle strength after traction treatment in a patient with lumbosacral radiculopathy have been evaluated. Motor Evoked Potentials (MEPs) have shown that a conduction block at the root can pay a role for long standing muscle weakness. After root decompression the effect of partial overcome of the conduction block was seen while at the end of treatment there was no evidence of impared motor function. It was concluded that traction therapy is a good alternative for surgery in patients with motor deficit and importance of MEPs in evaluation root disfunction is discussed.
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PMID:Fast dynamics of voluntary muscle strength and motor evoked potentials after traction therapy in patient with lumbosacral root lesion. 880 90

The aim of this study is to explore the clinical value of follow-up examinations of F-wave in patients with lumbosacral radiculopathy. Postoperative changes in the initial abnormalities and their relationship with improvement in clinical findings were examined. Results from conventional motor nerve conduction study at knee-ankle segment are also discussed. The subjects were 30 patients with unilateral lumbosacral radiculopathy caused by herniated disc. F-waves were obtained from abductor hallucis and extensor digitorum brevis by supramaximal stimulation to tibial and peroneal nerves, respectively, at the ankle. Minimal latency (Fmin), maximal latency (Fmax), chronodispersion (Fdif) and duration (Fdur) were used as the parameters. No subject had abnormal motor nerve conduction velocity (MCV) throughout the course of this study, and there was no significant difference between preoperative and postoperative levels. Peroneal Fmin, Fmax, Fdif and tibial Fdur all showed significant (p < 0.05 in Wicoxon signed-rank test) improvement after surgery. Moreover, these overall improvements significantly (p < 0.05 in chi 2 test) correlated with recovery in muscle weakness. However, normalization of F-wave was not always associated with full recovery in muscle weakness at that time. These findings suggested that follow-up examination of F-wave was of value for objective assessment after operation.
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PMID:Follow-up study on F-wave in patients with lumbosacral radiculopathy. Comparison between before and after surgery. 880 92

Acute brachial neuropathy (ABN) is a rare disease, characterized by an acute or subacute onset of pain followed by weakness of shoulder or arm muscles without trauma or traction injury. So the diagnosis of this clinical entity is not easy. The purpose of this study was to analyze retrospectively the ABN in 14 cases focusing on the clinical profile and to evaluate the effectiveness of electrophysiologic study in diagnosis of ABN with a new result helpful in localizing a brachial plexus disorder. The most helpful electrophysiologic data of ABN in my patients seemed to be abnormalities of low amplitude, abnormal right to left difference of compound motor action potentials (CMAPs) and sensory nerve action potentials (SNAPs) in axillary nerve, ulnar or median nerves. Results of nerve conduction velocity, terminal and F-wave latency were not as useful. But the electromyogram was most helpful in localization of upper or lower plexus lesions and cervical radiculopathy. The most striking clinical feature of ABN was the rapid onset of pain followed by the development of muscle weakness of shoulder girdle after a variable period or within four days. In contrast to other reports, intrinsic hand muscle weakness was observed in 3 cases with sensory changes in ulnar nerve distribution. The cervical radiculopathies (C5-C7 roots) were simultaneously combined with ipsilateral axillary neuropathy in 3 cases. In this study, decreased amplitude, abnormal right to left difference of SNAPs and CMAPs, and neurogenic EMG findings with normal data of NCV, terminal and F-wave latencies suggest that the pathology of ABN might not be a demyelinating process, but axonopathy.
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PMID:Acute brachial neuropathy--electrophysiological study and clinical profile. 883 64

Segmental zoster paresis (SZP) is the focal, asymmetrical neurogenic weakness which may occur in a limb affected by cutaneous zoster. We have summarized the features of this syndrome, based on a retrospective review of 8 personal and 96 published cases. Limb SZP becomes apparent in at least 3-5% of patients with cutaneous zoster, who are usually over the age of sixty and weak proximally (C5,6,7 or L2,3,4 innervated muscles). Functional motor recovery occurs in about 75% of cases, generally by 1-2 years. Limb weakness is probably due to a lesion of the ventral nerve root, in close proximity to the initiating dorsal ganglionitis. The electrodiagnostic findings, scarce in the literature, typically consist of absent compound sensory nerve action potentials in the involved limb, with less frequent reduction or loss of compound muscle action potentials. Fibrillations and positive sharp waves become detectable within 1-4 months in limb and related paraspinal muscles, decreasing or disappearing later. In addition to this radiculopathy, peripheral nerves may also occasionally become involved, manifest as mononeuropathies of the median, ulnar, long thoracic, recurrent laryngeal, and phrenic nerves. The zoster infection or consequent inflammatory response appears able to affect motor axons distally as well as proximally.
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PMID:Segmental zoster paresis of limbs. 889 77

Diabetic amyotrophy is a disabling illness that is distinct from other forms of diabetic neuropathy. It is characterized by weakness followed by wasting of pelvifemoral muscles, either unilaterally or bilaterally, with associated pain. Sensory impairment is minimal in the cutaneous distribution sharing the same root or peripheral nerve as affected musculature. Most commonly, the onset is in middle age or later, although it may occur in youth. A concomitant distal predominantly sensory neuropathy may be present. Electrodiagnostic studies are most often consistent with a neurogenic lesion attributable to a lumbosacral radiculopathy, plexopathy, or proximal crural neuropathy. The natural course of the illness is variable with gradual but often incomplete improvement. The site of the lesion and the pathogenesis of diabetic amyotrophy remain controversial. Recent studies suggest a role for immunomodulating agents in certain types of diabetic neuropathy, including diabetic amyotrophy.
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PMID:Diabetic amyotrophy: current concepts. 898 31

Twenty-five patients underwent an expansive cervical laminoplasty for nontraumatic cervical spondylosis with myelopathy during the period from June 1990 to November 1994, and all had a minimum of 18 months of follow-up review. The open-door laminoplasty procedure presently reported consisted of the same approach evaluated by Hirabayashi in 1977, except that the authors of this report used three rib allografts to anchor the "open door," rather than spinous process sutures or autologous bone grafts. Posterior foraminotomies and decompression were performed in patients with clinical radiculopathy and radiographic evidence of foraminal stenosis. Preoperatively, gait disturbance was present in all patients. All 25 patients (100%) had long-tract signs on presentation. Nondermatomal upper-extremity symptoms (numbness, tingling, weakness, and pain) were quite common in this group of patients. Bowel, bladder, and/or sexual dysfunction was found in 13 (52%) of 25 patients. Preoperative radiographic studies showed a mean midline anteroposterior diameter spinal canal/vertebral body (SC/VB) ratio of 0.623 and a mean compression ratio (sagittal/lateral diameter ratio x 100%) of 37%. This procedure was quite successful in relieving preoperative symptoms and few complications occurred. Gait disturbance was improved in 21 (84%) of 25 patients and hand numbness and tingling were improved in 13 (87%) of 15 patients. Bowel or bladder function improved in 10 (77%) of 13 patients. Radiculopathy, when present, was alleviated in all four patients after the decompressive procedure. The postoperative SC/VB ratio, as measured by plain lateral radiographs and/or computerized tomography scans, was improved to 0.871, a 38% improvement. In a comparison with the preoperative SC/VB ratio using the two-tailed t-test, alpha was less than 0.001. The compression ratio improved to 63% postoperatively, which yielded an alpha of less than 0.005 according to the two-tailed t-test. Only one postoperative complication, an anterior scalene syndrome, was encountered. Various predictors of surgical outcome based on gait improvement were evaluated. Age greater than 60 years at the time of presentation, duration of symptoms more than 18 months prior to surgery, preoperative bowel or bladder dysfunction, and lower-extremity dysfunction were found to be associated with poorer surgical outcome. Even when these conditions were present, gait improvement was noted in at least 70% of the patients.
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PMID:Modified open-door cervical expansive laminoplasty for spondylotic myelopathy: operative technique, outcome, and predictors for gait improvement. 898 83

Imaging studies have achieved a high degree of diagnostic accuracy for many disorders of the spinal cord but have significant limitations. We report on the case of a 49-yr-old man who developed neck pain and arm numbness. He was found to have extensive cervical spondylosis, with spinal cord impingement at C3-4 and cervical radiculopathy. He underwent a C3-7 laminectomy, with transient improvement in his symptoms. During the ensuing year, he developed increased weakness of the upper limbs, evidence of cervical myelopathy, and a severely flexed posture of the cervical spine. Magnetic resonance imaging (MRI) revealed cervical spinal cord atrophy but no evidence of extrinsic spinal cord compression. Cervical flexion and extension films revealed reversal of the normal cervical lordosis without segmental instability. Despite the absence of confirmatory radiologic studies, the patient was felt to have clinical evidence of intermittent compression of his cervical spinal cord attributable to excessive cervical kyphosis, was provided with a cervical collar, and subsequently underwent surgical stabilization. His cervical myelopathy showed marked improvement with these treatments. We conclude that intermittent compression of the spinal cord, occurring in the erect position, was not apparent on the MRI films obtained in the supine position. Flexion and extension films, obtained in the upright position, documented his abnormal cervical anatomy but did not reveal substantial segmental instability. Spinal deformity without segmental instability may cause cervical myelopathy after multilevel cervical laminectomies without evidence of extrinsic compression on MRI.
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PMID:Failure of magnetic resonance imaging to reveal the cause of a progressive cervical myelopathy related to postoperative spinal deformity: a case report. 903 15

We report the case histories of two patients treated in our unit for cervical radiculopathy by anterior cervical discectomy and BOP grafting. Both grafts disintegrated within 6 weeks of insertion resulting in increased neurological deficit from cervical cord compression. At reoperation fibres from the grafts were found to have separated and the larger fragments had extruded into the vertebral canal. No evidence of infection was seen, but a foreign body reaction was found in one case. Following graft removal the patients improved symptomatically although one was left with permanent mild biceps weakness.
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PMID:Disintegration of cervical intervertebral BOP grafts with neurological sequelae: a report of two cases. 915 22

A case is reported of a lumbosacral plexus compression by the fetus in a young 34-weeks pregnant woman, who had low-back pain and progressive muscular weakness of the leg. Neurological examination showed a grade IV motor weakness of the iliopsoas, quadriceps femoris and biceps femoris muscles. Mechanical stretch manoeuvers were negative. Electromyography revealed denervation activity in L4 and L5 muscles. Lumbosacral plexus radiculopathy was diagnosed. Although fetal compression appears to be an uncommon cause of lumbosacral radiculopathy during teenage pregnancy, both neurosurgeons and obstetricians should be aware of the possibility.
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PMID:Lumbosacral plexus compression by fetus: an unusual cause of radiculopathy during teenage pregnancy. 922 6

This prospective, randomised study compares the efficacy of surgery, physiotherapy and cervical collar with respect to pain, motor weakness and sensory loss in 81 patients with long-lasting cervical radiculopathy corresponding to a nerve root that was significantly compressed by spondylotic encroachment, with or without an additional bulging disk, as verified by MRI or CT-myelography. Pain intensity was registered on a visual analogue scale (VAS), muscle strength was measured by a hand-held dynamometer, Vigorometer and pinchometer. Sensory loss and paraesthesia were recorded. The measurements were performed before treatment (control 1), 4 months after the start of treatment (control 2) and after a further 12 months (control 3). A healthy control group was used for comparison and to test the reliability of the muscle-strength measurements. The study found that before start of treatment the groups were uniform with respect to pain, motor weakness and sensory loss. At control 2 the surgery group reported less pain, less sensory loss and had better muscle strength, measured as the ratio of the affected side to the non-affected side, compared to the two conservative treatment groups. After a further year (control 3), there were no differences in pain intensity, sensory loss or paraesthesia between the groups. An improvement in muscle strengths, measured as the ratio of the affected to the non-affected side, was seen in the surgery group compared to the physiotherapy group in wrist extension, elbow extension, shoulder abduction and internal rotation, but there were no differences in the ratios between the collar group and the other treatment groups. With respect to absolute muscle strength of the affected sides, there were no differences at control 1. At control 2, the surgery group performed some-what better than the two other groups but at control 3 there were no differences between the groups. We conclude that pain intensity, muscle weakness and sensory loss can be expected to improve within a few months after surgery, while slow improvement with conservative treatments and recurrent symptoms in the surgery group make the 1-year results about equal.
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PMID:Cervical radiculopathy: pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgery, physiotherapy or cervical collar. A prospective, controlled study. 929 50


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