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)

We reported a case of acute disseminated encephalomyelitis (ADEM) after Streptococcus infection. Brain MRI (T2-weighted image) showed high intensity lesion in the gray matter in the acute phase. The high intensity pattern of the lesion was different from those in previously reported cases. The boy, aged 14, had fever late in August 1993. He had lumbago and back pain since September 3 and also leg weakness developed since September 7. He became unable to urinate on September 10 and was admitted on September 12. His consciousness became indistinct. We considered ADEM on the basis of high CSF level of myelin basic protein, clinical course, symptoms and MRI findings and began to administer steroid hormone on the second day after admission. He rapidly recovered. We reported here an atypical case of ADEM as to the antecedent infection and MRI lesion.
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PMID:[A case of acute disseminated encephalomyelitis with lesions in the cerebral gray matter on MRI in the acute phase]. 766 10

The neurological deficits caused by tethered cord syndrome do not necessarily follow a dermatomal pattern of the affected spinal cord from caudal to cephalic fashion. The authors defined these neurological deficits as "skip lesions", and reviewed the neurological deficits in tethered cord syndrome. Among 29 cases, inconsecutive segmental motor weakness in 3 cases, inconsecutive segmental sensory impairment in 6 cases, positive Babinski reflex in 8 cases, supranuclear neurogenic bladder in 3 cases and lumbago or leg pain in 4 cases were observed and they were thought to be compatible with the neurological deficits called "skip lesions". The basic mechanism of this sign is that the cephalic portion of the spinal cord is functionally impaired during flexion of the lumbosacral spine, while the caudal spinal cord with decreased visco-elasticity dose not elongate. Inconsecutive motor-sensory disturbance, accelerated deep tendon reflexes in the lower extremities, positive Babinski or other pathological reflexes in the lower extremities, uninhibited neurogenic bladder, lumbago and pain in the legs were considered to belong to the category of "skip lesions" and they can be treated by the untethering procedure. The authors concluded that preoperative careful insight into the mechanism of "skip lesions" revealed surgical efficacy for the reversible neurological deficits by the untethering procedure, or the efficacy of decompression of the lipoma or neurolysis around the involved spinal nerve roots.
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PMID:["Skip lesions" in neurological deficits caused by tethered cord syndrome]. 784 8

A 42-year-old female with intradural lipoma at the level of L1 is reported. She was admitted with a history of 32 months of lumbago, 25 months of pain of the left leg, and 12 months of motor weakness in the left leg. Neurologically, sensory impairment below the L1 dermatome of the left leg, and motor weakness of bilateral legs were noted on admission. CT demonstrated a low density mass with no contrast enhanced effect at the level of L1. MRI showed a mass with high signal intensity on the T1-weighted image, and low signal intensity on the T2. L1 laminectomy, and additional Th12 and L2 partial laminectomy were performed and the tumor was partially removed. The tumor was completely in the intradural space. Pathologically, the tumor consisted of mature adipose cells with normal vessels. Postoperatively, the epidural effusion at the operative area caused sensory impairment and motor weakness of the right leg. Finally, the patient came to be neurologically free of defects except for slight sensory diminution of the L4 dermatome of the left leg. In this case, total removal of the tumor was difficult because of adhesion between the tumor, the cauda equina and the conus medullaris. Postoperatively, neurological findings showed a marked improvement. The preoperative neurological deterioration in this case seemed to be associated with simple compression exerted on the nerves.
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PMID:[An adult case of lumbar intradural lipoma]. 784 15

A 42-year-old female presented with progressive proximal muscle weakness, generalized hyperreflexia, marked bone pain, severe lumbago and knee arthralgia. Electromyographic study showed short-duration (5-10 msec), variable amplitude (200-2500 microV) polyphasic potentials. A muscle biopsy specimen revealed non-specific type II fiber atrophy. After a comprehensive laboratory work-up, adult Fanconi syndrome was diagnosed. The patient's symptoms, including bone pain and proximal muscle weakness, were relieved after a six-week supplement of tricalcium phosphate, vitamin D3 and sodium bicarbonate. The hyperreflexia also became less brisk.
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PMID:Adult Fanconi syndrome with proximal muscle weakness and hypophosphatemic osteomalacia: report of a case. 785 57

We reported a family case of HAM and HTLV-I carrier including two sisters presenting with myositis. Both the 65-year-old elder sister and her 53-year-old younger sister initially noted lumbago and developed difficulty in walking several years later. Neurologic examination revealed muscle weakness of the proximal parts of the upper and lower limbs (especially the latter). Mild hyperreflexia in all extremities, urinary disturbance and constipation were detected in the elder sister, while only urinary disturbance and constipation were seen in the younger. Anti-HTLV-I antibody in both serum and CSF was positive in both sisters. Muscle biopsy specimens showed features of myositis with perivascular, perimysial and endomysial lymphocyte infiltration. Although an association between HTLV-I and polymyositis had not yet been established, we think that our cases support such an association.
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PMID:[A family case of HAM and HTLV-I carrier including two sisters presenting with myositis]. 795 14

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

Seven cases of giant ependymomas of cauda equina, extending from the conus medullaris to the sacrum, are reported. Mean age of the patients was 36 years. The initial symptoms were not specific, including low back pain and radiculalgias. However, in two cases, the clinical presentation was related to hydrocephalus. At the time of the operation, 6 patients presented with pain, weakness and sphincter dysfunction. The diagnosis of tumor was made after myelogram in all cases. Metrizamide enhanced CT scan has been performed in one case. None patient had preoperative magnetic resonance imaging (MRI) but MRI allowed the follow up in 5 patients and detection of local and remote recurrences in 4 cases. All the tumors were attached to the filum terminale, and unless extended from L2 to S1. Pathologically, 3 patients had tumors classified as myxopapillary and 4 of the cellular type. Two patients had gross total resection of the tumor at the initial operation. Five patients had initial biopsy to make a diagnosis and required subsequent surgery for radical excision after an average of 16.8 months. Radiation therapy has been performed in 1 case after biopsy, in 1 case after total resection (grade III) and in 2 cases after recurrences. Three patients died 1 year, 5 years, 12 years post-operatively. Among these 3 patients, 2 had recurrences. Four patients are alive. One patient has no recurrence 5 years after initial surgery. Another patient remains symptom free 7 years after surgery but MRI showed a local recurrence. The last two patients present recurrences 7 years and 8 years after surgery. These recurrences have been treated by surgical removal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Giant ependymoma of the cauda equina. Long-term development apropos of 7 cases]. 824 20

A 36-year-old Russian man presented with neck and low back pain in September 1990. He was of normal stature, and there were no stigmata of rickets. The family history was negative for bone disease. He was found to have hypophosphatemia (2.3 mg/dl), impaired phosphate reabsorption (TmP/GFR 2.08), hyperphosphatasemia (254 IU/l), normocalcemia, normal vitamin D metabolite levels, and secondary hyperparathyroidism. Clinically, his spinal movements were quite impaired and there was moderate proximal muscle weakness. On skeletal radiographs, there was generalized osteosclerosis and multiple ligamentous calcifications. Transiliac biopsy was diagnostic for severe osteomalacia. He was treated with oral phosphate (240 mEq daily) and calcitriol (4 micrograms daily) with resultant very slow clinical, biochemical, and histomorphologic improvement. The patient had hypophosphatemic osteomalacia with some features of X-linked hypophosphatemia, but sporadic and of relatively late onset. The osteopenia, height loss, incapacitating weakness, and glycinuria that are characteristics of sporadic adult onset nonfamilial hypophosphatemia, with or without an associated tumor, and the low serum calcitriol levels that may be an additional characteristic of tumor-induced osteomalacia were absent. Other known causes of acquired renal tubular dysfunction were ruled out. The etiology, pathogenesis, and nosology of the disorder remain obscure, but treatment based on experience with other forms of hypophosphatemic osteomalacia was ultimately effective.
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PMID:A unique case of adult hypophosphatemic osteomalacia. 826 43

Known for its resistance to chemotherapy and radiation therapy, chondrosarcoma remains largely a surgically managed tumor predisposed to local recurrence and late distant metastasis. A 42-year-old man with known thoracic chondrosarcoma developed progressive low back pain, lower extremity weakness, and urinary incontinence. Magnetic resonance imaging and computed tomographic myelography demonstrated multiple filling defects throughout the lumbosacral region. Surgical excision of these lesions disclosed intradural, extramedullary drop metastases of the chondrosarcoma. The spread of neoplasms within the dural space is uncommon, accounting for less than 5% of spinal metastases, and has not previously been reported for chondrosarcoma.
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PMID:Intradural recurrence with chondrosarcoma of the spine. A case report and review of the literature. 835 50

There is little information regarding the functional status and quality of life of cardiac transplant patients. This investigation is the largest study describing outcome up to 10 years after cardiac transplantation. We conducted a cross-sectional survey of 200 cardiac transplant recipients using the Sickness Impact Profile and a supplementary questionnaire. The response rate was 48%. The median duration post-cardiac transplantation was 2.3 years (range, 0.5 to 9.7 years). The median age was 53 years (range, 27.1 to 68.7). In comparison to previously published studies, our sample of cardiac transplant recipients had worse quality of life than normals, similar scores to cardiac arrest survivors and post-myocardial infarction patients, and better quality of life than patients with low back pain. We found that those not working (44%) reported a lower quality of life. Musculoskeletal-neurologic complaints were highly prevalent, with generalized weakness in 54% responding, fatigue in 42%, and low back pain in 37%. Lower quality of life was found in patients reporting a higher number of musculoskeletal-neurological disorders. We conclude that there are specific areas for rehabilitation intervention in patients post-cardiac transplantation, and suggest areas for future research directed towards enhancing quality of life for cardiac transplant recipients.
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PMID:Health status and quality of life following cardiac transplantation. 848 57


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